Factors impacting cerebrospinal fluid leak rates in endoscopic sellar surgery.

PubMed

Karnezis, Tom T; Baker, Andrew B; Soler, Zachary M; Wise, Sarah K; Rereddy, Shruthi K; Patel, Zara M; Oyesiku, Nelson M; DelGaudio, John M; Hadjipanayis, Constantinos G; Woodworth, Bradford A; Riley, Kristen O; Lee, John; Cusimano, Michael D; Govindaraj, Satish; Psaltis, Alkis; Wormald, Peter John; Santoreneos, Steve; Sindwani, Raj; Trosman, Samuel; Stokken, Janalee K; Woodard, Troy D; Recinos, Pablo F; Vandergrift, W Alexander; Schlosser, Rodney J

2016-11-01

In patients undergoing transnasal endoscopic sellar surgery, an analysis of risk factors and predictors of intraoperative and postoperative cerebrospinal fluid leak (CSF) would provide important prognostic information. A retrospective review of patients undergoing endoscopic sellar surgery for pituitary adenomas or craniopharyngiomas between 2002 and 2014 at 7 international centers was performed. Demographic, comorbidity, and tumor characteristics were evaluated to determine the associations between intraoperative and postoperative CSF leaks. Correlations between reconstructive and CSF diversion techniques were associated with postoperative CSF leak rates. Odds ratios (OR) were identified using a multivariate logistic regression model. Data were collected on 1108 pituitary adenomas and 53 craniopharyngiomas. Overall, 30.1% of patients had an intraoperative leak and 5.9% had a postoperative leak. Preoperative factors associated with increased intraoperative leaks were mild liver disease, craniopharyngioma, and extension into the anterior cranial fossa. In patients with intraoperative CSF leaks, postoperative leaks occurred in 10.3%, with a higher postoperative leak rate in craniopharyngiomas (20.8% vs 5.1% in pituitary adenomas). Once an intraoperative leak occurred, craniopharyngioma (OR = 4.255, p = 0.010) and higher body mass index (BMI) predicted postoperative leak (OR = 1.055, p = 0.010). In patients with an intraoperative leak, the use of septal flaps reduced the occurrence of postoperative leak (OR = 0.431, p = 0.027). Rigid reconstruction and CSF diversion techniques did not impact postoperative leak rates. Intraoperative CSF leaks can occur during endoscopic sellar surgery, especially in larger tumors or craniopharyngiomas. Once an intraoperative leak occurs, risk factors for postoperative leaks include craniopharyngiomas and higher BMI. Use of septal flaps decreases this risk. © 2016 ARS-AAOA, LLC.

Cerebrospinal fluid otorhinorrhea due to cochlear dysplasias.

PubMed

Syal, Rajan; Tyagi, Isha; Goyal, Amit

2005-07-01

Cochlear dysplasia associated with defect in stapes footplate can be a cause of cerebrospinal fluid leak. Repair of cerebrospinal fluid leak in these cases is usually done by packing the vestibule with muscle or fascia. This traditional method of repair has 30-60% failure rate. Cerebrospinal fluid leak in four such patients was successfully repaired using multiple layer packing of vestibule, reinforced by pedicle temporalis muscle graft. Intraoperatively continuous lumbar drain was done. Magnetic resonance imaging of inner ear using 3D FSE T2WI and 3D FIESTA sequences was found helpful noninvasive investigation to localize site and route of cerebrospinal fluid leak.

Milestone Report #2: Direct Evaporator Leak and Flammability Analysis Modifications and Optimization of the Organic Rankine Cycle to Improve the Recovery of Waste Heat

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

Guillen, Donna Post

2013-09-01

The direct evaporator is a simplified heat exchange system for an Organic Rankine Cycle (ORC) that generates electricity from a gas turbine exhaust stream. Typically, the heat of the exhaust stream is transferred indirectly to the ORC by means of an intermediate thermal oil loop. In this project, the goal is to design a direct evaporator where the working fluid is evaporated in the exhaust gas heat exchanger. By eliminating one of the heat exchangers and the intermediate oil loop, the overall ORC system cost can be reduced by approximately 15%. However, placing a heat exchanger operating with a flammablemore » hydrocarbon working fluid directly in the hot exhaust gas stream presents potential safety risks. The purpose of the analyses presented in this report is to assess the flammability of the selected working fluid in the hot exhaust gas stream stemming from a potential leak in the evaporator. Ignition delay time for cyclopentane at temperatures and pressure corresponding to direct evaporator operation was obtained for several equivalence ratios. Results of a computational fluid dynamic analysis of a pinhole leak scenario are given.« less

Modeling the Risk of Fire/Explosion Due to Oxidizer/Fuel Leaks in the Ares I Interstage

NASA Technical Reports Server (NTRS)

Ring, Robert W.; Stott, James E.; Hales, Christy

2008-01-01

A significant flight hazard associated with liquid propellants, such as those used in the upper stage of NASA's new Ares I launch vehicle, is the possibility of leakage of hazardous fluids resulting in a catastrophic fire/explosion. The enclosed and vented interstage of the Ares I contains numerous oxidizer and fuel supply lines as well as ignition sources. The potential for fire/explosion due to leaks during ascent depends on the relative concentrations of hazardous and inert fluids within the interstage along with other variables such as pressure, temperature, leak rates, and fluid outgasing rates. This analysis improves on previous NASA Probabilistic Risk Assessment (PRA) estimates of the probability of deflagration, in which many of the variables pertinent to the problem were not explicitly modeled as a function of time. This paper presents the modeling methodology developed to analyze these risks.

Body mass index predicts risk for complications from transtemporal cerebellopontine angle surgery.

PubMed

Mantravadi, Avinash V; Leonetti, John P; Burgette, Ryan; Pontikis, George; Marzo, Sam J; Anderson, Douglas

2013-03-01

To determine the relationship between body mass index (BMI) and risk for specific complications from transtemporal cerebellopontine angle (CPA) surgery for nonmalignant disease. Case series with chart review. Tertiary-care academic hospital. Retrospective review of 134 consecutive patients undergoing transtemporal cerebellopontine angle surgery for nonmalignant disease from 2009 to 2011. Data were collected regarding demographics, body mass index, intraoperative details, hospital stay, and complications including cerebrospinal fluid leak, wound complications, and brachial plexopathy. One hundred thirty-four patients were analyzed with a mean preoperative body mass index of 28.58. Statistical analysis demonstrated a significant difference in body mass index between patients with a postoperative cerebrospinal fluid leak and those without (P = .04), as well as a similar significant difference between those experiencing postoperative brachial plexopathy and those with no such complication (P = .03). Logistical regression analysis confirmed that body mass index is significant in predicting both postoperative cerebrospinal fluid leak (P = .004; odds ratio, 1.10) and brachial plexopathy (P = .04; odds ratio, 1.07). Elevated body mass index was not significant in predicting wound complications or increased hospital stay beyond postoperative day 3. Risk of cerebrospinal fluid leak and brachial plexopathy is increased in patients with elevated body mass index undergoing surgery of the cerebellopontine angle. Consideration should be given to preoperative optimization via dietary and lifestyle modifications as well as intraoperative somatosensory evoked potential monitoring of the brachial plexus to decrease these risks.

The effect of autologous fibrin tissue adhesive on postoperative cerebrospinal fluid leak in spinal cord surgery: a randomized controlled trial.

PubMed

Nakamura, Hiroshi; Matsuyama, Yukihiro; Yoshihara, Hisatake; Sakai, Yoshihito; Katayama, Yoshito; Nakashima, Shojiro; Takamatsu, Jyunki; Ishiguro, Naoki

2005-07-01

A prospective randomized study evaluating the efficacy of autologous fibrin tissue adhesive for decreasing postoperative cerebrospinal fluid (CSF) leak in spinal cord surgery. To compare postoperative CSF leak in 3 groups (i.e., autologous fibrin tissue adhesive used, commercial fibrin glue used, and no fibrin tissue adhesive used) of patients undergoing spinal surgery who needed dural incision. Spinal cord operations, particularly when dural incision is inevitable, sometimes involve postoperative CSF leak. Because CSF leak is a serious complication, countermeasure is necessary to prevent it after dural suture. Commercial fibrin tissue adhesive was formerly used. Because the possibility of prion infection was widely noticed, commercial fibrin tissue adhesive containing animal components has been used less often. In 13 of 39 cases in which dural incision would be made, 400 mL whole blood was drawn, and autologous fibrin tissue adhesive was made of plasma. Cases were divided into 3 groups: (1) dural closure alone, (2) use of autologous fibrin tissue adhesive after dural closure, and (3) use of commercial fibrin tissue adhesive after dural closure. The primary outcome measure was determined as postoperative (3 days) volume of drainage fluid, and results were analyzed using the analysis of variance. The secondary outcome measure was general blood test, coagulation assay, and plasma fibrinogen, and these were analyzed also using the analysis of variance. There was a significant difference in the primary outcome between the autologous and control groups. No complications such as infection or continuous CSF leak were observed in any case. The mean volume of drainage fluid was 586.2 mL in the group with autologous fibrin tissue adhesive and 1026.1 mL in the group without fibrin tissue adhesive. The volume of drainage fluid was significantly lower in the former group than that in the latter group. There was no statistical difference between the volumes of the group with autologous adhesive and with commercial adhesive (639.2 mL). We used autologous fibrin tissue adhesive as a new sealant after dural closure instead of commercial fibrin tissue adhesive. No definitive CSF leak was observed, and the volume of drainage fluid was significantly lower in the group with autologous fibrin tissue adhesive than that in the group without fibrin tissue adhesive. The use of autologous fibrin tissue adhesive was superior to that of commercial fibrin tissue adhesive in cost.

Rock deformation models and fluid leak-off in hydraulic fracturing

NASA Astrophysics Data System (ADS)

Yarushina, Viktoriya M.; Bercovici, David; Oristaglio, Michael L.

2013-09-01

Fluid loss into reservoir rocks during hydraulic fracturing is modelled via a poro-elastoplastic pressure diffusion equation in which the total compressibility is a sum of fluid, rock and pore space compressibilities. Inclusion of pore compressibility and porosity-dependent permeability in the model leads to a strong pressure dependence of leak-off (i.e. drainage rate). Dilation of the matrix due to fluid invasion causes higher rates of fluid leak-off. The present model is appropriate for naturally fractured and tight gas reservoirs as well as for soft and poorly consolidated formations whose mechanical behaviour departs from simple elastic laws. Enhancement of the leak-off coefficient by dilation, predicted by the new model, may help explain the low percentage recovery of fracturing fluid (usually between 5 and 50 per cent) in shale gas stimulation by hydraulic fracturing.

Detecting subsurface fluid leaks in real-time using injection and production rates

NASA Astrophysics Data System (ADS)

Singh, Harpreet; Huerta, Nicolas J.

2017-12-01

CO2 injection into geologic formations for either enhanced oil recovery or carbon storage introduces a risk for undesired fluid leakage into overlying groundwater or to the surface. Despite decades of subsurface CO2 production and injection, the technologies and methods for detecting CO2 leaks are still costly and prone to large uncertainties. This is especially true for pressure-based monitoring methods, which require the use of simplified geological and reservoir flow models to simulate the pressure behavior as well as background noise affecting pressure measurements. In this study, we propose a method to detect the time and volume of fluid leakage based on real-time measurements of well injection and production rates. The approach utilizes analogies between fluid flow and capacitance-resistance modeling. Unlike other leak detection methods (e.g. pressure-based), the proposed method does not require geological and reservoir flow models to simulate the behavior that often carry significant sources of uncertainty; therefore, with our approach the leak can be detected with greater certainty. The method can be applied to detect when a leak begins by tracking a departure in fluid production rate from the expected pattern. The method has been tuned to detect the effect of boundary conditions and fluid compressibility on leakage. To highlight the utility of this approach we use our method to detect leaks for two scenarios. The first scenario simulates a fluid leak from the storage formation into an above-zone monitoring interval. The second scenario simulates intra-reservoir migration between two compartments. We illustrate this method to detect fluid leakage in three different reservoirs with varying levels of geological and structural complexity. The proposed leakage detection method has three novelties: i) requires only readily-available data (injection and production rates), ii) accounts for fluid compressibility and boundary effects, and iii) in addition to detecting the time when a leak is activated and the volume of that leakage, this method provides an insight about the leak location, and reservoir connectivity. We are proposing this as a complementary method that can be used with other, more expensive, methods early on in the injection process. This will allow an operator to conduct more expensive surveys less often because the proposed method can show if there are no leaks on a monthly basis that is cheap and fast.

Water pollution risk associated with natural gas extraction from the Marcellus Shale.

PubMed

Rozell, Daniel J; Reaven, Sheldon J

2012-08-01

In recent years, shale gas formations have become economically viable through the use of horizontal drilling and hydraulic fracturing. These techniques carry potential environmental risk due to their high water use and substantial risk for water pollution. Using probability bounds analysis, we assessed the likelihood of water contamination from natural gas extraction in the Marcellus Shale. Probability bounds analysis is well suited when data are sparse and parameters highly uncertain. The study model identified five pathways of water contamination: transportation spills, well casing leaks, leaks through fractured rock, drilling site discharge, and wastewater disposal. Probability boxes were generated for each pathway. The potential contamination risk and epistemic uncertainty associated with hydraulic fracturing wastewater disposal was several orders of magnitude larger than the other pathways. Even in a best-case scenario, it was very likely that an individual well would release at least 200 m³ of contaminated fluids. Because the total number of wells in the Marcellus Shale region could range into the tens of thousands, this substantial potential risk suggested that additional steps be taken to reduce the potential for contaminated fluid leaks. To reduce the considerable epistemic uncertainty, more data should be collected on the ability of industrial and municipal wastewater treatment facilities to remove contaminants from used hydraulic fracturing fluid. © 2012 Society for Risk Analysis.

Fluid leakage detector for vacuum applications

NASA Technical Reports Server (NTRS)

Nguyen, Bich Ngoc (Inventor); Farkas, Tibor (Inventor); Kim, Brian Byungkyu (Inventor)

2002-01-01

A leak detection system for use with a fluid conducting system in a vacuum environment, such as space, is described. The system preferably includes a mesh-like member substantially disposed about the fluid conducting system, and at least one sensor disposed within the mesh-like member. The sensor is capable of detecting a decrease in temperature of the mesh-like member when a leak condition causes the fluid of the fluid conducting system to freeze when exposed to the vacuum environment. Additionally, a signal processor in preferably in communication with the sensor. The sensor transmits an electrical signal to the signal processor such that the signal processor is capable of indicating the location of the fluid leak in the fluid conducting system.

Leak and Pipe Detection Method and System

NASA Technical Reports Server (NTRS)

Youngquist, Robert C. (Inventor)

2003-01-01

A method and system for locating leaks of conductive fluids from non-conductive pipes and other structures or for locat- ing non-conductive pipes or structures having conductive fluid contained therein, employ a charge generator to apply a time varying charge to the conductive fluid, and a capaci- tive type detector that can detect the variable charge that is induced in the fluid. The capacitive detector, which prefer- ably includes a handheld housing, employs a large conduc- tive pickup plate that is used to locate the pipe or leak by scanning the plate over the ground and detecting the induced charge that is generated when the plate comes in close proximity to the pipe or leak. If a leak is encountered, the resulting signal will appear over an area larger than expected for a buried pipe, assuming the leak provides an electrically conductive path between the flow and the wet surrounding ground. The detector uses any suitable type of indicator device, such as a pair of headphones that enable an operator to hear the detected signal as a chirping sound, for example.

Experimental investigation of the effect orifice shape and fluid pressure has on high aspect ratio cross-sectional jet behaviour.

PubMed

Wakes, S J; Holdø, A E; Meares, A J

2002-01-04

Prevention of major disasters such as Piper Alpha is a concern of oil and gas companies when commissioning a new offshore superstructure. Safety studies are undertaken to identify potential major hazards, risks to personnel and that sufficient precautions have been employed to minimise these. Such an assessment will also include the consideration of the protection from gas leaks such as the optimum positions of gas leak detectors and startup safety procedures after a leak. This requires a comprehensive knowledge of the behaviour of the leaking hydrocarbons as they emerge from the leak into the area of concern. Such leaks are most likely to emanate from a high aspect ratio cross-sectional curved slot in a pipeline. This paper challenges the conventional view that it is sufficient to model such leaks as axisymmetric jets. This paper is therefore concerned with an experimental study carried out on a series of more realistic high aspect ratio cross-sectional jets issuing from a flange orifice. Both high quality photographs in both planes of the jets and some quantitative pressure data is examined for a high aspect ratio cross-sectional jet of air at pressures up to 4.136bar. The effect of changing aspect ratio, fluid pressure and orifice shape will be discussed and put into context with regard to how this relates to offshore analysis studies.

40 CFR 60.562-2 - Standards: Equipment leaks of VOC.

Code of Federal Regulations, 2013 CFR

2013-07-01

... from bleed ports in existing pumps in light liquid service are not considered to be a leak as defined... feature of the pump whereby polymer fluid used to provide lubrication and/or cooling of the pump shaft exits the pump, thereby resulting in a visible leak of fluid. This exemption expires when the existing...

40 CFR 60.562-2 - Standards: Equipment leaks of VOC.

Code of Federal Regulations, 2014 CFR

2014-07-01

... from bleed ports in existing pumps in light liquid service are not considered to be a leak as defined... feature of the pump whereby polymer fluid used to provide lubrication and/or cooling of the pump shaft exits the pump, thereby resulting in a visible leak of fluid. This exemption expires when the existing...

40 CFR 60.562-2 - Standards: Equipment leaks of VOC.

Code of Federal Regulations, 2011 CFR

2011-07-01

... from bleed ports in existing pumps in light liquid service are not considered to be a leak as defined... feature of the pump whereby polymer fluid used to provide lubrication and/or cooling of the pump shaft exits the pump, thereby resulting in a visible leak of fluid. This exemption expires when the existing...

40 CFR 60.562-2 - Standards: Equipment leaks of VOC.

Code of Federal Regulations, 2012 CFR

2012-07-01

... from bleed ports in existing pumps in light liquid service are not considered to be a leak as defined... feature of the pump whereby polymer fluid used to provide lubrication and/or cooling of the pump shaft exits the pump, thereby resulting in a visible leak of fluid. This exemption expires when the existing...

Immunisations and antibiotics in patients with anterior skull base cerebrospinal fluid leaks.

PubMed

Rimmer, J; Belk, C; Lund, V J; Swift, A; White, P

2014-07-01

There are no UK guidelines for the use of antibiotics and/or immunisations in patients with an active anterior skull base cerebrospinal fluid leak. This study aimed to define current UK practice in this area and inform appropriate guidelines for ENT surgeons. A web-based survey of all members of the British Rhinological Society was carried out and the literature in this area was reviewed. Of those who responded to the survey, 14 per cent routinely give prophylactic antibiotics to patients with cerebrospinal fluid leaks, and 34.9 per cent recommend immunisation against at least one organism, most commonly Streptococcus pneumoniae (86.7 per cent). There is no evidence to support the use of antibiotic prophylaxis in patients with a cerebrospinal fluid leak. We propose that all such patients are advised to seek immunisation against pneumococcus, meningococcus and haemophilus.

Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas.

PubMed

Mehta, Gautam U; Oldfield, Edward H

2012-06-01

Cerebrospinal fluid leakage is a major complication of transsphenoidal surgery. An intraoperative CSF leak, which occurs in up to 50% of pituitary tumor cases, is the only modifiable risk factor for postoperative leaks. Although several techniques have been described for surgical repair when an intraoperative leak is noted, none has been proposed to prevent an intraoperative CSF leak. The authors postulated that intraoperative CSF drainage would diminish tension on the arachnoid, decrease the rate of intraoperative CSF leakage during surgery for larger tumors, and reduce the need for surgical repair of CSF leaks. The results of 114 transsphenoidal operations for pituitary macroadenoma performed without intraoperative CSF drainage were compared with the findings from 44 cases in which a lumbar subarachnoid catheter was placed before surgery to drain CSF at the time of dural exposure and tumor removal. Cerebrospinal fluid drainage reduced the rate of intraoperative CSF leakage from 41% to 5% (p < 0.001). This reduction occurred in macroadenomas with (from 57% to 5%, p < 0.001) and those without suprasellar extension (from 29% to 0%, p = 0.31). The rate of postoperative CSF leakage was similar (5% vs 5%), despite the fact that intraoperative CSF drainage reduced the need for operative repair (from 32% to 5%, p < 0.001). There were no significant catheter-related complications. Cerebrospinal fluid drainage during transsphenoidal surgery for macroadenomas reduces the rate of intraoperative CSF leaks. This preventative measure obviated the need for surgical repair of intraoperative CSF leaks using autologous fat graft placement, other operative techniques, postoperative lumbar drainage, and/or reoperation in most patients and is associated with minimal risks.

Innovative real CSF leak simulation model for rhinology training: human cadaveric design.

PubMed

AlQahtani, Abdulaziz A; Albathi, Abeer A; Alhammad, Othman M; Alrabie, Abdulkarim S

2018-04-01

To study the feasibility of designing a human cadaveric simulation model of real CSF leak for rhinology training. The laboratory investigation took place at the surgical academic center of Prince Sultan Military Medical City between 2016 and 2017. Five heads of human cadaveric specimens were cannulated into the intradural space through two frontal bone holes. Fluorescein-dyed fluid was injected intracranialy, then endoscopic endonasal iatrogenic skull base defect was created with observation of fluid leak, followed by skull base reconstruction. The outcome measures included subjective assessment of integrity of the design, the ability of creating real CSF leak in multiple site of skull base and the possibility of watertight closure by various surgical techniques. The fluid filled the intradural space in all specimens without spontaneous leak from skull base or extra sinus areas. Successfully, we demonstrated fluid leak from all areas after iatrogenic defect in the cribriform plate, fovea ethmoidalis, planum sphenoidale sellar and clival regions. Watertight closure was achieved in all defects using different reconstruction techniques (overly, underlay and gasket seal closure). The design is simulating the real patient with CSF leak. It has potential in the learning process of acquiring and maintaining the surgical skills of skull base reconstruction before direct involvement of the patient. This model needs further evaluation and competence measurement as training tools in rhinology training.

Postoperative ascitic leaks: the ongoing challenge.

PubMed

Rosemurgy, A S; Statman, R C; Murphy, C G; Albrink, M H; McAllister, E W

1992-06-01

The leak of ascitic fluid from surgical incisions is thought to be associated with a very high mortality rate. There have been few reports, however, focusing on the clinical characteristics, management, or mortality rates of this condition. During a 10-year period, 18 patients with postoperative ascitic fluid leaks were treated. All patients had ascites before surgery and all had liver disease; in 13 of the 18 patients alcoholic liver disease was the cause of ascites. Ten of the 18 patients died (56%). Midline incisions were more often associated with recalcitrant leaks and fatal complications than were transverse incisions. Early consideration of fascial dehiscence and prompt repair is emphasized. The most effective predictor of survival was cessation of the leak.

Sensitivity of MRI of the spine compared with CT myelography in orthostatic headache with CSF leak.

PubMed

Starling, Amaal; Hernandez, Fatima; Hoxworth, Joseph M; Trentman, Terrence; Halker, Rashmi; Vargas, Bert B; Hastriter, Eric; Dodick, David

2013-11-12

To investigate the sensitivity of MRI of the spine compared with CT myelography (CTM) in detecting CSF leaks. Between July 1998 and October 2010, 12 patients with orthostatic headache and a CTM-confirmed spinal CSF leak underwent an MRI of the spine with and without contrast. Using CTM as the gold standard, we retrospectively investigated the sensitivity of spinal MRI in detecting a CSF leak. Eleven of 12 patients with a CSF leak documented by CTM also had extradural fluid collections on spinal MRI (sensitivity 91.7%). Six patients with extradural fluid collections on spinal MRI also had spinal dural enhancement. When compared with the gold standard of CTM, MRI of the spine appears to be a sensitive and less invasive imaging modality for detecting a spinal CSF leak, suggesting that MRI of the spine should be the imaging modality of first choice for the detection of spinal CSF leaks.

Simulation and evaluation of respirator faceseal leaks using computational fluid dynamics and infrared imaging.

PubMed

Lei, Zhipeng; Yang, James; Zhuang, Ziqing; Roberge, Raymond

2013-05-01

This paper presents a computational fluid dynamics (CFD) simulation approach for the prediction of leakage between an N95 filtering facepiece respirator (FFR) and a headform and an infrared camera (IRC) method for validating the CFD approach. The CFD method was used to calculate leak location(s) and 'filter-to-faceseal leakage' (FTFL) ratio for 10 headforms and 6 FFRs.The computational geometry and leak gaps were determined from analysis of the contact simulation results between each headform-N95 FFR combination. The volumetric mesh was formed using a mesh generation method developed by the authors. The breathing cycle was described as a time-dependent profile of the air velocity through the nostril. Breathing air passes through both the FFR filter medium and the leak gaps. These leak gaps are the areas failing to achieve a seal around the circumference of the FFR. The CFD approach was validated by comparing facial temperatures and leak sites from IRC measurements with eight human subjects. Most leaks appear at the regions of the nose (40%) and right (26%) and left cheek (26%) sites. The results also showed that, with N95 FFR (no exhalation valves) use, there was an increase in the skin temperature at the region near the lip, which may be related to thermal discomfort. The breathing velocity and the viscous resistance coefficient of the FFR filter medium directly impacted the FTFL ratio, while the freestream flow did not show any impact on the FTFL ratio. The proposed CFD approach is a promising alternative method to study FFR leakage if limitations can be overcome.

Occurrence of occult CSF leaks during standard FESS procedures.

PubMed

Bucher, S; Kugler, A; Probst, E; Epprecht, L; Stadler, R S; Holzmann, D; Soyka, M B

2018-03-18

To determine the incidence of occult cerebrospinal fluid leaks (CSF) after functional endoscopic sinus surgery (FESS) and to evaluate the diagnostic performance of beta2-transferrin in blood-contaminated conditions. Prospective cohort study. An analysis of 57 intraoperative samples using hydrogel 6 beta2-transferrin assay after FESS was undertaken. In case of CSF positive samples and continuing rhinorrhea, reanalysis after more than 1 year was conducted. In-vivo analysis of a primary spontaneous CSF leak sample took place to verify difficulties in detecting beta2-transferrin in blood-contaminated settings. Own titrations were performed to evaluate detection limits of CSF by beta2-transferrin and beta-trace protein assays in these settings. An incidence of 13% for occult CSF leaks after FESS was found. In blood-contaminated conditions, routine beta2-transferrin assays showed low sensitivity. In over 1 year follow-up, all samples were negative for CSF and none of them developed clinical relevant CSF leaks or meningitis. Occult and clinically irrelevant CSF leaks do occur in a significant proportion of patients during and shortly after FESS. Intra- and postoperatively, routine beta2-transferrin assays show low sensitivity. They should not be used in these settings. The clinical course of patients with occult CSF leaks indicated possibility of an uneventful follow-up.

Treatment of cerebrospinal fluid leak after spine surgery.

PubMed

Fang, Zhao; Tian, Rong; Jia, Yu-Tao; Xu, Tian-Tong; Liu, Yang

2017-04-01

Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this review, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

The Redax® Coaxial Drain in pulmonary lobectomy: a study of efficacy

PubMed Central

Parini, Sara; Papalia, Esther; Massera, Fabio; Turello, Davide; Baietto, Guido; Casadio, Caterina

2017-01-01

Background Pleural drainage is required after pulmonary lobectomy to evacuate air-leak and fluid. We compared the performance of the new Redax® Coaxial Drain (CD) (Redax, Mirandola, Italy) with a standard chest tube (CT) in terms of fluid and air-leak evacuation. Methods Fifty-two patients receiving a 24-F CD under water-seal after pulmonary lobectomy through open surgery or video-assisted thoracic surgery (VATS) were matched according to demographic, clinical and pathological variables with 104 patients receiving a 24-F CT. Fluid evacuation and post-operative day 0 (POD0) fluid evacuation rate, air-leak rate, tension pneumothorax or increasing subcutaneous emphysema, tube occlusion at removal, visual analog scale (VAS) score at rest and during cough, chest drain duration, pleural fluid accumulation or residual pleural cavity after tube removal, post-operative morbidity and mortality rate were recorded and compared between the two groups. Results No differences were recorded in post-operative morbidity and mortality rates. Fluid drainage rates on POD0 were significantly higher in CD group (73% vs. 48%; P=0.004); air-leak occurrence was similar in both groups and no differences were recorded in terms of tension pneumothorax or increasing subcutaneous emphysema rates; VAS score was lower for CD when compared with CT and it reached significant difference in the subgroups of patients operated on by VATS; no cases of occlusion at removal were recorded in CD patient. Conclusions Redax® CD is safe and efficient in air-leak and fluid evacuation; due to its design and constituting material it is superior to standard CTs in terms of fluid evacuation rate and patient post-operative comfort. PMID:29221298

Effect of rock rheology on fluid leak- off during hydraulic fracturing

NASA Astrophysics Data System (ADS)

Yarushina, V. M.; Bercovici, D.; Oristaglio, M. L.

2012-04-01

In this communication, we evaluate the effect of rock rheology on fluid leak­off during hydraulic fracturing of reservoirs. Fluid leak-off in hydraulic fracturing is often nonlinear. The simple linear model developed by Carter (1957) for flow of fracturing fluid into a reservoir has three different regions in the fractured zone: a filter cake on the fracture face, formed by solid additives from the fracturing fluid; a filtrate zone affected by invasion of the fracturing fluid; and a reservoir zone with the original formation fluid. The width of each zone, as well as its permeability and pressure drop, is assumed to remain constant. Physical intuition suggests some straightforward corrections to this classical theory to take into account the pressure dependence of permeability, the compressibility or non-Newtonian rheology of fracturing fluid, and the radial (versus linear) geometry of fluid leak­off from the borehole. All of these refinements, however, still assume that the reservoir rock adjacent to the fracture face is non­deformable. Although the effect of poroelastic stress changes on leak-off is usually thought to be negligible, at the very high fluid pressures used in hydraulic fracturing, where the stresses exceed the rock strength, elastic rheology may not be the best choice. For example, calculations show that perfectly elastic rock formations do not undergo the degree of compaction typically seen in sedimentary basins. Therefore, pseudo-elastic or elastoplastic models are used to fit observed porosity profiles with depth. Starting from balance equations for mass and momentum for fluid and rock, we derive a hydraulic flow equation coupled with a porosity equation describing rock compaction. The result resembles a pressure diffusion equation with the total compressibility being a sum of fluid, rock and pore-space compressibilities. With linear elastic rheology, the bulk formation compressibility is dominated by fluid compressibility. But the possibility of permanent, time-independent (plastic) rock deformation significantly increases the pore space compressibility (compaction), which becomes a leading term in the total compressibility. Inclusion of rock and fluid compressibilities in the model can explain both linear and nonlinear leak­off. In particular, inclusion of rock compaction and decompaction may be important for description of naturally fractured and tight gas reservoirs for which very strong dependence of permeability on porosity has been reported. Carter R.D. Derivation of the general equation for estimating the extent of the fractured area. Appendix I of "Optimum fluid characteristics for fracture extension", Drilling and Production Practice, G.C. Howard and C.R.Fast, New York, New York, USA, American Petroleum Institute (1957), 261-269.

[External lumbar drainage with volumetric continuing infusion pump in patients with cerebrospinal fluid leak. A case series].

PubMed

Manso Melgosa, Ana Belén; García Gutiérrez, Helena; Fernández Porras, Mónica; Castrillo Manero, Ana Berta; Pérez Marijuán, Belén

To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. Retrospective descriptive case series study. patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP. age, sex, type of intervention, variables related to the practice of the pump and complications. Average and medians were calculated for quantitative variables, frequencies and percentages for qualitative. Sample: 11 subjects. Incidence in running IP: disconnection, occlusion and acoustic alarm activation. Most frequently complication is headache; a case of pneumocephalus. The small number of subjects and the heterogeneity of these do not allow for comparison or establishing associations between variables. The resolution of the cerebrospinal fluid leak with continuous IP is lower in this study than others, and may be influenced by the small number of subjects. It should be noted the frequent activation of the pump alarm for no apparent cause. Protocol would be developed for preparing the IP team to reduce the acoustic alarm activation, and would make a prospective multicenter study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Outcomes of endoscopic repair of cerebrospinal fluid rhinorrhea without lumbar drains.

PubMed

Adams, Austin S; Russell, Paul T; Duncavage, James A; Chandra, Rakesh K; Turner, Justin H

2016-11-01

Lumbar drains (LD) are commonly used during endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea, either to facilitate graft healing or to monitor CSF fluid dynamics. However, the indications and necessity of LD placement remains controversial. The current study sought to evaluate endoscopic CSF leak repair outcomes in the setting of limited LD use. Patients who underwent endoscopic repair of CSF rhinorrhea between 2004 and 2014 were identified by a review of medical records. Demographic and clinical data were extracted and compared between patients who had surgery with and patients who had surgery without a perioperative LD. A univariate analysis was performed to identify factors predictive of recurrence. A total of 107 patients (116 surgical procedures) were identified, with a mean follow-up of 15.8 months. Eighty-eight of 107 patients (82.2%) had surgery without an LD. The mean hospital stay was 4.48 days in the LD group versus 1.03 days in the non-LD group (p < 0.00001). There was no difference in recurrence rate between the LD and non-LD groups. Predictors of recurrence included repair technique (p = 0.04) and size of defect (p = 0.005). Body mass index, leak site (ethmoid, sphenoid, frontal), and etiology (spontaneous, iatrogenic, traumatic) were not predictive of leak recurrence. Use of LDs in endoscopic CSF leak repair was not associated with reduced recurrence rates, regardless of leak etiology, and resulted in a significant increase in hospital length of stay. Although the use of perioperative LDs to monitor CSF dynamics may have some therapeutic and diagnostic advantages, it may not be associated with clinically significant improvements in patient outcomes or recurrence rates.

Imaging review of cerebrospinal fluid leaks

PubMed Central

Vemuri, Naga V; Karanam, Lakshmi S P; Manchikanti, Venkatesh; Dandamudi, Srinivas; Puvvada, Sampath K; Vemuri, Vineet K

2017-01-01

Cerebrospinal fluid (CSF) leak occurs due to a defect in the dura and skull base. Trauma remains the most common cause of CSF leak; however, a significant number of cases are iatrogenic, and result from a complication of functional endoscopic sinus surgery (FESS). Early diagnosis of CSF leak is of paramount importance to prevent life-threatening complications such as brain abscess and meningitis. Imaging plays a crucial role in the detection and characterization of CSF leaks. Three-dimensional, isotropic, high resolution computed tomography (HRCT) accurately detects the site and size of the bony defect. CT cisternography, though invasive, helps accurately identify the site of CSF leak, especially in the presence of multiple bony defects. Magnetic resonance imaging (MRI) accurately detects CSF leaks and associated complications such as the encephaloceles and meningoceles. In this review, we emphasize the importance and usefulness of 3D T2 DRIVE MR cisternography in localizing CSF leaks. This sequence has the advantages of effective bone and fat suppression, decreased artefacts, faster acquisition times, three-dimensional capability, y and high spatial resolution in addition to providing very bright signal from the CSF. PMID:29379240

Imaging review of cerebrospinal fluid leaks.

PubMed

Vemuri, Naga V; Karanam, Lakshmi S P; Manchikanti, Venkatesh; Dandamudi, Srinivas; Puvvada, Sampath K; Vemuri, Vineet K

2017-01-01

Cerebrospinal fluid (CSF) leak occurs due to a defect in the dura and skull base. Trauma remains the most common cause of CSF leak; however, a significant number of cases are iatrogenic, and result from a complication of functional endoscopic sinus surgery (FESS). Early diagnosis of CSF leak is of paramount importance to prevent life-threatening complications such as brain abscess and meningitis. Imaging plays a crucial role in the detection and characterization of CSF leaks. Three-dimensional, isotropic, high resolution computed tomography (HRCT) accurately detects the site and size of the bony defect. CT cisternography, though invasive, helps accurately identify the site of CSF leak, especially in the presence of multiple bony defects. Magnetic resonance imaging (MRI) accurately detects CSF leaks and associated complications such as the encephaloceles and meningoceles. In this review, we emphasize the importance and usefulness of 3D T2 DRIVE MR cisternography in localizing CSF leaks. This sequence has the advantages of effective bone and fat suppression, decreased artefacts, faster acquisition times, three-dimensional capability, y and high spatial resolution in addition to providing very bright signal from the CSF.

Capillary leak syndrome: etiologies, pathophysiology, and management.

PubMed

Siddall, Eric; Khatri, Minesh; Radhakrishnan, Jai

2017-07-01

In various human diseases, an increase in capillary permeability to proteins leads to the loss of protein-rich fluid from the intravascular to the interstitial space. Although sepsis is the disease most commonly associated with this phenomenon, many other diseases can lead to a "sepsis-like" syndrome with manifestations of diffuse pitting edema, exudative serous cavity effusions, noncardiogenic pulmonary edema, hypotension, and, in some cases, hypovolemic shock with multiple-organ failure. The term capillary leak syndrome has been used to describe this constellation of disease manifestations associated with an increased capillary permeability to proteins. Diseases other than sepsis that can result in capillary leak syndrome include the idiopathic systemic capillary leak syndrome or Clarkson's disease, engraftment syndrome, differentiation syndrome, the ovarian hyperstimulation syndrome, hemophagocytic lymphohistiocytosis, viral hemorrhagic fevers, autoimmune diseases, snakebite envenomation, and ricin poisoning. Drugs including some interleukins, some monoclonal antibodies, and gemcitabine can also cause capillary leak syndrome. Acute kidney injury is commonly seen in all of these diseases. In addition to hypotension, cytokines are likely to be important in the pathophysiology of acute kidney injury in capillary leak syndrome. Fluid management is a critical part of the treatment of capillary leak syndrome; hypovolemia and hypotension can cause organ injury, whereas capillary leakage of administered fluid can worsen organ edema leading to progressive organ injury. The purpose of this article is to discuss the diseases other than sepsis that produce capillary leak and review their collective pathophysiology and treatment. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

77 FR 64696 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... installing an unmodified wing panel on that airplane. Delta justified its request by stating that the lack of... following a ground fire incident and reports of flammable fluid leaks from the wing leading edge area onto... area of the wing. We are issuing this AD to prevent flammable fluid from leaking onto the engine...

Hazardous fluid leak detector

DOEpatents

Gray, Harold E.; McLaurin, Felder M.; Ortiz, Monico; Huth, William A.

1996-01-01

A device or system for monitoring for the presence of leaks from a hazardous fluid is disclosed which uses two electrodes immersed in deionized water. A gas is passed through an enclosed space in which a hazardous fluid is contained. Any fumes, vapors, etc. escaping from the containment of the hazardous fluid in the enclosed space are entrained in the gas passing through the enclosed space and transported to a closed vessel containing deionized water and two electrodes partially immersed in the deionized water. The electrodes are connected in series with a power source and a signal, whereby when a sufficient number of ions enter the water from the gas being bubbled through it (indicative of a leak), the water will begin to conduct, thereby allowing current to flow through the water from one electrode to the other electrode to complete the circuit and activate the signal.

Leaks, Lumps, and Lines: Stigma and Women's Bodies

ERIC Educational Resources Information Center

Chrisler, Joan C.

2011-01-01

Women's bodies have often been positioned in art and popular culture as monstrous or defiled and women's bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women's bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those…

Connective tissue spectrum abnormalities associated with spontaneous cerebrospinal fluid leaks: a prospective study.

PubMed

Reinstein, Eyal; Pariani, Mitchel; Bannykh, Serguei; Rimoin, David L; Schievink, Wouter I

2013-04-01

We aimed to assess the frequency of connective tissue abnormalities among patients with cerebrospinal fluid (CSF) leaks in a prospective study using a large cohort of patients. We enrolled a consecutive group of 50 patients, referred for consultation because of CSF leak. All patients have been carefully examined for the presence of connective tissue abnormalities, and based on findings, patients underwent genetic testing. Ancillary diagnostic studies included echocardiography, eye exam, and histopathological examinations of skin and dura biopsies in selected patients. We identified nine patients with heritable connective tissue disorders, including Marfan syndrome, Ehlers-Danlos syndrome and other unclassified forms. In seven patients, spontaneous CSF leak was the first noted manifestation of the genetic disorder. We conclude that spontaneous CSF leaks are associated with a spectrum of connective tissue abnormalities and may be the first noted clinical presentation of the genetic disorder. We propose that there is a clinical basis for considering spontaneous CSF leak as a clinical manifestation of heritable connective tissue disorders, and we suggest that patients with CSF leaks should be screened for connective tissue and vascular abnormalities.

Skull Base Cerebrospinal Fluid Leakage Control with a Fibrin-Based Composite Tissue Adhesive

PubMed Central

Rock, Jack P.; Sierra, David H.; Castro-Moure, Frederico; Jiang, Feng

1996-01-01

Cerebrospinal fluid (CSF) leaks can be responsible for significant patient morbidity and mortality. While the majority of leaks induced after head trauma will seal without intervention, spontaneous or surgically-induced leaks often require operative repair. Many modifications on standard surgical technique are available for repair of CSF fistulae, but none assures adequate closure. We have studied the efficacy of a novel fibrin-based composite tissue adhesive (CTA) for closure of experimentally-induced CSF leaks in rats. Fistulae were created in two groups of animals. Two weeks after creation of the leaks, the animals were sacrificed and analyzed for persistence of leak. A 58% leakage rate was noted in the control group (n = 12), and no leaks were noted in the experimental group closed after application of CTA to the surgical defect followed by skin closure (n = 11). Comparing the control group to the experimental group, results were statistically significant (p = 0.015). These data suggest that CTA may be effective as an adjunct for the closure of CSF fistulae. ImagesFigure 2Figure 3 PMID:17170969

METHODOLOGY TO EVALUATE THE POTENTIAL FOR GROUND WATER CONTAMINATION FROM GEOTHERMAL FLUID RELEASES

EPA Science Inventory

This report provides analytical methods and graphical techniques to predict potential ground water contamination from geothermal energy development. Overflows and leaks from ponds, pipe leaks, well blowouts, leaks from well casing, and migration from injection zones can be handle...

Vanishing calcification associated with a spontaneous ventral spinal cerebrospinal fluid leak.

PubMed

Schievink, Wouter I; Ross, Lindsey; Prasad, Ravi S; Maya, M Marcel

2016-12-01

Some patients with spontaneous intracranial hypotension have a ventral spinal cerebrospinal fluid (CSF) leak and these CSF leaks may be associated with calcified disk herniations. Identifying these calcifications is helpful in directing treatment. We report here the unusual case of a patient with a ventral CSF leak in whom the associated calcification absorbed over a five-month period. A 42-year-old woman developed orthostatic headaches and bilateral abducens nerve palsies. Magnetic resonance imaging of her brain showed typical findings of spontaneous intracranial hypotension. Magnetic resonance imaging of her spine showed an extensive cervicothoracic CSF leak. Computed tomographic myelography showed calcification at the Th1-2 disk space. Three epidural blood patches were performed, but her symptoms persisted. Digital subtraction myelography performed five months later showed an upper thoracic ventral CSF, but the calcification was no longer present. A dural tear, found at surgery at the Th1-2 level, was repaired and the patient made an uneventful recovery. The resorption of calcifications at the level of a ventral spinal CSF leak could explain the absence of any calcifications in at least some patients with such leaks and demonstrates the usefulness of reviewing previous imaging in patients with ventral CSF leaks if the exact site of the leak remains unknown. © International Headache Society 2016.

[Endonasal endoscopic surgery in the treatment of spontaneous or post-traumatic cerebrospinal fluid (csf) leaks].

PubMed

Nallet, E; Decq, P; Bezzo, A; Le Lievre, G; Peynegre, R; Coste, A

1998-10-01

The incidence and the risk of meningitidis justify treatment in all cases of cerebrospinal fluid rhinorrhea with spontaneous etiology or after traumatic injury. Endonasal surgery with endoscopic instruments provides many advantages compared with transcranial or transfacial approach used by neurosurgeons. We report our experience and our surgical technique in the treatment of CSF leaks in 5 patients. Intrathecal injection of fluoresceine was very useful in all cases for detecting the CSF leak. Total or selected ethmoidectomy depended on the localization of the leakage. Wide sphenoidotomy enables detection and repair of CSF leaks from the sphenoid cavity. A free graft of inferior turbinal mucosal was used to repair the breache. This rapid low morbidity surgery offered secure closure of rhinorrhea in 4 cases after one procedure and in 1 case after two procedures with an average follow up of 22 months. Cerebrospinal fluid rhinorrhea can be managed in first line therapy with endoscopic intranasal surgical techniques when they are localized in the anterior ethmoid or in the sphenoid cavity.

Initiation and propagation of a PKN hydraulic fracture in permeable rock: Toughness dominated regime

NASA Astrophysics Data System (ADS)

Sarvaramini, E.; Garagash, D.

2011-12-01

The present work investigates the injection of a low-viscosity fluid into a pre-existing fracture with constrained height (PKN), as in waterflooding or supercritical CO2 injection. Contrary to conventional hydraulic fracturing, where 'cake build up' limits diffusion to a small zone, the low viscosity fluid allows for diffusion over a wider range of scales. Over large injection times the pattern becomes 2 or 3-D, necessitating a full-space diffusion modeling. In addition, the dissipation of energy associated with fracturing of rock dominates the energy needed for the low-viscosity fluid flow into the propagating crack. As a result, the fracture toughness is important in evaluating both the initiation and the ensuing propagation of these fractures. Classical PKN hydraulic fracturing model, amended to account for full-space leak-off and the toughness [Garagash, unpublished 2009], is used to evaluate the pressure history and fluid leak-off volume during the injection of low viscosity fluid into a pre-existing and initially stationary. In order to find the pressure history, the stationary crack is first subject to a step pressure increase. The response of the porous medium to the step pressure increase in terms of fluid leak-off volume provides the fundamental solution, which then can be used to find the transient pressurization using Duhamel theorem [Detournay & Cheng, IJSS 1991]. For the step pressure increase an integral equation technique is used to find the leak-off rate history. For small time the solution must converge to short time asymptote, which corresponds to 1-D diffusion pattern. However, as the diffusion length in the zone around the fracture increases the assumption of a 1-D pattern is no longer valid and the diffusion follows a 2-D pattern. The solution to the corresponding integral equation gives the leak-off rate history, which is used to find the cumulative leak-off volume. The transient pressurization solution is obtained using global conservation of fluid injected into the fracture. With increasing pressure in the fracture due to the fluid injection, the energy release rate eventually becomes equal to the toughness and fracture propagates. The evolution of the fracture length is established using the method similar to the one employed for the stationary crack.

Fluid pipeline leak detection and location with miniature RF tags

DOEpatents

McIntyre, Timothy J.

2017-05-16

Sensors locate troublesome leaks in pipes or conduits that carry a flowing medium. These sensors, through tailored physical and geometric properties, preferentially seek conduit leaks or breaches due to flow streaming. The sensors can be queried via transceivers outside the conduit or located and interrogated inside by submersible unmanned vehicle to identify and characterize the nature of a leak. The sensors can be functionalized with other capabilities for additional leak and pipeline characterization if needed. Sensors can be recovered from a conduit flow stream and reused for future leak detection activities.

Smokestack leak in central serous chorioretinopathy.

PubMed

Bujarborua, Dhiren; Nagpal, Pran N; Deka, Manab

2010-03-01

To study the demography, various morphological patterns and fluid dynamics of the smokestack leak by fluorescein angiography (FA) in central serous chorioretinopathy (CSC). Part I (clinical): review of the medical records and angiographic documents of 69 consecutive cases of CSC with smokestack leak. Part II (experimental): documentation of the movement of various concentrations of fluorescein dye due to convection currents in a laboratory model that roughly represents a closed chamber similar to that of CSC in human eyes. The clinical study (Part I) revealed that 14.40% of 479 consecutive cases had smokestack leak, of which 70% occurred in first acute episode (p-value: <0.001), 27.14% in acute recurrent episodes (50% fresh leak) and 2.85% in chronic stage. Patients were predominantly male (84.05%) with a median age of 34.00 +/- 8.14 years. The median symptom duration excluding the chronic cases was 15 +/- 34.28 days. This type of leak was mostly (48.57%) seen in medium-sized CSC, and the majority were in the parafoveal superonasal quadrant (31.42%). The ascending type of leak was predominant (94.28%). In four eyes, an atypical pattern and in two eyes more than one smokestack leak were seen within the same detached area. The experimental study (Part II) demonstrated that fluid containing a low concentration of fluorescein ascended due to convection currents, whereas highly concentrated dye descended. The clinical study revealed smokestack leaks to be significantly more common in a primary acute episode, and they usually develop in the early part of the acute phase of the disease (average duration 15 +/- 34.28 days). Rarely, this type of leak can occur in the chronic stage, and multiple leaks may develop in the same detached space. The various patterns of dye movement due to convection currents in the experimental model resembled the dye movement in certain cases of CSC of the present series. The experimental study also hinted at the probability of drainage of unbound fluorescein molecules along with protein-laden heavy fluid in downward spread of the leak.

40 CFR 63.1409 - Heat exchange system provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... representative substances whose presence in cooling water indicate a leak shall comply with the requirements... detect leaks of process fluids into cooling water. The plan shall require monitoring of one or more... provisions in either paragraph (b) or (c) of this section. Whenever a leak is detected, the owner or operator...

40 CFR 61.135 - Standard: Equipment leaks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Emissions from Coke By-Product Recovery Plants § 61.135 Standard: Equipment leaks. (a) Each owner or... benzene service. (d) Each exhauster shall be monitored quarterly to detect leaks by the methods specified... stuffing box pressure; or (ii) Equipped with a barrier fluid system that is connected by a closed vent...

The role of ICP monitoring in patients with persistent cerebrospinal fluid leak following spinal surgery: a case series.

PubMed

Craven, Claudia; Toma, Ahmed K; Khan, Akbar A; Watkins, Laurence D

2016-09-01

Cerebrospinal fluid (CSF) leak following spinal surgery is a relatively common surgical complication. A disturbance in the underlying CSF dynamics could be the causative factor in a small group of patients with refractory CSF leaks that require multiple surgical repairs and prolonged hospital admission. A retrospective case series of patients with persistent post spinal surgery CSF leak referred to the hydrocephalus service for continuous intracranial pressure (ICP) monitoring. Patients' notes were reviewed for medical history, ICP data, radiological data, and subsequent management and outcome. Five patients (two males/three females, mean age, 35.4 years) were referred for ICP monitoring over a 12-month period. These patients had prolonged CSF leak despite multiple repair attempts 252 ± 454 days (mean ± SD). On ICP monitoring, all five patients had abnormal results, with the mean ICP 8.95 ± 4.41 mmHg. Four had abnormal pulse amplitudes, mean 6.15 mmHg ± 1.22 mmHg. All five patients underwent an intervention. Three patients underwent insertion of ventriculoperitoneal (VP) shunts. One patient had venous sinus stent insertion and one patient underwent medical management with acetazolamide. All five of the patients' CSF leak resolved post intervention. The mean time to resolution of CSF leak post intervention was 10.8  ± 12.9 days. Abnormal cerebrospinal fluid dynamics could be the underlying factor in patients with a persistent and treatment-refractory CSF leak post spinal surgery. Treatments aimed at lowering ICP may be beneficial in this group of patients. Whether abnormal pressure and dynamics represent a pre-existing abnormality or is induced by spinal surgery should be a subject of further study.

Risk factors for cerebrospinal fluid leak in pediatric patients undergoing endoscopic endonasal skull base surgery.

PubMed

Stapleton, Amanda L; Tyler-Kabara, Elizabeth C; Gardner, Paul A; Snyderman, Carl H; Wang, Eric W

2017-02-01

To determine the risk factors associated with cerebrospinal fluid (CSF) leak following endoscopic endonasal surgery (EES) for pediatric skull base lesions. Retrospective chart review of pediatric patients (ages 1 month to 18 years) treated for skull base lesions with EES from 1999 to 2014. Five pathologies were reviewed: craniopharyngioma, clival chordoma, pituitary adenoma, pituitary carcinoma, and Rathke's cleft cyst. Fisher's exact tests were used to evaluate the different factors to determine which had a statistically higher risk of leading to a post-operative CSF leak. 55 pediatric patients were identified who underwent 70 EES's for tumor resection. Of the 70 surgeries, 47 surgeries had intraoperative CSF leaks that were repaired at the time of surgery. 11 of 47 (23%) surgeries had post-operative CSF leaks that required secondary operative repair. Clival chordomas had the highest CSF leak rate at 36%. There was no statistical difference in leak rate based on the type of reconstruction, although 28% of cases that used a vascularized flap had a post-operative leak, whereas only 9% of those cases not using a vascularized flap had a leak. Post-operative hydrocephalus and perioperative use of a lumbar drain were not significant risk factors. Pediatric patients with an intra-operative CSF leak during EES of the skull base have a high rate of post-operative CSF leaks. Clival chordomas appear to be a particularly high-risk group. The use of vascularized flaps and perioperative lumbar drains did not statistically decrease the rate of post-operative CSF leak. Copyright © 2017 Elsevier B.V. All rights reserved.

Method and means of passive detection of leaks in buried pipes

DOEpatents

Claytor, T.

1979-10-30

A method and means for passive detection of a leak in a buried pipe containing fluid under pressure includes a plurality of acoustic detectors that are placed in contact with the pipe. Noise produced by the leak is detected by the detectors, and the detected signals are correlated to locate the leak. In one embodiment of the invention two detectors are placed at different locations to locate a leak between them. In an alternate embodiment two detectors of different waves are placed at substantially the same location to determine the distance of the leak from the location.

Method and means of passive detection of leaks in buried pipes

DOEpatents

Claytor, Thomas N.

1981-01-01

A method and means for passive detection of a leak in a buried pipe containing fluid under pressure includes a plurality of acoustic detectors that are placed in contact with the pipe. Noise produced by the leak is detected by the detectors, and the detected signals are correlated to locate the leak. In one embodiment of the invention two detectors are placed at different locations to locate a leak between them. In an alternate embodiment two detectors of different waves are placed at substantially the same location to determine the distance of the leak from the location.

Cerebrospinal fluid cutaneous fistula following obstetric epidural analgaesia. Case report.

PubMed

Fedriani de Matos, J J; Quintero Salvago, A V; Gómez Cortés, M D

2017-10-01

Cutaneous fistula of cerebrospinal fluid is a rare complication of neuroaxial blockade. We report the case of a parturient in whom an epidural catheter was placed for labour analgesia and 12h after the catheter was removed, presented an abundant asymptomatic fluid leak from the puncture site, compatible in the cyto-chemical analysis with cerebrospinal fluid. She was treated with acetazolamide, compression of skin orifice of the fluid leakage, antibiotic prophylaxis, hydration and rest, and progressed satisfactorily without requiring blood patch. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

76 FR 34918 - Airworthiness Directives; The Boeing Company Model 767 Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

...We propose to adopt a new airworthiness directive (AD) for the products listed above. This proposed AD would require modification of the fluid drain path in the leading edge area of the wing. This proposed AD was prompted by a design review following a ground fire incident and reports of flammable fluid leaks from the wing leading edge area onto the engine exhaust area. We are proposing this AD to prevent flammable fluid from leaking onto the engine exhaust nozzle which could result in a fire.

Reactivation of a Propped Hydraulic Fracture

NASA Astrophysics Data System (ADS)

Sarvaramini, E.; Garagash, D.

2014-12-01

The problem of massive fluid injection into a pre-existing fracture has many applications in petroleum industry including underground liquid waste disposal and waterflooding to increase recovery from a hydrocarbon reservoir. Understanding the conditions leading to the re-activation of pre-existing fractures and ensuing propagation is critical for a successful injection project design, and it may also help to mitigate potential environmental hazards, such as contamination of underground aquifers and induced seismicity. The problem of injection of a low viscosity fluid into a permeable formation can be distinguished from conventional hydraulic fracture by the mechanism of fluid leak-off. In conventional fracturing, high viscosity and cake building properties of injected fluid limit leak-off to a 1-D boundary layer incasing the crack. In the case of injection of low viscosity fluid into a fracture, leak-off and related pore fluid diffusion will take place over wider range of scales, from 1-D to 2 or 3-D. We consider a pre-existing stationary propped hydraulic fracture with constrained height into which a fluid is injected under constant flow rate. Although the net effective stress on the crack is initially compressive, the proppant keeps the crack open. It is worthwhile to note that during injection and related pressurization of a propped crack, the fracture breakdown is to be achieved prior to the fracture re-opening. Therefore, the effect of the change of the propped fracture storage on the pressurization dynamics can be neglected. The objective of this work is to study the transient pressurization and the onset of the propagation for a propped fracture. To the end, we formulate and solve a general problem of injection into a fracture accounting for viscous dissipation (i.e. non-uniform pressure distribution). We quantify how the fracture breakdown condition depends upon the rock and fluid properties, the in-situ stress and the fluid injection rate. We also establish a criterion when the assumption of negligible viscous dissipation is justified. The obtained solution is also transportable to the production well test analysis of a fractured well (Cinco et al., SPE 1978).

[Group A streptococcal meningitis: Streptococcus pneumoniae is not the only one to seep into the CSF fluid leak!].

PubMed

Zappella, N; Barrelet, A; Pangon, B; Laurent, V; Bruneel, F

2013-11-01

We reported a case of group A streptococcal meningitis in a patient with a CSF fluid leak. This case underlined several relevant points: (i) an unfrequent cause of bacterial meningitis; (ii) the main diagnosis to evoke when the direct examination of CSF shows Gram+ cocci with a negative pneumococcal antigen; (iii) that bacteria other than Streptococcus pneumoniae are possible in front of a meningitis associated with a CSF fluif leak. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Clinical characteristics of 15 cases of chronic subdural hematomas due to spontaneous intracranial hypotension with spinal cerebrospinal fluid leak.

PubMed

Wan, Yingfeng; Xie, Jixi; Xie, Dajiang; Xue, Zhaoliang; Wang, Yirong; Yang, Shuxu

2016-12-01

The etiology of chronic subdural hematoma (CSDH) in patients is diverse. The primary objective of this article was to discuss one of the causes, spontaneous intracranial hypotension with spinal cerebrospinal fluid (CSF) leak, which is usually neglected by the neurosurgeon. All the consecutive 15 patients who underwent operation for CSDHs between June 2012 and June 2014 at Sir Run Run Shaw Hospital of Zhejiang University were included in this retrospective cohort study. The clinical and imaging data of these patients with CSDHs due to spinal CSF leak were retrospectively studied. Fifteen patients, with a mean age of 53.8 ± 8.3 years, underwent operations for CSDH. Hematomas were unilateral in 4 patients and bilateral in 11 patients. Among these patients, eight patients had recurrence of hematomas after operation due to neglect of spinal CSF leak. All patients had fully recovery. Spinal CSF leak is a cause of cSDH, which is overlooked by the doctor.

Leak detection aid

DOEpatents

Steeper, Timothy J.

1989-01-01

A leak detection apparatus and method for detecting leaks across an O-ring sealing a flanged surface to a mating surface is an improvement in a flanged surface comprising a shallow groove following O-ring in communication with an entrance and exit port intersecting the shallow groove for injecting and withdrawing, respectively, a leak detection fluid, such as helium. A small quantity of helium injected into the entrance port will flow to the shallow groove, past the O-ring and to the exit port.

The Management of Cerebrospinal Fluid Leak After Anterior Cervical Decompression Surgery.

PubMed

Zhai, Jiliang; Panchal, Ripul R; Tian, Ye; Wang, Shujie; Zhao, Lijuan

2018-03-01

Cerebrospinal fluid (CSF) leak is a rare but potentially troublesome and occasionally catastrophic complication after anterior cervical decompression surgery. There is limited literature describing this complication, and the management of CSF leak varies. The aim of this study was to retrospectively review the treatment of cases with CSF leak and develop a management algorithm. A series of 14 patients with CSF leak from January 2011 to May 2016 were included in this study. Their characteristics, management of CSF leak, and outcomes were documented. There were 5 male and 9 female patients. Mean age at surgery was 57.1±9.9 years (range, 37-76 years). All instances of CSF leak, except 1 noted postoperatively, were indirectly repaired intraoperatively. A closed straight wound drain was placed for all patients. A lumbar subarachnoid drain was placed immediately after surgery in 4 patients and postoperatively in 7 patients. In 1 patient, lumbar drain placement was unsuccessful. In 2 additional patients, the surgeon decided not to place a lumbar drain. One patient developed meningitis and recovered after antibiotic therapy with meropenem and vancomycin. Another patient had a deep wound infection and required a revision surgery. Wound drains and lumbar drains should be immediately considered when CSF leak is identified. Antibiotics also should be considered to prevent intradural infection. [Orthopedics. 2018; 41(2):e283-e288.]. Copyright 2018, SLACK Incorporated.

Cerebrospinal Fluid Leak at Percutaneous Exit of Ventricular Catheter as a Crucial Risk Factor for External Ventricular Drainage-Related Infection in Adult Neurosurgical Patients.

PubMed

Park, Jaechan; Choi, Yeon-Ju; Ohk, Boram; Chang, Hyun-Ha

2018-01-01

The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage or intraventricular hemorrhage (IVH) were enrolled in this prospective study. A CSF leak-detection paper (small sterilized filter paper) was applied at the percutaneous catheter exit site to check for any bloody CSF leak. In addition, radiologic and clinical data were collected. Four of the 52 patients (7.7%) developed an EVD-related CSF infection from organisms including Staphylococcus epidermidis (n = 3) and Staphylococcus hominis (n = 1). A prolonged CSF leak >1 day was detected in 9 patients (17.3%) and revealed as a significant risk factor for CSF infection with a 44.4% positive predictive value. Moreover, an IVH >10 mL was found in 11 patients (21.2%) and revealed as a significant predisposing factor for a CSF leak at the percutaneous catheter exit. A prolonged CSF leak for >1 day at the percutaneous catheter exit site is a crucial risk factor for EVD-related CSF infection and an IVH >10 mL is a predisposing factor for a CSF leak. Copyright © 2017 Elsevier Inc. All rights reserved.

Can the Risks of Cerebrospinal Fluid Leak After Vestibular Schwannoma Surgery Be Predicted?

PubMed

Russel, Adrien; Hoffmann, Charles P; Nguyen, Duc T; Beurton, Renaud; Parietti-Winkler, Cécile

2017-02-01

Identifying predictive factors of cerebrospinal fluid (CSF) leak after translabyrinthine approach (TLA) for vestibular schwannoma. Retrospective study. Tertiary care center. All patients (n = 275) operated for a vestibular schwannoma by TLA between 2004 and 2013 were included. Vestibular schwannoma surgery by TLA. The rate of postoperative CSF leak considering the age, sex, body mass index (BMI), tumor staging, and duration of surgical procedure. A logistic regression model was used to identify the predictors and compute a biometric predictive model of CSF leak. Thirty-three patients (12.0%) developed a CSF leak after surgery. In a multivariable model, an increased risk of CSF leak was found for younger patients (OR 0.95, 95% CI 0.92-0.98), longer duration of surgery (OR 1.85, 95% CI 1.12-3.05), and the male sex (0 = male; 1 = female; OR 0.22, 95% CI 0.09-0.54), while also adjusting for BMI. The probability of developing a CSF leak after vestibular schwannoma surgery was calculated using a statistical prediction model, with a percentage of false negative of 7.0% and an overall correct prediction of 88.4%. The predictors of CSF leak after TLA for vestibular schwannoma are young age, male sex, longer duration of surgery, which adjusting for BMI. In this regard, the surgical team should adapt its management during pre- and postoperative period to decrease the likelihood of a leak.

Combined Endoscopic Transorbital and Endonasal Repair of High Flow Orbital Apex/Middle Fossa Cerebrospinal Fluid Leak with a Nasoseptal Flap.

PubMed

Lucke-Wold, Brandon; Mendez, Gustavo; Cua, David; Akins, Paul; Gillham, Haley; Ciporen, Jeremy

2018-01-01

High flow orbital apex or middle fossa cerebrospinal fluid (CSF) leaks can be life threatening and complex to repair. These leaks associated with large dural defects are most commonly repaired with an open temporalis muscle patch or free flaps, but these flaps do not always stop the leak. A 65-year-old patient presented two years after orbital exenteration and radiation for squamous cell carcinoma. He developed multi-organism meningitis and pneumocephalus secondary to a large high-flow orbital apex/middle fossa CSF leak. To repair the leak, a combined endoscopic transorbital/endonasal approach with pedicled nasospetal flap and dermis fat graft was used. We describe the unique endoscopic technique that was used to treat the life threatening high flow orbital apex/middle fossa CSF leak. The technique allowed the use of the transposed pedicled flap, which is an alternative to the free flap in controlling CSF leak. Cisternogram post-operatively and clinical exam confirmed resolution of CSF leak. Although a critically ill patient at admission with a modified Rankin scale (MRS) of 5, he was discharged home on continued IV antibiotic therapy with a MRS of 3. Endoscopic evaluation at three months after treatment showed the effectiveness of the flap and he continued to improve clinically. This is the first case to describe a combined endoscopic transorbital and endonasal repair of high flow orbital apex/middle fossa CSF leak with a pedicled nasoseptal flap. These techniques can be utilized during initial reconstruction after orbital exenteration or as a salvage flap.

High serum lactate as an adjunct in the early prediction of anastomotic leak following oesophagectomy.

PubMed

Ip, B; Ng, K T; Packer, S; Paterson-Brown, S; Couper, G W

2017-10-01

Anastomotic leak (AL) following oesophagectomy carries a high mortality and morbidity. Early detection and intervention is required for a successful outcome. We have examined the role of a high postoperative serum lactate in predicting which patients are at risk of developing an anastomotic leak(AL). All patients who underwent transthoracic oesophagectomy over a 3-year period were identified from a prospectively collected database. Medical records were reviewed to identify the highest serum lactate recorded from blood gas analysis over each 24hr post-operative period. Patients who underwent transhiatal and left thoraco-abdominal oesophagectomies were excluded. Patients who developed a chyle leak were excluded. Of a total of 136 oesophagectomies included for analysis, 18 developed an AL (13.2%). Of these patients, 10 underwent thoracoscopic oesophageal mobilization with cervical anastomosis and the rest an Ivor Lewis procedure. Predictive factors for AL included neoadjuvant chemotherapy (15/18 83.3% vs 55/118 46.6% p = 0.0046) and number of positive lymph nodes (mean 4.2 vs control mean 2.3 p = 0.045). Overall net fluid balance was comparable between the 2 groups, although AL patients received slightly more fluid on Day 3. High lactate levels on days 1-3 were associated with an AL. Using a Day 2 lactate of 1.7 mmol/L, the sensitivity of predicting AL was 72% and specificity 88%. The mean lag time using existing diagnostic modalities was 7.9 days. A serum lactate of >1.7 mmol/l on day 2 should raise the possibility of a potential AL. Such patients should be selected for more intensive monitoring, optimization and selective gastroscopy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

76 FR 34625 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

...We propose to adopt a new airworthiness directive (AD) for the products listed above. This proposed AD would require modification of the fluid drain path in the leading edge area of the wing. This proposed AD was prompted by a design review following a ground fire incident and reports of flammable fluid leaks from the wing leading edge area onto the engine exhaust area. We are proposing this AD to prevent flammable fluid from leaking onto the engine exhaust nozzle, which could result in a fire.

Failure detection of liquid cooled electronics in sealed packages. [in airborne information management system

NASA Technical Reports Server (NTRS)

Hoadley, A. W.; Porter, A. J.

1991-01-01

The theory and experimental verification of a method of detecting fluid-mass loss, expansion-chamber pressure loss, or excessive vapor build-up in NASA's Airborne Information Management System (AIMS) are presented. The primary purpose of this leak-detection method is to detect the fluid-mass loss before the volume of vapor on the liquid side causes a temperature-critical part to be out of the liquid. The method detects the initial leak after the first 2.5 pct of the liquid mass has been lost, and it can be used for detecting subsequent situations including the leaking of air into the liquid chamber and the subsequent vapor build-up.

Leak detection aid

DOEpatents

Steeper, T.J.

1989-12-26

A leak detection apparatus and method for detecting leaks across an O-ring sealing a flanged surface to a mating surface is an improvement in a flanged surface comprising a shallow groove following O-ring in communication with an entrance and exit port intersecting the shallow groove for injecting and withdrawing, respectively, a leak detection fluid, such as helium. A small quantity of helium injected into the entrance port will flow to the shallow groove, past the O-ring and to the exit port. 2 figs.

Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?-A prospective randomized trial.

PubMed

De Waele, Michèle; Agzarian, John; Hanna, Waël C; Schieman, Colin; Finley, Christian J; Macri, Joseph; Schneider, Laura; Schnurr, Terri; Farrokhyar, Forough; Radford, Katherine; Nair, Parameswaran; Shargall, Yaron

2017-06-01

Prolonged air leak and high-volume pleural drainage are the most common causes for delays in chest tube removal following lung resection. While digital pleural drainage systems have been successfully used in the management of post-operative air leak, their effect on pleural drainage and inflammation has not been studied before. We hypothesized that digital drainage systems (as compared to traditional analog continuous suction), using intermittent balanced suction, are associated with decreased pleural inflammation and postoperative drainage volumes, thus leading to earlier chest tube removal. One hundred and three [103] patients were enrolled and randomized to either analog (n=50) or digital (n=53) drainage systems following oncologic lung resection. Chest tubes were removed according to standardized, pre-defined protocol. Inflammatory mediators [interleukin-1B (IL-1B), 6, 8, tumour necrosis factor-alpha (TNF-α)] in pleural fluid and serum were measured and analysed. The primary outcome of interest was the difference in total volume of postoperative fluid drainage. Secondary outcome measures included duration of chest tube in-situ, prolonged air-leak incidence, length of hospital stay and the correlation between pleural effusion formation, degree of inflammation and type of drainage system used. There was no significant difference in total amount of fluid drained or length of hospital stay between the two groups. A trend for shorter chest tube duration was found with the digital system when compared to the analog (P=0.055). Comparison of inflammatory mediator levels revealed no significant differences between digital and analog drainage systems. The incidence of prolonged post-operative air leak was significantly higher when using the analog system (9 versus 2 patients; P=0.025). Lobectomy was associated with longer chest tube duration (P=0.001) and increased fluid drainage when compared to sub-lobar resection (P<0.001), regardless of drainage system. Use of post-lung resection digital drainage does not appear to decrease pleural fluid formation, but is associated with decreased prolonged air leaks. Total pleural effusion volumes did not differ with the type of drainage system used. These findings support previously established benefits of the digital system in decreasing prolonged air leaks, but the advantages do not appear to extend to decreased pleural fluid formation.

Cerebrospinal fluid leak (image)

MedlinePlus

... brain and spinal cord by acting like a liquid cushion. The fluid allows the organs to be buoyant protecting them from blows or other trauma. Inside the skull the cerebrospinal fluid is contained by the dura which covers ...

Leak detection in gas pipeline by acoustic and signal processing - A review

NASA Astrophysics Data System (ADS)

Adnan, N. F.; Ghazali, M. F.; Amin, M. M.; Hamat, A. M. A.

2015-12-01

The pipeline system is the most important part in media transport in order to deliver fluid to another station. The weak maintenance and poor safety will contribute to financial losses in term of fluid waste and environmental impacts. There are many classifications of techniques to make it easier to show their specific method and application. This paper's discussion about gas leak detection in pipeline system using acoustic method will be presented in this paper. The wave propagation in the pipeline is a key parameter in acoustic method when the leak occurs and the pressure balance of the pipe will generated by the friction between wall in the pipe. The signal processing is used to decompose the raw signal and show in time- frequency. Findings based on the acoustic method can be used for comparative study in the future. Acoustic signal and HHT is the best method to detect leak in gas pipelines. More experiments and simulation need to be carried out to get the fast result of leaking and estimation of their location.

Body mass index and the risk of postoperative cerebrospinal fluid leak following trans-sphenoidal surgery in an Asian population.

PubMed

Sun, Ira; Lim, Jia Xu; Goh, Chun Peng; Low, Shiong Wen; Kirollos, Ramez W; Tan, Chuen Seng; Lwin, Sein; Yeo, Tseng Tsai

2016-09-22

Postoperative cerebrospinal fluid (CSF) leak is a serious complication following trans-sphenoidal surgery for which elevated body mass index (BMI) has been implicated as a risk factor, albeit only in two recent North American studies. Given the paucity of evidence, we sought to determine if this association held true in an Asian population, where BMI criteria for obesity differ from the international standard. A retrospective study of 119 patients who underwent 123 trans-sphenoidal procedures for sellar lesions between May 2000 and May 2012 was conducted. Univariate and multivariate logistic regression analyses were performed to investigate the impact of elevated BMI and other risk factors on postoperative CSF leak. We found 10 (8.1%) procedures in ten patients that were complicated by postoperative CSF leak. The median BMI of patients with postoperative leak following trans-sphenoidal procedures was significantly higher than that of patients without postoperative CSF leak (27.0 kg/m2 vs. 24.6 kg/m2; p = 0.018). Patients categorised as either moderate or high risk under the Asian BMI classification were more likely to suffer from a postoperative leak (p = 0.030). Repeat procedures were also found to be significantly associated with postoperative CSF leak (p = 0.041). Elevated BMI predicts for postoperative CSF leak following trans-sphenoidal procedures, even in an Asian population, where the definition of obesity differs from international standards. Thus, BMI should be borne in mind during local and regional management decision-making processes prior to such procedures.

The Demonstration of a Robotic External Leak Locator on the International Space Station

NASA Technical Reports Server (NTRS)

Naids, Adam; Rossetti, Dino; Bond, Tim; Johnson, Brien; Huang, Alvin; Deal, Alexandra; Fox, Katie; Heiser, Michael; Hartman, William; Mikatarian, Ronald

2017-01-01

The International Space Station (ISS) and all currently conceivable future manned spacecraft are susceptible to mission impacts due to fluid/gas leaks to the exterior environment. For example, there is a well-known risk of ammonia leaks from the ISS External Thermal Control System loops and currently no method to locate them. It was, therefore, critical to develop a method for detecting and locating leaks to preserve vehicle health. The Robotic External Leak Locator (RELL) was developed and deployed to the ISS to provide this capability. An on-orbit validation and demonstration was successfully completed in December 2016 and leak locating operations occurred in February 2017. This paper discusses the results of those exercises including measurements of the environment around ISS, detection of the small ammonia leak and implementation of leak locating methodologies.

Fibrin Sealants in Dura Sealing: A Systematic Literature Review

PubMed Central

2016-01-01

Background Fibrin sealants are widely used in neurosurgery to seal the suture line, provide watertight closure, and prevent cerebrospinal fluid leaks. The aim of this systematic review is to summarize the current efficacy and safety literature of fibrin sealants in dura sealing and the prevention/treatment of cerebrospinal fluid leaks. Methods A comprehensive electronic literature search was run in the following databases: Cochrane Database of Systematic Reviews, Cochrane Central Resister of Controlled Trials, clinicaltrials.gov, MEDLINE/PubMed, and EMBASE. Titles and abstracts of potential articles of interest were reviewed independently by 3 of the authors. Results A total of 1006 database records and additional records were identified. After screening for duplicates and relevance, a total of 78 articles were assessed by the investigators for eligibility. Thirty-eight were excluded and the full-text of 40 articles were included in the qualitative synthesis. Seven of these included only safety data and were included in the safety assessment. The remaining 33 articles included findings from 32 studies that enrolled a total of 2935 patients who were exposed to fibrin sealant. Among these 33 studies there were only 3 randomized controlled trials, with the remaining being prospective cohort analysis, case controlled studies, prospective or retrospective case series. One randomized controlled trial, with 89 patients exposed to fibrin sealant, found a greater rate of intraoperative watertight dura closure in the fibrin sealant group than the control group (92.1% versus 38.0%, p<0.001); however, post-operative cerebrospinal fluid leakage occurred in more fibrin sealant than control patients (6.7% versus 2.0%, p>0.05). Other clinical trials evaluated the effect of fibrin sealant in the postoperative prevention of cerebrospinal fluid leaks. These were generally lower level evidence studies (ie, not prospective, randomized, controlled trials) that were not designed or powered to demonstrate a significant advantage to fibrin sealant use. Two small case series studies evaluated the effect of fibrin sealants in persistent cerebrospinal fluid leak treatment, but did not establish firm efficacy conclusions. Specific adverse reports where fibrin sealants were used for dura sealing were limited, with only 8 cases reported in neurosurgical procedures since 1987 and most reporting only a speculative relationship/association with fibrin sealant exposure. Conclusions A major finding of this systematic literature review is that there is a paucity of randomized studies that have evaluated the effectiveness and safety of fibrin sealants in providing intraoperative watertight dura closure and post-operative cerebrospinal fluid leakage. Among the limited studies available, evidence from a single randomized, controlled trial indicates that fibrin sealants provide a higher rate of intraoperative watertight closure of the dura suture line than control, albeit with a higher rate of postoperative cerebrospinal fluid leakage. Evidence from non-randomized, controlled trials suggests that fibrin sealants may be effective in preventing cerebrospinal fluid leaks with an acceptable safety profile. There is a substantial need for randomized, controlled clinical trials or well-designed prospective observational trials where the conduct of a randomized trial is not feasible to fully assess the impact of fibrin sealant utilization on the rates of intraoperative dura closure, postoperative cerebrospinal leakage, and safety. PMID:27119993

Fibrin Sealants in Dura Sealing: A Systematic Literature Review.

PubMed

Esposito, Felice; Angileri, Filippo Flavio; Kruse, Peter; Cavallo, Luigi Maria; Solari, Domenico; Esposito, Vincenzo; Tomasello, Francesco; Cappabianca, Paolo

2016-01-01

Fibrin sealants are widely used in neurosurgery to seal the suture line, provide watertight closure, and prevent cerebrospinal fluid leaks. The aim of this systematic review is to summarize the current efficacy and safety literature of fibrin sealants in dura sealing and the prevention/treatment of cerebrospinal fluid leaks. A comprehensive electronic literature search was run in the following databases: Cochrane Database of Systematic Reviews, Cochrane Central Resister of Controlled Trials, clinicaltrials.gov, MEDLINE/PubMed, and EMBASE. Titles and abstracts of potential articles of interest were reviewed independently by 3 of the authors. A total of 1006 database records and additional records were identified. After screening for duplicates and relevance, a total of 78 articles were assessed by the investigators for eligibility. Thirty-eight were excluded and the full-text of 40 articles were included in the qualitative synthesis. Seven of these included only safety data and were included in the safety assessment. The remaining 33 articles included findings from 32 studies that enrolled a total of 2935 patients who were exposed to fibrin sealant. Among these 33 studies there were only 3 randomized controlled trials, with the remaining being prospective cohort analysis, case controlled studies, prospective or retrospective case series. One randomized controlled trial, with 89 patients exposed to fibrin sealant, found a greater rate of intraoperative watertight dura closure in the fibrin sealant group than the control group (92.1% versus 38.0%, p<0.001); however, post-operative cerebrospinal fluid leakage occurred in more fibrin sealant than control patients (6.7% versus 2.0%, p>0.05). Other clinical trials evaluated the effect of fibrin sealant in the postoperative prevention of cerebrospinal fluid leaks. These were generally lower level evidence studies (ie, not prospective, randomized, controlled trials) that were not designed or powered to demonstrate a significant advantage to fibrin sealant use. Two small case series studies evaluated the effect of fibrin sealants in persistent cerebrospinal fluid leak treatment, but did not establish firm efficacy conclusions. Specific adverse reports where fibrin sealants were used for dura sealing were limited, with only 8 cases reported in neurosurgical procedures since 1987 and most reporting only a speculative relationship/association with fibrin sealant exposure. A major finding of this systematic literature review is that there is a paucity of randomized studies that have evaluated the effectiveness and safety of fibrin sealants in providing intraoperative watertight dura closure and post-operative cerebrospinal fluid leakage. Among the limited studies available, evidence from a single randomized, controlled trial indicates that fibrin sealants provide a higher rate of intraoperative watertight closure of the dura suture line than control, albeit with a higher rate of postoperative cerebrospinal fluid leakage. Evidence from non-randomized, controlled trials suggests that fibrin sealants may be effective in preventing cerebrospinal fluid leaks with an acceptable safety profile. There is a substantial need for randomized, controlled clinical trials or well-designed prospective observational trials where the conduct of a randomized trial is not feasible to fully assess the impact of fibrin sealant utilization on the rates of intraoperative dura closure, postoperative cerebrospinal leakage, and safety.

Dural diverticulum with a symptomatic cerebrospinal fluid leak.

PubMed

Armstrong, Nicholas; Williamson, Clinton; Williamson, Natalie; Fortes, Manuel; Tjauw, Iwan; Vij, Vikas; Trojan, Ryan

2016-03-01

A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

Mechanics of Hydraulic Fractures

NASA Astrophysics Data System (ADS)

Detournay, Emmanuel

2016-01-01

Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

Area Monitoring for Detection of Leaks and/or Flames

NASA Technical Reports Server (NTRS)

Mian, Zahid F. (Inventor); Gamache, Ronald W. (Inventor); Glasser, Nick (Inventor)

2015-01-01

A solution for monitoring an area for the presence of a flame and/or a leak, such as from a pressurized fluid, is provided. An imaging device can be used that acquires image data based on electromagnetic radiation having wavelengths only corresponding to at least one region of the electromagnetic spectrum in which electromagnetic radiation from an ambient light source is less than the electromagnetic radiation emitted by at least one type of flame for which the presence within the area is being monitored. An acoustic device can be used that is configured to acquire acoustic data for the area and enhance acoustic signals in a range of frequencies corresponding to a leak of a pressurized fluid present in the area.

Area Monitoring for Detection of Leaks And/Or Flames

NASA Technical Reports Server (NTRS)

Mian, Zahid F. (Inventor); Gamache, Ronald W. (Inventor); Glasser, Nicholas (Inventor)

2017-01-01

A solution for monitoring an area for the presence of a flame and/or a leak, such as from a pressurized fluid, is provided. An imaging device can be used that acquires image data based on electromagnetic radiation having wavelengths only corresponding to at least one region of the electromagnetic spectrum in which electromagnetic radiation from an ambient light source is less than the electromagnetic radiation emitted by at least one type of flame for which the presence within the area is being monitored. An acoustic device can be used that is configured to acquire acoustic data for the area and enhance acoustic signals in a range of frequencies corresponding to a leak of a pressurized fluid present in the area.

Normally-Closed Zero-Leak Valve with Magnetostrictive Actuator

NASA Technical Reports Server (NTRS)

Ramspacher, Daniel J. (Inventor); Richard, James A. (Inventor)

2017-01-01

A non-pyrotechnic, normally-closed, zero-leak valve is a replacement for the pyrovalve used for both in-space and launch vehicle applications. The valve utilizes a magnetostrictive alloy for actuation, rather than pyrotechnic charges. The alloy, such as Terfenol-D, experiences magnetostriction, i.e. a gross elongation, when exposed to a magnetic field. This elongation fractures a parent metal seal, allowing fluid flow through the valve. The required magnetic field is generated by redundant coils that are isolated from the working fluid.

Real-Time Model-Based Leak-Through Detection within Cryogenic Flow Systems

NASA Technical Reports Server (NTRS)

Walker, M.; Figueroa, F.

2015-01-01

The timely detection of leaks within cryogenic fuel replenishment systems is of significant importance to operators on account of the safety and economic impacts associated with material loss and operational inefficiencies. Associated loss in control of pressure also effects the stability and ability to control the phase of cryogenic fluids during replenishment operations. Current research dedicated to providing Prognostics and Health Management (PHM) coverage of such cryogenic replenishment systems has focused on the detection of leaks to atmosphere involving relatively simple model-based diagnostic approaches that, while effective, are unable to isolate the fault to specific piping system components. The authors have extended this research to focus on the detection of leaks through closed valves that are intended to isolate sections of the piping system from the flow and pressurization of cryogenic fluids. The described approach employs model-based detection of leak-through conditions based on correlations of pressure changes across isolation valves and attempts to isolate the faults to specific valves. Implementation of this capability is enabled by knowledge and information embedded in the domain model of the system. The approach has been used effectively to detect such leak-through faults during cryogenic operational testing at the Cryogenic Testbed at NASA's Kennedy Space Center.

Control of Flowing Liquid Films by Electrostatic Fields in Space

NASA Technical Reports Server (NTRS)

Griffing, E. M.; Bankoff, S. G.; Schluter, R. A.; Miksis, M. J.

1999-01-01

The interaction of a spacially varying electric field and a flowing thin liquid film is investigated experimentally for the design of a proposed light weight space radiator. Electrodes are utilized to create a negative pressure at the bottom of a fluid film and suppress leaks if a micrometeorite punctures the radiator surface. Experimental pressure profiles under a vertical falling film, which passes under a finite electrode, show that fields of sufficient strength can be used safely in such a device. Leak stopping experiments demonstrate that leaks can be stopped with an electric field in earth gravity. A new type of electrohydrodynamic instability causes waves in the fluid film to develop into 3D cones and touch the electrode at a critical voltage. Methods previously used to calculate critical voltages for non moving films are shown to be inappropriate for this situation. The instability determines a maximum field which may be utilized in design, so the possible dependence of critical voltage on electrode length, height above the film, and fluid Reynolds number is discussed.

Temperature and Atomic Oxygen Effects on Helium Leak Rates of a Candidate Main Interface Seal

NASA Technical Reports Server (NTRS)

Penney, Nicholas; Wasowski, Janice L.; Daniels, Christopher C.

2011-01-01

Helium leak tests were completed to characterize the leak rate of a 54 in. diameter composite space docking seal design in support of the National Aeronautics and Space Administration s (NASA's) Low Impact Docking System (LIDS). The evaluated seal design was a candidate for the main interface seal on the LIDS, which would be compressed between two vehicles, while docked, to prevent the escape of breathable air from the vehicles and into the vacuum of space. Leak tests completed at nominal temperatures of -30, 20, and 50 C on untreated and atomic oxygen (AO) exposed test samples were examined to determine the influence of both test temperature and AO exposure on the performance of the composite seal assembly. Results obtained for untreated seal samples showed leak rates which increased with increased test temperature. This general trend was not observed in tests of the AO exposed specimens. Initial examination of collected test data suggested that AO exposure resulted in higher helium leak rates, however, further analysis showed that the differences observed in the 20 and 50 C tests between the untreated and AO exposed samples were within the experimental error of the test method. Lack of discernable trends in the test data prevented concrete conclusions about the effects of test temperature and AO exposure on helium leak rates of the candidate seal design from being drawn. To facilitate a comparison of the current test data with results from previous leak tests using air as the test fluid, helium leak rates were converted to air leak rates using standard conversion factors for viscous and molecular flow. Flow rates calculated using the viscous flow conversion factor were significantly higher than the experimental air leakage values, whereas values calculated using the molecular flow conversion factor were significantly lower than the experimentally obtained air leak rates. The difference in these sets of converted flow rates and their deviation from the experimentally obtained air leak rate data suggest that neither conversion factor can be used alone to accurately convert helium leak rates to equivalent air leak rates for the test seals evaluated in this study; other leak phenomena, including permeation, must also be considered.

Analysis of various tracts of mastoid air cells related to CSF leak after the anterior transpetrosal approach.

PubMed

Tamura, Ryota; Tomio, Ryosuke; Mohammad, Farrag; Toda, Masahiro; Yoshida, Kazunari

2018-03-16

OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed. METHODS Preoperative and postoperative target imaging of the temporal bone was performed in a total of 117 patients who underwent ATPA, and various surgery-related parameters were analyzed. RESULTS The existence of air cells at the petrous apex, as well as fluid collection in the mastoid antrum detected by a postoperative CT scan, were possible risk factors for CSF leakage. Tracts that directly connected to the antrum from the squamous part of the temporal bone and petrous apex, rather than through numerous air cells, were significantly related to CSF leak and were defined as "direct tract." All patients with a refractory CSF leak possessed "unusual tracts" that connected to the attic, tympanic cavity, or eustachian tube, rather than through the mastoid antrum. CONCLUSIONS Preoperative assessment of petrous pneumatization types is necessary to prevent CSF leaks. Direct and unusual tracts are particularly strong risk factors for CSF leaks.

Leakage Through a Channel Formed by a Gasket, a Sealing Surface, and a Filament Trapped Between Them

NASA Technical Reports Server (NTRS)

Russell, John; Adams, Frederick

1996-01-01

Plumbing for the transport of liquid Hydrogen or liquid Oxygen at the Kennedy Space Center (KSC) is very critical. Every piece of hardware for handling such a hazardous cryogen is subject to testing prior to installation and use. Safe, realistic testing of all such hardware is prohibitively expensive, which leads, perforce, to expidients such as: (1) lead testing with non-flammable tracer fluids (e.g, liquid nitrogen) and (2) leak testing with room temperature tracer fluids (e.g. liquid helium). Such expedients undermine the realism of the tests. If however, one could apply rational fluid dynamics methods to derive a general analytical expression with which one could relate the throughput of gaseous Helium through a given leak channel to the throughput of liquid Hydrogen through the same channel, then one could recover much of the information that one would otherwise forfeit through these expedients. These facts lead to the following questions: (1) What would be an example of a generic flaw in a gasket?; and (2) How can one calculate the flow of fluid in it? The report addresses these questions. It considers a particular leak geometry, namely one formed by a gasket, a sealing surface, and a filament trapped between them (so that the cross section of the leak channel is a flat bottomed curvilinear triangle, two sides of which are circular arcs and which has cusps on all three corners).

Lumbar Drains Decrease the Risk of Postoperative Cerebrospinal Fluid Leak Following Endonasal Endoscopic Surgery for Suprasellar Meningiomas in Patients With High Body Mass Index.

PubMed

Cohen, Salomon; Jones, Samuel H; Dhandapani, Sivashanmugam; Negm, Hazem M; Anand, Vijay K; Schwartz, Theodore H

2018-01-01

Postoperative cerebrospinal fluid (CSF) leak is a persistent, albeit much less prominent, complication following endonasal endoscopic surgery. The pathology with highest risk is suprasellar meningiomas. A postoperative lumbar drain (LD) is used to decrease the risk of CSF leak but is not universally accepted. To compare the rates of postoperative CSF leak between patients with and without LD who underwent endonasal endoscopic surgical resection of suprasellar meningiomas. A consecutive series of newly diagnosed suprasellar meningiomas was drawn from a prospectively acquired database of endonasal endoscopic surgeries at our institution. An intraoperative, preresection LD was placed and left open at 5 cc/h for ∼48 h. In a subset of patients, the LD could not be placed. Rates of postoperative CSF leak were compared between patients with and without an LD. Twenty-five patients underwent endonasal endoscopic surgical resection of suprasellar meningiomas. An LD could not be placed in 2 patients. There were 2 postoperative CSF leaks (8%), both of which occurred in the patients who did not have an LD (P = .0033). The average body mass index (BMI) of the patients in whom the LD could not be placed was 39.1 kg/m2, compared with 27.6 kg/m2 for those in whom the LD could be placed (P = .009). In the subgroup of obese patients (BMI > 30 kg/m2), LD placement was protective against postoperative CSF leak (P = .022). The inability to place an LD in patients with obesity is a risk factor for postoperative CSF leak. An LD may be useful to prevent postoperative CSF leak, particularly in patients with elevated BMI. Copyright © 2017 by the Congress of Neurological Surgeons

Sinus anatomy associated with inadvertent cerebrospinal fluid leak during functional endoscopic sinus surgery.

PubMed

Heaton, Chase M; Goldberg, Andrew N; Pletcher, Steven D; Glastonbury, Christine M

2012-07-01

Anatomic variations in skull base anatomy may predispose the surgeon to inadvertent skull base injury with resultant cerebrospinal fluid (CSF) leak during functional endoscopic sinus surgery (ESS). Our objective was to compare preoperative sinus imaging of patients who underwent FESS with and without CSF leak to elucidate these variations. In this retrospective case-control study, 18 patients with CSF leak following FESS for chronic rhinosinusitis (CRS) from 2000 to 2011 were compared to 18 randomly selected patients who underwent preoperative imaging for FESS for CRS. Measurements were obtained from preoperative computed tomography images with specific attention to anatomic differences in cribriform plate and ethmoid roof heights in the coronal plane, and the skull base angle in the sagittal plane. Mean values of measured variables were compared using a nonparametric Mann-Whitney test. When compared to controls, patients with CSF leak demonstrated a greater angle of the skull base in the sagittal plane (P < .001) and a greater slope of the skull base in the coronal plane (P < .006). A lower cribriform height relative to ethmoid roof height was also noted in cases of CSF leak as compared to controls (P < .04). A steep skull base angle in the sagittal plane, a greater slope of the skull base in the coronal plane, and a low cribriform height relative to the ethmoid roof predispose the patient to CSF leak during FESS. Preoperative review of imaging with specific attention paid to these anatomic variations may help to prevent iatrogenic CSF leak. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Multiscale integral analysis of a HT leakage in a fusion nuclear power plant

NASA Astrophysics Data System (ADS)

Velarde, M.; Fradera, J.; Perlado, J. M.; Zamora, I.; Martínez-Saban, E.; Colomer, C.; Briani, P.

2016-05-01

The present work presents an example of the application of an integral methodology based on a multiscale analysis that covers the whole tritium cycle within a nuclear fusion power plant, from a micro scale, analyzing key components where tritium is leaked through permeation, to a macro scale, considering its atmospheric transport. A leakage from the Nuclear Power Plants, (NPP) primary to the secondary side of a heat exchanger (HEX) is considered for the present example. Both primary and secondary loop coolants are assumed to be He. Leakage is placed inside the HEX, leaking tritium in elementary tritium (HT) form to the secondary loop where it permeates through the piping structural material to the exterior. The Heating Ventilation and Air Conditioning (HVAC) system removes the leaked tritium towards the NPP exhaust. The HEX is modelled with system codes and coupled to Computational Fluid Dynamic (CFD) to account for tritium dispersion inside the nuclear power plants buildings and in site environment. Finally, tritium dispersion is calculated with an atmospheric transport code and a dosimetry analysis is carried out. Results show how the implemented methodology is capable of assessing the impact of tritium from the microscale to the atmospheric scale including the dosimetric aspect.

Low Level Leaks

NASA Technical Reports Server (NTRS)

1998-01-01

NASA has transferred the improved portable leak detector technology to UE Systems, Inc.. This instrument was developed to detect leaks in fluid systems of critical launch and ground support equipment. This system incorporates innovative electronic circuitry, improved transducers, collecting horns, and contact sensors that provide a much higher degree of reliability, sensitivity and versatility over previously used systems. Potential commercial uses are pipelines, underground utilities, air-conditioning systems, petrochemical systems, aerospace, power transmission lines and medical devices.

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

Moulin, D.; Chapuliot, S.; Drubay, B.

For structures like vessels or pipes containing a fluid, the Leak-Before-Break (LBB) assessment requires to demonstrate that it is possible, during the lifetime of the component, to detect a rate of leakage due to a possible defect, the growth of which would result in a leak before-break of the component. This LBB assessment could be an important contribution to the overall structural integrity argument for many components. The aim of this paper is to review some practices used for LBB assessment and to describe how some new R & D results have been used to provide a simplified approach ofmore » fracture mechanics analysis and especially the evaluation of crack shape and size during the lifetime of the component.« less

Development of a leak location system for use on underground electric power transmission cable

NASA Astrophysics Data System (ADS)

Williams, J. A.

1982-10-01

This report describes a study to evaluate methods for locating leaks of dielectric fluid from buried high voltage cable systems. Two primary types of leak location systems were investigated: (1) systems that will rapidly isolate the leak within a manhole section, typically 1000 m long on a feeder that might be 30 km long; and (2) systems that will then pinpoint the location of the leak. Rapid leak isolation was accomplished by developing an enhanced conductivity oil probe which allows the injection of a small quantity of conductive oil and which indicates the path of the oil as it drifts downstream in the direction of the leak. Two methods for pinpointing the leak were proven. The more successful method was the use of trained leak location dogs which were found to have far better sensitivity than instruments and which could detect cable oil alone without the need for additives. A tracer gas injection and detection scheme was developed for use in areas where the dogs may be unsuitable.

77 FR 16143 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-20

...We are adopting a new airworthiness directive (AD) for certain The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747-200C, 747-200F, 747-300, 747-400, 747-400D, 747-400F, 747SR, and 747SP series airplanes. This AD was prompted by a design review following a ground fire incident and reports of flammable fluid leaks from the wing leading edge area onto the engine exhaust area. This AD requires modifying the fluid drain path in the leading edge area of the wing. We are issuing this AD to prevent flammable fluid from leaking onto the engine exhaust nozzle, which could result in a fire.

Use of duraseal in repair of cerebrospinal fluid leaks.

PubMed

Chin, Christopher J; Kus, Lukas; Rotenberg, Brian W

2010-10-01

The purpose of our article is to review the use of the DuraSeal Sealant System (Confluent Surgical Inc., Waltham, MA) in the repair of complex cerebrospinal fluid (CSF) leaks in endoscopic skull-base surgery. Retrospective chart review. London Health Sciences Centre. A database of endoscopic skull-base cases between 2007 and 2009 that involved CSF leakage repaired with DuraSeal was created. Demographic data and operative reports were collected and analyzed qualitatively. Recurrence of CSF leak after repair. Five cases were identified that met study criteria. In four of the five cases, the repair was successful. There were no complications related to DuraSeal use. Comparison to a subset of patients using Tisseel Fibrin Sealant (Baxter, Toronto, ON) for repair did not show a significant difference in failure rate (χ2 = 0.029, p = .858). There are a variety of techniques described to repair CSF rhinorrhea, with various studies demonstrating the advantages of using tissue glues in CSF leak repairs. We used DuraSeal in five patients to enhance graft strength and form a watertight seal. The system was effective in the majority of patients. Our study is the first to report on endoscopic endonasal repair of CSF leaks using DuraSeal.

Spontaneous cerebrospinal fluid leak from an anomalous thoracic nerve root: case report.

PubMed

Lopez, Alejandro J; Campbell, Robert K; Arnaout, Omar; Curran, Yvonne M; Shaibani, Ali; Dahdaleh, Nader S

2016-12-01

The authors report the case of a 28-year-old woman with a spontaneous cerebrospinal fluid leak from the sleeve of a redundant thoracic nerve root. She presented with postural headaches and orthostatic symptoms indicative of intracranial hypotension. CT myelography revealed that the lesion was located at the T-11 nerve root. After failure of conservative management, including blood patches and thrombin glue injections, the patient was successfully treated with surgical decompression and ligation of the duplicate nerve, resulting in full resolution of her orthostatic symptoms.

Postural headache in a child with Marfan syndrome: case report and review of the literature.

PubMed

Rosser, Tena; Finkel, Julie; Vezina, Gilbert; Majd, Massoud

2005-02-01

The case of a 10-year-old female with Marfan syndrome and postural headache secondary to spontaneous intracranial hypotension is described. The patient was found to have multiple dural ectasias and a cerebrospinal fluid leak at the left cervicothoracic junction. Her presentation, diagnostic work-up, and management are reviewed, and the relevant literature is discussed. Spontaneous intracranial hypotension secondary to cerebrospinal fluid leaks from dural ectasia should be recognized as a potential complication in children with Marfan syndrome and other connective tissue diseases.

Aerospace Payloads Leak Test Methodology

NASA Technical Reports Server (NTRS)

Lvovsky, Oleg; Grayson, Cynthia M.

2010-01-01

Pressurized and sealed aerospace payloads can leak on orbit. When dealing with toxic or hazardous materials, requirements for fluid and gas leakage rates have to be properly established, and most importantly, reliably verified using the best Nondestructive Test (NDT) method available. Such verification can be implemented through application of various leak test methods that will be the subject of this paper, with a purpose to show what approach to payload leakage rate requirement verification is taken by the National Aeronautics and Space Administration (NASA). The scope of this paper will be mostly a detailed description of 14 leak test methods recommended.

Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note.

PubMed

Felbaum, Daniel R; Mueller, Kyle; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

2016-12-28

 Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk.  A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months.  Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%).  Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.

VEGF-D promotes pulmonary oedema in hyperoxic acute lung injury.

PubMed

Sato, Teruhiko; Paquet-Fifield, Sophie; Harris, Nicole C; Roufail, Sally; Turner, Debra J; Yuan, Yinan; Zhang, You-Fang; Fox, Stephen B; Hibbs, Margaret L; Wilkinson-Berka, Jennifer L; Williams, Richard A; Stacker, Steven A; Sly, Peter D; Achen, Marc G

2016-06-01

Leakage of fluid from blood vessels, leading to oedema, is a key feature of many diseases including hyperoxic acute lung injury (HALI), which can occur when patients are ventilated with high concentrations of oxygen (hyperoxia). The molecular mechanisms driving vascular leak and oedema in HALI are poorly understood. VEGF-D is a protein that promotes blood vessel leak and oedema when overexpressed in tissues, but the role of endogenous VEGF-D in pathological oedema was unknown. To address these issues, we exposed Vegfd-deficient mice to hyperoxia. The resulting pulmonary oedema in Vegfd-deficient mice was substantially reduced compared to wild-type, as was the protein content of bronchoalveolar lavage fluid, consistent with reduced vascular leak. Vegf-d and its receptor Vegfr-3 were more highly expressed in lungs of hyperoxic, versus normoxic, wild-type mice, indicating that components of the Vegf-d signalling pathway are up-regulated in hyperoxia. Importantly, VEGF-D and its receptors were co-localized on blood vessels in clinical samples of human lungs exposed to hyperoxia; hence, VEGF-D may act directly on blood vessels to promote fluid leak. Our studies show that Vegf-d promotes oedema in response to hyperoxia in mice and support the hypothesis that VEGF-D signalling promotes vascular leak in human HALI. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland. © 2016 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.

Lumbar subarachnoid drainage in cerebrospinal fluid leaks after lateral skull base surgery.

PubMed

Allen, Kyle P; Isaacson, Brandon; Purcell, Patricia; Kutz, Joe Walter; Roland, Peter S

2011-12-01

To determine the efficacy of lumbar drainage in managing cerebrospinal fluid (CSF) leak after lateral skull base surgery. Retrospective case review. Academic tertiary referral center. Patients who had a lumbar subarachnoid drain placed after a lateral skull base procedure between July 1999 and February 2010 were included. Patients were identified by searching medical records for lateral skull base approach Current Procedural Terminology codes. The following variables were recorded for each subject: diagnosis, type of lateral skull base operation, duration of lumbar drainage, need for revision surgery, and presence of meningitis. Successful cessation of postoperative CSF leakage. Five hundred eight charts were reviewed, and 63 patients were identified who received a lumbar drain after a lateral skull base operation. The most common diagnosis was acoustic neuroma in 61.9%. The most common skull base approaches were the translabyrinthine, middle fossa, and transpetrosal approaches. Approximately 60.3% of patients had CSF rhinorrhea, 23.8% had an incisional leak, and 14.3% had otorrhea. The mean duration of lumbar drainage was 4.6 days. Forty eight (76.2%) study subjects had resolution of their CSF leak with lumbar drainage. Fifteen patients (23.8%) required revision surgery to stop the CSF leak. Lumbar drainage was successful in 90% of leaks after the translabyrinthine approach but in only 50% of those undergoing a suboccipital approach, which was a statistically significant difference. Postoperative CSF leaks after lateral skull base surgery can be managed with a lumbar subarachnoid drain in a majority of cases but is more successful after the translabyrinthine than the suboccipital approach. Recurrent CSF leaks after lumbar drainage is likely to require a revision operation.

Theoretical and experimental investigation into structural and fluid motions at low frequencies in water distribution pipes

NASA Astrophysics Data System (ADS)

Gao, Yan; Liu, Yuyou

2017-06-01

Vibrational energy is transmitted in buried fluid-filled pipes in a variety of wave types. Axisymmetric (n = 0) waves are of practical interest in the application of acoustic techniques for the detection of leaks in underground pipelines. At low frequencies n = 0 waves propagate longitudinally as fluid-dominated (s = 1) and shell-dominated (s = 2) waves. Whilst sensors such as hydrophones and accelerometers are commonly used to detect leaks in water distribution pipes, the mechanism governing the structural and fluid motions is not well documented. In this paper, the low-frequency behaviour of the pipe wall and the contained fluid is investigated. For most practical pipework systems, these two waves are strongly coupled; in this circumstance the ratios of the radial pipe wall displacements along with the internal pressures associated with these two wave types are obtained. Numerical examples show the relative insensitivity of the structural and fluid motions to the s = 2 wave for both metallic and plastic pipes buried in two typical soils. It is also demonstrated that although both acoustic and vibration sensors at the same location provide the identical phase information of the transmitted signals, pressure responses have significantly higher levels than acceleration responses, and thus hydrophones are better suited in a low signal-to-noise ratio (SNR) environment. This is supported by experimental work carried out at a leak detection facility. Additional pressure measurements involved excitation of the fluid and the pipe fitting (hydrant) on a dedicated water pipe. This work demonstrates that the s = 1 wave is mainly responsible for the structural and fluid motions at low frequencies in water distribution pipes as a result of water leakage and direct pipe excitation.

Collagen matrix as an inlay in endoscopic skull base reconstruction.

PubMed

Oakley, G M; Christensen, J M; Winder, M; Jonker, B P; Davidson, A; Steel, T; Teo, C; Harvey, R J

2018-03-01

Multi-layer reconstruction has become standard in endoscopic skull base surgery. The inlay component used can vary among autografts, allografts, xenografts and synthetics, primarily based on surgeon preference. The short- and long-term outcomes of collagen matrix in skull base reconstruction are described. A case series of patients who underwent endoscopic skull base reconstruction with collagen matrix inlay were assessed. Immediate peri-operative outcomes (cerebrospinal fluid leak, meningitis, ventriculitis, intracranial bleeding, epistaxis, seizures) and delayed complications (delayed healing, meningoencephalocele, prolapse of reconstruction, delayed cerebrospinal fluid leak, ascending meningitis) were examined. Of 120 patients (51.0 ± 17.5 years, 41.7 per cent female), peri-operative complications totalled 12.7 per cent (cerebrospinal fluid leak, 3.3 per cent; meningitis, 3.3 per cent; other intracranial infections, 2.5 per cent; intracranial bleeding, 1.7 per cent; epistaxis, 1.7 per cent; and seizures, 0 per cent). Delayed complications did not occur in any patients. Collagen matrix is an effective inlay material. It provides robust long-term separation between sinus and cranial cavities, and avoids donor site morbidity, but carries additional cost.

Method and apparatus for container leakage testing

DOEpatents

Kronberg, James W.

1995-01-01

An apparatus for use in one-hundred percent leak testing of food containers used in conjunction with a tracer gas. The apparatus includes a shell with entrance and exit air locks to create a controlled atmosphere through which a series of containers is conveyed by a conveyor belt. The pressure in the shell is kept lower than the pressure in the containers and the atmosphere is made to flow with the containers so that a tracer gas placed in the packages before sealing them will leak more readily, but the leaked tracer gas will remain associated with the leaking package as it moves through the shell. The leaks are detected with a sniffer probe in fluid communication with a gas chromatograph. The gas chromatograph issues a signal when it detects a leak to an ejector that will eject the leaking container from the conveyor. The system is timed so that the series of containers can move continuously into and out of the shell, past the probe and the ejector, without stopping, yet each package is tested for leaks and removed if leaking.

40 CFR 63.1331 - Equipment leak provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... in pumps and agitator seals in light liquid service shall not be considered to be a leak. For purposes of this subpart, a “bleed port” is a technologically-required feature of the pump or seal whereby polymer fluid used to provide lubrication and/or cooling of the pump or agitator shaft exits the pump...

Fault seal analysis of Okan and Meren fields, Nigeria

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

Eisenberg, R.A.; Brenneman, R.J.; Adeogba, A.A.

The sealing capacity and the dynamic seal behavior of faults between juxtaposed reservoirs were analyzed for Okan and Meren fields, offshore Nigeria. In both fields correlations were found between reservoir performance, juxtaposed fluid types, oil geochemistry, interpreted fluid contact relationships, fault sealing/leaking condition, and calculated smear gouge ratios. Integration of these data has been invaluable in quantifying fault seal risk and may effect depletion strategies for fault-juxtaposed reservoirs within these fields. Fault plane sections defined reservoir juxtapositions and aided visualization of potential cross-fault spill points. Smear gouge ratios calculated from E-logs were used to estimate the composition of fault-gouge materialsmore » between the juxtaposed reservoirs. These tools augmented interpretation of seal/nonseal character based on fluid contact relationships in proved reservoirs and, in addition, were used to quantify fault seal risk of untested fault-dependent closures in Okan. The results of these analyses were then used to interpret production-induced fault seal breakdown within the G-sands and also to risk seal integrity of fault dependent closures within the untested O-sands in an adjacent, upthrown fault block. Within this fault block the presence of potential fault intersection leak points and large areas of sand/sand juxtaposition with high smear gouge ratios (low sealing potential) limits potential reserves within the O-sand package. In Meren Field the E- and G-sands are juxtaposed, on different pressure decline, geochemically distinct, and are characterized by low smear gouge ratios. In contrast, specific G- and H-sands, juxtaposed across the same fault, contain similar OOWCs and are characterized by high smear gouge ratios. The cross-sealing and/or cross-leaking nature of compartment boundaries at Meren is related to fault displacement variation and the composition of displaced stratigraphy.« less

Assessments of fluid friction factors for use in leak rate calculations

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

Chivers, T.C.

1997-04-01

Leak before Break procedures require estimates of leakage, and these in turn need fluid friction to be assessed. In this paper available data on flow rates through idealized and real crack geometries are reviewed in terms of a single friction factor k It is shown that for {lambda} < 1 flow rates can be bounded using correlations in terms of surface R{sub a} values. For {lambda} > 1 the database is less precise, but {lambda} {approx} 4 is an upper bound, hence in this region flow calculations can be assessed using 1 < {lambda} < 4.

14 CFR 25.1183 - Flammable fluid-carrying components.

Code of Federal Regulations, 2012 CFR

2012-01-01

... safeguard against the ignition of leaking flammable fluid. An integral oil sump of less than 25-quart..., essential services or equipment. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-11, 32...

14 CFR 25.1183 - Flammable fluid-carrying components.

Code of Federal Regulations, 2011 CFR

2011-01-01

... safeguard against the ignition of leaking flammable fluid. An integral oil sump of less than 25-quart..., essential services or equipment. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-11, 32...

14 CFR 25.1183 - Flammable fluid-carrying components.

Code of Federal Regulations, 2010 CFR

2010-01-01

... safeguard against the ignition of leaking flammable fluid. An integral oil sump of less than 25-quart..., essential services or equipment. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-11, 32...

14 CFR 25.1183 - Flammable fluid-carrying components.

Code of Federal Regulations, 2013 CFR

2013-01-01

... safeguard against the ignition of leaking flammable fluid. An integral oil sump of less than 25-quart..., essential services or equipment. [Doc. No. 5066, 29 FR 18291, Dec. 24, 1964, as amended by Amdt. 25-11, 32...

Fluid sampling device

NASA Technical Reports Server (NTRS)

Studenick, D. K. (Inventor)

1977-01-01

An inlet leak is described for sampling gases, more specifically, for selectively sampling multiple fluids. This fluid sampling device includes a support frame. A plurality of fluid inlet devices extend through the support frame and each of the fluid inlet devices include a longitudinal aperture. An opening device that is responsive to a control signal selectively opens the aperture to allow fluid passage. A closing device that is responsive to another control signal selectively closes the aperture for terminating further fluid flow.

Group invariant solution for a pre-existing fracture driven by a power-law fluid in permeable rock

NASA Astrophysics Data System (ADS)

Fareo, A. G.; Mason, D. P.

2016-06-01

Group invariant analytical and numerical solutions for the evolution of a two-dimensional fracture with nonzero initial length in permeable rock and driven by an incompressible non-Newtonian fluid of power-law rheology are obtained. The effect of fluid leak-off on the evolution of the power-law fluid fracture is investigated.

Preservation of the Myofascial Cuff During Posterior Fossa Surgery to Reduce the Rate of Pseudomeningocele Formation and Cerebrospinal Fluid Leak: A Technical Note

PubMed Central

Felbaum, Daniel R; Anaizi, Amjad; Mason, Robert B; Jean, Walter C; Voyadzis, Jean M

2016-01-01

Introduction: Suboccipital craniotomy is a workhorse neurosurgical operation for approaching the posterior fossa but carries a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leak. We describe our experience with a simple T-shaped fascial opening that preserves the occipital myofascial cuff as compared to traditional methods to reduce this risk. Methods: A single institution, retrospective review of prospectively collected database was performed of patients that underwent a suboccipital craniectomy or craniotomy. Patient data was reviewed for craniotomy or craniectomy, dural graft, and/or sealant use as well as CSF complications. A pseudomeningocele was defined as a subcutaneous collection of cerebrospinal fluid palpable clinically and confirmed on imaging. A CSF leak was defined as a CSF-cutaneous fistula manifested by CSF leaking through the wound. All patients underwent regular postoperative visits of two weeks, one month, and three months. Results: Our retrospective review identified 33 patients matching the inclusion criteria. Overall, our cohort had a 21% (7/33) rate of clinical and radiographic pseudomeningocele formation with 9% (3/33) requiring surgical revision or a separate procedure. The rate of clinical and radiographic pseudomeningocele formation in the myofascial cuff preservation technique was less than standard techniques (12% and 31%, respectively). Revision or further surgical procedures were also reduced in the myofascial cuff preservation technique vs. the standard technique (6% vs 13%). Conclusions: Preservation of the myofascial cuff during posterior fossa surgery is a simple and adoptable technique that reduces the rate of pseudomeningocele formation and CSF leak as compared with standard techniques.   PMID:28133584

The utility of CT for predicting bile leaks in hepatic trauma.

PubMed

LeBedis, Christina A; Anderson, Stephan W; Mercier, Gustavo; Kussman, Steven; Coleman, Stephanie L; Golden, Louis; Penn, David R; Uyeda, Jennifer W; Soto, Jorge A

2015-04-01

The purpose of this study was to determine the efficacy of CT to predict the development of bile leaks in hepatic trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients who sustained hepatic trauma between January 1, 2006, and January 31, 2012, and who underwent CT and hepatobiliary scans during the same hospital admission were included. One hundred and thirty-two patients met the inclusion criteria. Comparison between the presence of biliary injury relative to American Association for the Surgery of Trauma (AAST) hepatic injury grade and mean distance of the hepatic laceration to the inferior vena cava (IVC) was made. The ability of free fluid to predict bile injury was analyzed. Forty-one (31 %) of the 132 patients had positive hepatobiliary scans. Of these 41 patients, seven (17 %) sustained low-grade and 34 (83 %) sustained high-grade hepatic injury compared with the 37 (41 %) low-grade and 54 (59 %) high-grade hepatic injuries in the negative hepatobiliary scan group. The mean distance to the IVC was 2.4 cm (SD 2.9 cm) and 3.6 cm (SD 3.3 cm) in patients with and without bile leaks, respectively. A statistically significant difference in the proportion of high-grade injuries and the mean distance from the IVC between the two groups was identified. The presence of free fluid on CT is sensitive, but not specific, for detecting a bile leak. CT findings, including AAST liver injury grade and location of the liver laceration, are able to predict which patients are at risk for developing bile leaks as seen on hepatobiliary scintigraphy, whereas the presence of free fluid is not.

40 CFR 63.1363 - Standards for equipment leaks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... mechanical seal system that includes a barrier fluid system and meets the requirements specified in... dual mechanical seal system is: (A) Operated with the barrier fluid at a pressure that is at all times... paragraph (a)(2) of this section. (5) Lines and equipment not containing process fluids are not subject to...

The analysis of the transient pressure response of the shuttle EPS-ECS cryogenic tanks with external pressurization systems

NASA Technical Reports Server (NTRS)

Barton, J. E.; Patterson, H. W.

1973-01-01

An analysis of transient pressures in externally pressurized cryogenic hydrogen and oxygen tanks was conducted and the effects of design variables on pressure response determined. The analysis was conducted with a computer program which solves the compressible viscous flow equations in two-dimensional regions representing the tank and external loop. The external loop volume, thermal mass, and heat leak were the dominant design variables affecting the system pressure response. No significant temperature stratification occurred in the fluid contained in the tank.

Leak rate of seals: Effective-medium theory and comparison with experiment.

PubMed

Lorenz, B; Persson, B N J

2010-02-01

Seals are extremely useful devices to prevent fluid leakage. We present an effective-medium theory of the leak rate of rubber seals, which is based on a recently developed contact mechanics theory. We compare the theory with experimental results for seals consisting of silicon rubber in contact with sandpaper and sand-blasted PMMA surfaces.

Cerebrospinal fluid leaks following spinal or posterior fossa surgery: use of fat grafts for prevention and repair.

PubMed

Black, P

2000-01-01

Cerebrospinal fluid (CSF) leaks are relatively common following spinal or posterior fossa surgery. A midline dural tear in the spine is readily repaired by direct application of a suture. However, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author reports his experience with using fat grafts for the prevention or repair of CSF leaks and proposes a technique in which a large sheet of fat, harvested from the patient's subcutaneous layer, is used to cover not only the dural tear(s) but all of the exposed dura and is tucked into the lateral recess. This procedure prevents CSF from seeping around the fat, which may be tacked to the dura with a few sutures. Fibrin glue is spread on the surface of the fat and is further covered with Surgicel or Gelfoam. For ventral dural tears (associated with procedures in which disc material is excised), fat is packed into the disc space to seal off the ventral dural leak. Leaks in the posterior fossa are managed similarly to those in the spine. Dural suture lines, following suboccipital or spinal intradural exploration, are prophylactically protected from CSF leakage in the same manner. With one exception, 27 dural tears noted during 1650 spinal procedures were successfully repaired using this technique. There was one case of postoperative CSF leakage in 150 cases in which intradural exploration for tumor or other lesions was undertaken. Both postoperative CSF leaks were controlled by applying additional skin sutures. The use of a fat graft is recommended as a rapid, effective means of prevention and repair of CSF leaks following posterior fossa and spinal surgery.

Technique for detecting liquid metal leaks

DOEpatents

Bauerle, James E.

1979-01-01

In a system employing flowing liquid metal as a heat transfer medium in contact with tubular members containing a working fluid, i.e., steam, liquid metal leaks through the wall of the tubular member are detected by dislodging the liquid metal compounds forming in the tubular member at the leak locations and subsequently transporting the dislodged compound in the form of an aerosol to a detector responsive to the liquid metal compound. In the application to a sodium cooled tubular member, the detector would consist of a sodium responsive device, such as a sodium ion detector.

Fiber optic distributed chemical sensor for the real time detection of hydrocarbon fuel leaks

NASA Astrophysics Data System (ADS)

Mendoza, Edgar; Kempen, C.; Esterkin, Yan; Sun, Sunjian

2015-09-01

With the increase worldwide demand for hydrocarbon fuels and the vast development of new fuel production and delivery infrastructure installations around the world, there is a growing need for reliable hydrocarbon fuel leak detection technologies to provide safety and reduce environmental risks. Hydrocarbon leaks (gas or liquid) pose an extreme danger and need to be detected very quickly to avoid potential disasters. Gas leaks have the greatest potential for causing damage due to the explosion risk from the dispersion of gas clouds. This paper describes progress towards the development of a fast response, high sensitivity, distributed fiber optic fuel leak detection (HySense™) system based on the use of an optical fiber that uses a hydrocarbon sensitive fluorescent coating to detect the presence of fuel leaks present in close proximity along the length of the sensor fiber. The HySense™ system operates in two modes, leak detection and leak localization, and will trigger an alarm within seconds of exposure contact. The fast and accurate response of the sensor provides reliable fluid leak detection for pipelines, storage tanks, airports, pumps, and valves to detect and minimize any potential catastrophic damage.

Intracochlear drug injections through the round window membrane: Measures to improve drug retention

PubMed Central

Plontke, Stefan K.; Hartsock, Jared J.; Gill, Ruth M.; Salt, Alec N.

2016-01-01

The goal of this study was to develop appropriate methodology to apply drugs quantitatively to perilymph of the ear. Intratympanic applications of drugs to the inner ear often result in variable drug levels in perilymph and can only be used for molecules that readily permeate the round window (RW) membrane. Direct intracochlear and intralabyrinthine application procedures for drugs, genes or cell-based therapies by-pass the tight boundaries at the round window, oval window, otic capsule and the blood-labyrinth barrier. However, perforations can release inner ear pressure, allowing cerebrospinal fluid to enter through the cochlear aqueduct, displacing the injected drug solution into the middle ear. Two markers, fluorescein or fluorescein isothiocyanate (FITC)-labeled dextran, were used to quantify how much of an injected substance was retained in cochlear perilymph following an intracochlear injection. We evaluated whether procedures to mitigate fluid leaks improved marker retention in perilymph. Almost all procedures to reduce volume efflux, including the use of gel for internal sealing and glue for external sealing of the injection site, resulted in improved retention of the marker in perilymph. Adhesive on the RW membrane effectively prevented leaks but also influenced fluid exchange between CSF and perilymph. We conclude that drugs can be delivered to the ear in a consistent, quantitative manner using intracochlear injections if care is taken to control the fluid leaks that result from cochlear perforation. PMID:26905306

40 CFR 63.1084 - What heat exchange systems are exempt from the requirements of this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... requires monitoring of a parameter or condition to detect a leak of process fluids to cooling water. (2... you to report and correct leaks to the cooling water when the parameter or condition exceeds the... the cooling water side at least 35 kilopascals greater than the maximum pressure on the process side...

Spinal cerebrospinal fluid leak as the cause of chronic subdural hematomas in nongeriatric patients.

PubMed

Beck, Jürgen; Gralla, Jan; Fung, Christian; Ulrich, Christian T; Schucht, Philippe; Fichtner, Jens; Andereggen, Lukas; Gosau, Martin; Hattingen, Elke; Gutbrod, Klemens; Z'Graggen, Werner J; Reinert, Michael; Hüsler, Jürg; Ozdoba, Christoph; Raabe, Andreas

2014-12-01

The etiology of chronic subdural hematoma (CSDH) in nongeriatric patients (≤ 60 years old) often remains unclear. The primary objective of this study was to identify spinal CSF leaks in young patients, after formulating the hypothesis that spinal CSF leaks are causally related to CSDH. All consecutive patients 60 years of age or younger who underwent operations for CSDH between September 2009 and April 2011 at Bern University Hospital were included in this prospective cohort study. The patient workup included an extended search for a spinal CSF leak using a systematic algorithm: MRI of the spinal axis with or without intrathecal contrast application, myelography/fluoroscopy, and postmyelography CT. Spinal pathologies were classified according to direct proof of CSF outflow from the intrathecal to the extrathecal space, presence of extrathecal fluid accumulation, presence of spinal meningeal cysts, or no pathological findings. The primary outcome was proof of a CSF leak. Twenty-seven patients, with a mean age of 49.6 ± 9.2 years, underwent operations for CSDH. Hematomas were unilateral in 20 patients and bilateral in 7 patients. In 7 (25.9%) of 27 patients, spinal CSF leakage was proven, in 9 patients (33.3%) spinal meningeal cysts in the cervicothoracic region were found, and 3 patients (11.1%) had spinal cysts in the sacral region. The remaining 8 patients (29.6%) showed no pathological findings. The direct proof of spinal CSF leakage in 25.9% of patients suggests that spinal CSF leaks may be a frequent cause of nongeriatric CSDH.

Cerebrospinal fluid leaks following spinal surgery: use of fat grafts for prevention and repair. Technical note.

PubMed

Black, Perry

2002-03-01

Cerebrospinal fluid (CSF) leaks are relatively common following spinal surgery. A midline dural tear in the spine is readily repaired by direct application of sutures; however, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author reports his experience with using fat grafts for the prevention or repair of CSF leaks and proposes a technique in which a large sheet of fat, harvested from the patient's subcutaneous layer, is used to cover not only the dural tear(s) but all of the exposed dura and is tucked into the lateral recess. This procedure prevents CSF from seeping around the fat, which may be tacked to the dura with a few sutures. Fibrin glue is spread on the surface of the fat and is further covered with Surgicel or Gelfoam. For ventral dural tears (associated with procedures in which disc material is excised), fat is packed into the disc space to seal off the ventral dural leak. Dural suture lines following spinal intradural exploration are prophylatically protected from CSF leakage in the same manner. With one exception, 27 dural tears noted during 1650 spinal procedures were successfully repaired using this technique. There was one case of postoperative CSF leakage in 140 cases in which intradural exploration for tumor or other lesions was undertaken. Both postoperative CSF leaks were controlled by applying additional skin sutures. The use of a fat graft is recommended as a rapid, effective means of prevention and repair of CSF leaks following spinal surgery.

Reliable Intraoperative Repair Nuances of Cerebrospinal Fluid Leak in Anterior Cervical Spine Surgery and Review of the Literature.

PubMed

Mitchell, Bartley D; Verla, Terence; Reddy, Duemani; Winnegan, Lona; Omeis, Ibrahim

2016-04-01

Cerebrospinal fluid (CSF) leak during anterior cervical spine surgery can lead to complications, including wound breakdown, meningitis, headaches, need for lumbar drain, or additional surgery. These leaks can be difficult to manage given the limited field of view and lack of deep access. Herein, we describe 8 consecutive patients who underwent intraoperative repair of CSF leak, with no postoperative evidence of wound dehiscence or drainage. A retrospective review was performed on 8 cases where CSF leak was encountered during an anterior cervical spine surgery. Patients had ossification of the posterior longitudinal ligament, intradural disk herniation, or dural ectasia. Intraoperative repair was as follows. First, CSF was drained to low pressure, and durotomy was covered by dural substitute and sealant agent. Then the interbody graft used was manually undersized in the anteroposterior dimension to allow for expansion of the agents used. Anterior instrumentation was then performed. Finally, a wound drain was anchored to a biologic bag for shoulder level passive drainage. In all 8 cases, there were no cases of wound dehiscence or CSF leak using this strategy. Likewise, there was no evidence of cord compression or neurologic deficits. No meningitis or persistent headaches were reported, and there was no need for lumbar drain placement at any time postoperatively. Once durotomy is encountered during anterior spine surgery, draining the CSF to a low pressure followed by dural substitute with a sealing agent, followed by a smaller anteroposterior size graft is an effective strategy of preventing complications in an inescapable problem. Copyright © 2016 Elsevier Inc. All rights reserved.

Intraoperative seizure and cerebrospinal fluid leak during adult cochlear implant surgery.

PubMed

Musser, Alexander B; Golub, Justin S; Samy, Ravi N; Phero, James C

2016-01-01

To report a rare case of cerebrospinal fluid gusher and subsequent seizure immediately after cochlear implant electrode insertion. After the cochlear implant electrode was inserted, brisk flow of 10 mL of cerebrospinal fluid was seen. The electrode was promptly inserted and the leak was additionally sealed with fascia. Seconds later, the patient had a tonic-clonic seizure lasting 30 seconds. Two additional episodes occurred during the case. Her postoperative course was uneventful with no subsequent seizures. The device has been successfully activated. Intervention & Technique: Postoperative imaging showed correct intracochlear placement of the electrode as well as an incidental enlarged vestibular aqueduct. Neurology consultation including electroencephalogram was unremarkable. To our knowledge, this is the first report of a seizure temporally associated with cochlear implant electrode insertion. The significance and possible casual relationship between these two events is discussed.

Water Pipeline Monitoring and Leak Detection using Flow Liquid Meter Sensor

NASA Astrophysics Data System (ADS)

Rahmat, R. F.; Satria, I. S.; Siregar, B.; Budiarto, R.

2017-04-01

Water distribution is generally installed through underground pipes. Monitoring the underground water pipelines is more difficult than monitoring the water pipelines located on the ground in open space. This situation will cause a permanent loss if there is a disturbance in the pipeline such as leakage. Leaks in pipes can be caused by several factors, such as the pipe’s age, improper installation, and natural disasters. Therefore, a solution is required to detect and to determine the location of the damage when there is a leak. The detection of the leak location will use fluid mechanics and kinematics physics based on harness water flow rate data obtained using flow liquid meter sensor and Arduino UNO as a microcontroller. The results show that the proposed method is able to work stably to determine the location of the leak which has a maximum distance of 2 metres, and it’s able to determine the leak location as close as possible with flow rate about 10 litters per minute.

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

1999-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flowrates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effects resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Analytical Assessment of a Gross Leakage Event Within the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS)

NASA Technical Reports Server (NTRS)

Holt, James M.; Clanton, Stephen E.

2001-01-01

Results of the International Space Station (ISS) Node 2 Internal Active Thermal Control System (IATCS) gross leakage analysis are presented for evaluating total leakage flow rates and volume discharge caused by a gross leakage event (i.e. open boundary condition). A Systems Improved Numerical Differencing Analyzer and Fluid Integrator (SINDA85/FLUINT) thermal hydraulic mathematical model (THMM) representing the Node 2 IATCS was developed to simulate system performance under steady-state nominal conditions as well as the transient flow effect resulting from an open line exposed to ambient. The objective of the analysis was to determine the adequacy of the leak detection software in limiting the quantity of fluid lost during a gross leakage event to within an acceptable level.

Modeling and measurement of the performance of a branched conduit sampling system in a mass spectrometer leak detector

NASA Technical Reports Server (NTRS)

Russell, John M.

1994-01-01

In the leak testing of a large engineering system, one may distinguish three stages, namely leakage measurement by an overall enclosure, leak location, and leakage measurement by a local enclosure. Sniffer probes attached to helium mass spectrometer leak detectors are normally designed for leak location, a qualitative inspection technique intended to pinpoint where a leak is but not to quantify its rate of discharge. The main conclusion of the present effort is that local leakage measurement by a leak detector with a sniffer probe is feasible provided one has: (1) quantitative data on the performance of the mass separator cell (a device interior to the unit where the stream of fluid in the sample line branches); and (2) a means of stabilizing the mass transfer boundary layer that is created near a local leak site when a sniffer probe is placed in its immediate vicinity. Theoretical models of the mass separator cell are provided and measurements of the machine-specific parameters in the formulas are presented. A theoretical model of a porous probe end for stabilizing the mass transfer boundary is also presented.

Modeling and measurement of the performance of a branched conduit sampling system in a mass spectrometer leak detector

NASA Astrophysics Data System (ADS)

Russell, John M.

1994-10-01

In the leak testing of a large engineering system, one may distinguish three stages, namely leakage measurement by an overall enclosure, leak location, and leakage measurement by a local enclosure. Sniffer probes attached to helium mass spectrometer leak detectors are normally designed for leak location, a qualitative inspection technique intended to pinpoint where a leak is but not to quantify its rate of discharge. The main conclusion of the present effort is that local leakage measurement by a leak detector with a sniffer probe is feasible provided one has: (1) quantitative data on the performance of the mass separator cell (a device interior to the unit where the stream of fluid in the sample line branches); and (2) a means of stabilizing the mass transfer boundary layer that is created near a local leak site when a sniffer probe is placed in its immediate vicinity. Theoretical models of the mass separator cell are provided and measurements of the machine-specific parameters in the formulas are presented. A theoretical model of a porous probe end for stabilizing the mass transfer boundary is also presented.

Interpretation of discrepancies in mass spectroscopy data obtained from different experimental configurations

NASA Technical Reports Server (NTRS)

Russell, John M.

1993-01-01

Many helium mass spectrometer leak detectors at KSC employ sampling systems that feature hand held sniffer probes. Authors of general leakage-testing literature recommend sniffer probes for leak location but not for quantitative leakage measurement. Their use in the latter application at KSC involves assumptions that may be subtle. The purpose of the research effort reported herein was to establish the significance of indicated leak rates displayed by sniffer-probe equipped leak detectors and to determine whether the use of alternative hardware or testing procedures may reduce the uncertainty of leakage measurements made with them. The report classifies probe-type sampling systems for helium leak detectors according to their internal plumbing (direct or branched), presents a basic analysis of the fluid dynamics in the sampling system in the branched-conduit case, describes the usual test method for measuring the internal supply-to-sample flowrate ratio (a.k.a permeation ratio), and describes a concept for a sponge-tipped probe whose external supply-to-sample flowrate ratio promises to be lower than that of a simple-ended probe. One conclusion is that the main source of uncertainty in the use of probe-type sampling systems for leakage measurement is uncertainty in the external supply-to-sample flowrate ratio. In contrast, the present method for measuring the internal supply-to-sample flowrate ratio is quantitative and satisfactory. The implication is that probes of lower external supply-to-sample flowrate ratio must be developed before this uncertainty may be reduced significantly.

Study to develop improved methods to detect leakage in fluid systems, phase 2

NASA Technical Reports Server (NTRS)

Janus, J. C.; Cimerman, I.

1971-01-01

An ultrasonic contact sensor engineering prototype leak detection system was developed and its capabilities under cryogenic operations demonstrated. The results from tests indicate that the transducer performed well on liquid hydrogen plumbing, that flow and valve actuation could be monitored, and that the phase change from gaseous to liquid hydrogen could be detected by the externally mounted transducers. Tests also demonstrate the ability of the system to detect internal leaks past valve seats and to function as a flow meter. Such a system demonstrates that it is not necessary to break into welded systems to locate internal leaks.

Endoscopic Removal of a Bullet in Rosenmuller Fossa: Case Report

PubMed Central

Burks, Joshua D.; Glenn, Chad A.; Conner, Andrew K.; Bonney, Phillip A.; Sanclement, Jose A.; Sughrue, Michael E.

2016-01-01

Fractures of the anterior skull base may occur in gunshot victims and can result in traumatic cerebrospinal fluid (CSF) leak. Less commonly, CSF leaks occur days or even weeks after the trauma occurred. Here, we present the case of a 21-year-old man with a delayed-onset, traumatic CSF leak secondary to a missile injury that left a bullet fragment in the Rosenmuller fossa. The patient was treated successfully with endoscopic, endonasal extraction of the bullet, and repair with a nasal septal flap. Foreign bodies lodged in Rosenmuller fossa can be successfully treated with endoscopic skull base surgery. PMID:27330924

Nonintrusive diagnosis of premature ruptured amniotic membranes using a novel polymer.

PubMed

Bornstein, Jacob; Geva, Adam; Solt, Ido; Fait, Vladimir; Schoenfeld, Alex; Shoham, Hadar Kessary; Sobel, Jack

2006-08-01

This article describes the evaluation of the diagnostic efficacy of AL-SENSE panty-liner in detecting premature rupture of membranes (PROM). One hundred and three women attending the labor and delivery ward were enrolled into three groups: women presenting with a vaginal leak of fluid who had not yet been examined; women with overt PROM, and women with no fluid leak. The result of the AL-SENSE strip test was compared with the clinical diagnosis, which was based on direct visualization of the posterior vaginal fornix and cervix, crystallization, and nitrazine tests. AL-SENSE panty-liner test had a sensitivity of 100% and a specificity of 75% in detecting PROM, with an overall agreement of 82.35% between the AL-SENSE test result and the clinical diagnosis. AL-SENSE may be used as a reliable test to rule out PROM and as an effective device to diagnose PROM and differentiate it from urine leak and vulvovaginal candidiasis.

Inverse Transient Analysis for Classification of Wall Thickness Variations in Pipelines

PubMed Central

Tuck, Jeffrey; Lee, Pedro

2013-01-01

Analysis of transient fluid pressure signals has been investigated as an alternative method of fault detection in pipeline systems and has shown promise in both laboratory and field trials. The advantage of the method is that it can potentially provide a fast and cost effective means of locating faults such as leaks, blockages and pipeline wall degradation within a pipeline while the system remains fully operational. The only requirement is that high speed pressure sensors are placed in contact with the fluid. Further development of the method requires detailed numerical models and enhanced understanding of transient flow within a pipeline where variations in pipeline condition and geometry occur. One such variation commonly encountered is the degradation or thinning of pipe walls, which can increase the susceptible of a pipeline to leak development. This paper aims to improve transient-based fault detection methods by investigating how changes in pipe wall thickness will affect the transient behaviour of a system; this is done through the analysis of laboratory experiments. The laboratory experiments are carried out on a stainless steel pipeline of constant outside diameter, into which a pipe section of variable wall thickness is inserted. In order to detect the location and severity of these changes in wall conditions within the laboratory system an inverse transient analysis procedure is employed which considers independent variations in wavespeed and diameter. Inverse transient analyses are carried out using a genetic algorithm optimisation routine to match the response from a one-dimensional method of characteristics transient model to the experimental time domain pressure responses. The accuracy of the detection technique is evaluated and benefits associated with various simplifying assumptions and simulation run times are investigated. It is found that for the case investigated, changes in the wavespeed and nominal diameter of the pipeline are both important to the accuracy of the inverse analysis procedure and can be used to differentiate the observed transient behaviour caused by changes in wall thickness from that caused by other known faults such as leaks. Further application of the method to real pipelines is discussed.

Joint properties of a tool machining process to guarantee fluid-proof abilities

NASA Astrophysics Data System (ADS)

Bataille, C.; Deltombe, R.; Jourani, A.; Bigerelle, M.

2017-12-01

This study addressed the impact of rod surface topography in contact with reciprocating seals. Rods were tooled with and without centreless grinding. All rods tooled with centreless grinding were fluid-proof, in contrast to rods tooled without centreless grinding that either had leaks or were fluid-proof. A method was developed to analyse the machining signature, and the software Mesrug™ was used in order to discriminate roughness parameters that can be used to characterize the sealing functionality. According to this surface roughness analysis, a fluid-proof rod tooled without centreless grinding presents aperiodic large plateaus, and the relevant roughness parameter for characterizing the sealing functionality is the density of summits S DS. Increasing the density of summits counteracts leakage, which may be because motif decomposition integrates three topographical components: circularity (perpendicular long-wave roughness), longitudinal waviness, and roughness thanks to the Wolf pruning algorithm. A 3D analytical contact model was applied to analyse the contact area of each type of sample with the seal surface. This model provides a leakage probability, and the results were consistent with the interpretation of the topographical analysis.

Effect of External Pressure Drop on Loop Heat Pipe Operating Temperature

NASA Technical Reports Server (NTRS)

Jentung, Ku; Ottenstein, Laura; Rogers, Paul; Cheung, Kwok; Obenschain, Arthur F. (Technical Monitor)

2002-01-01

This paper discusses the effect of the pressure drop on the operating temperature in a loop heat pipe (LHP). Because the evaporator and the compensation chamber (CC) both contain two-phase fluid, a thermodynamic constraint exists between the temperature difference and the pressure drop for these two components. As the pressure drop increases, so will the temperature difference. The temperature difference in turn causes an increase of the heat leak from the evaporator to the CC, resulting in a higher CC temperature. Furthermore, the heat leak strongly depends on the vapor void fraction inside the evaporator core. Tests were conducted by installing a valve on the vapor line so as to vary the pressure drop, and by charging the LHP with various amounts of fluid. Test results verify that the LHP operating temperature increases with an increasing differential pressure, and the temperature increase is a strong function of the fluid inventory in the loop.

Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear.

PubMed

Altuna, Xabier; Navarro, Juan José; García, Leire; Ugarte, Ane; Thomas, Izaskun

Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Headaches caused by decreased intracranial pressure: diagnosis and management.

PubMed

Mokri, Bahram

2003-06-01

More patients with spontaneous intracranial hypotension are now being diagnosed, and it is realized that most cases result from spontaneous cerebrospinal fluid leaks. A broader clinical and imaging spectrum of the disorder is recognized. This paper reviews new insights into the variability of clinical manifestations, imaging features, etiological factors, anatomy of leaks, and implications of these in patient management. Spontaneous intracranial hypotension should not be equated with post-lumbar puncture headaches. In a substantial minority of patients, headaches are not orthostatic and may mimic other types of headache. Additional diverse neurological manifestations may dominate the clinical picture and patients may occasionally have no headache at all. Reports on unusual presentations of the disorder continue to appear in the literature. Furthermore, additional imaging features of cerebrospinal fluid leaks are recognized. High-flow and slow-flow leaks may present diagnostic challenges, and require modification of diagnostic studies aimed at locating the site of the leak. Stigmata of connective tissue abnormality, especially abnormalities of fibrillin and elastin, are seen in a notable minority of patients, pointing to weakness of the dural sac as one of the etiological factors. After treatment of spontaneous intracranial hypotension, surgically or by epidural blood patch, a rebound and self-limiting intracranial hypertension may sometimes develop. In the past decade, interest in spontaneous intracranial hypotension has been rekindled, with a substantial growth of knowledge on various aspects of the disorder. We are in the learning phase, and new information will probably appear in the future, with notable diagnostic and therapeutic implications.

Treatment of Temporal Bone Fractures

PubMed Central

Diaz, Rodney C.; Cervenka, Brian; Brodie, Hilary A.

2016-01-01

Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted. PMID:27648399

Treatment of Temporal Bone Fractures.

PubMed

Diaz, Rodney C; Cervenka, Brian; Brodie, Hilary A

2016-10-01

Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted.

Dual diaphragm tank with telltale drain

NASA Technical Reports Server (NTRS)

Tuthill, Wallace C., Jr. (Inventor)

1991-01-01

A fluid storage and expulsion system comprising a tank with an internal flexible diaphragm assembly of dual diaphragms in back-to-back relationship, at least one of which is provided with a patterned surface having fine edges such that the diaphragms are in contact along said edges without mating contact of surface areas to thereby form fluid channels which extend outwardly to the peripheral edges of the diaphragms is described. The interior wall of the tank at the juncture of tank sections is formed with a circumferential annular recess comprising an outer annular recess portion which forms a fluid collection chamber and an inner annular recess portion which accommodates the peripheral edge portions of the diaphragms and a sealing ring in clamped sealing relation therebetween. The sealing ring is perforated with radially extending passages which allow any fluid leaking or diffusing past a diaphragm to flow through the fluid channels between the diaphragms to the fluid collection chamber. Ports connectable to pressure fittings are provided in the tank sections for admission of fluids to opposite sides of the diaphragm assembly. A drain passage through the tank wall to the fluid collection chamber permits detection, analysis and removal of fluids in the collection chamber.

Hydrogel sealant versus sutures to prevent fluid egress after cataract surgery.

PubMed

Masket, Samuel; Hovanesian, John A; Levenson, Jeffrey; Tyson, Farrell; Flynn, William; Endl, Michael; Majmudar, Parag A; Modi, Satish; Chu, Ralph; Raizman, Michael B; Lane, Stephen S; Kim, Terry

2014-12-01

To evaluate the effectiveness of a hydrogel sealant versus a suture in preventing fluid egress after wound leakage in cataract surgery. Twenty-four ophthalmic clinical practices in the United States. Prospective randomized parallel-arm controlled multicenter subject-masked study. Healthy patients having uneventful clear corneal incision (CCI) cataract surgery were eligible for the study. Spontaneous and provoked fluid egress from wounds was evaluated at the time of surgery using a calibrated force gauge. Eyes with leakage were randomized to receive a hydrogel sealant (Resure) or a nylon suture at the main incision site. Incision leakage was reevaluated 1, 3, 7, and 28 days postoperatively. Of 500 eyes, 488 had leakage at the time of cataract surgery. The leak was spontaneous in 244 cases (48.8%), and 488 (97.6%) of all incisions leaked with 1.0 ounce or less of applied force. After randomization, 12 (4.1%) of 295 eyes in the sealant group and 60 (34.1%) of 176 eyes in the suture group had wound leakage with provocation (P<.0001). The overall incidence of adverse ocular events was statistically significantly lower in the sealant group than in the suture group (P<.05). In this study, 97.6% of CCIs leaked after cataract surgery. The hydrogel sealant was safe and effective and better than a suture for the intraoperative management of CCIs with leakage as seen on Seidel testing and for the prevention of postoperative fluid egress. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Reconstruction after retrosigmoid approaches using autologous fat graft-assisted Medpor Titan cranioplasty: assessment of postoperative cerebrospinal fluid leaks and headaches in 60 cases.

PubMed

Ling, Phoebe Y; Mendelson, Zachary S; Reddy, Rohit K; Jyung, Robert W; Liu, James K

2014-10-01

Postoperative cerebrospinal fluid (CSF) leaks and headaches remain potential complications after retrosigmoid approaches for lesions in the posterior fossa and cerebellopontine angle. The authors describe a simple repair technique with an autologous fat graft-assisted Medpor Titan cranioplasty and investigate the incidence of postoperative CSF leaks and headaches using this technique. A retrospective chart review was conducted on all cases (n = 60) of retrosigmoid craniectomy from September 2009 to May 2014 in patients who underwent fat graft-assisted cranioplasty. After obtaining a watertight dural closure and sealing off any visible mastoid air cells with bone wax, an autologous fat graft was placed over the dural suture line and up against the waxed-off air cells. The fat graft filled the retrosigmoid cranial defect and was then bolstered with a Medpor Titan (titanium mesh embedded in porous polyethylene) cranioplasty. A postoperative mastoid pressure dressing was applied for 48 h, and prophylactic lumbar drainage was not used. Factors examined in this study included postoperative CSF leak (incisional, rhinorrhea, otorrhea), pseudomeningocele formation, incidence and severity of postoperative headache, length of hospital stay, and length of follow-up. No patients developed postoperative CSF leaks (0 %), pseudomeningoceles (0 %), or new-onset postoperative headaches (0 %) with the described repair technique. There were no cases of graft site morbidity such as hematoma or wound infection. Mean duration of postoperative hospital stay was 3.8 days (range 2-10 days). Mean postoperative follow-up was 12.4 months (range 2.0-41.1 months). Our multilayer repair technique with a fat graft-assisted Medpor Titan cranioplasty appears effective in preventing postoperative CSF leaks and new-onset postoperative headaches after retrosigmoid approaches. Postoperative lumbar drainage may not be necessary.

77 FR 42454 - Airworthiness Directives; Piaggio Aero Industries S.p.A.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

... the brake hydraulic fluid from leaking because of the brake assembly rods contacting the brake valve... session during which conflicting inputs were given to the brake pads between pilot and copilot, a brake... tubings connected to the brake valves, with consequent fluid leakage. Prompted by these findings, PAI...

Zero-leak valve

NASA Technical Reports Server (NTRS)

Macglashan, W. F., Jr.

1980-01-01

Zero-leakage valve has fluid-sealing diaphragm support and flat sievelike sealing surface. Diaphragm-support valve is easy to fabricate and requires minimum maintenance. Potential applications include isolation valve for waste systems and remote air-actuated valve. Device is also useful in controlling flow of liquid fluorine and corrosive fluids at high pressures.

Sensitivity and specificity of intrathecal fluorescein and white light excitation for detecting intraoperative cerebrospinal fluid leak in endoscopic skull base surgery: a prospective study.

PubMed

Raza, Shaan M; Banu, Matei A; Donaldson, Angela; Patel, Kunal S; Anand, Vijay K; Schwartz, Theodore H

2016-03-01

The intraoperative detection of CSF leaks during endonasal endoscopic skull base surgery is critical to preventing postoperative CSF leaks. Intrathecal fluorescein (ITF) has been used at varying doses to aid in the detection of intraoperative CSF leaks. However, the sensitivity and specificity of ITF at certain dosages is unknown. A prospective database of all endoscopic endonasal procedures was reviewed. All patients received 25 mg ITF diluted in 10 ml CSF and were pretreated with dexamethasone and Benadryl. Immediately after surgery, the operating surgeon prospectively noted if there was an intraoperative CSF leak and fluorescein was identified. The sensitivity, specificity, and positive and negative predictive power of ITF for detecting intraoperative CSF leak were calculated. Factors correlating with postoperative CSF leak were determined. Of 419 patients, 35.8% of patients did not show a CSF leak. Fluorescein-tinted CSF (true positive) was noted in 59.7% of patients and 0 false positives were encountered. CSF without fluorescein staining (false negative) was noted in 4.5% of patients. The sensitivity and specificity of ITF were 92.9% and 100%, respectively. The negative and positive predictive values were 88.8% and 100%, respectively. Postoperative CSF leaks only occurred in true positives at a rate of 2.8%. ITF is extremely specific and very sensitive for detecting intraoperative CSF leaks. Although false negatives can occur, these patients do not appear to be at risk for postoperative CSF leak. The use of ITF may help surgeons prevent postoperative CSF leaks by intraoperatively detecting and confirming a watertight repair.

Recognition and management of idiopathic systemic capillary leak syndrome: an evidence-based review.

PubMed

Baloch, Noor Ul-Ain; Bikak, Marvi; Rehman, Abdul; Rahman, Omar

2018-05-01

Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.

White gauze test: a novel technique in preventing post-hepatectomy bile leak.

PubMed

Yugasaravanan, K; Affirul, C A; Zamri, Z; Azlanudin, A; Bong, J J

Post-hepatectomy bile leak may lead to undesired morbidity. Multiple methods have been employed to identify this leak but can be inconclusive and taxing. This novel white gauze test is a simple and reliable method. This is a prospective study performed from January 2010 until March 2011. All open hepatic resection were included. Dry white gauze is compressed onto the transected surface and observed for bile staining. The leaking duct is repaired immediately upon detection. The process is repeated until negative. Drain was removed on postoperative day-5. Post-operative bile leak is defined as: 1. Bilirubin concentration of the drain fluid is 3 times or higher than serum; 2. Presence of intra-abdominal bile collection on imaging and upon drainage; 3. Bile leak demonstrated on postoperative cholangiography. 42 patients were recruited. Seven (16.7%) patients were cirrhotic with Child-Pugh A. White gauze test were positive for intra-operative bile leaks in 29 patients (70%), which were primarily repaired. As a result, there was no postoperative bile leak in this series. One mortality was detected in this series due to postoperative pancreatic fistula and multi organ failure. The White Gauze Test is a useful method for the prevention of bile leakage after hepatic resection. It is safe, quick and cheap.

14 CFR 33.91 - Engine system and component tests.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., reliability, and durability. (c) Each unpressurized hydraulic fluid tank may not fail or leak when subjected to a maximum operating temperature and an internal pressure of 5 p.s.i., and each pressurized hydraulic fluid tank must meet the requirements of § 33.64. (d) For an engine type certificated for use in...

Spontaneous CSF-leaks and meningoencephaloceles in sphenoid sinus by persisting Sternberg's canal.

PubMed

Tomazic, Peter Valentin; Stammberger, Heinz

2009-12-01

Cerebrospinal fluid (CSF) leaks and meningoencephaloceles of the lateral recess of sphenoid sinuses are rare findings. A congenital bony defect in the lateral wall of sphenoid sinus called Sternberg's canal could be the origin of these lesions. Their endoscopic transnasal management is challenging though less traumatic than transcranial approaches. The aim of this study was to define Sternberg's canal as a potential source for these rare lesions and to describe their endoscopic endonasal management. In a retrospective analysis clinical charts of 27 patients with CSF-leaks and / or meningoencephaloceles operated between March 2002 and October 2008 at the University ENT-hospital Graz have been reviewed. All patients were treated by an endoscopic endonasal approach. Five patients (4 female / 1 male) were identified with spontaneous CSF-leaks from sphenoid sinus and meningoencephaloceles. In all five cases, Sternberg's canal was the site of leakage, with the bony and dural defects always located laterally between the maxillary and Vidian nerves. Mean age was 51.2 years and mean body mass index (BMI) was 31.9 kg/m2. All patients were operated using a multilayer closure technique. Two patients had recurrences after 12 days and 7 months, respectively, managed by endoscopic revision surgery resulting in a 100% closure rate after one revision (mean follow-up: 6.5 months). Persisting Sternberg's canal can be the source of spontaneous CSF-leaks and meningoencephaloceles in the lateral recess of sphenoid sinus especially when associated with extensive pneumatisation. Endoscopic management is technically challenging, nevertheless its advantages are a good view of the surgical field while being less traumatic than transcranial approaches.

Ultrafast dynamic computed tomography myelography for the precise identification of high-flow cerebrospinal fluid leaks caused by spiculated spinal osteophytes.

PubMed

Thielen, Kent R; Sillery, John C; Morris, Jonathan M; Hoxworth, Joseph M; Diehn, Felix E; Wald, John T; Rosebrock, Richard E; Yu, Lifeng; Luetmer, Patrick H

2015-03-01

Precise localization and understanding of the origin of spontaneous high-flow spinal CSF leaks is required prior to targeted treatment. This study demonstrates the utility of ultrafast dynamic CT myelography for the precise localization of high-flow CSF leaks caused by spiculated spinal osteophytes. This study reports a series of 14 patients with high-flow CSF leaks caused by spiculated spinal osteophytes who underwent ultrafast dynamic CT myelography between March 2009 and December 2010. There were 10 male and 4 female patients, with an average age of 49 years (range 37-74 years). The value of ultrafast dynamic CT myelography in depicting the CSF leak site was qualitatively assessed. In all 14 patients, ultrafast dynamic CT myelography was technically successful at precisely demonstrating the site of the CSF leak, the causative spiculated osteophyte piercing the dura, and the relationship of the implicated osteophyte to adjacent structures. Leak sites included 3 cervical, 11 thoracic, and 0 lumbar levels, with 86% of the leaks occurring from C-5 to T-7. Information obtained from the ultrafast dynamic CT myelogram was considered useful in all treated CSF leaks. Spinal osteophytes piercing the dura are a more frequent cause of high-flow CSF leaks than previously recognized. Ultrafast dynamic CT myelography adds value beyond standard dynamic myelography or digital subtraction myelography in the diagnosis and anatomical characterization of high-flow spinal CSF leaks caused by these osteophytes. This information allows for appropriate planning for percutaneous or surgical treatment.

Real-time electronic monitoring of a pitted and leaking gas gathering pipeline

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

Asperger, R.G.; Hewitt, P.G.

1986-08-01

Hydrogen patch, flush electrical resistance, and flush linear polarization proves wre used with flush coupons to monitor corrosion rates in a pitted and leaking sour gas gathering line. Four inhibitors were evaluated in stopping the leaks. Inhibitor residuals and the amount and ratio of water and condensate in the lines were measured at five locations along the line. The best inhibitor reduced reduced the pit-leak frequency by over a factor of 10. Inhibitor usage rate was optimized using the hydrogen patch current as a measure of the instantaneous corrosion rate. Improper pigging was identified as a cause of corrosion transients.more » This problem is discussed in relation to the pigging of pipelines in stratified flow where moving fluids are the carriers for continuously injected corrosion inhibitors.« less

Modeling the GPR response of leaking, buried pipes

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

Powers, M.H.; Olhoeft, G.R.

1996-11-01

Using a 2.5D, dispersive, full waveform GPR modeling program that generates complete GPR response profiles in minutes on a Pentium PC, the effects of leaking versus non-leaking buried pipes are examined. The program accounts for the dispersive, lossy nature of subsurface materials to GPR wave propagation, and accepts complex functions of dielectric permittivity and magnetic permeability versus frequency through Cole-Cole parameters fit to laboratory data. Steel and plastic pipes containing a DNAPL chlorinated solvent, an LNAPL hydrocarbon, and natural gas are modeled in a surrounding medium of wet, moist, and dry sand. Leaking fluids are found to be more detectablemore » when the sand around the pipes is fully water saturated. The short runtimes of the modeling program and its execution on a PC make it a useful tool for exploring various subsurface models.« less

A Hydrazine Leak Sensor Based on Chemically Reactive Thermistors

NASA Technical Reports Server (NTRS)

Davis, Dennis D.; Mast, Dion J.; Baker, David L.

1999-01-01

Leaks in the hydrazine supply system of the Shuttle APU can result in hydrazine ignition and fire in the aft compartment of the Shuttle. Indication of the location of a leak could provide valuable information required for operational decisions. WSTF has developed a small, single use sensor for detection of hydrazine leaks. The sensor is composed of a thermistor bead coated with copper(II) oxide (CuO) dispersed in a clay or alumina binder. The CuO-coated thermistor is one of a pair of closely located thermistors, the other being a reference. On exposure to hydrazine the CuO reacts exothermically with the hydrazine and increases the temperature of the coated-thermistor by several degrees. The temperature rise is sensed by a resistive bridge circuit and an alarm registered by data acquisition software. Responses of this sensor to humidity changes, hydrazine concentration, binder characteristics, distance from a liquid leak, and ambient pressure levels as well as application of this sensor concept to other fluids are presented.

Spinal Cord Herniation After Cervical Corpectomy with Cerebrospinal Fluid Leak: Case Report and Review of the Literature.

PubMed

Guppy, Kern H; Silverthorn, James W

2017-04-01

Spinal cord herniation (SCH) is rare, is mostly idiopathic, and occurs predominantly in the thoracic spine. SCH is less common in the cervical spine and has been reported after posterior cervical spine surgery associated with the development of pseudomeningoceles. Two cases of SCH have been reported after anterior cervical corpectomies for ossified posterior longitudinal ligament with cerebrospinal fluid (CSF) leaks. We report the third such case, but the first in a patient without ossified posterior longitudinal ligament (degenerative disc disease and pseudarthrosis). A 56-year-old woman presented with bilateral arm pain and weakness. She had undergone 3 previous anterior cervical spine surgeries at an outside medical center with the most recent 7 years ago with C5 and C6 corpectomies and fusion with a persistent CSF leak. Magnetic resonance imaging and computed tomography myelography showed spinal cord herniation through the mesh cage at C6. The patient underwent a redo C5 and C6 corpectomy with untethering of the spinal cord. The patient was asymptomatic 2 years later. This is the first reported case of anterior cervical SCH in a patient without ossified posterior longitudinal ligament after multiple anterior cervical fusions including a cervical corpectomy for pseudarthrosis with a CSF leak. We hypothesize that persistent CSF leak causes a pressure gradient across the dura mater through the cage to the lower pressure in the retropharyngeal space, which led to herniation of the spinal cord into the anterior cage. We review the literature and discuss the treatment choices for anterior cervical SCH. Copyright © 2017 Elsevier Inc. All rights reserved.

CT-Guided Percutaneous Drainage of Infected Collections Due to Gastric Leak After Sleeve Gastrectomy for Morbid Obesity: Initial Experience

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

Kelogrigoris, M., E-mail: kelogre.mic@hotmail.com; Sotiropoulou, E.; Stathopoulos, K.

This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26-52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkagemore » of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.« less

40 CFR 60.482-2 - Standards: Pumps in light liquid service.

Code of Federal Regulations, 2011 CFR

2011-07-01

...; or (ii) Equipped with a barrier fluid degassing reservoir that is routed to a process or fuel gas... in VOC service. (3) Each barrier fluid system is equipped with a sensor that will detect failure of...) Designate the visual indications of liquids dripping as a leak. (5)(i) Each sensor as described in paragraph...

40 CFR 60.482-2 - Standards: Pumps in light liquid service.

Code of Federal Regulations, 2010 CFR

2010-07-01

...; or (ii) Equipped with a barrier fluid degassing reservoir that is routed to a process or fuel gas... in VOC service. (3) Each barrier fluid system is equipped with a sensor that will detect failure of...) Designate the visual indications of liquids dripping as a leak. (5)(i) Each sensor as described in paragraph...

40 CFR 63.163 - Standards: Pumps in light liquid service.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Equipped with a barrier fluid degassing reservoir that is routed to a process or fuel gas system or... with a sensor that will detect failure of the seal system, the barrier fluid system, or both. (4) Each... per million or greater is measured, a leak is detected. (5) Each sensor as described in paragraph (e...

METHOD AND APPARATUS FOR THE DETECTION OF LEAKS IN PIPE LINES

DOEpatents

Jefferson, S.; Cameron, J.F.

1961-11-28

A method is described for detecting leaks in pipe lines carrying fluid. The steps include the following: injecting a radioactive solution into a fluid flowing in the line; flushing the line clear of the radioactive solution; introducing a detector-recorder unit, comprising a radioactivity radiation detector and a recorder which records the detector signal over a time period at a substantially constant speed, into the line in association with a go-devil capable of propelling the detector-recorder unit through the line in the direction of the fluid flow at a substantia1ly constant velocity; placing a series of sources of radioactivity at predetermined distances along the downstream part of the line to make a characteristic signal on the recorder record at intervals corresponding to the location of said sources; recovering the detector-recorder unit at a downstream point along the line; transcribing the recorder record of any radioactivity detected during the travel of the detector- recorder unit in terms of distance along the line. (AEC)

Fuel leak detection apparatus for gas cooled nuclear reactors

DOEpatents

Burnette, Richard D.

1977-01-01

Apparatus is disclosed for detecting nuclear fuel leaks within nuclear power system reactors, such as high temperature gas cooled reactors. The apparatus includes a probe assembly that is inserted into the high temperature reactor coolant gaseous stream. The probe has an aperture adapted to communicate gaseous fluid between its inside and outside surfaces and also contains an inner tube for sampling gaseous fluid present near the aperture. A high pressure supply of noncontaminated gas is provided to selectively balance the pressure of the stream being sampled to prevent gas from entering the probe through the aperture. The apparatus includes valves that are operable to cause various directional flows and pressures, which valves are located outside of the reactor walls to permit maintenance work and the like to be performed without shutting down the reactor.

Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak, and fluid balance

PubMed Central

2012-01-01

Introduction Capillary leak in critically ill patients leads to interstitial edema. Fluid overload is independently associated with poor prognosis. Bedside measurement of intra-abdominal pressure (IAP), extravascular lung water index (EVLWI), fluid balance, and capillary leak index (CLI) may provide a valuable prognostic tool in mechanically ventilated patients. Methods We performed an observational study of 123 mechanically ventilated patients with extended hemodynamic monitoring, analyzing process-of-care variables for the first week of ICU admission. The primary outcome parameter was 28-day mortality. ΔmaxEVLWI indicated the maximum difference between EVLWI measurements during ICU stay. Patients with a ΔmaxEVLWI <−2 mL/kg were called 'responders'. CLI was defined as C-reactive protein (milligrams per deciliter) over albumin (grams per liter) ratio and conservative late fluid management (CLFM) as even-to-negative fluid balance on at least two consecutive days. Results CLI had a biphasic course. ΔmaxEVLWI was lower if CLFM was achieved and in survivors (−2.4 ± 4.8 vs 1.0 ± 5.5 mL/kg, p = 0.001; −3.3 ± 3.8 vs 2.5 ± 5.3 mL/kg, p = 0.001, respectively). No CLFM achievement was associated with increased CLI and IAPmean on day 3 and higher risk to be nonresponder (odds ratio (OR) 2.76, p = 0.046; OR 1.28, p = 0.011; OR 5.52, p = 0.001, respectively). Responders had more ventilator-free days during the first week (2.5 ± 2.3 vs 1.5 ± 2.3, p = 0.023). Not achieving CLFM and being nonresponder were strong independent predictors of mortality (OR 9.34, p = 0.001 and OR 7.14, p = 0.001, respectively). Conclusion There seems to be an important correlation between CLI, EVLWI kinetics, IAP, and fluid balance in mechanically ventilated patients, associated with organ dysfunction and poor prognosis. In this context, we introduce the global increased permeability syndrome. PMID:22873410

Comparative evaluation of three shaft seals proposed for high performance turbomachinery

NASA Technical Reports Server (NTRS)

Hendricks, R. C.

1982-01-01

Experimental pressure profiles and leak rate characteristics for three shaft seal prototype model configurations proposed for the space shuttle turbopump were assessed in the concentric and fully eccentric, to point of rub, positions without the effects of rotation. The parallel-cylindrical configuration has moderate to good stiffness with a higher leak rate. It represents a simple concept, but for practical reasons and possible increases in stability, all such seals should be conical-convergent. The three-stepdown-sequential, parallel-cylindrical seal is converging and represents good to possible high stiffness when fluid separation occurs, with a significant decrease in leak rate. Such seals can be very effective. The three-stepdown-sequential labyrinth seal of 33-teeth (i.e., 12-11-10 teeth from inlet to exit) provides excellent leak control but usually has very poor stiffness, depending on cavity design. The seal is complex and not recommended for dynamic control.

Chest tube insertion

MedlinePlus

... leaks from inside the lung into the chest ( pneumothorax ) Fluid buildup in the chest (called a pleural ... on the reason a chest tube is inserted. Pneumothorax most often improves, but sometimes surgery is needed ...

Coconut Model for Learning First Steps of Craniotomy Techniques and Cerebrospinal Fluid Leak Avoidance.

PubMed

Drummond-Braga, Bernardo; Peleja, Sebastião Berquó; Macedo, Guaracy; Drummond, Carlos Roberto S A; Costa, Pollyana H V; Garcia-Zapata, Marco T; Oliveira, Marcelo Magaldi

2016-12-01

Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid leak avoidance practice using a coconut is described. The coconut is a drupe from Cocos nucifera L. (coconut tree). The green coconut has 4 layers, and some similarity can be seen between these layers and the human skull. The materials used in the simulation are the same as those used in the operating room. The coconut is placed on the head holder support with the face up. The burr holes are made until endocarp is reached. The mesocarp is dissected, and the conductor is passed from one hole to the other with the Gigli saw. The hook handle for the wire saw is positioned, and the mesocarp and endocarp are cut. After sawing the 4 margins, mesocarp is detached from endocarp. Four burr holes are made from endocarp to endosperm. Careful dissection of the endosperm is done, avoiding liquid albumen leak. The Gigli saw is passed through the trephine holes. Hooks are placed, and the endocarp is cut. After cutting the 4 margins, it is dissected from the endosperm and removed. The main goal of the procedure is to remove the endocarp without fluid leakage. The coconut model for learning the first steps of craniotomy and cerebrospinal fluid leak avoidance has some limitations. It is more realistic while trying to remove the endocarp without damage to the endosperm. It is also cheap and can be widely used in low-income countries. However, the coconut does not have anatomic landmarks. The mesocarp makes the model less realistic because it has fibers that make the procedure more difficult and different from a real craniotomy. The model has a potential pedagogic neurosurgical application for freshman residents before they perform a real craniotomy for the first time. Further validity is necessary to confirm this hypothesis. Copyright © 2016 Elsevier Inc. All rights reserved.

Cryogenic Feedthrough Test Rig

NASA Technical Reports Server (NTRS)

Skaff, Antony

2009-01-01

The cryogenic feedthrough test rig (CFTR) allows testing of instrumentation feedthroughs at liquid oxygen and liquid hydrogen temperature and pressure extremes (dangerous process fluid) without actually exposing the feedthrough to a combustible or explosive process fluid. In addition, the helium used (inert gas), with cryogenic heat exchangers, exposes the feedthrough to that environment that allows definitive leak rates of feedthrough by typical industry-standard helium mass spectrometers.

40 CFR 60.105a - Monitoring of emissions and operations for fluid catalytic cracking units (FCCU) and fluid coking...

Code of Federal Regulations, 2012 CFR

2012-07-01

... for air leaks, torn or broken bags or filter media, or any other condition that may cause an increase... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF... nozzles must conduct a daily check of the air or water pressure to the spray nozzles and record the...

An approximate solution for a penny-shaped hydraulic fracture that accounts for fracture toughness, fluid viscosity and leak-off.

PubMed

Dontsov, E V

2016-12-01

This paper develops a closed-form approximate solution for a penny-shaped hydraulic fracture whose behaviour is determined by an interplay of three competing physical processes that are associated with fluid viscosity, fracture toughness and fluid leak-off. The primary assumption that permits one to construct the solution is that the fracture behaviour is mainly determined by the three-process multiscale tip asymptotics and the global fluid volume balance. First, the developed approximation is compared with the existing solutions for all limiting regimes of propagation. Then, a solution map, which indicates applicability regions of the limiting solutions, is constructed. It is also shown that the constructed approximation accurately captures the scaling that is associated with the transition from any one limiting solution to another. The developed approximation is tested against a reference numerical solution, showing that accuracy of the fracture width and radius predictions lie within a fraction of a per cent for a wide range of parameters. As a result, the constructed approximation provides a rapid solution for a penny-shaped hydraulic fracture, which can be used for quick fracture design calculations or as a reference solution to evaluate accuracy of various hydraulic fracture simulators.

An approximate solution for a penny-shaped hydraulic fracture that accounts for fracture toughness, fluid viscosity and leak-off

NASA Astrophysics Data System (ADS)

Dontsov, E. V.

2016-12-01

This paper develops a closed-form approximate solution for a penny-shaped hydraulic fracture whose behaviour is determined by an interplay of three competing physical processes that are associated with fluid viscosity, fracture toughness and fluid leak-off. The primary assumption that permits one to construct the solution is that the fracture behaviour is mainly determined by the three-process multiscale tip asymptotics and the global fluid volume balance. First, the developed approximation is compared with the existing solutions for all limiting regimes of propagation. Then, a solution map, which indicates applicability regions of the limiting solutions, is constructed. It is also shown that the constructed approximation accurately captures the scaling that is associated with the transition from any one limiting solution to another. The developed approximation is tested against a reference numerical solution, showing that accuracy of the fracture width and radius predictions lie within a fraction of a per cent for a wide range of parameters. As a result, the constructed approximation provides a rapid solution for a penny-shaped hydraulic fracture, which can be used for quick fracture design calculations or as a reference solution to evaluate accuracy of various hydraulic fracture simulators.

Fully Coupled 3D Finite Element Model of Hydraulic Fracturing in a Permeable Rock Formation

NASA Astrophysics Data System (ADS)

Salimzadeh, S.; Paluszny, A.; Zimmerman, R. W.

2015-12-01

Hydraulic fracturing in permeable rock formations is a complex three-dimensional multi-physics phenomenon. Numerous analytical models of hydraulic fracturing processes have been proposed that typically simplify the physical processes, or somehow reduce the problem from three dimensions to two dimensions. Moreover, although such simplified models are able to model the growth of a single hydraulic fracture into an initially intact, homogeneous rock mass, they are generally not able to model fracturing of heterogeneous rock formations, or to account for interactions between multiple induced fractures, or between an induced fracture and pre-existing natural fractures. We have developed a numerical finite-element model for hydraulic fracturing that does not suffer from any of the limitations mentioned above. The model accounts for fluid flow within a fracture, the propagation of the fracture, and the leak-off of fluid from the fracture into the host rock. Fluid flow through the permeable rock matrix is modelled using Darcy's law, and is coupled with the laminar flow within the fracture. Fractures are discretely modelled in the three-dimensional mesh. Growth of a fracture is modelled using the concepts of linear elastic fracture mechanics (LEFM), with the onset and direction of growth based on stress intensity factors that are computed for arbitrary tetrahedral meshes. The model has been verified against several analytical solutions available in the literature for plane-strain (2D) and penny-shaped (3D) fractures, for various regimes of domination: viscosity, toughness, storage and leak-off. The interaction of the hydraulically driven fracture with pre-existing fractures and other fluid-driven fractures in terms of fluid leak-off, stress interaction and fracture arrest is investigated and the results are presented. Finally, some preliminary results are presented regarding the interaction of a hydraulically-induced fracture with a set of pre-existing natural fractures.

40 CFR 63.1331 - Equipment leak provisions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... pump or seal whereby polymer fluid used to provide lubrication and/or cooling of the pump or agitator... limited to, a rupture disk indicator, magnetic sensor, motion detector on the pressure relief valve stem...

Lack of causal association between spontaneous intracranial hypotension and cranial cerebrospinal fluid leaks.

PubMed

Schievink, Wouter I; Schwartz, Marc S; Maya, M Marcel; Moser, Franklin G; Rozen, Todd D

2012-04-01

Spontaneous intracranial hypotension is an important cause of headaches and an underlying spinal CSF leak can be demonstrated in most patients. Whether CSF leaks at the level of the skull base can cause spontaneous intracranial hypotension remains a matter of controversy. The authors' aim was to examine the frequency of skull base CSF leaks as the cause of spontaneous intracranial hypotension. Demographic, clinical, and radiological data were collected from a consecutive group of patients evaluated for spontaneous intracranial hypotension during a 9-year period. Among 273 patients who met the diagnostic criteria for spontaneous intracranial hypotension and 42 who did not, not a single instance of CSF leak at the skull base was encountered. Clear nasal drainage was reported by 41 patients, but a diagnosis of CSF rhinorrhea could not be established. Four patients underwent exploratory surgery for presumed CSF rhinorrhea. In addition, the authors treated 3 patients who had a postoperative CSF leak at the skull base following the resection of a cerebellopontine angle tumor and developed orthostatic headaches; spinal imaging, however, demonstrated the presence of a spinal source of CSF leakage in all 3 patients. There is no evidence for an association between spontaneous intracranial hypotension and CSF leaks at the level of the skull base. Moreover, the authors' study suggests that a spinal source for CSF leakage should even be suspected in patients with orthostatic headaches who have a documented skull base CSF leak.

Cerebrospinal fluid leaks and encephaloceles of temporal bone origin: nuances to diagnosis and management.

PubMed

Jeevan, Dhruve S; Ormond, D Ryan; Kim, Ana H; Meiteles, Lawrence Z; Stidham, Katrina R; Linstrom, Christopher; Murali, Raj

2015-04-01

Temporal bone encephalocele has become less common as the incidence of chronic mastoid infection and surgery for this condition has decreased. As a result, the diagnosis is often delayed, and the encephalocele is often an incidental finding. This situation can result in serious neurologic complications with patients presenting with cerebrospinal fluid leak and meningitis. We review the occurrence of, characteristics of, and repair experience with temporal encephaloceles from 2000-2012. We conducted a retrospective review of 32 patients undergoing combined mastoidectomy and middle cranial fossa craniotomy for the treatment of temporal encephalocele. The diagnosis of temporal encephalocele was made in all patients using high-resolution temporal bone computed tomography and magnetic resonance imaging. At the time of diagnosis, 12 patients had confirmed cerebrospinal fluid leak; other common presenting symptoms included hearing loss and ear fullness. Tegmen defect was most commonly due to chronic otitis media (n = 14). Of these patients, 8 had undergone prior mastoidectomy, suggesting an iatrogenic cause. Other etiologies included radiation exposure, congenital defects, and spontaneous defects. Additionally, 2 patients presented with meningitis; 1 patient had serious neurologic deficits resulting from venous infarction. The risk of severe neurologic complications after the herniation of intracranial contents through a tegmen defect necessitates prompt recognition and appropriate management. Computed tomography and magnetic resonance imaging aid in definitive diagnosis. A combined mastoid/middle fossa approach allows for sustainable repair with adequate exposure of defects and support of intracranial contents. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-limiting advection caused by the development of a dissolution/precipitation zone and implications for the fate of leaky wells in CO2 sequestration

NASA Astrophysics Data System (ADS)

Huerta, N. J.; Hesse, M. A.; Bryant, S. L.; Strazisar, B. R.

2013-12-01

Leaking wells that penetrate a geologic CO2 sequestration site provide a potential direct pathway for the escape of CO2 to an overlying aquifer or even back into the atmosphere. Leakage is a highly coupled system, involving transport of CO2-saturated brine and reaction of carbonic acid with the cement that encases wells. Carbonic acid attacks cement phases to dissolve calcium rich components and raise the fluid pH. Our experiments show that total dissolution of the cement matrix, which would lead to self-enhancing leakage, is prevented by an amorphous aluminosilicate phase that remains after dissolution to constrain fluid flux. Conversely, self-limiting behavior develops in a zone where pH is sufficiently high for carbonate minerals to become insoluble and precipitate. Extrapolation of these bench-scale observations indicates that a barrier of carbonate precipitation would develop as more CO2-saturated brine leaks along a well. The process of sealing of the pathway and the timescale of sealing are critical for any risk assessment of the sequestration operation. Using numerical models to interpret the experiments, we find a lag in self-limiting behavior which is controlled by the saturation state of carbonate phases. Sufficient residence time is crucial for the development of the precipitation zone. Precipitation need not seal uniformly across an entire fracture, only in dominant flow paths. Simply growing the width of a zone of precipitation is insufficient to capture the self-limiting behavior we observe in experiments. To seal, the precipitating material must also accumulate and grow into the open fracture space and close the aperture. Closure rate is a function of the initial leak path conductivity, pressure differential (which controls fluid flux), leak path length, and CO2-saturation in the brine. Combining these results with risk assessment tools that incorporate the well development history will give stakeholders a tool to quantitatively predict well leakage for candidate sites.

Investigation of positive shaft seals

NASA Technical Reports Server (NTRS)

Pfouts, J. O.

1970-01-01

Welded metal bellows secondary seals prevent secondary seal leakage with a minimum number of potential leak paths. High performance seal is obtained by controlling the potentially unstable seal-face movements induced by mechanical vibrations and fluid pressure pulsations.

Baker's Cyst

MedlinePlus

... Rarely, a Baker's cyst bursts and synovial fluid leaks into the calf region, causing: Sharp pain in your knee Swelling in the calf Sometimes, redness of your calf or a feeling of water running down your calf These signs and symptoms ...

Spleen and Lymphatic System (For Parents)

MedlinePlus

... they have many tiny openings that allow gases, water, and nutrients to pass through to the surrounding cells, nourishing them and taking away waste products. When lymph fluid leaks through in this way it is called interstitial ...

A sonic transducer to detect fluid leaks

NASA Technical Reports Server (NTRS)

Cimerman, I.; Janus, J.

1972-01-01

Ultrasonic detector utilizes set of contact transducers and bandpass filters to detect and analyze sonic energy produced by flow or leakage. Detector covers wide frequency range and is operable at cryogenic temperatures and in vacuum.

Three-dimensional analysis for liquid hydrogen in a cryogenic storage tank with heat pipe pump system

NASA Astrophysics Data System (ADS)

Ho, Son H.; Rahman, Muhammad M.

2008-01-01

This paper presents a study on fluid flow and heat transfer of liquid hydrogen in a zero boil-off cryogenic storage tank in a microgravity environment. The storage tank is equipped with an active cooling system consisting of a heat pipe and a pump-nozzle unit. The pump collects cryogen at its inlet and discharges it through its nozzle onto the evaporator section of the heat pipe in order to prevent the cryogen from boiling off due to the heat leaking through the tank wall from the surroundings. A three-dimensional (3-D) finite element model is employed in a set of numerical simulations to solve for velocity and temperature fields of liquid hydrogen in steady state. Complex structures of 3-D velocity and temperature distributions determined from the model are presented. Simulations with an axisymmetric model were also performed for comparison. Parametric study results from both models predict that as the speed of the cryogenic fluid discharged from the nozzle increases, the mean or bulk cryogenic fluid speed increases linearly and the maximum temperature within the cryogenic fluid decreases.

Mitigated Transfer Line Leaks that Result in Surface Pools and Spray Leaks into Pits

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

HEY, B.E.

This analysis provides radiological and toxicological consequence calculations for postulated mitigated leaks during transfers of six waste compositions. Leaks in Cleanout Boxes equipped with supplemental covers and leaks in pits are analyzed.

MASS SPECTROMETER LEAK

DOEpatents

Shields, W.R.

1960-10-18

An improved valve is described for precisely regulating the flow of a sample fluid to be analyzed, such as in a mass spectrometer, where a gas sample is allowed to "leak" into an evacuated region at a very low, controlled rate. The flow regulating valve controls minute flow of gases by allowing the gas to diffuse between two mating surfaces. The structure of the valve is such as to prevent the corrosive feed gas from contacting the bellows which is employed in the operation of the valve, thus preventing deterioration of the bellows.

Complications of pediatric auditory brain stem implantation via retrosigmoid approach.

PubMed

Bayazit, Yildirim A; Abaday, Ayça; Dogulu, Fikret; Göksu, Nebil

2011-01-01

We aimed to present the complications of auditory brain stem implantations (ABI) in pediatric patients which were performed via retrosigmoid approach. Between March 2007 and February 2010, five prelingually deaf children underwent ABI (Medel device) operation via retrosigmoid approach. All children had severe cochlear malformations. The ages ranged from 20 months to 5 years. The perioperative complications encountered in 2 patients were evaluated retrospectively. No intraoperative complication was observed in the patients. Cerebrospinal fluid (CSF) leakage was the most common postoperative complication that was seen in 2 patients. The CSF leak triggered a cascade of comorbidities, and elongated the hospitalization. Pediatric ABI surgery can lead to morbidity. The CSF leak is the most common complication encountered in retrosigmoid approach. The other complications usually result from long-term hospital stay during treatment period of the CSF leak. Therefore, every attempt must be made to prevent occurrence of CSF leaks in pediatric ABI operations. Copyright © 2011 S. Karger AG, Basel.

Identification of sewage leaks by active remote-sensing methods

NASA Astrophysics Data System (ADS)

Goldshleger, Naftaly; Basson, Uri

2016-04-01

The increasing length of sewage pipelines, and concomitant risk of leaks due to urban and industrial growth and development is exposing the surrounding land to contamination risk and environmental harm. It is therefore important to locate such leaks in a timely manner, to minimize the damage. Advances in active remote sensing Ground Penetrating Radar (GPR) and Frequency Domain Electromagnetic (FDEM) technologies was used to identify leaking potentially responsible for pollution and to identify minor spills before they cause widespread damage. This study focused on the development of these electromagnetic methods to replace conventional acoustic methods for the identification of leaks along sewage pipes. Electromagnetic methods provide an additional advantage in that they allow mapping of the fluid-transport system in the subsurface. Leak-detection systems using GPR and FDEM are not limited to large amounts of water, but enable detecting leaks of tens of liters per hour, because they can locate increases in environmental moisture content of only a few percentage along the pipes. The importance and uniqueness of this research lies in the development of practical tools to provide a snapshot and monitoring of the spatial changes in soil moisture content up to depths of about 3-4 m, in open and paved areas, at relatively low cost, in real time or close to real time. Spatial measurements performed using GPR and FDEM systems allow monitoring many tens of thousands of measurement points per hectare, thus providing a picture of the spatial situation along pipelines and the surrounding. The main purpose of this study was to develop a method for detecting sewage leaks using the above-proposed geophysical methods, since their contaminants can severely affect public health. We focused on identifying, locating and characterizing such leaks in sewage pipes in residential and industrial areas.

The Predictive Value of Coefficient of PCT × BG for Anastomotic Leak in Esophageal Carcinoma Patients With ARDS After Esophagectomy.

PubMed

Li, Huan; Wang, Daofeng; Wei, Wenxiao; Ouyang, Lamei; Lou, Ning

2017-01-01

Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Early recognition and intervention treatment of anastomotic leak may alleviate complication and improve outcome. We retrospectively analyzed 71 patients, accepting mechanical ventilation support because of ARDS as the complication after radical resection of esophagus cancer. Clinical data were collected from the patients' electronic medical records, including their clinically hematological examination, drainage fluid cultures, and sputum culture. Accord to appearance of anastomotic leak or not, all patients were divided into 2 groups, leak group and no-leak group. Inflammatory markers, such as CRP, PCT, and the coefficient of BG and PCT, were significantly different between the 2 groups. Respiratory index, white blood cell, hemoglobin (HBG), platelet (PLT), and other clinical factors were not significantly different between the 2 groups. Receiver operating characteristic curves were constructed to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve for various cutoff levels of several factors. Blood G tests presented the better predicting value for anastomotic leak. Blood G tests and PCT should be tested after esophagectomy. The coefficient of PCT and BG (>260) is of great significance, and clinical value to predict anastomotic leak for patients with postesophagectomy ARDS, early PCT and BG test, and especially, dynamic variation may alleviate complication and improve outcome.

78 FR 46306 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... on the A330 and A340 type design Section 19, which is a flammable fluid leakage zone and a zone... Model A340 series airplanes: Doing the bleed leak detection loop modification of the auxiliary power...

Cirrhosis: A Patient's Guide

MedlinePlus

... the veins of the liver is ascites. Fluid leaks out into the belly and it begins to fill it up. This can make the abdomen enlarge like a balloon filled with water. The legs can get swollen too. This can ...

Use of an electric field in an electrostatic liquid film radiator.

PubMed

Bankoff, S G; Griffing, E M; Schluter, R A

2002-10-01

Experimental and numerical work was performed to further the understanding of an electrostatic liquid film radiator (ELFR) that was originally proposed by Kim et al.(1) The ELFR design utilizes an electric field that exerts a normal force on the interface of a flowing film. The field lowers the pressure under the film in a space radiator and, thereby, prevents leakage through a puncture in the radiator wall. The flowing film is subject to the Taylor cone instability, whereby a cone of fluid forms underneath an electrode and sharpens until a jet of fluid is pulled toward the electrode and disintegrates into droplets. The critical potential for the instability is shown to be as much as an order of magnitude higher than that used in previous designs.(2) Furthermore, leak stoppage experiments indicate that the critical field is adequate to stop leaks in a working radiator.

Evaluation of Esophageal Anastomotic Integrity With Serial Pleural Amylase Levels.

PubMed

Miller, Daniel L; Helms, Gerald A; Mayfield, William R

2018-01-01

An anastomotic leak is the most devastating and potentially fatal complication after esophagectomy. Current detection methods can be inaccurate and place patients at risk of other complications. Analysis of pleural fluid for amylase may be more accurate and place patients at less of a risk for evaluating the integrity of an esophageal anastomosis. We retrospectively reviewed prospective data of 45 consecutive patients who underwent an Ivor Lewis esophagectomy over an 18-month period and evaluated their anastomotic integrity with serial pleural amylase levels (PAL). There were 40 men (89%), and median age was 63 years (range, 35 to 79). Indication for esophagectomy was cancer in 38 patients (84%); 27 (71%) underwent neoadjuvant chemoradiation. A barium swallow was performed in the first 25 patients at median postoperative day (POD) 5 (range, 5 to 10); the swallow was negative in 23 patients (93%). Serial PALs were obtained starting on POD 3 and stopped 1 day after toleration of clear liquids. The PALs in the no-leak patients were highest on POD 3 (median 42 IU/L; range, 20 to 102 IU/L) and decreased (median 15 IU/L; range, 8 to 34 IU/L) to the lowest levels 1 day after clear liquid toleration (p = 0.04). Two patients had a leak and had peak PALs of 227 IU/L and 630 IU/L, respectively; both leaks occurred on POD 4, 1 day before their scheduled swallow test. The last 20 patients underwent serial PALs only, without a planned swallow test or computed tomography scan for anastomotic integrity evaluation. One of these patients had a leak on POD 5 with a low PAL of 55 IU/L the day before the spike of more than 4,000 IU/L. Two of the leaks were treated with esophageal stent placement and intravenous antibiotics, and the remaining patient's leak resolved with intravenous antibiotics, no oral intake, and observation only. None of the leak patients required transthoracic esophageal repair or drainage of an empyema. There was 1 postoperative death (2%) secondary to aspiration pneumonia on POD 10; no leak was ever identified, and the patient had been eating for 3 days before death. Complications occurred in 15 patients (33%), most commonly respiratory; no respiratory issues occurred in PAL-only evaluated patients. No late anastomotic leaks occurred in any patient while in the hospital or after discharge. Serial PALs for the detection of esophageal anastomotic leaks proved to be accurate, safe, and inexpensive. Elimination of barium swallows and computed tomography scans for evaluation of anastomotic integrity may decrease aspiration risks as well as associated pulmonary failure during the postoperative period. Serial PALs may be the preferred method of detecting an anastomotic leak after esophagectomy. A prospective randomized study is warranted. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

PubMed

Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

2015-01-01

Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing to curtail transcapillary albumin leakage and resulting in increasingly positive net fluid balances. GIPS may represent a third hit after the initial insult and the ischaemia reperfusion injury. Novel markers like the capillary leak index, extravascular lung water and pulmonary permeability index may help the clinician in guiding appropriate fluid management. Capillary leak is an inflammatory condition with diverse triggers that results from a common pathway that includes ischaemia-reperfusion, toxic oxygen metabolite generation, cell wall and enzyme injury leading to a loss of capillary endothelial barrier function. Fluid overload should be avoided in this setting.

Fault-Tolerant Heat Exchanger

NASA Technical Reports Server (NTRS)

Izenson, Michael G.; Crowley, Christopher J.

2005-01-01

A compact, lightweight heat exchanger has been designed to be fault-tolerant in the sense that a single-point leak would not cause mixing of heat-transfer fluids. This particular heat exchanger is intended to be part of the temperature-regulation system for habitable modules of the International Space Station and to function with water and ammonia as the heat-transfer fluids. The basic fault-tolerant design is adaptable to other heat-transfer fluids and heat exchangers for applications in which mixing of heat-transfer fluids would pose toxic, explosive, or other hazards: Examples could include fuel/air heat exchangers for thermal management on aircraft, process heat exchangers in the cryogenic industry, and heat exchangers used in chemical processing. The reason this heat exchanger can tolerate a single-point leak is that the heat-transfer fluids are everywhere separated by a vented volume and at least two seals. The combination of fault tolerance, compactness, and light weight is implemented in a unique heat-exchanger core configuration: Each fluid passage is entirely surrounded by a vented region bridged by solid structures through which heat is conducted between the fluids. Precise, proprietary fabrication techniques make it possible to manufacture the vented regions and heat-conducting structures with very small dimensions to obtain a very large coefficient of heat transfer between the two fluids. A large heat-transfer coefficient favors compact design by making it possible to use a relatively small core for a given heat-transfer rate. Calculations and experiments have shown that in most respects, the fault-tolerant heat exchanger can be expected to equal or exceed the performance of the non-fault-tolerant heat exchanger that it is intended to supplant (see table). The only significant disadvantages are a slight weight penalty and a small decrease in the mass-specific heat transfer.

Fluid flow and assessment of the leakage potential in the Snohvit reservoir and overburden in the Barents Sea

NASA Astrophysics Data System (ADS)

Tasianas, A.

2012-12-01

Department of Geology, University of Tromsø, Dramsveien 201, 9037 Tromsø, Norway Abstract ____________________________________________________________________________ The Snøhvit reservoir and overburden have been an important location for testing Carbon Capture and Storage (CCS) techniques. Fluid flow in the region is caused mainly by repeated glacial cycles and differential geographic uplift, which caused tilting and spilling of various structural traps in the area. Geological modeling, undertaken as part of the ECO2 project activities, has allowed to model the local stratigraphy and any potential fluid flow pathways in order to determine how effective CCS would be in the area. 3D seismic data related to cube ST0306 from the Hammerfest Sedimentary Basin (HFB), covering the Snohvit and Albatross fields, were used to better understand the pathways and mechanisms related to fluid flow in the area and thus propose also potential leakage scenarios. The inclusion of geological features such as gas chimneys, faults, wells, pockmarks at the seabed and vertical fluid flow structures underlying the pockmarks in the models has also allowed to accurately simulate fluid flow through realistic geological models. Leaking of CO2 from the Tubåen Formation (Fm) can partially migrate upwards to the Hekkingen Fm or less deep formations via the faults. If leaking reaches the tertiary faults, CO2 can migrate through the Top kvitting Fm and maybe continue via pipe structures, faults or the clinoforms of the Torsk Fm and accumulate under the Upper Regional Unconformity (URU). The presence of pockmarks at the seabed could indicate further leakage between the URU and the seabed via vertical fluid flow structures underlying the pockmarks. Depending on the leakage mode, models of different types of domain size and grid resolution were created and populated with properties such as porosity (SPhi), vertical permeability (kv), horizontal permeability (Kh), anisotropy ratio (AnIso), Total Oganic Carbon, [Cl],[CaCO3], [CH4] and various alkalinities. A temperature vs depth profile (Trock) and a lithology model were also associated with it. Modelling results indicate that the most likely sites for leakage, when the crust is subject to erosion-related compressive stresses, would be the faults. The possible presence of any gas hydrates above the BSR could act as a seal for the free gas accumulating below the BSR. This reason as well as the fact that we don't expect any major stress changes in the region in the next few Million years signifies that the faults should remain sealing and thus prevent any CO2 leakage. Preliminary simulation results indicate highest saturation values of CO2 near the base of the overburden with no signs of any CO2 reaching the seabed, thus reducing to a minimum the threat of any contamination to the seawater and marine wildlife. Both Composition 2 and 3 gas hydrates are stable, providing a supplementary sealing effect that prevents any potential leaking fluid reaching the seabed. The study area is however lying outside the Composition 1 pure methane gas hydrate stability field. Any fluid with such composition leaking from the reservoir will thus not form gas hydrates. Keywords : geological modeling, CO2, fluid flow, leakage mechanisms, gas hydrate

Extensive traumatic anterior skull base fractures with cerebrospinal fluid leak: classification and repair techniques using combined vascularized tissue flaps.

PubMed

Archer, Jacob B; Sun, Hai; Bonney, Phillip A; Zhao, Yan Daniel; Hiebert, Jared C; Sanclement, Jose A; Little, Andrew S; Sughrue, Michael E; Theodore, Nicholas; James, Jeffrey; Safavi-Abbasi, Sam

2016-03-01

This article introduces a classification scheme for extensive traumatic anterior skull base fracture to help stratify surgical treatment options. The authors describe their multilayer repair technique for cerebrospinal fluid (CSF) leak resulting from extensive anterior skull base fracture using a combination of laterally pediculated temporalis fascial-pericranial, nasoseptal-pericranial, and anterior pericranial flaps. Retrospective chart review identified patients treated surgically between January 2004 and May 2014 for anterior skull base fractures with CSF fistulas. All patients were treated with bifrontal craniotomy and received pedicled tissue flaps. Cases were classified according to the extent of fracture: Class I (frontal bone/sinus involvement only); Class II (extent of involvement to ethmoid cribriform plate); and Class III (extent of involvement to sphenoid bone/sinus). Surgical repair techniques were tailored to the types of fractures. Patients were assessed for CSF leak at follow-up. The Fisher exact test was applied to investigate whether the repair techniques were associated with persistent postoperative CSF leak. Forty-three patients were identified in this series. Thirty-seven (86%) were male. The patients' mean age was 33 years (range 11-79 years). The mean overall length of follow-up was 14 months (range 5-45 months). Six fractures were classified as Class I, 8 as Class II, and 29 as Class III. The anterior pericranial flap alone was used in 33 patients (77%). Multiple flaps were used in 10 patients (3 salvage) (28%)--1 with Class II and 9 with Class III fractures. Five (17%) of the 30 patients with Class II or III fractures who received only a single anterior pericranial flap had persistent CSF leak (p < 0.31). No CSF leak was found in patients who received multiple flaps. Although postoperative CSF leak occurred only in high-grade fractures with single anterior flap repair, this finding was not significant. Extensive anterior skull base fractures often require aggressive treatment to provide the greatest long-term functional and cosmetic benefits. Several vascularized tissue flaps can be used, either alone or in combination. Vascularized flaps are an ideal substrate for cranial base repair. Dual and triple flap techniques that combine the use of various anterior, lateral, and nasoseptal flaps allow for a comprehensive arsenal in multilayered skull base repair and salvage therapy for extensive and severe fractures.

Natura abhorret a vacuo--use of fibrin glue as a filler and sealant in neurosurgical "dead spaces". Technical note.

PubMed

Cappabianca, Paolo; Esposito, Felice; Magro, Francesco; Cavallo, Luigi Maria; Solari, Domenico; Stella, Lucio; de Divitiis, Oreste

2010-05-01

The objective of this study is to report our experience and illustrate our technique in the use of fibrin glue in the treatment of post-operatory cerebrospinal fluid (CSF) leaks and collections following different neurosurgical procedures. In a 3-year period, 40 subjects underwent endoscopic endonasal approach for different sellar and skull base lesions (three tuberculum sellae meningiomas, six craniopharyngiomas, three Rathke's cleft cysts and 28 pituitary macroadenomas), in which an intraoperative CSF leakage was evident. In such subjects, the fibrin glue was used as a first step of the final phase of the procedure-i.e. the reconstruction of the skull base defect-followed by the other materials employed. Furthermore, ten other patients, who had undergone transsphenoidal (four cases), spinal (two cases), posterior fossa (three cases) and transcortical intraventricular tumour removal (one case) neurosurgical procedures and developed CSF leaks or collections, were conservatively treated by single or repeated in situ injections of "modified" fibrin glue under local anaesthesia according to different described techniques. In total, 50 patients constitute the clinical material of the present study. In the cases where the fibrin glue was used during the reconstruction phase of the procedure (40 cases), the glue was injected inside the tumour cavity to fill the dead space left by the removal of the lesion. In case of post-operative CSF leak or CSF fluid collection (ten cases), after discarding 50-80% of the thrombin solution to obtain prevalence of the product's adhesive properties, fibrin glue was injected directly in the path of the CSF leak or into the collection cavity after aspiration of the collection's content. This was performed with the provided application system or through lumbar or Tuohy needles. Applications were repeated every 48 h until the disappearance of the leak. In all the treated cases, the disappearance of CSF leaks or collections was obtained with a number of applications ranging from one to five. Successful results are stable with a follow-up ranging from 6 months to 3 years. In our experience, the injection of fibrin glue has proved to be effective in filling or sealing post-operative "dead spaces" and treating minor or initial CSF leaks resulting from procedures of transsphenoidal, cranial and spinal surgery, adding another possibility in the management of many of these dreadful complications.

Stochastic Consequence Analysis for Waste Leaks

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

HEY, B.E.

This analysis evaluates the radiological consequences of potential Hanford Tank Farm waste transfer leaks. These include ex-tank leaks into structures, underneath the soil, and exposed to the atmosphere. It also includes potential misroutes, tank overflow

Cryogenic Propellant Feed System Analytical Tool Development

NASA Technical Reports Server (NTRS)

Lusby, Brian S.; Miranda, Bruno M.; Collins, Jacob A.

2011-01-01

The Propulsion Systems Branch at NASA s Lyndon B. Johnson Space Center (JSC) has developed a parametric analytical tool to address the need to rapidly predict heat leak into propellant distribution lines based on insulation type, installation technique, line supports, penetrations, and instrumentation. The Propellant Feed System Analytical Tool (PFSAT) will also determine the optimum orifice diameter for an optional thermodynamic vent system (TVS) to counteract heat leak into the feed line and ensure temperature constraints at the end of the feed line are met. PFSAT was developed primarily using Fortran 90 code because of its number crunching power and the capability to directly access real fluid property subroutines in the Reference Fluid Thermodynamic and Transport Properties (REFPROP) Database developed by NIST. A Microsoft Excel front end user interface was implemented to provide convenient portability of PFSAT among a wide variety of potential users and its ability to utilize a user-friendly graphical user interface (GUI) developed in Visual Basic for Applications (VBA). The focus of PFSAT is on-orbit reaction control systems and orbital maneuvering systems, but it may be used to predict heat leak into ground-based transfer lines as well. PFSAT is expected to be used for rapid initial design of cryogenic propellant distribution lines and thermodynamic vent systems. Once validated, PFSAT will support concept trades for a variety of cryogenic fluid transfer systems on spacecraft, including planetary landers, transfer vehicles, and propellant depots, as well as surface-based transfer systems. The details of the development of PFSAT, its user interface, and the program structure will be presented.

Spontaneous nasal cerebrospinal fluid leaks and empty sella syndrome: a clinical association.

PubMed

Schlosser, Rodney J; Bolger, William E

2003-01-01

Spontaneous, idiopathic nasal meningoencephaloceles are herniations of arachnoid/dura and cerebrospinal fluid (CSF) through anatomically fragile sites within the skull base. Empty sella syndrome occurs when intracranial contents herniate through the sellar diaphragm filling the sella turcica with CSF and giving the radiographic appearance of an absent pituitary gland. The objective of this study was to examine the association between spontaneous encephaloceles/CSF leaks and empty sella syndrome because of their similar clinical features and potential common pathophysiology. Retrospective. Sixteen patients were treated for spontaneous encephaloceles between 1996 and 2001. All 16 patients had associated CSF leaks. Five patients had multiple simultaneous encephaloceles. Fifteen patients with imaging of the sella turcica had empty (10 patients) or partially empty (5 patients) sellas. One patient did not have complete imaging of the sella. Three patients had lumbar punctures with measurement of CSF pressure during computed tomography cisternograms because of multiple skull base defects. Mean CSF pressure was 28.3 cm of water (range, 19-34 cm; normal, 0-15 cm). Thirteen of 16 patients (81%) were obese women (mean body mass index 35.9 kg/m2; normal, <25 kg/m2). Mean follow-up was 14.2 months with 100% success in closure of the defects after one procedure. Spontaneous meningoencephaloceles and CSF leaks are strongly associated with radiographic findings of an empty sella and suggest a common pathophysiology. The underlying condition probably represents a form of intracranial hypertension that exerts hydrostatic pressure at anatomically weakened sites within the skull base. Otolaryngologists should be familiar with this disease entity and the implications intracranial hypertension has on patient management.

Intracranial hypotension headache caused by a massive cerebrospinal fluid leak successfully treated with a targeted c2 epidural blood patch: a case report.

PubMed

Sykes, Kenneth T; Yi, Xiaobin

2013-01-01

Cervical epidural steroid injections, administered either interlaminarly or transforaminally, are common injection therapies used in many interventional pain management practices to treat cervicalgia or cervicobrachial pain secondary to spondylosis or intervertebral disc displacement of the cervical spine. Among the risks associated with these procedures are the risk for inadvertent dural puncture and the development of positional headache from intracranial hypotension. We report the case of a 31-year-old woman with a history of migraine and cervicalgia from cervical spine spondylosis and cervical disc degenerative disease that developed an intractable orthostatic headache accompanied by nausea and vomiting after a therapeutic high cervical intralaminar epidural steroid injection was administered directly to the C1-C2 spinal level. Although the initial magnetic resonance imaging of the brain was unremarkable, a computed tomography myelogram study revealed a massive cerebrospinal fluid (CSF) leak from the cervical spine.  Repeated cervical epidural blood patches using a catheter targeted to the high cervical spine (C2) to inject 15 mL of autologous blood was required to totally alleviate her symptoms after she failed conservative therapy. Determining the optimal location or approach to administer an epidural blood patch can be a challenge depending on the location of the CSF leak. Our case demonstrates that targeted cervical epidural blood patch placement using an easily manipulated catheter under fluoroscopic guidance is a safe and effective approach to treat a massive CSF leak in the high cervical spine region caused by prior therapeutic cervical spine epidural steroid injection.

Modified Graded Repair of Cerebrospinal Fluid Leaks in Endoscopic Endonasal Transsphenoidal Surgery

PubMed Central

Park, Jae-Hyun; Choi, Jai Ho; Kim, Young-Il; Kim, Sung Won

2015-01-01

Objective Complete sellar floor reconstruction is critical to avoid postoperative cerebrospinal fluid (CSF) leakage during transsphenoidal surgery. Recently, the pedicled nasoseptal flap has undergone many modifications and eventually proved to be valuable and efficient. However, using these nasoseptal flaps in all patients who undergo transsphenoidal surgery, including those who had none or only minor CSF leakage, appears to be overly invasive and time-consuming. Methods Patients undergoing endoscopic endonasal transsphenoidal tumor surgery within a 5 year-period were reviewed. Since 2009, we classified the intraoperative CSF leakage into grades from 0 to 3. Sellar floor reconstruction was tailored to each leak grade. We did not use any tissue grafts such as abdominal fat and did not include any procedures of CSF diversions such as lumbar drainage. Results Among 200 cases in 188 patients (147 pituitary adenoma and 41 other pathologies), intraoperative CSF leakage was observed in 27.4% of 197 cases : 14.7% Grade 1, 4.6% Grade 2a, 3.0% Grade 2b, and 5.1% Grade 3. Postoperative CSF leakage was observed in none of the cases. Septal bone buttress was used for Grade 1 to 3 leakages instead of any other foreign materials. Pedicled nasoseptal flap was used for Grades 2b and 3 leakages. Unused septal bones and nasoseptal flaps were repositioned. Conclusion Modified classification of intraoperative CSF leaks and tailored repair technique in a multilayered fashion using an en-bloc harvested septal bone and vascularized nasoseptal flaps is an effective and reliable method for the prevention of postoperative CSF leaks. PMID:26279811

14 CFR 33.91 - Engine system and component tests.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., reliability, and durability. (c) Each unpressurized hydraulic fluid tank may not fail or leak when subjected... minimum operating values. [Doc. No. 3025, 29 FR 7453, June 10, 1964, as amended by Amdt. 33-6, 39 FR 35469...

MECHANICAL INTEGRITY TESTING AND TRAINING FACILITY

EPA Science Inventory

Underground injection control regulations of the U.S. Environmental Protection Agency require that all injection wells demonstrate mechanical integrity, which is defined as no significant leak in the casing, tubing or packer, and no significant fluid movement into an underground ...

Combining supercritical fluid extraction of soil herbicides with enzyme immunoassay analysis.

PubMed

Stearman, G K

2001-10-01

Supercritical fluid extraction (SFE) of soil herbicides followed by enzyme immunoassay analysis (EIA) is explained in a step-by-step process. Extracted herbicides, include 2,4-D, simazine, atrazine, and alachlor. The herbicide, trifluralin was not successfully analyzed by EIA because of crossreacting metabolites. Problems with SFE, including uneven packing of cells, leaks, uneven flow and clogging, can largely be eliminated as the method parameters are optimized. It was necessary to add modifiers including methanol or acetone to the SF CO2 to increase the solubility of the analytes. Detection limits of 2.5 ng/g soil for atrazine and alachlor and 15 ng/g soil for simazine and 2,4-D without concentration of the sample were achieved. Recoveries above 80% and relative standard deviations (RSDs) less than 15% for 2,4-D simazine, atrazine and alachlor were achieved. Atrazine and alachlor recoveries were above 90% with RSDs below 10%. Forty soil samples could be extracted and analyzed in an 8-h day.

Supraorbital Versus Endoscopic Endonasal Approaches for Olfactory Groove Meningiomas: A Cost-Minimization Study.

PubMed

Gandhoke, Gurpreet S; Pease, Matthew; Smith, Kenneth J; Sekula, Raymond F

2017-09-01

To perform a cost-minimization study comparing the supraorbital and endoscopic endonasal (EEA) approach with or without craniotomy for the resection of olfactory groove meningiomas (OGMs). We built a decision tree using probabilities of gross total resection (GTR) and cerebrospinal fluid (CSF) leak rates with the supraorbital approach versus EEA with and without additional craniotomy. The cost (not charge or reimbursement) at each "stem" of this decision tree for both surgical options was obtained from our hospital's finance department. After a base case calculation, we applied plausible ranges to all parameters and carried out multiple 1-way sensitivity analyses. Probabilistic sensitivity analyses confirmed our results. The probabilities of GTR (0.8) and CSF leak (0.2) for the supraorbital craniotomy were obtained from our series of 5 patients who underwent a supraorbital approach for the resection of an OGM. The mean tumor volume was 54.6 cm 3 (range, 17-94.2 cm 3 ). Literature-reported rates of GTR (0.6) and CSF leak (0.3) with EEA were applied to our economic analysis. Supraorbital craniotomy was the preferred strategy, with an expected value of $29,423, compared with an EEA cost of $83,838. On multiple 1-way sensitivity analyses, supraorbital craniotomy remained the preferred strategy, with a minimum cost savings of $46,000 and a maximum savings of $64,000. Probabilistic sensitivity analysis found the lowest cost difference between the 2 surgical options to be $37,431. Compared with EEA, supraorbital craniotomy provides substantial cost savings in the treatment of OGMs. Given the potential differences in effectiveness between approaches, a cost-effectiveness analysis should be undertaken. Copyright © 2017 Elsevier Inc. All rights reserved.

Drain Tube-Induced Jejunal Penetration Masquerading as Bile Leak following Whipple's Operation.

PubMed

Bae, Sang Ho; Lee, Tae Hoon; Lee, Sae Hwan; Lee, Suck-Ho; Park, Sang-Heum; Kim, Sun-Joo; Kim, Chang Ho

2011-05-01

A 70-year-old man had undergone pancreaticoduodenectomy due to a distal common bile duct malignancy. After the operation, serous fluid discharge decreased from two drain tubes in the retroperitoneum. Over four weeks, the appearance of the serous fluid changed to a greenish bile color and the patient persistently drained over 300 ml/day. Viewed as bile leak at the choledochojejunostomy, treatment called for endoscopic diagnosis and therapy. Cap-fitted forward-viewing endoscopy demonstrated that the distal tip of a pancreatic drain catheter inserted at the pancreaticojejunostomy site had penetrated the opposite jejunum wall. One of the drain tubes primarily placed in the retroperitoneum had also penetrated the jejunum wall, with the distal tip positioned near the choledochojejunostomy site. No leak of contrast appeared beyond the jejunum or anastomosis site. Following repositioning of a penetrating catheter of the pancreaticojejunostomy, four days later, the patient underwent removal of two drain tubes without additional complications. In conclusion, the distal tip of the catheter, placed to drain pancreatic juice, penetrated the jejunum wall and may have caused localized perijejunal inflammation. The other drain tube, placed in the retroperitoneal space, might then have penetrated the inflamed wall of the jejunum, allowing persistent bile drainage via the drain tube. The results masqueraded as bile leakage following pancreaticoduodenectomy.

Evaluation of Spontaneous Spinal Cerebrospinal Fluid Leaks Disease by Computerized Image Processing.

PubMed

Yıldırım, Mustafa S; Kara, Sadık; Albayram, Mehmet S; Okkesim, Şükrü

2016-05-17

Spontaneous Spinal Cerebrospinal Fluid Leaks (SSCFL) is a disease based on tears on the dura mater. Due to widespread symptoms and low frequency of the disease, diagnosis is problematic. Diagnostic lumbar puncture is commonly used for diagnosing SSCFL, though it is invasive and may cause pain, inflammation or new leakages. T2-weighted MR imaging is also used for diagnosis; however, the literature on T2-weighted MRI states that findings for diagnosis of SSCFL could be erroneous when differentiating the diseased and control. One another technique for diagnosis is CT-myelography, but this has been suggested to be less successful than T2-weighted MRI and it needs an initial lumbar puncture. This study aimed to develop an objective, computerized numerical analysis method using noninvasive routine Magnetic Resonance Images that can be used in the evaluation and diagnosis of SSCFL disease. Brain boundaries were automatically detected using methods of mathematical morphology, and a distance transform was employed. According to normalized distances, average densities of certain sites were proportioned and a numerical criterion related to cerebrospinal fluid distribution was calculated. The developed method was able to differentiate between 14 patients and 14 control subjects significantly with p = 0.0088 and d = 0.958. Also, the pre and post-treatment MRI of four patients was obtained and analyzed. The results were differentiated statistically (p = 0.0320, d = 0.853). An original, noninvasive and objective diagnostic test based on computerized image processing has been developed for evaluation of SSCFL. To our knowledge, this is the first computerized image processing method for evaluation of the disease. Discrimination between patients and controls shows the validity of the method. Also, post-treatment changes observed in four patients support this verdict.

Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation.

PubMed

Rancourt, Raymond C; Veress, Livia A; Ahmad, Aftab; Hendry-Hofer, Tara B; Rioux, Jacqueline S; Garlick, Rhonda B; White, Carl W

2013-10-01

Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O2 saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin-antithrombin complex (TAT), active plasminogen activator inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. Copyright © 2013 Elsevier Inc. All rights reserved.

Integrated fault seal analysis and risk assessemt: Okan and Meren Fields, Nigeria

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

Eisenberg, R.A.; Brenneman, R.J.; Adepoju, A.A.

1996-01-01

Integration of production, geochemical, seismic, well log, and structural data provides important constraints on the sealing capacity and dynamic behavior of fault juxtaposed reservoirs in Okan and Meren fields, offshore Nigeria. Correlations were found between pressure decline histories, juxtaposed fluid types, oil composition, fluid contact relationships, fault sealing/leaking condition, and estimates of the composition of the fault gouge. Fault plane sections defined reservoir juxtapositions and potential cross-fault spill points. Smear gouge ratios calculated from E-logs were used to estimate the composition of fault-gouge materials between juxtaposed reservoirs. These tools augmented interpretation of seal/nonseal character in proved reservoirs and were usedmore » to quantify fault seal risk of untested, fault-dependent closures. In the Okan Field juxtapositions of the G-, H, L-, M, and O-sands were analyzed. Smear gouge ratios correlated to fluid contact relationships and pressure decline histories within these juxtaposed reservoirs empirically calibrate sealing potential. The results of these analyses were then used to interpret production-induced fault seal breakdown within the G-sands and to risk seal integrity of fault-dependent closures within the untested 0-sands in an adjacent, upthrown fault block. Within this fault block the presence of potential fault intersection leak points and large areas of sand/sand juxtaposition with high smear gouge ratios (low sealing potential) limits column heights and potential reserves within the O-sand package. In the Meren Field the E- and G-sands are juxtaposed, on different pressure decline, geochemically distinct, and are characterized by low smear gouge ratios. In contrast, the G- and H-sands, juxtaposed across the same fault, contain similar OOWCs and are characterized by high smear gouge ratios.« less

Integrated fault seal analysis and risk assessemt: Okan and Meren Fields, Nigeria

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

Eisenberg, R.A.; Brenneman, R.J.; Adepoju, A.A.

Integration of production, geochemical, seismic, well log, and structural data provides important constraints on the sealing capacity and dynamic behavior of fault juxtaposed reservoirs in Okan and Meren fields, offshore Nigeria. Correlations were found between pressure decline histories, juxtaposed fluid types, oil composition, fluid contact relationships, fault sealing/leaking condition, and estimates of the composition of the fault gouge. Fault plane sections defined reservoir juxtapositions and potential cross-fault spill points. Smear gouge ratios calculated from E-logs were used to estimate the composition of fault-gouge materials between juxtaposed reservoirs. These tools augmented interpretation of seal/nonseal character in proved reservoirs and were usedmore » to quantify fault seal risk of untested, fault-dependent closures. In the Okan Field juxtapositions of the G-, H, L-, M, and O-sands were analyzed. Smear gouge ratios correlated to fluid contact relationships and pressure decline histories within these juxtaposed reservoirs empirically calibrate sealing potential. The results of these analyses were then used to interpret production-induced fault seal breakdown within the G-sands and to risk seal integrity of fault-dependent closures within the untested 0-sands in an adjacent, upthrown fault block. Within this fault block the presence of potential fault intersection leak points and large areas of sand/sand juxtaposition with high smear gouge ratios (low sealing potential) limits column heights and potential reserves within the O-sand package. In the Meren Field the E- and G-sands are juxtaposed, on different pressure decline, geochemically distinct, and are characterized by low smear gouge ratios. In contrast, the G- and H-sands, juxtaposed across the same fault, contain similar OOWCs and are characterized by high smear gouge ratios.« less

Chronic toxicity of Pydraul 50E to lake trout

USGS Publications Warehouse

Mayer, Foster L.; Woodward, Daniel F.; Adams, William J.

1993-01-01

Industrial phosphate esters, both triaryl and alkyl aryl phosphate esters, are used as fire resistant hydraulic fluids and as fire retardant plasticizers (Lapp 1976). Hydraulic fluids probably represent the largest contribution of phosphate ester compounds released into the environment. Lapp (1976) estimated that 65 to 70 percent of all phosphate ester hydraulic fluids were utilized in automotive and steel industries. He also estimated that 80 percent of the annual consumption of hydraulic fluids in 1976 was the result of leaks in industrial hydraulic systems. These data suggest phosphate esters are likely to be constituents of industrial effluents and, consequently, could be in point source discharges.

Leak-off mechanism and pressure prediction for shallow sediments in deepwater drilling

NASA Astrophysics Data System (ADS)

Tan, Qiang; Deng, Jingen; Sun, Jin; Liu, Wei; Yu, Baohua

2018-02-01

Deepwater sediments are prone to loss circulation in drilling due to a low overburden gradient. How to predict the magnitude of leak-off pressure more accurately is an important issue in the protection of drilling safety and the reduction of drilling cost in deep water. Starting from the mechanical properties of a shallow formation and based on the basic theory of rock-soil mechanics, the stress distribution around a borehole was analyzed. It was found that the rock or soil on a borehole is in the plastic yield state before the effective tensile stress is generated, and the effective tangential and vertical stresses increase as the drilling fluid density increases; thus, tensile failure will not occur on the borehole wall. Based on the results of stress calculation, two mechanisms and leak-off pressure prediction models for shallow sediments in deepwater drilling were put forward, and the calculated values of these models were compared with the measured value of shallow leak-off pressure in actual drilling. The results show that the MHPS (minimum horizontal principle stress) model and the FIF (fracturing in formation) model can predict the lower and upper limits of leak-off pressure. The PLC (permeable lost circulation) model can comprehensively analyze the factors influencing permeable leakage and provide a theoretical basis for leak-off prevention and plugging in deepwater drilling.

Comprehensive Quantitative Analysis on Privacy Leak Behavior

PubMed Central

Fan, Lejun; Wang, Yuanzhuo; Jin, Xiaolong; Li, Jingyuan; Cheng, Xueqi; Jin, Shuyuan

2013-01-01

Privacy information is prone to be leaked by illegal software providers with various motivations. Privacy leak behavior has thus become an important research issue of cyber security. However, existing approaches can only qualitatively analyze privacy leak behavior of software applications. No quantitative approach, to the best of our knowledge, has been developed in the open literature. To fill this gap, in this paper we propose for the first time four quantitative metrics, namely, possibility, severity, crypticity, and manipulability, for privacy leak behavior analysis based on Privacy Petri Net (PPN). In order to compare the privacy leak behavior among different software, we further propose a comprehensive metric, namely, overall leak degree, based on these four metrics. Finally, we validate the effectiveness of the proposed approach using real-world software applications. The experimental results demonstrate that our approach can quantitatively analyze the privacy leak behaviors of various software types and reveal their characteristics from different aspects. PMID:24066046

Comprehensive quantitative analysis on privacy leak behavior.

PubMed

Fan, Lejun; Wang, Yuanzhuo; Jin, Xiaolong; Li, Jingyuan; Cheng, Xueqi; Jin, Shuyuan

2013-01-01

Privacy information is prone to be leaked by illegal software providers with various motivations. Privacy leak behavior has thus become an important research issue of cyber security. However, existing approaches can only qualitatively analyze privacy leak behavior of software applications. No quantitative approach, to the best of our knowledge, has been developed in the open literature. To fill this gap, in this paper we propose for the first time four quantitative metrics, namely, possibility, severity, crypticity, and manipulability, for privacy leak behavior analysis based on Privacy Petri Net (PPN). In order to compare the privacy leak behavior among different software, we further propose a comprehensive metric, namely, overall leak degree, based on these four metrics. Finally, we validate the effectiveness of the proposed approach using real-world software applications. The experimental results demonstrate that our approach can quantitatively analyze the privacy leak behaviors of various software types and reveal their characteristics from different aspects.

Evaluation of an Interferometric Sensor for In-Space Detection of Gas Leaks

NASA Technical Reports Server (NTRS)

Polzin, Kurt A.; Korman, Valentin; Sinko, John; Hendrickson, Adam

2009-01-01

Space mission planning often involves long-term storage of volatile liquids or high-pressure gases. These may include cryogenic fuels and oxidizers, high-pressure gases, and life-support-critical consumables. The risk associated with the storage of fluids and gases in space systems has long been an issue and the ability to retain these fluids is often tied to mission success. A leak in the storage or distribution system can cause many different problems, including a simple, but mission endangering, loss of inventory or, in severe cases, unbalanced thrust loads on a flight vehicle. Cryogenic propellants are especially difficult to store, especially over a long duration. The propellant can boil off and be lost through the insulating walls of the tank or simple thermal cycling of the fittings, valves, and propellant feed lines may unseat seals allowing the fluid to escape. Current NASA missions call for long-duration in-space storage of propellants, oxidizers, and life support supplies. Leaks of a scale detectable through a pressure drop in the storage tank are often catastrophic and have long been the focus of ground-based mitigation efforts where redundant systems are often employed. However, there is presently no technology available for detecting and monitoring low-level, but still mission-endangering, gas leaks in space. Standard in-space gas detection methods either have a very limited pressure range over which they operate effectively or are limited to certain gases. Mass spectrometer systems are able to perform the detection tasks, but their size, mass and use of high voltage, which could potentially lead to an arc that ignites a combustible propellent, severely limit their usefulness in a space system. In this paper, we present results from testing of the light-based interferometric gas monitoring and leak detection sensor shown in Fig. 1. The output of the sensor is an interference fringe pattern that is a function of the gas density, and commensurate index of refraction, in the sample region. Changes in the density of gas cause the interference fringes to move across a photodiode detector, providing a temporal history of the leak. The sensor is fiber coupled and constructed from solid optics, allowing for placement almost anywhere on the spacecraft. It is also advantageous in that it consumes very little power and does not introduce an ignition source. Data are presented demonstrating the capability of the sensor to measure density variations in different gas species. In addition, the transient response of the sensor in vacuum is demonstrated. These data extend and improve upon the results previously presented by the authors in Ref. [1].

Anastomotic leaks: what is the best diagnostic imaging study?

PubMed

Nicksa, G A; Dring, R V; Johnson, K H; Sardella, W V; Vignati, P V; Cohen, J L

2007-02-01

Postoperative anastomotic leaks are one of the most devastating consequences of colorectal surgery. Diagnostic imaging for upper gastrointestinal anastomotic leaks has been evaluated and reported on extensively. No study has compared the utility and effectiveness of CT scans and water-soluble enemas for the identification of postoperative lower gastrointestinal anastomotic leaks. The present study was designed to evaluate and compare these two common radiographic imaging modalities in detecting lower gastrointestinal anastomotic leaks. A retrospective chart review was performed that identified 36 patients during a seven-year period who underwent reoperative surgery for a lower gastrointestinal anastomotic leak. Patient's imaging studies were classified as positive if extravasation of contrast material was demonstrated. When negative, a study was retrospectively reviewed in an attempt to identify findings suggestive of an anastomotic leak. There were 36 patients identified with a postoperative lower gastrointestinal leak requiring surgical intervention. There were 28 of 36 patients (78 percent) re-explored on the basis of a radiologic study demonstrating an anastomotic leak. A total of 27 CT scans were performed, of which 4 (14.8 percent) were considered positive for an anastomotic leak. On review of the remaining negative CT scans, nine (33.3 percent) were considered descriptive positive with a large amount of fluid or air in the peritoneal cavity but without obvious extravasation of contrast. Eighteen patients were evaluated with a water-soluble enema and 15 (83.3 percent) demonstrated extravasation of contrast material. In the 26 patients with a distal anastomotic leak, 17 water-soluble enemas were performed, with 15 (88 percent) demonstrating a leak. In contrast, only 2 of 17 (12 percent) CT scans were positive in this group of patients (P < 0.001). There were ten patients who initially had a CT scan followed by a water-soluble enema. Of these patients, eight of nine (88 percent) initially had a negative CT scan but were considered to be clinically suspicious of having an anastomotic leak and subsequently had a leak demonstrated on a water-soluble enema. Early intervention in patients who develop an anastomotic leak can be shown to improve the ultimate outcome, especially with respect to mortality. It is usually necessary to obtain objective tests of anastomotic integrity because of the nonspecificity of clinical signs. Our study supported the superiority of water-soluble enema to CT imaging in patients in whom both modalities were used. This difference was most pronounced for distal anastomotic leaks, whereas no radiologic imaging study proved effective in evaluating proximal anastomoses.

Present-day stress magnitude at depth from leak-off tests in Italy

NASA Astrophysics Data System (ADS)

Mariucci, M. T.; Montone, P.; Pierdominici, S.

2012-04-01

We present new results from the analysis of leak-off tests, performed in deep oil wells in Italy, to characterize the present-day stress magnitude and regime in the crust. In the last years we have collected a large number of data (more than 500) from different stress indicators, mainly borehole breakouts, earthquake focal mechanisms and fault data, which provided information on the present-day stress orientations. In some areas the tectonic regime has been inferred either from fault plane solutions of M≥4 earthquakes or from stress inversions of smaller earthquakes. Where seismicity lacks, the regime is not well constrained and little or no information on the magnitude of the crustal stresses is available. In order to improve our knowledge in stress regime and its magnitude in Italy, in this work we use the leak-off test technique. Each test is performed at the bottom of an open hole by sealing off a section and then slowly pressurizing with a fluid until hydraulic tensile fractures develop. The minimum horizontal stress is inferred by leak-off pressure record, the vertical stress is computed by rock density data and the maximum horizontal stress is estimated applying a specific formula from the literature. Thanks to ENI S.p.A. (Italian oil company), that kindly provided new well data, we have been able to perform a critical review of our preliminary calculations and to enhance our previous results concerning stress magnitudes. Totally, we have analyzed 192 leak-off tests at depth between 200 and 5400m (average 1800m). In particular, wells are located along the Italian peninsula and in Sicily: most of them are in the Po Plain and along the Apenninic foredeep; few are in southern Apenninic belt and a few tens are in Sicily. After an accurate selection of the most robust results, we better characterize the Italian stress regime at depth.

Leak Isolation in Pressurized Pipelines using an Interpolation Function to approximate the Fitting Losses

NASA Astrophysics Data System (ADS)

Badillo-Olvera, A.; Begovich, O.; Peréz-González, A.

2017-01-01

The present paper is motivated by the purpose of detection and isolation of a single leak considering the Fault Model Approach (FMA) focused on pipelines with changes in their geometry. These changes generate a different pressure drop that those produced by the friction, this phenomenon is a common scenario in real pipeline systems. The problem arises, since the dynamical model of the fluid in a pipeline only considers straight geometries without fittings. In order to address this situation, several papers work with a virtual model of a pipeline that generates a equivalent straight length, thus, friction produced by the fittings is taking into account. However, when this method is applied, the leak is isolated in a virtual length, which for practical reasons does not represent a complete solution. This research proposes as a solution to the problem of leak isolation in a virtual length, the use of a polynomial interpolation function in order to approximate the conversion of the virtual position to a real-coordinates value. Experimental results in a real prototype are shown, concluding that the proposed methodology has a good performance.

Endoscopic Versus Microscopic Transsphenoidal Surgery in the Treatment of Pituitary Adenoma: A Systematic Review and Meta-Analysis.

PubMed

Li, Aijun; Liu, Weisheng; Cao, Peicheng; Zheng, Yuehua; Bu, Zhenfu; Zhou, Tao

2017-05-01

Inconsistent findings have been reported regarding the efficacy and safety of endoscopic and microscopic transsphenoidal surgery for pituitary adenoma. This study aimed to assess the benefits and shortcomings of these surgical methods in patients with pituitary adenoma. The electronic databases PubMed, Embase, and the Cochrane Library were systematically searched, as well as proceedings of major meetings. Eligible studies with a retrospective or prospective design that evaluated endoscopic versus microscopic methods in patients with pituitary adenoma were included. Primary outcomes included gross tumor removal, cerebrospinal fluid leak, diabetes insipidus, and other complications. Overall, 23 studies (4 prospective and 19 retrospective) assessing 2272 patients with pituitary adenoma were included in the final analysis. Endoscopic transsphenoidal surgery was associated with a higher incidence of gross tumor removal (odds ratio, 1.52; 95% confidence interval, 1.11-2.08; P = 0.009) than those with microscopic transsphenoidal surgery. In addition, endoscopic transsphenoidal surgery had no significant effect on the risk of cerebrospinal fluid leak, compared with microscopic transsphenoidal surgery. Furthermore, endoscopic transsphenoidal surgery was associated with a 22% reduction in risk of diabetes insipidus compared with microscopic transsphenoidal surgery, but the difference was not statistically significant. Endoscopic transsphenoidal surgery significantly reduced the risk of septal perforation (odds ratio, 0.29; 95% confidence interval, 0.11-0.78; P = 0.014) and was not associated with the risk of meningitis, epistaxis, hematoma, hypopituitarism, hypothyroidism, hypocortisolism, total mortality, and recurrence. Endoscopic transsphenoidal surgery is associated with higher gross tumor removal and lower incidence of septal perforation in patients with pituitary adenoma. Future large-scale prospective randomized controlled trials are needed to verify these findings. Copyright © 2017 Elsevier Inc. All rights reserved.

Petrous bone fractures violating otic capsule.

PubMed

Magliulo, Giuseppe; Ciniglio Appiani, Mario; Iannella, Giannicola; Artico, Marco

2012-12-01

This study presents our experience with a series of patients suffering from petrous bone fractures violating the otic capsule who underwent subtotal petrosectomy combined with eustachian tube, middle ear, and mastoid obliteration, with the goal of preventing cerebrospinal fluid (CSF) leak and meningitis. This study enrolled 26 patients between 1997 and 2011. The clinical symptoms, otoscopy, and preoperative and postoperative audiometry and facial function, as well as CSF leak or meningitis, were evaluated in each patient. The entire group underwent a subtotal petrosectomy using the technique described in detail by Fisch. In addition, each patient was interviewed using a questionnaire to evaluate the impact on quality of life. Intraoperatively, we found significant CSF leaks in 14 patients (42.5%). No patient reported other episodes of CSF leak or meningitis after the surgery. The patients' responses of facial nerve function were slightly worse than the House-Brackmann evaluation (50% versus 42.3%; p < 0.05). The vast majority (88.5%) of the patients experienced no social impact. Our findings suggest the importance of not underestimating the risk for CSF leak in the petrous bone fractures violating the otic capsule. Preoperative counseling regarding the various troublesome complications must adequately motivate candidates to undergo surgery by pointing out the positive impact of the proposed treatment.

Spontaneous spinal cerebrospinal fluid leak as a cause of coma after craniotomy for clipping of an unruptured intracranial aneurysm.

PubMed

Schievink, Wouter I; Palestrant, David; Maya, M Marcel; Rappard, George

2009-03-01

Spontaneous spinal CSF leaks are best known as a cause of orthostatic headache, but may also be the cause of coma. The authors encountered a unique case of a spontaneous spinal CSF leak causing coma 2 days after craniotomy for clipping of an unruptured aneurysm. This 44-year-old woman with autosomal dominant polycystic kidney disease underwent an uneventful craniotomy for an incidental anterior choroidal artery aneurysm. No intraoperative spinal CSF drainage was used. Two days after surgery the patient became comatose with a left oculomotor nerve palsy. Computed tomography scanning revealed a right extraceberal hematoma and loss of gray-white matter differentiation. The hematoma was evacuated and a diagnosis of hemodialysis disequilibrium syndrome was made. Continuous hemodialysis and hyperosmolar therapy were instituted without any improvement. The CT scans were then reinterpreted as showing sagging of the brain, and the patient was placed in the Trendelenburg position which resulted in prompt improvement in her level of consciousness. A CT myelogram demonstrated an upper thoracic CSF leak that eventually required surgical correction. The patient made a complete neurological recovery. Neurological deterioration after craniotomy may be caused by brain sagging caused by a spontaneous spinal CSF leak, similar to intracranial hypotension due to intraoperative lumbar CSF drainage.

Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks.

PubMed

Bertholet, Joost W M; Joosten, Joris J A; Keemers-Gels, Mariël E; van den Wildenberg, Frits J H; Barendregt, Wouter B

2011-01-01

Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay.

A short review on a complication of lumbar spine surgery: CSF leak.

PubMed

Menon, Sajesh K; Onyia, Chiazor U

2015-12-01

Cerebrospinal fluid (CSF) leak is a common complication of surgery involving the lumbar spine. Over the past decades, there has been significant advancement in understanding the basis, management and techniques of treatment for post-operative CSF leak following lumbar spine surgery. In this article, we review previous work in the literature on the various factors and technical errors during or after lumbar spine surgery that may lead to this feared complication, the available options of management with focus on the various techniques employed, the outcomes and also to highlight on the current trends. We also discuss the presentation, factors contributing to its development, basic concepts and practical aspects of the management with emphasis on the different techniques of treatment. Different outcomes following various techniques of managing post-operative CSF leak after lumbar spine surgery have been well described in the literature. However, there is currently no most ideal technique among the available options. The choice of which technique to be applied in each case is dependent on each surgeon's cumulative experience as well as a clear understanding of the contributory underlying factors in each patient, the nature and site of the leak, the available facilities and equipment. Copyright © 2015 Elsevier B.V. All rights reserved.

Williams working on the JAXA MS (Marangoni Surface) Experiment

NASA Image and Video Library

2009-11-05

ISS021-E-020304 (5 Nov. 2009) --- NASA astronaut Jeffrey Williams, Expedition 21 flight engineer, works with Fluid Physics Experiment Facility/Marangoni Surface (FPEF MS) Core hardware in the Kibo laboratory of the International Space Station. Williams first inserted the Marangoni Inside (MI) cassette in the MI Core for a leak check, and then installed the MI Core into the FPEF MI Body. The Marangoni convection experiment in the FPEF examines fluid tension flow in micro-G.

Middle cranial fossa approach to repair tegmen defects assisted by three-dimensionally printed temporal bone models.

PubMed

Ahmed, Sameer; VanKoevering, Kyle K; Kline, Stephanie; Green, Glenn E; Arts, H Alexander

2017-10-01

To explore the perioperative utility of three-dimensionally (3D)-printed temporal bone models of patients undergoing repair of lateral skull base defects and spontaneous cerebrospinal fluid leaks with the middle cranial fossa approach. Case series. 3D-printed temporal bone models-based on patient-specific, high-resolution computed tomographic imaging-were constructed using inexpensive polymer materials. Preoperatively, the models demonstrated the extent of temporal lobe retraction necessary to visualize the proposed defects in the lateral skull base. Also preoperatively, Silastic sheeting was arranged across the modeled tegmen, marked, and cut to cover all of the proposed defect sites. The Silastic sheeting was then sterilized and subsequently served as a precise intraoperative template for a synthetic dural replacement graft. Of note, these grafts were customized without needing to retract the temporal lobe. Five patients underwent the middle cranial fossa approach assisted by 3D-printed temporal bone models to repair tegmen defects and spontaneous cerebrospinal fluid leaks. No complications were encountered. The prefabricated dural repair grafts were easily placed and fit precisely onto the middle fossa floor without any additional modifications. All defects were covered as predicted by the 3D temporal bone models. At their postoperative visits, all five patients maintained resolution of their spontaneous cerebrospinal fluid leaks. Inexpensive 3D-printed temporal bone models of tegmen defects can serve as beneficial adjuncts during lateral skull base repair. The models provide a panoramic preoperative view of all tegmen defects and allow for custom templating of dural grafts without temporal lobe retraction. 4 Laryngoscope, 127:2347-2351, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Conceptual design and analysis of orbital cryogenic liquid storage and supply systems

NASA Technical Reports Server (NTRS)

Eberhardt, R. N.; Cunnington, G. R.; Johns, W. A.

1981-01-01

A wide variety of orbital cryogenic liquid storage and supply systems are defined in NASA and DOD long-range plans. These systems include small cooling applications, large chemical and electrical orbit transfer vehicles and supply tankers. All have the common requirements of low-g fluid management to accomplish gas-free liquid expulsion and efficient thermal control to manage heat leak and tank pressure. A preliminary design study was performed to evaluate tanks ranging from 0.6 to 37.4 cu m (22 to 1320 cu ft). Liquids of interest were hydrogen, oxygen, methane, argon and helium. Conceptual designs were generated for each tank system and fluid dynamic, thermal and structural analyses were performed for Shuttle compatible operations. Design trades considered the paradox of conservative support structure and minimum thermal input. Orbital performance and weight data were developed, and a technology evaluation was completed.

[Management of cerebrospinal fluid leaks according to size. Our experience].

PubMed

Alobid, Isam; Enseñat, Joaquim; Rioja, Elena; Enriquez, Karla; Viscovich, Liza; de Notaris, Matteo; Bernal-Sprekelsen, Manuel

2014-01-01

We present our experience in the reconstruction of cerebrospinal fluid (CSF) leaks according to their size and location. Fifty-four patients who underwent advanced skull base surgery (large defects) and 62 patients with CSF leaks of different origin (small and medium-sized defects) were included. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata and lumbar drainage was used. In small and medium-sized leaks of other origin, intrathecal fluorescein 5% was applied previously to identify the defect. Fascia lata in an underlay position was used for reconstruction, which was then covered with mucoperiosteum from the turbinate. Perioperative antibiotics were administered for 5-7 days. Nasal packing was removed after 24-48 hours. The most frequent aetiology for small and medium-sized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%) and others. The success rate was of 91% after the first surgery and 98% in large skull base defects and small/medium-sized respectively. After rescue surgery, the rate of closure achieved was 100%. The follow-up was 15.6 ± 12.4 months for large defects and 75.3 ± 51.3 months for small/medium-sized defects without recurrence. Endoscopic surgery for closure of any type of skull base defect is the gold standard approach. Defect size does not play a significant role in the success rate. Fascia lata and mucoperiosteum allow a reconstruction of small/medium-sized defects. For larger skull base defects, a combination of fat, fascia lata and nasoseptal pedicled flaps provide a successful reconstruction. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Space Shuttle RCS Oxidizer Leak Repair for STS-26

NASA Technical Reports Server (NTRS)

Delventhal, R. A.; Faget, N. M.

1989-01-01

Following propellant loading of the Space Shuttle's reaction control system (RCS) for mission STS 26, an oxidizer leak was detected in the left orbital maneuvering system (OMS) pod, where the RCS is located. Subsequent investigation determined that the leak was isolated at a mechanical Dynatube fitting near the RCS nitrogen tetroxide tank. An intense effort was initiated to design, fabricate, and qualify a sealing device to stop the oxidizer leak externally so that the Space Shuttle launch could proceed. It was discovered that sealing devices called clamshells were widely used throughout the petrochemical and power generation industries to stop leaks developed in large diameter pipes which carry steam or other hazardous fluids. These clamshells are available in different diameters and strengths and are placed around the pipe at the location of the leak. A sealing compound is then injected under high pressure into the clamshell to stop the leak. This technology was scaled down and applied to the problem of stopping the leak on the Orbiter, which was on a half-inch diameter line in a nearly inaccessible location. Many obstacles had to be overcome such as determining that the sealing material would be compatible with the nitrogen tetroxide and ensuring that the clamshell would actually fit around the Dynatube fitting without interfering with other lines which were in close proximity. The effort at the NASA Johnson Space Center included materials compatibility testing of several sealants, design of a clamshell to fit in the confined compartment, and manufacture and qualification of the flight hardware. A clamshell was successfully placed around the Dynatube fitting on the Orbiter and the oxidizer leak was terminated. Then it was decided to apply this technology further and design clamshells for other mechanical fittings onboard the Orbiter and develop sealing compounds which will be compatible with fuels such as monomethyl hydrazine (MMH). The potential exists for using this type of sealing device in numerous other applications throughout the aerospace industry.

Comprehensive leak detection survey and benefit/cost analysis

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

Scholze, R.J. Jr.; Maloney, S.W.

1995-06-01

Fort Carson, Colorado was the site of a comprehensive leak detection investigation of the potable water system with the express purpose of quantifying the benefits to be derived by a military installation from use of leak detection and repair technology. Military bases are often the size of a small city and one Directorate or Department has responsibility for all real estate (buildings, roads, grounds, etc.) unlike a municipal public works department. The investigation used state of the art noise correlation and computer correlation technology to survey the distribution system mains. This was complemented by a building to building survey coveringmore » office and commercial buildings along with family and barracks housing where investigators entered buildings and quantified visible leaks in faucets and water closets, etc. Following repairs and a year`s time, a follow-on survey is performed to again examine all aspects of the system. The result was a complete economic evaluation and benefit/cost analysis of the installation. Representative findings include: the majority of distribution system leaks were at hydrants or similar appurtenances; and family housing was found to be the other major concentration of leaks. However, where the first survey found 80 percent of housing units had leaks, findings from the second round on the order of 20 percent. Office buildings were found from the first survey to not merit follow-on attention due to limited numbers of leaks. Water-consciousness was raised for both the responsible directorate and individuals in family housing and leak repair was given a higher priority for repairs. This paper will outline the leak detection methodology used, characterize the types and patterns of leaks found, introduce an economic analysis for the entire leak detection process, and finally, provide lessons learned with practical results and implications.« less

75 FR 60302 - Airworthiness Directives; Eurocopter France (Eurocopter) Model AS332C, L, L1, and L2 Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... light come on during the approach phase. Investigation revealed a hydraulic fluid leak from the.... We will consider all comments received by the closing date and may amend the AD in light of those...

Definition and classification of chyle leak after pancreatic operation: A consensus statement by the International Study Group on Pancreatic Surgery.

PubMed

Besselink, Marc G; van Rijssen, L Bengt; Bassi, Claudio; Dervenis, Christos; Montorsi, Marco; Adham, Mustapha; Asbun, Horacio J; Bockhorn, Maximillian; Strobel, Oliver; Büchler, Markus W; Busch, Olivier R; Charnley, Richard M; Conlon, Kevin C; Fernández-Cruz, Laureano; Fingerhut, Abe; Friess, Helmut; Izbicki, Jakob R; Lillemoe, Keith D; Neoptolemos, John P; Sarr, Michael G; Shrikhande, Shailesh V; Sitarz, Robert; Vollmer, Charles M; Yeo, Charles J; Hartwig, Werner; Wolfgang, Christopher L; Gouma, Dirk J

2017-02-01

Recent literature suggests that chyle leak may complicate up to 10% of pancreatic resections. Treatment depends on its severity, which may include chylous ascites. No international consensus definition or grading system of chyle leak currently is available. The International Study Group on Pancreatic Surgery, an international panel of pancreatic surgeons working in well-known, high-volume centers, reviewed the literature and worked together to establish a consensus on the definition and classification of chyle leak after pancreatic operation. Chyle leak was defined as output of milky-colored fluid from a drain, drain site, or wound on or after postoperative day 3, with a triglyceride content ≥110 mg/dL (≥1.2 mmol/L). Three different grades of severity were defined according to the management needed: grade A, no specific intervention other than oral dietary restrictions; grade B, prolongation of hospital stay, nasoenteral nutrition with dietary restriction, total parenteral nutrition, octreotide, maintenance of surgical drains, or placement of new percutaneous drains; and grade C, need for other more invasive in-hospital treatment, intensive care unit admission, or mortality. This classification and grading system for chyle leak after pancreatic resection allows for comparison of outcomes between series. As with the other the International Study Group on Pancreatic Surgery consensus statements, this classification should facilitate communication and evaluation of different approaches to the prevention and treatment of this complication. Copyright © 2016 Elsevier Inc. All rights reserved.

Cesium vapor cycle for an advanced LMFBR

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

Fraas, A.P.

1975-01-01

A review indicates that a cesium vapor topping cycle appears attractive for use in the intermediate fluid circuit of an advanced LMFBR designed for a reactor outlet temperature of 1250$sup 0$F or more and would have the following advantages: (1) it would increase the thermal efficiency by about 5 to 10 points (from approximately 40 percent to approximately 45 to 50 percent) thus reducing the amount of waste heat rejected to the environment by 15 to 30 percent. (2) the higher thermal efficiency should reduce the overall capital cost of the reactor plant in dollars per kilowatt. (3) the cesiummore » can be distilled out of the intermediate fluid circuit to leave it bone-dry, thus greatly reducing the time and cost of maintenance work (particularly for the steam generator). (4) the large volume and low pressure of the cesium vapor region in the cesium condenser-steam generator greatly reduces the magnitude of pressure fluctuations that might occur in the event of a leak in a steam generator tube, and the characteristics inherent in a condenser make it easy to design for rapid concentration of any noncondensibles that may form as a consequence of a steam leak into the cesium region so that a steam leak can be detected easily in the very early stages of its development. (auth)« less

Water displacement mercury pump

DOEpatents

Nielsen, Marshall G.

1985-01-01

A water displacement mercury pump has a fluid inlet conduit and diffuser, a valve, a pressure cannister, and a fluid outlet conduit. The valve has a valve head which seats in an opening in the cannister. The entire assembly is readily insertable into a process vessel which produces mercury as a product. As the mercury settles, it flows into the opening in the cannister displacing lighter material. When the valve is in a closed position, the pressure cannister is sealed except for the fluid inlet conduit and the fluid outlet conduit. Introduction of a lighter fluid into the cannister will act to displace a heavier fluid from the cannister via the fluid outlet conduit. The entire pump assembly penetrates only a top wall of the process vessel, and not the sides or the bottom wall of the process vessel. This insures a leak-proof environment and is especially suitable for processing of hazardous materials.

Water displacement mercury pump

DOEpatents

Nielsen, M.G.

1984-04-20

A water displacement mercury pump has a fluid inlet conduit and diffuser, a valve, a pressure cannister, and a fluid outlet conduit. The valve has a valve head which seats in an opening in the cannister. The entire assembly is readily insertable into a process vessel which produces mercury as a product. As the mercury settles, it flows into the opening in the cannister displacing lighter material. When the valve is in a closed position, the pressure cannister is sealed except for the fluid inlet conduit and the fluid outlet conduit. Introduction of a lighter fluid into the cannister will act to displace a heavier fluid from the cannister via the fluid outlet conduit. The entire pump assembly penetrates only a top wall of the process vessel, and not the sides or the bottom wall of the process vessel. This insures a leak-proof environment and is especially suitable for processing of hazardous materials.

Demonstration and Validation of a High-Performance Floor-Sealant System to Reduce Concrete Degradation

DTIC Science & Technology

2015-05-01

1 Recycled Antifreeze 01-197-7692 MIL-PRF-10924H GAA Grease 01-102-9455 MIL-PRF-46176B Brake Fluid 00-252-6383 MIL-PRF-5606H Hydraulic Fluid H515...contaminated clothing , clean thoroughly before reuse. Inhalation: Move to fresh air. If not breathing, give rescue breathing. I f breathing is...material to absorb the spill, use plastic shovel to pick up absorbent for disposal Spills and Leaks: Dispose in accordance to local, state or federal

Tolerance requirements to prevent fluid leakage in the crucible/plunger MEA experiment MPS 770030

NASA Technical Reports Server (NTRS)

Rathz, T. J.

1982-01-01

Molten Al-In leaked unexpectedly out of the crucible of a proposed MEA materials processing in space experiment. The molten metals use a spring loaded plunger to eliminate most free surfaces. The critical criteria necessary to initiate flow and the rate of fluid flow into the crucible/plunger annulus is calculated. Experimental in situ X-radiographs are interpreted according to the calculations. A note on possible effects of capillary flow if wetting occurs between crucible/plunger and liquids is included.

METHODS FOR DETERMINING THE MECHANICAL INTEGRITY OF CLASS II INJECTION WELLS

EPA Science Inventory

The mechanical integrity of injection wells must be determined to insure that there is no significant leak in the casing, tubing or packer, and that there is no significant fluid movement through vertical channels adjacent to the injection well. Methods for mechanical integrity t...

Brine flow up a borehole caused by pressure perturbation from CO2 storage: Static and dynamic evaluations

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

Birkholzer, J.T.; Nicot, J.-P.; Oldenburg, C.M.

Industrial-scale storage of CO{sub 2} in saline sedimentary basins will cause zones of elevated pressure, larger than the CO{sub 2} plume itself. If permeable conduits (e.g., leaking wells) exist between the injection reservoir and overlying shallow aquifers, brine could be pushed upwards along these conduits and mix with groundwater resources. This paper discusses the potential for such brine leakage to occur in temperature- and salinity-stratified systems. Using static mass-balance calculations as well as dynamic well flow simulations, we evaluate the minimum reservoir pressure that would generate continuous migration of brine up a leaking wellbore into a freshwater aquifer. Since themore » brine invading the well is denser than the initial fluid in the wellbore, continuous flow only occurs if the pressure perturbation in the reservoir is large enough to overcome the increased fluid column weight after full invasion of brine into the well. If the threshold pressure is exceeded, brine flow rates are dependent on various hydraulic (and other) properties, in particular the effective permeability of the wellbore and the magnitude of pressure increase. If brine flow occurs outside of the well casing, e.g., in a permeable fracture zone between the well cement and the formation, the fluid/solute transfer between the migrating fluid and the surrounding rock units can strongly retard brine flow. At the same time, the threshold pressure for continuous flow to occur decreases compared to a case with no fluid/solute transfer.« less

Individual surgeon is an independent risk factor for leak after double-stapled colorectal anastomosis: An institutional analysis of 800 patients.

PubMed

García-Granero, Eduardo; Navarro, Francisco; Cerdán Santacruz, Carlos; Frasson, Matteo; García-Granero, Alvaro; Marinello, Franco; Flor-Lorente, Blas; Espí, Alejandro

2017-11-01

Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons. The main outcome variable was anastomotic leak, defined as leak of luminal contents from a colorectal anastomosis between 2 hollow viscera diagnosed radiologically, clinically, endoscopically, or intraoperatively. Pelvic abscesses were also considered to be an anastomotic leak. Radiologic examination was performed when there was clinical suspicion of leak. Anastomotic leak occurred in 6.1% of patients, of which 33 (67%) were treated operatively, 6 (12%) with radiologic drains, and 10 (21%) by medical treatment. Postoperative mortality rate was 2.9% for the whole group of 800 patients. In patients with anastomotic leak, mortality rate increased up to 16% vs 2.0% in patients without anastomotic leak (P < .0001). At multivariate analysis, rectal location of tumor, male sex, bowel obstruction preoperatively, tobacco use, diabetes, perioperative transfusion, and the individual surgeon were independent risk factors for anastomotic leak. The surgeon was the most important factor (mean odds ratio 4.9; range 1.0 to 13.5). The variance of anastomotic leak between the different surgeons was 0.56 in the logit scale. The individual surgeon is an independent risk factor for leakage in double-stapled, colorectal, end-to-end anastomosis after oncologic left-sided colorectal resection. Copyright © 2017 Elsevier Inc. All rights reserved.

Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base.

PubMed

Filippidis, Aristotelis S; Kalani, M Yashar S; Nakaji, Peter; Rekate, Harold L

2011-11-01

Negative-pressure and low-pressure hydrocephalus are rare clinical entities that are frequently misdiagnosed. They are characterized by recurrent episodes of shunt failure because the intracranial pressure is lower than the opening pressure of the valve. In this report the authors discuss iatrogenic CSF leaks as a cause of low- or negative-pressure hydrocephalus after approaches to the cranial base. The authors retrospectively reviewed cases of low-pressure or negative-pressure hydrocephalus presenting after cranial approaches complicated with a CSF leak at their institution. Three patients were identified. Symptoms of high intracranial pressure and ventriculomegaly were present, although the measured pressures were low or negative. A blocked communication between the ventricles and the subarachnoid space was documented in 2 of the cases and presumed in the third. Shunt revisions failed repeatedly. In all cases, temporary clinical and radiographic improvement resulted from external ventricular drainage at subatmospheric pressures. The CSF leaks were sealed and CSF communication was reestablished operatively. In 1 case, neck wrapping was used with temporary success. Negative-pressure or low-pressure hydrocephalus associated with CSF leaks, especially after cranial base approaches, is difficult to treat. The solution often requires the utilization of subatmospheric external ventricular drains to establish a lower ventricular drainage pressure than the drainage pressure created in the subarachnoid space, where the pressure is artificially lowered by the CSF leak. Treatment involves correction of the CSF leak, neck wrapping to increase brain turgor and allow the pressure in the ventricles to rise to the level of the opening pressure of the valve, and reestablishing the CSF route.

Perioperative lumbar drain utilization in transsphenoidal pituitary resection.

PubMed

Alharbi, Shatha; Harsh, Griffith; Ajlan, Abdulrazag

2018-01-01

To evaluate lumbar drain (LD) efficacy in transnasal resection of pituitary macroadenomas in preventing postoperative cerebrospinal fluid (CSF) leak, technique safety, and effect on length of hospital stay. We conducted a retrospective data review of pituitary tumor patients in our institution who underwent surgery between December 2006 and January 2013. All patients were operated on for complete surgical resection of pituitary macroadenoma tumors. Patients were divided into 2 groups: group 1 received a preoperative drain, while LD was not preoperatively inserted in group 2. In cases of tumors with suprasellar extension with anticipation of high-flow leak, LD was inserted after the patient was intubated and in a lateral position. Lumbar drain was used for 48 hours, and the drain was removed if no leak was observed postoperatively. In documented postoperative CSF leak patients with no preoperative drain, the leak was treated by LD trial prior to surgical reconstruction. Cases in which leak occurred 6 months postoperatively were excluded. Our study population consisted of 186 patients, 99 women (53%) and 87 men (47%), with a mean age of 50.3+/-16.1 years. Complications occurred in 7 patients (13.7%) in group 1 versus 21 (15.5%) in group 2 (p=0.72). Postoperative CSF leak was observed in 1 patient (1.9%) in group 1 and 7 (5%) in group 2 (Fisher exact test=0.3). Length of hospital stay was a mean of 4.7+/-1.9 days in group 1 and a mean of 2.7+/-2.4 days in group 2 (p<001). The most common reason to extend hospital stay was management of diabetes insipidus. Although LD insertion is generally considered safe with a low risk of complications, it increases the length of hospitalization. Minor complications include headaches and patient discomfort.

Development problem analysis of correlation leak detector’s software

NASA Astrophysics Data System (ADS)

Faerman, V. A.; Avramchuk, V. S.; Marukyan, V. M.

2018-05-01

In the article, the practical application and the structure of the correlation leak detectors’ software is studied and the task of its designing is analyzed. In the first part of the research paper, the expediency of the facilities development of correlation leak detectors for the following operating efficiency of public utilities exploitation is shown. The analysis of the functional structure of correlation leak detectors is conducted and its program software tasks are defined. In the second part of the research paper some development steps of the software package – requirement forming, program structure definition and software concept creation – are examined in the context of the usage experience of the hardware-software prototype of correlation leak detector.

40 CFR 60.562-2 - Standards: Equipment leaks of VOC.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES Standards of Performance for Volatile Organic Compound (VOC) Emissions from the Polymer Manufacturing Industry § 60.562-2 Standards... feature of the pump whereby polymer fluid used to provide lubrication and/or cooling of the pump shaft...

Inspection tool for butt-welded tubing

NASA Technical Reports Server (NTRS)

Horman, D. P.

1977-01-01

Inspection tool for tubing consists of metal casing housing elastic collar. Collar is clamped around weld site under test. Leakage through weld is contained within chamber and is bled to detector via tubing attached to fitting. Tool, originally designed to detect fluid leakage in tubing, can be used to detect gas leaks.

40 CFR 63.1032 - Sampling connection systems standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) [Reserved] (3) Be designed and operated to capture and transport all the purged process fluid to a control... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 2 Standards § 63.1032 Sampling... design and operation. Each closed-purge, closed-loop, or closed vent system as required in paragraph (b...

40 CFR 63.1013 - Sampling connection systems standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 1 § 63.1013 Sampling connection... container are not required to be collected or captured. (c) Equipment design and operation. Each closed... process fluid to a process; or (3) Be designed and operated to capture and transport all the purged...

40 CFR 63.1032 - Sampling connection systems standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) [Reserved] (3) Be designed and operated to capture and transport all the purged process fluid to a control... (CONTINUED) National Emission Standards for Equipment Leaks-Control Level 2 Standards § 63.1032 Sampling... design and operation. Each closed-purge, closed-loop, or closed vent system as required in paragraph (b...

46 CFR 58.25-85 - Special requirements for tank vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (e), (h), (i), and (j); (2) Ensure working access to machinery and controls in the steering-gear compartment (which must include handrails and either gratings or other non-slip surfaces to ensure a safe working environment in case hydraulic fluid leaks); (3) Have two separate and independent steering-gear...

Experimental investigation of 20 K two-stage layered active magnetic regenerative refrigerator

NASA Astrophysics Data System (ADS)

Park, Inmyong; Jeong, Sangkwon

2015-12-01

The performance of a two-stage layered AMRR is experimentally investigated. The test apparatus includes two-stage layered AMRs, low temperature superconducting (LTS) magnet which generates maximum magnetic field of 4 T, and the helium gas flow system. The helium compressor with the tandem rotary valve is employed to generate the oscillating flow of the helium gas minimizing the pressure swing effect. The mass flow rate of working fluid is controlled separately at the first and second stages of the AMR by solenoid valves. The mass flow rate of the AMRs is measured by the mass flow meter and the cryogenic hot-film sensor which is calibrated at cryogenic temperature range from 20 K to 77 K. In order to reduce the heat leak by shuttle heat transfer of the working fluid, void volumes have been implemented and connected to the cold ends of the AMR1 and AMR2. The temperature span of the AMR is recorded as 52 K and the performance of the AMR with the variation of the mass flow rate is analysed. The results show that the mass flow rate and the heat leak due to the shuttle heat transfer by oscillating working fluid are crucial factors in the AMR performance.

Ammonia Leak Locator Study

NASA Technical Reports Server (NTRS)

Dodge, Franklin T.; Wuest, Martin P.; Deffenbaugh, Danny M.

1995-01-01

The thermal control system of International Space Station Alpha will use liquid ammonia as the heat exchange fluid. It is expected that small leaks (of the order perhaps of one pound of ammonia per day) may develop in the lines transporting the ammonia to the various facilities as well as in the heat exchange equipment. Such leaks must be detected and located before the supply of ammonia becomes critically low. For that reason, NASA-JSC has a program underway to evaluate instruments that can detect and locate ultra-small concentrations of ammonia in a high vacuum environment. To be useful, the instrument must be portable and small enough that an astronaut can easily handle it during extravehicular activity. An additional complication in the design of the instrument is that the environment immediately surrounding ISSA will contain small concentrations of many other gases from venting of onboard experiments as well as from other kinds of leaks. These other vapors include water, cabin air, CO2, CO, argon, N2, and ethylene glycol. Altogether, this local environment might have a pressure of the order of 10(exp -7) to 10(exp -6) torr. Southwest Research Institute (SwRI) was contracted by NASA-JSC to provide support to NASA-JSC and its prime contractors in evaluating ammonia-location instruments and to make a preliminary trade study of the advantages and limitations of potential instruments. The present effort builds upon an earlier SwRI study to evaluate ammonia leak detection instruments [Jolly and Deffenbaugh]. The objectives of the present effort include: (1) Estimate the characteristics of representative ammonia leaks; (2) Evaluate the baseline instrument in the light of the estimated ammonia leak characteristics; (3) Propose alternative instrument concepts; and (4) Conduct a trade study of the proposed alternative concepts and recommend promising instruments. The baseline leak-location instrument selected by NASA-JSC was an ion gauge.

A CFD Analysis of Hydrogen Leakage During On-Pad Purge in the ORION/ARES I Shared Volume

NASA Technical Reports Server (NTRS)

Ajmani, Kumud; Edwards, Daryl A.

2011-01-01

A common open volume is created by the stacking of the Orion vehicle onto the Ares I Upper Stage. Called the Shared Volume, both vehicles contribute to its gas, fluid, and thermal environment. One of these environments is related to hazardous hydrogen gas. While both vehicles use inert purge gas to mitigate any hazardous gas buildup, there are concerns that hydrogen gas may still accumulate and that the Ares I Hazardous Gas Detection System will not be sufficient for monitoring the integrated volume. This Computational Fluid Dynamics (CFD) analysis has been performed to examine these topics. Results of the analysis conclude that the Ares I Hazardous Gas Detection System will be able to sample the vent effluent containing the highest hydrogen concentrations. A second conclusion is that hydrogen does not accumulate under the Orion Service Module (SM) avionics ring as diffusion and purge flow mixing sufficiently dilute the hydrogen to safe concentrations. Finally the hydrogen concentrations within the Orion SM engine nozzle may slightly exceed the 1 percent volume fraction when the entire worse case maximum full leak is directed vertically into the engine nozzle.

A new tool for the rapid remote detection of leaks from subsea pipelines during remotely operated vehicle inspections

NASA Astrophysics Data System (ADS)

McStay, D.; McIlroy, J.; Forte, A.; Lunney, F.; Greenway, T.; Thabeth, K.; Dean, G.

2005-06-01

A new 2000 m depth rated subsea sensor that can effectively, rapidly and remotely detect leaks of fluorescein dye, leak detection chemicals and hydraulic fluids from underwater structures is reported. The system utilizes ultra-bright LED technology to project a structured beam of light, at a wavelength suitable to excite the fluorescence of the target material, into the water column. The resultant fluorescence is collected and digital signal processing used to extract the intensity. The system is capable of detecting ppm concentrations of fluorescein at a range of 2.5 m in water in real time. The ability to stand-off from subsea structures, while rapidly detecting the chemicals makes the system highly suited to subsea leak inspections with remotely operated vehicles or autonomous underwater vehicles, as it allows the vehicles to be flown quickly and safely over the structure to be inspected. This increases both the speed and effectiveness of the inspection. The remote detection capability is also highly effective for probing complex underwater structures. The system has been successfully used in real subsea survey applications and has been found to be effective, user friendly and to dramatically reduce inspection times and hence costs.

Hydraulic Fracture Growth in a Layered Formation based on Fracturing Experiments and Discrete Element Modeling

NASA Astrophysics Data System (ADS)

Yushi, Zou; Xinfang, Ma; Tong, Zhou; Ning, Li; Ming, Chen; Sihai, Li; Yinuo, Zhang; Han, Li

2017-09-01

Hydraulic fracture (HF) height containment tends to occur in layered formations, and it significantly influences the entire HF geometry or the stimulated reservoir volume. This study aims to explore the influence of preexisting bedding planes (BPs) on the HF height growth in layered formations. Laboratory fracturing experiments were performed to confirm the occurrence of HF height containment in natural shale that contains multiple weak and high-permeability BPs under triaxial stresses. Numerical simulations were then conducted to further illustrate the manner in which vertical stress, BP permeability, BP density(or spacing), pump rate, and fluid viscosity control HF height growth using a 3D discrete element method-based fracturing model. In this model, the rock matrix was considered transversely isotropic and multiple BPs can be explicitly represented. Experimental and numerical results show that the vertically growing HF tends to be limited by multi-high-permeability BPs, even under higher vertical stress. When the vertically growing HF intersects with the multi-high-permeability BPs, the injection pressure will be sharply reduced. If a low pumping rate or a low-viscosity fluid is used, the excess fracturing fluid leak-off into the BPs obviously decreases the rate of pressure build up, which will then limit the growth of HF. Otherwise, a higher pumping rate and/or a higher viscosity will reduce the leak-off time and fluid volume, but increase the injection pressure to drive the HF to grow and to penetrate through the BPs.

Mechanical Expansion of Steel Tubing as a Solution to Leaky Wellbores

PubMed Central

Radonjic, Mileva; Kupresan, Darko

2014-01-01

Wellbore cement, a procedural component of wellbore completion operations, primarily provides zonal isolation and mechanical support of the metal pipe (casing), and protects metal components from corrosive fluids. These are essential for uncompromised wellbore integrity. Cements can undergo multiple forms of failure, such as debonding at the cement/rock and cement/metal interfaces, fracturing, and defects within the cement matrix. Failures and defects within the cement will ultimately lead to fluid migration, resulting in inter-zonal fluid migration and premature well abandonment. Currently, there are over 1.8 million operating wells worldwide and over one third of these wells have leak related problems defined as Sustained Casing Pressure (SCP)1. The focus of this research was to develop an experimental setup at bench-scale to explore the effect of mechanical manipulation of wellbore casing-cement composite samples as a potential technology for the remediation of gas leaks. The experimental methodology utilized in this study enabled formation of an impermeable seal at the pipe/cement interface in a simulated wellbore system. Successful nitrogen gas flow-through measurements demonstrated that an existing microannulus was sealed at laboratory experimental conditions and fluid flow prevented by mechanical manipulation of the metal/cement composite sample. Furthermore, this methodology can be applied not only for the remediation of leaky wellbores, but also in plugging and abandonment procedures as well as wellbore completions technology, and potentially preventing negative impacts of wellbores on subsurface and surface environments. PMID:25490436

Mechanical expansion of steel tubing as a solution to leaky wellbores.

PubMed

Radonjic, Mileva; Kupresan, Darko

2014-11-20

Wellbore cement, a procedural component of wellbore completion operations, primarily provides zonal isolation and mechanical support of the metal pipe (casing), and protects metal components from corrosive fluids. These are essential for uncompromised wellbore integrity. Cements can undergo multiple forms of failure, such as debonding at the cement/rock and cement/metal interfaces, fracturing, and defects within the cement matrix. Failures and defects within the cement will ultimately lead to fluid migration, resulting in inter-zonal fluid migration and premature well abandonment. Currently, there are over 1.8 million operating wells worldwide and over one third of these wells have leak related problems defined as Sustained Casing Pressure (SCP). The focus of this research was to develop an experimental setup at bench-scale to explore the effect of mechanical manipulation of wellbore casing-cement composite samples as a potential technology for the remediation of gas leaks. The experimental methodology utilized in this study enabled formation of an impermeable seal at the pipe/cement interface in a simulated wellbore system. Successful nitrogen gas flow-through measurements demonstrated that an existing microannulus was sealed at laboratory experimental conditions and fluid flow prevented by mechanical manipulation of the metal/cement composite sample. Furthermore, this methodology can be applied not only for the remediation of leaky wellbores, but also in plugging and abandonment procedures as well as wellbore completions technology, and potentially preventing negative impacts of wellbores on subsurface and surface environments.

Water conservation study. Badger Army Ammunition Plant, Baraboo, Wisconsin. Final report

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

NONE

1995-05-01

The purpose of this water conservation study is to identify projects which result in energy maintenance and cost savings in the process water distribution system at Badger Army Ammunition Plant (BAAP) in Baraboo, Wisconsin. A leak detection survey was performed on all process water piping with a diameter of 6 inches or greater. The leak detection analysis was performed using a combination of listening devices and preamplified-transducer systems to identify the majority of leak locations. When the location of the leak could not be readily identified using these methods, a leak correlator was used. The leak correlator determines leak locationmore » based on the time it takes for sound to travel from the leak to a waterline connection point.« less

Modulation of leak K(+) channel in hypoglossal motoneurons of rats by serotonin and/or variation of pH value.

PubMed

Xu, Xue-Feng; Tsai, Hao-Jan; Li, Lin; Chen, Yi-Fan; Zhang, Cheng; Wang, Guang-Fa

2009-08-25

The cloned TWIK-related acid-sensitive K(+) channel (TASK-1) is sensitive to the pH changes within physiological pH range (pK~7.4). Recently, the native TASK-1-like channel was suggested to be the main contributor to the background (or leak) K(+) conductance in the motoneurons of the brain stem. Serotonin (5-HT) and variation of pH value in perfused solution could modulate these currents. Here we aimed to examine the properties and modulation of the currents by serotonin or variation of pH value in hypoglossal motoneurons of rats. Transverse slices were prepared from the brainstem of neonatal Sprague-Dawley rats (postnatal days 7-8). Hypoglossal motoneurons were used for the study. The leak K(+) current (TASK-1-like current) and hyperpolarization-activated cationic current (I(h)) were recorded with the whole-cell patch-clamp technique. The results showed that these currents were inhibited by acidified artificial cerebrospinal fluid (ACSF, pH 6.0) and activated by alkalized ACSF (pH 8.5). 5-HT (10 mumol/L) significantly inhibited both leak K(+) current and I(h) with depolarization of membrane potential and the occurrence of oscillation and/or spikes. Bath application of Ketanserine, an antagonist of 5-HT₂ receptor, reversed or reduced the inhibitory effect of acidified solution on leak K(+) current and I(h). The results suggest that 5-HT₂ receptors mediate the effects of acidified media on leak K(+) current and I(h) in hypoglossal motoneurons.

Risk of anastomotic leak after laparoscopic versus open colectomy.

PubMed

Murray, Alice C A; Chiuzan, Cody; Kiran, Ravi P

2016-12-01

Anastomotic leak following colorectal surgery is associated with significant morbidity and mortality. With the widespread adoption of laparoscopy, data from initial clinical trials evaluating the efficacy of laparoscopic when compared to open surgery may not currently be generalizable. We assess the risk of anastomotic leak after laparoscopic versus open colorectal resection using a nationwide database with standardized definitions. The 2012-2013 ACS-NSQIP targeted colectomy data were queried for all elective colorectal resections. Characteristics were compared for those patients undergoing laparoscopic versus open operations. Univariable and multivariable analyses, followed by a propensity score-matched analysis, were performed to assess the impact of laparoscopy on the development of an anastomotic leak. Of 23,568 patients, 3.4 % developed an anastomotic leak. Laparoscopic surgery was associated with a leak rate of 2.8 % (n = 425) and open surgery, 4.5 % (n = 378, p < 0.0001). Patients who developed a leak were more likely to die within 30 days of surgery (5.7 vs. 0.6 %, p < 0.0001). Patients who underwent laparoscopic surgery compared to open were younger (61 vs. 63 years, p = 0, p = 0.045) and with fewer comorbidities. On univariable analysis laparoscopic surgery was associated with reduced odds of developing an anastomotic leak (OR 0.60, p < 0.0001), and this remained after adjusting for all significant preoperative and disease-related confounders (OR 0.69, 95 % CI 0.58-0.82). A propensity score-matched analysis confirmed benefit of laparoscopic surgery over open surgery for anastomotic leak. Laparoscopic colectomy is safe and associated with reduced odds of developing an anastomotic leak following colectomy when controlling for patient-, disease- and procedure-related factors.

Experiences with leak rate calculations methods for LBB application

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

Grebner, H.; Kastner, W.; Hoefler, A.

1997-04-01

In this paper, three leak rate computer programs for the application of leak before break analysis are described and compared. The programs are compared to each other and to results of an HDR Reactor experiment and two real crack cases. The programs analyzed are PIPELEAK, FLORA, and PICEP. Generally, the different leak rate models are in agreement. To obtain reasonable agreement between measured and calculated leak rates, it was necessary to also use data from detailed crack investigations.

Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.

PubMed

Ghobrial, George M; Anderson, Paul A; Chitale, Rohan; Campbell, Peter G; Lobel, Darlene A; Harrop, James

2013-10-01

In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity. To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model. The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine. Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all. Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.

Alteration of fault rocks by CO2-bearing fluids with implications for sequestration

NASA Astrophysics Data System (ADS)

Luetkemeyer, P. B.; Kirschner, D. L.; Solum, J. G.; Naruk, S.

2011-12-01

Carbonates and sulfates commonly occur as primary (diagenetic) pore cements and secondary fluid-mobilized veins within fault zones. Stable isotope analyses of calcite, formation fluid, and fault zone fluids can help elucidate the carbon sources and the extent of fluid-rock interaction within a particular reservoir. Introduction of CO2 bearing fluids into a reservoir/fault system can profoundly affect the overall fluid chemistry of the reservoir/fault system and may lead to the enhancement or degradation of porosity within the fault zone. The extent of precipitation and/or dissolution of minerals within a fault zone can ultimately influence the sealing properties of a fault. The Colorado Plateau contains a number of large carbon dioxide reservoirs some of which leak and some of which do not. Several normal faults within the Paradox Basin (SE Utah) dissect the Green River anticline giving rise to a series of footwall reservoirs with fault-dependent columns. Numerous CO2-charged springs and geysers are associated with these faults. This study seeks to identify regional sources and subsurface migration of CO2 to these reservoirs and the effect(s) faults have on trap performance. Data provided in this study include mineralogical, elemental, and stable isotope data for fault rocks, host rocks, and carbonate veins that come from two localities along one fault that locally sealed CO2. This fault is just tens of meters away from another normal fault that has leaked CO2-charged waters to the land surface for thousands of years. These analyses have been used to determine the source of carbon isotopes from sedimentary derived carbon and deeply sourced CO2. XRF and XRD data taken from several transects across the normal faults are consistent with mechanical mixing and fluid-assisted mass transfer processes within the fault zone. δ13C range from -6% to +10% (PDB); δ18O values range from +15% to +24% (VSMOW). Geochemical modeling software is used to model the alteration productions of fault rocks from fluids of various chemistries coming from several different reservoirs within an active CO2-charged fault system. These results are compared to data obtained in the field.

Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation

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

Rancourt, Raymond C., E-mail: raymond.rancourt@ucdenver.edu; Veress, Livia A., E-mail: livia.veress@ucdenver.edu; Ahmad, Aftab, E-mail: aftab.ahmad@ucdenver.edu

Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Methods: Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5 mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O{sub 2} saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin–antithrombin complex (TAT), active plasminogen activatormore » inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Results: Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Conclusions: Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. - Highlights: • TFPI administration to rats after mustard inhalation reduces airway cast formation. • Inhibition of thrombin activation is the likely mechanism for limiting casts. • Rats given TFPI had improved tissue oxygenation, and mortality was prevented.« less

Severe capillary leak syndrome after inner ear decompression sickness in a recreational scuba diver.

PubMed

Gempp, Emmanuel; Lacroix, Guillaume; Cournac, Jean-Marie; Louge, Pierre

2013-07-01

Post-decompression shock with plasma volume deficit is a very rare event that has been observed under extreme conditions of hypobaric and hyperbaric exposure in aviators and professional divers. We report a case of severe hypovolemic shock due to extravasation of plasma in a recreational scuba diver presenting with inner ear decompression sickness. Impaired endothelial function can lead to capillary leak with hemoconcentration and hypotension in severe cases. This report suggests that decompression-induced circulating bubbles may have triggered the endothelial damage, activating the classic inflammatory pathway of increased vascular permeability. This observation highlights the need for an accurate diagnosis of this potentially life-threatening condition at the initial presentation in the Emergency Department after a diving-related injury. An elevated hematocrit in a diver should raise the suspicion for the potential development of capillary leak syndrome requiring specific treatment using albumin infusion as primary fluid replacement. Copyright © 2013 Elsevier Inc. All rights reserved.

Behavior and dynamics of bubble breakup in gas pipeline leaks and accidental subsea oil well blowouts.

PubMed

Wang, Binbin; Socolofsky, Scott A; Lai, Chris C K; Adams, E Eric; Boufadel, Michel C

2018-06-01

Subsea oil well blowouts and pipeline leaks release oil and gas to the environment through vigorous jets. Predicting the breakup of the released fluids in oil droplets and gas bubbles is critical to predict the fate of petroleum compounds in the marine water column. To predict the gas bubble size in oil well blowouts and pipeline leaks, we observed and quantified the flow behavior and breakup process of gas for a wide range of orifice diameters and flow rates. Flow behavior at the orifice transitions from pulsing flow to continuous discharge as the jet crosses the sonic point. Breakup dynamics transition from laminar to turbulent at a critical value of the Weber number. Very strong pure gas jets and most gas/liquid co-flowing jets exhibit atomization breakup. Bubble sizes in the atomization regime scale with the jet-to-plume transition length scale and follow -3/5 power-law scaling for a mixture Weber number. Copyright © 2018 Elsevier Ltd. All rights reserved.

77 FR 63712 - Airworthiness Directives; Piaggio Aero Industries S.p.A.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... authority for Italy. We issued that AD to prevent the brake hydraulic fluid from leaking because of the brake assembly rods contacting the brake valve tubing, which could result in the inability to adequately... brake pads between pilot and copilot, a brake system rod was found deflected. The rod, in this bent...

The Distribution of Natural Fractures Above a Gas Shale: Questions About Whether Deep Fracture Fluid Leaks into Groundwater Outside the Realm of Faulty Borehole Construction

EPA Pesticide Factsheets

The question is whether this gas leakage is a case of faulty borehole construction or whether this is a case of methane traveling toward the water table along natural pathways, most likely consisting of unhealed faults or fractures

46 CFR 58.25-40 - Arrangement of the steering-gear compartment.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., separated from any machinery space; (2) Ensure working access to machinery and controls in the compartment; and (3) Include handrails and either gratings or other non-slip surfaces to ensure a safe working environment if hydraulic fluid leaks. Note: Where practicable, all steering gear should be located in the...

40 CFR 60.482-5 - Standards: Sampling connection systems.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., provided the purged process fluid is not hazardous waste as defined in 40 CFR part 261. (c) In situ... Equipment Leaks of VOC in the Synthetic Organic Chemicals Manufacturing Industry for which Construction...-purge, closed-loop, or closed-vent system, except as provided in § 60.482-1(c) and paragraph (c) of this...

40 CFR 60.482-5 - Standards: Sampling connection systems.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., provided the purged process fluid is not hazardous waste as defined in 40 CFR part 261. (c) In situ... Equipment Leaks of VOC in the Synthetic Organic Chemicals Manufacturing Industry for which Construction...-purge, closed-loop, or closed-vent system, except as provided in § 60.482-1(c) and paragraph (c) of this...

40 CFR 60.482-5 - Standards: Sampling connection systems.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., provided the purged process fluid is not hazardous waste as defined in 40 CFR part 261. (c) In situ... Equipment Leaks of VOC in the Synthetic Organic Chemicals Manufacturing Industry for which Construction...-purge, closed-loop, or closed-vent system, except as provided in § 60.482-1(c) and paragraph (c) of this...

Quantitative computed tomography versus spirometry in predicting air leak duration after major lung resection for cancer.

PubMed

Ueda, Kazuhiro; Kaneda, Yoshikazu; Sudo, Manabu; Mitsutaka, Jinbo; Li, Tao-Sheng; Suga, Kazuyoshi; Tanaka, Nobuyuki; Hamano, Kimikazu

2005-11-01

Emphysema is a well-known risk factor for developing air leak or persistent air leak after pulmonary resection. Although quantitative computed tomography (CT) and spirometry are used to diagnose emphysema, it remains controversial whether these tests are predictive of the duration of postoperative air leak. Sixty-two consecutive patients who were scheduled to undergo major lung resection for cancer were enrolled in this prospective study to define the best predictor of postoperative air leak duration. Preoperative factors analyzed included spirometric variables and area of emphysema (proportion of the low-attenuation area) that was quantified in a three-dimensional CT lung model. Chest tubes were removed the day after disappearance of the air leak, regardless of pleural drainage. Univariate and multivariate proportional hazards analyses were used to determine the influence of preoperative factors on chest tube time (air leak duration). By univariate analysis, site of resection (upper, lower), forced expiratory volume in 1 second, predicted postoperative forced expiratory volume in 1 second, and area of emphysema (< 1%, 1% to 10%, > 10%) were significant predictors of air leak duration. By multivariate analysis, site of resection and area of emphysema were the best independent determinants of air leak duration. The results were similar for patients with a smoking history (n = 40), but neither forced expiratory volume in 1 second nor predicted postoperative forced expiratory volume in 1 second were predictive of air leak duration. Quantitative CT is superior to spirometry in predicting air leak duration after major lung resection for cancer. Quantitative CT may aid in the identification of patients, particularly among those with a smoking history, requiring additional preventive procedures against air leak.

Hazardous Gas Leak Analysis in the Space Shuttle

NASA Technical Reports Server (NTRS)

Barile, Ronald G.

1991-01-01

Helium tests of the main propulsion system in the Space Shuttle and on hydrogen leaks are examined. The hazardous gas detection system (HGDS) in the mobile launch pad uses mass spectrometers (MS) to monitor the shuttle environment for leaks. The mass spectrometers are fed by long tubes to sample gas from the payload bay, mid-body, aft engine compartment, and external tank. The purpose is to improve the HGDS, especially in its potential for locating cryogen leaks. Pre-existing leak data was analyzed for transient information to determine if the leak location could be pinpointed from test data. A rapid response leak detection experiment was designed, built, and tested. Large eddies and vortices were visually seen with Schlieren imaging, and they were detected in the time plots of the various instruments. The response time of the MS was found in the range of 0.05 to 0.1 sec. Pulsed concentration waves were clearly detected at 25 cycles per sec by spectral analysis of MS data. One conclusion is that the backup HGDS sampling frequency should be increased above the present rate of 1 sample per second.

Intraoperative air leak measured after lobectomy is associated with postoperative duration of air leak.

PubMed

Brunelli, Alessandro; Salati, Michele; Pompili, Cecilia; Gentili, Paolo; Sabbatini, Armando

2017-11-01

To verify the association between the air leak objectively measured intraoperatively (IAL) using the ventilator and the air leak duration after pulmonary lobectomy. Prospective analysis on 111 patients submitted to pulmonary lobectomy (33 by video-assisted thoracic surgery). After resection, objective assessment of air leak (in milliliter per minute) was performed before closure of the chest by measuring the difference between a fixed inspired and expired volume, using a tidal volume of 8 ml/kg, a respiratory rate of 10 and a positive-end expiratory pressure of 5 cmH2O. A multivariable analysis was performed for identifying factors associated with duration of postoperative air leak. Average IAL was 158 ml/min (range 0-1500 ml/min). The best cut-off (receiver-operating characteristics analysis) associated with air leak longer than 5 days was 500 ml/min. Nine patients had IAL >500 ml/min (8%). They had a longer duration of postoperative air leak compared with those with a lower IAL (mean values, 10.1 days, SD 8.8 vs 1.5 days, SD 4.9 P < 0.001). The following variables remained associated with days of air leak duration after multivariable regression: left side resection (P = 0.018), upper site resection (P = 0.031) and IAL >500 ml/min (P < 0.001). The following equation estimating the days of air leak duration was generated: 1.7 + 2.4 × left side + 2.2 × upper site + 8.8 × IAL >500. The air leak measurement using the ventilator parameters after lung resection may assist in estimating the risk of postoperative prolonged air leak. An IAL > 500 ml/min may warrant the use of intraoperative preventative measures, particularly after video-assisted thoracic surgery lobectomy where a submersion test is often unreliable. © 2017 European Society of Cardiology and European Atherosclerosis Association. All rights reserved. For permissions please email: journals.permissions@oup.com.

Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy.

PubMed

Gaillard, Martin; Tranchart, Hadrien; Maitre, Sophie; Perlemuter, Gabriel; Lainas, Panagiotis; Dagher, Ibrahim

2018-03-02

Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery. The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG. A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG as primary procedure. Total psoas muscles (TPA) and total visible muscles (TMA) areas were measured on a preoperative computed tomography (CT). Sarcopenia was defined as lowest tertile of skeletal muscular mass indexes (muscular areas over square of height) in each gender (using TPA or TMA). Multivariate analysis was performed to determine preoperative risk factors for staple-line leak. During the study period, 205 patients were included in the analysis. Median BMI was 40.8 kg/m 2 (34.2-49.6), and 9 patients (4.4%) presented a gastric leak. The sex-specific cut-offs for skeletal muscular mass index according to TPA were 8.2 cm 2 /m 2 for men and 6.08 cm 2 /m 2 for women. After multivariate analysis, preoperative weight (OR = 1043) and sarcopenia (TPA) (OR = 5204) were independent predictive factors for gastric leak. The present series suggests that CT scan-determined sarcopenic obesity is associated with increased risk of gastric leak after SG. This preoperatively radiological examination would be a useful clinical tool to tailor patient management according to gastric leak risk.

Postoperative Diabetes Insipidus and Hyponatremia in Children after Transsphenoidal Surgery for Adrenocorticotropin Hormone and Growth Hormone Secreting Adenomas.

PubMed

Saldarriaga, Carolina; Lyssikatos, Charlampos; Belyavskaya, Elena; Keil, Margaret; Chittiboina, Prashant; Sinaii, Ninet; Stratakis, Constantine A; Lodish, Maya

2018-04-01

To define the incidence and risk factors of postoperative sodium alterations in pediatric patients undergoing transsphenoidal surgery (TSS) for adrenocorticotropic hormone and growth hormone secreting pituitary adenomas. We retrospectively reviewed 160 patients ≤18 years of age who had TSS for pituitary adenomas at our institution from 1999 to 2017. Variables included daily serum sodium through postoperative day 10, urine specific gravity, and medications administered. We examined associations between sex, repeat surgery, manipulation of the posterior pituitary (PP), tumor invasion into the PP, tumor type and size, cerebrospinal fluid (CSF) leak, lumbar drain insertion, body mass index, puberty, and development of diabetes insipidus (DI) or syndrome of inappropriate antidiuretic hormone secretion (SIADH). Mean age was 12.9 ± 3.4 years (female = 81). Patients had adrenocorticotropic hormone (150/160) and growth hormone (10/160) producing adenomas. Forty-two (26%) patients developed DI. Among the 37 of 160 who required desmopressin acutely, 13 of 37 required it long term. Risk of long-term need for desmopressin was significantly higher in patients who had CSF leak 9 of 48 (P = .003), lumbar drain 6 of 30 (P = .019), manipulation 11 of 50 (P < .001), or invasion 4 of 15 (P = .022) of the PP. Sixty patients developed hyponatremia, 19 because of SIADH, 39 to hypotonic fluids and 2 to cerebral salt wasting syndrome. Patients with SIADH were placed on fluid restriction; 1 received salt tablets. Among 160 children who underwent TSS for pituitary adenomas, the incidence of DI and SIADH after TSS was 26% and 14%, respectively. Combined risk factors for DI and/or SIADH include female sex, manipulation of and/or tumor invasion into the PP, and CSF leak or lumbar drain. ClinicalTrials.gov: NCT00001595 and NCT00060541. Published by Elsevier Inc.

Demonstration of rapid and sensitive module leak certification for space station freedom. Final report

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

Dietz, R.N.; Goodrich, R.W.

1991-03-01

A leak detection and quantification demonstration using perflurocarbon tracer (PFT) technology was successfully performed at the NASA Marshall Space Flight Center on January 25, 1991. The real-time Dual Trap Analyzer (DTA) at one-half hour after the start of the first run gave an estimated leak rate of 0.7 mL/min. This has since been refined to be 1.15 {plus_minus} 0.09 mL/min. The leak rates in the next three runs were determined to be 9.8 {plus_minus} 0.7, {minus}0.4 {plus_minus} 0.3, and 76 {plus_minus} 6 mL/min, respectively. The theory on leak quantification in the steady-state and time-dependent modes for a single zone testmore » facility was developed and applied to the above determinations. The laboratory PFT analysis system gave a limit-of-detection (LOD) of 0.05 fL for ocPDCH. This is the tracer of choice and is about 100-fold better than that for the DTA. Applied to leak certification, the LOD is about 0.00002 mL/s (0.000075 L/h), a 5 order-of-magnitude improvement over the original leak certification specification. Furthermore, this limit can be attained in a measurement period of 3 to 4 hours instead of days, weeks, or months. A new Leak Certification Facility is also proposed to provide for zonal (three zones) determination of leak rates. The appropriate multizone equations, their solutions, and error analysis have already been derived. A new concept of seal-integrity certification has been demonstrated for a variety of controlled leaks in the range of module leak testing. High structural integrity leaks were shown to have a linear dependence of flow on {Delta}p. The rapid determination of leak rates at different pressures is proposed and is to be determined while subjecting the module to other external force-generating parameters such as vibration, torque, solar intensity, etc. 13 refs.« less

Demonstration of rapid and sensitive module leak certification for space station freedom

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

Dietz, R.N.; Goodrich, R.W.

1991-03-01

A leak detection and quantification demonstration using perflurocarbon tracer (PFT) technology was successfully performed at the NASA Marshall Space Flight Center on January 25, 1991. The real-time Dual Trap Analyzer (DTA) at one-half hour after the start of the first run gave an estimated leak rate of 0.7 mL/min. This has since been refined to be 1.15 {plus minus} 0.09 mL/min. The leak rates in the next three runs were determined to be 9.8 {plus minus} 0.7, {minus}0.4 {plus minus} 0.3, and 76 {plus minus} 6 mL/min, respectively. The theory on leak quantification in the steady-state and time-dependent modes formore » a single zone test facility was developed and applied to the above determinations. The laboratory PFT analysis system gave a limit-of-detection (LOD) of 0.05 fL for ocPDCH. This is the tracer of choice and is about 100-fold better than that for the DTA. Applied to leak certification, the LOD is about 0.00002 mL/s (0.000075 L/h), a 5 order-of-magnitude improvement over the original leak certification specification. Furthermore, this limit can be attained in a measurement period of 3 to 4 hours instead of days, weeks, or months. A new Leak Certification Facility is also proposed to provide for zonal (three zones) determination of leak rates. The appropriate multizone equations, their solutions, and error analysis have already been derived. A new concept of seal-integrity certification has been demonstrated for a variety of controlled leaks in the range of module leak testing. High structural integrity leaks were shown to have a linear dependence of flow on {Delta}p. The rapid determination of leak rates at different pressures is proposed and is to be determined while subjecting the module to other external force-generating parameters such as vibration, torque, solar intensity, etc. 13 refs.« less

Demonstration of rapid and sensitive module leak certification for Space Station Freedom

NASA Technical Reports Server (NTRS)

Dietz, R. N.; Goodrich, R. W.

1991-01-01

A leak detection and quantification demonstration using perflurocarbon tracer (PFT) technology was successfully performed at the NASA Marshall Space Flight Center on January 25, 1991. The real-time Dual Trap Analyzer (DTA) at one-half hour after the start of the first run gave an estimated leak rate of 0.7 mL/min. This has since been refined to be 1.15 (+ or -) 0.09 mL/min. The leak rates in the next three runs were determined to be 9.8 (+ or -) 0.7, -0.4 (+ or -) 0.3, and 76 (+ or -) 6 mL/min, respectively. The theory on leak quantification in the steady-state and time-dependent modes for a single zone test facility was developed and applied to the above determinations. The laboratory PFT analysis system gave a limit-of-detection (LOD) of 0.05 fL for ocPDCH. This is the tracer of choice and is about 100-fold better than that for the DTA. Applied to leak certification, the LOD is about 0.00002 mL/s (0.000075 L/h), a 5 order-of-magnitude improvement over the original leak certification specification. Furthermore, this limit can be attained in a measurement period of 3 to 4 hours instead of days, weeks, or months. A new Leak Certification Facility is also proposed to provide for zonal (three zones) determination of leak rates. The appropriate multizone equations, their solutions, and error analysis have already been derived. A new concept of seal-integrity certification has been demonstrated for a variety of controlled leaks in the range of module leak testing. High structural integrity leaks were shown to have a linear dependence of flow on (Delta)p. The rapid determination of leak rates at different pressures is proposed and is to be determined while subjecting the module to other external force-generating parameters such as vibration, torque, solar intensity, etc.

Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy.

PubMed

Sethi, Monica; Zagzag, Jonathan; Patel, Karan; Magrath, Melissa; Somoza, Eduardo; Parikh, Manish S; Saunders, John K; Ude-Welcome, Aku; Schwack, Bradley F; Kurian, Marina S; Fielding, George A; Ren-Fielding, Christine J

2016-03-01

Staple line leak is a serious complication of sleeve gastrectomy. Intraoperative methylene blue and air leak tests are routinely used to evaluate for leak; however, the utility of these tests is controversial. We hypothesize that the practice of routine intraoperative leak testing is unnecessary during sleeve gastrectomy. A retrospective cohort study was designed using a prospectively collected database of seven bariatric surgeons from two institutions. All patients who underwent sleeve gastrectomy from March 2012 to November 2014 were included. The performance of intraoperative leak testing and the type of test (air or methylene blue) were based on surgeon preference. Data obtained included BMI, demographics, comorbidity, presence of intraoperative leak test, result of test, and type of test. The primary outcome was leak rate between the leak test (LT) and no leak test (NLT) groups. SAS version 9.4 was used for univariate and multivariate analyses. A total of 1550 sleeve gastrectomies were included; most were laparoscopic (99.8%), except for one converted and two open cases. Routine intraoperative leak tests were performed in 1329 (85.7%) cases, while 221 (14.3%) did not have LTs. Of the 1329 cases with LTs, there were no positive intraoperative results. Fifteen (1%) patients developed leaks, with no difference in leak rate between the LT and NLT groups (1 vs. 1%, p = 0.999). After adjusting for baseline differences between the groups with a propensity analysis, the observed lack of association between leak and intraoperative leak test remained. In this cohort, leaks presented at a mean of 17.3 days postoperatively (range 1-67 days). Two patients with staple line leaks underwent repeat intraoperative leak testing at leak presentation, and the tests remained negative. Intraoperative leak testing has no correlation with leak due to laparoscopic sleeve gastrectomy and is not predictive of the later development of staple line leak.

Clogging of Manifolds with Evaporatively Frozen Propellants. Part 2; Analysis

NASA Technical Reports Server (NTRS)

Simmon, J. A.; Gift, R. D.; Spurlock, J. M.

1966-01-01

The mechanisms of evaporative freezing of leaking propellant and the creation of flow stoppages within injector manifolds is discussed. A quantitative analysis of the conditions, including the existence of minimum and maximum leak rates, for the accumulation of evaporatively frozen propellant is presented. Clogging of the injector manifolds of the Apollo SPS and the Gemini OAMS engines by the freezing of leaking propellant is predicted and the seriousness of the consequences are discussed. Based on the analysis a realistic evaluation of selected techniques to eliminate flow stoppages by frozen propellant is made.

Leak Detection in Spacecraft Using a 64-Element Multiplexed Passive Array to Monitor Structure-Borne Noise

NASA Astrophysics Data System (ADS)

Holland, Stephen D.; Song, Jun-Ho; Chimenti, D. E.; Roberts, Ron

2006-03-01

We demonstrate an array sensor method intended to locate leaks in manned spacecraft using leak-generated, structure-borne ultrasonic noise. We have developed and tested a method for sensing and processing leak noise to reveal the leak location involving the use of a 64-element phased-array. Cross-correlations of ultrasonic noise waveforms from a leak into vacuum have been used with a phased-array analysis to find the direction from the sensor to the leak. This method measures the propagation of guided ultrasonic Lamb waves passing under the PZT array sensor in the spacecraft skin structure. This paper will describe the custom-designed array with integrated electronics, as well as the performance of the array in prototype applications. We show that this method can be used to successfully locate leaks to within a few millimeters on a 0.6-m square aluminum plate.

Endotracheal tube leak pressure and tracheal lumen size in swine.

PubMed

Finholt, D A; Audenaert, S M; Stirt, J A; Marcella, K L; Frierson, H F; Suddarth, L T; Raphaely, R C

1986-06-01

Endotracheal tube "leak" is often estimated in children to judge the fit of uncuffed endotracheal tubes within the trachea. Twenty-five swine were intubated with uncuffed tracheal tubes to determine whether a more sensitive measurement of leaks could be devised and whether leak pressure estimates fit between tracheal tube and trachea. We compared leak pressure measurement using a stethoscope and aneroid manometer with a technique using a microphone, pressure transducer, and recorder, and found no differences between the two methods. The tracheas were then removed and slides prepared of tracheal cross-sectional specimens. Regression analysis revealed a linear relationship between tracheal lumen size and tracheal tube size for both low leak pressure (y = -0.4 + 0.79x, r = 0.88, P less than 0.05) and high leak pressure (y = -2.9 + 0.71x, r = 0.92, P less than 0.05) groups. We conclude that leak testing with a stethoscope and aneroid manometer is sensitive and accurate, and that tracheal tube leak pressure accurately portrays fit between tube and trachea.

Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography.

PubMed

Dreizin, David; Boscak, Alexis R; Anstadt, Michael J; Tirada, Nikki; Chiu, William C; Munera, Felipe; Bodanapally, Uttam K; Hornick, Michael; Stein, Deborah M

2016-12-01

Purpose To determine the diagnostic performance of multidetector computed tomography (CT) with trajectography for penetrating colorectal injuries. Materials and Methods This institutional review board-approved and HIPAA-compliant study was a 6-year blinded retrospective review by two independent readers of 182 consecutive patients who preoperatively underwent 40- or 64-row multidetector CT for penetrating torso trauma below the diaphragm and had surgically confirmed findings. Colorectal perforation was present in 42 patients. Trajectory analysis with postprocessing software was used for all studies. Additional signs evaluated were rectal contrast agent leak, collections of extruded fecal material, mural defect, wall thickening, abnormal enhancement, free fluid or stranding, and free air. The quality of the colorectal contrast agent administration was recorded. Sensitivity, specificity, predictive values, areas under the receiver operating characteristic curves (AUCs), and Cohen κ were determined. Results In patients with rectal contrast agent administration (n = 151), AUCs were 0.90-0.91, which indicated excellent accuracy. Trajectory was sensitive (88%-91%). For single wounds (n = 104), sensitivity of trajectory was 96% for both readers, but was only 80% for multiple wounds (n = 47). Contrast agent leak was highly specific (96%-98%), but insensitive (42%-46%). Improved diagnostic performance was observed in patients with poor colonic distension or opacification. Accuracy remained high (AUC, 0.86-0.99) in the group without rectal contrast agent administration (n = 31). Conclusion Trajectory had excellent sensitivity, while rectal contrast agent leak was specific but insensitive. Sensitivity of trajectory was lower for multiple wounds. Accuracy remained high in patients without rectal contrast agent administration. © RSNA, 2016.

First impressions about Adherus, a new dural sealant.

PubMed

Zoia, Cesare; Bongetta, Daniele; Lombardi, Francesco; Custodi, Viola Marta; Pugliese, Raffaelino; Gaetani, Paolo

2015-12-18

The aim of the study is to report our first impressions about Adherus, a novel dural sealant, used in neurosurgical endoscopic transnasal procedures. We retrospectively reviewed the clinical and surgical records of the first 11 patients with intraoperative high-flow cerebrospinal fluid leak treated with the aid of Adherus at our center between February and October 2014. The healing at the level of the dural plasty was monitored and evaluated radiologically and with regular endoscopic inspections. With a median follow-up of 210 days, no postoperative CSF leak or surgical site infections were found in any of the cases. Based on our preliminary experience, this new dural sealant seems to provide an effective aid in dural plasty during endoscopic transphenoidal procedures.

Apparatus for detecting a condition of a medication infusion system and providing an informational signal in response thereto

NASA Technical Reports Server (NTRS)

Fischell, Robert E. (Inventor)

1988-01-01

A medication infusion system having a means for providing an informational signal when (1) medication in the reservoir falls below a threshold level; (2) a fluid leak occurs in different portions of the system; and (3) the intended medication pumping does not correlate with the pumping actually affected.

Operation of a Third Generation JPL Electronic Nose in the Regenerative ECLSS Module Simulator at MSFC

NASA Technical Reports Server (NTRS)

Ryan, M. A.; Shevade, A. V.; Manatt, K. S.; Haines, B. E.; Perry, J. L.; Roman, M. C.; Scott, J. P.; Frederick, K. R.

2010-01-01

An electronic nose has been developed at the Jet Propulsion Laboratory (JPL) to monitor spacecraft cabin air for anomalous events such as leaks and spills of solvents, coolants or other fluids with near-real-time analysis. It is designed to operate in the environment of the US Lab on ISS and was deployed on the International Space Station for a seven-month experiment in 2008-2009. In order improve understanding of ENose response to crew activities, an ENose was installed in the Regenerative ECLSS Module Simulator (REMS) at Marshall Space Flight Center (MSFC) for several months. The REMS chamber is operated with continuous analysis of the air for presence and concentration of CO, CO2, ethane, ethanol and methane. ENose responses were analyzed and correlated with logged activities and air analyses in the REMS.

Financial validation of the European Society of Thoracic Surgeons risk score predicting prolonged air leak after video-assisted thoracic surgery lobectomy.

PubMed

Brunelli, Alessandro; Pompili, Cecilia; Dinesh, Padma; Bassi, Vinod; Imperatori, Andrea

2018-04-27

The objective of this study was to verify whether the European Society of Thoracic Surgeons prolonged air leak risk score for video-assisted thoracoscopic lobectomy was associated with incremental postoperative costs. We retrospectively analyzed 353 patients subjected to video-assisted thoracoscopic lobectomy or segmentectomy (April 2014 to March 2016). Postoperative costs were obtained from the hospital Finance Department. Patients were grouped in different classes of risk according to their prolonged air leak risk score. To verify the independent association of the prolonged air leak risk score with postoperative costs, we performed a stepwise multivariable regression analysis in which the dependent variable was postoperative cost. Prolonged air leak developed in 56 patients (15.9%). Their length of stay was 3 days longer compared with those without prolonged air leak (8.3 vs 5.4, P < .0001). Their postoperative cost was higher than that of patients without prolonged air leak: $5939.8 versus $4381.7 (P = .001). After grouping the patients according to their prolonged air leak risk score, prolonged air leak incidence was 12.3% in class A, 13.7% in class B, 28.8% in class C, and 22.2% in class D (P = .020). The average postoperative cost was $4031.0 in class A, $4498.2 in class B, $6146.6 in class C, and $6809.3 in class D (analysis of variance test, P < .001). Multivariable regression analysis showed that being in classes C and D of PAL score (P = .001) and the presence of cardiopulmonary complications (P < .0001) were the only independent factors significantly associated with postoperative costs. We financially validated the European Society of Thoracic Surgeons prolonged air leak risk score for video-assisted thoracoscopic lobectomies, which appears useful in selecting those patients in whom the application of additional intraoperative interventions to avoid prolonged air leak may be more cost-effective. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Development of the T+M coupled flow–geomechanical simulator to describe fracture propagation and coupled flow–thermal–geomechanical processes in tight/shale gas systems

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

Kim, Jihoon; Moridis, George J.

2013-10-01

We developed a hydraulic fracturing simulator by coupling a flow simulator to a geomechanics code, namely T+M simulator. Modeling of the vertical fracture development involves continuous updating of the boundary conditions and of the data connectivity, based on the finite element method for geomechanics. The T+M simulator can model the initial fracture development during the hydraulic fracturing operations, after which the domain description changes from single continuum to double or multiple continua in order to rigorously model both flow and geomechanics for fracture-rock matrix systems. The T+H simulator provides two-way coupling between fluid-heat flow and geomechanics, accounting for thermoporomechanics, treatsmore » nonlinear permeability and geomechanical moduli explicitly, and dynamically tracks changes in the fracture(s) and in the pore volume. We also fully accounts for leak-off in all directions during hydraulic fracturing. We first validate the T+M simulator, matching numerical solutions with the analytical solutions for poromechanical effects, static fractures, and fracture propagations. Then, from numerical simulation of various cases of the planar fracture propagation, shear failure can limit the vertical fracture propagation of tensile failure, because of leak-off into the reservoirs. Slow injection causes more leak-off, compared with fast injection, when the same amount of fluid is injected. Changes in initial total stress and contributions of shear effective stress to tensile failure can also affect formation of the fractured areas, and the geomechanical responses are still well-posed.« less

Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid-A Case Report.

PubMed

Nguyen, Emilie T; Tudtud-Hans, Leah A

2017-01-01

We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management.

[Endoscopic endonasal detection of cerebrospinal fluid leakage with topical fluorescein].

PubMed

Sato, Taku; Kishida, Yugo; Watanabe, Tadashi; Tani, Akiko; Tada, Yasuhiro; Tamura, Takamitsu; Ichikawa, Masahiro; Sakuma, Jun; Omori, Koichi; Saito, Kiyoshi

2013-08-01

We evaluated the effectiveness of intraoperative topical application of fluorescein to detect the leakage point of cerebrospinal fluid(CSF)rhinorrhea. Three patients with CSF rhinorrhea were treated with an endoscopic endonasal technique. Ten percent fluorescein was topically used for intraoperative localization of the leak site. A change of the fluorescein color from brown to green due to dilation of CSF were recognized as evidence of CSF rhinorrhea. We repeated the procedure to detect any small defects. All CSF rhinorrheas were successfully repaired by this endoscopic endonasal approach. Topical application of fluorescein is simple and sensitive for identifying intraoperative CSF rhinorrhea.

A Comparison between the Decimated Padé Approximant and Decimated Signal Diagonalization Methods for Leak Detection in Pipelines Equipped with Pressure Sensors.

PubMed

Lay-Ekuakille, Aimé; Fabbiano, Laura; Vacca, Gaetano; Kitoko, Joël Kidiamboko; Kulapa, Patrice Bibala; Telesca, Vito

2018-06-04

Pipelines conveying fluids are considered strategic infrastructures to be protected and maintained. They generally serve for transportation of important fluids such as drinkable water, waste water, oil, gas, chemicals, etc. Monitoring and continuous testing, especially on-line, are necessary to assess the condition of pipelines. The paper presents findings related to a comparison between two spectral response algorithms based on the decimated signal diagonalization (DSD) and decimated Padé approximant (DPA) techniques that allow to one to process signals delivered by pressure sensors mounted on an experimental pipeline.

A Small Leak Detection Method Based on VMD Adaptive De-Noising and Ambiguity Correlation Classification Intended for Natural Gas Pipelines.

PubMed

Xiao, Qiyang; Li, Jian; Bai, Zhiliang; Sun, Jiedi; Zhou, Nan; Zeng, Zhoumo

2016-12-13

In this study, a small leak detection method based on variational mode decomposition (VMD) and ambiguity correlation classification (ACC) is proposed. The signals acquired from sensors were decomposed using the VMD, and numerous components were obtained. According to the probability density function (PDF), an adaptive de-noising algorithm based on VMD is proposed for noise component processing and de-noised components reconstruction. Furthermore, the ambiguity function image was employed for analysis of the reconstructed signals. Based on the correlation coefficient, ACC is proposed to detect the small leak of pipeline. The analysis of pipeline leakage signals, using 1 mm and 2 mm leaks, has shown that proposed detection method can detect a small leak accurately and effectively. Moreover, the experimental results have shown that the proposed method achieved better performances than support vector machine (SVM) and back propagation neural network (BP) methods.

A Small Leak Detection Method Based on VMD Adaptive De-Noising and Ambiguity Correlation Classification Intended for Natural Gas Pipelines

PubMed Central

Xiao, Qiyang; Li, Jian; Bai, Zhiliang; Sun, Jiedi; Zhou, Nan; Zeng, Zhoumo

2016-01-01

In this study, a small leak detection method based on variational mode decomposition (VMD) and ambiguity correlation classification (ACC) is proposed. The signals acquired from sensors were decomposed using the VMD, and numerous components were obtained. According to the probability density function (PDF), an adaptive de-noising algorithm based on VMD is proposed for noise component processing and de-noised components reconstruction. Furthermore, the ambiguity function image was employed for analysis of the reconstructed signals. Based on the correlation coefficient, ACC is proposed to detect the small leak of pipeline. The analysis of pipeline leakage signals, using 1 mm and 2 mm leaks, has shown that proposed detection method can detect a small leak accurately and effectively. Moreover, the experimental results have shown that the proposed method achieved better performances than support vector machine (SVM) and back propagation neural network (BP) methods. PMID:27983577

Grading of Emphysema Is Indispensable for Predicting Prolonged Air Leak After Lung Lobectomy.

PubMed

Murakami, Junichi; Ueda, Kazuhiro; Tanaka, Toshiki; Kobayashi, Taiga; Hamano, Kimikazu

2018-04-01

The aim of this study was to assess the utility of quantitative computed tomography-based grading of emphysema for predicting prolonged air leak after thoracoscopic lobectomy. A consecutive series of 284 patients undergoing thoracoscopic lobectomy for lung cancer was retrospectively reviewed. Prolonged air leak was defined as air leaks lasting 7 days or longer. The grade of emphysema (emphysema index) was defined by the proportion of the emphysematous lung volume (less than -910 HU) to the total lung volume (-600 to -1,024 HU) by a computer-assisted histogram analysis of whole-lung computed tomography scans. The mean length of chest tube drainage was 1.5 days. Fifteen patients (5.3%) presented with prolonged air leak. According to a receiver-operating characteristics curve analysis, the emphysema index was the best predictor of prolonged air leak, with an area under the curve of 0.85 (95% confidence interval: 0.73 to 0.98). An emphysema index of 35% or greater was the best cutoff value for predicting prolonged air leak, with a negative predictive value of 0.99. The emphysema index was the only significant predictor for the length of postoperative chest tube drainage among conventional variables, including the pulmonary function and resected lobe, in both univariate and multivariate analyses. Prolonged air leak resulted in an increased duration of hospitalization (p < 0.001) and was frequently accompanied by pneumonia or empyema (p < 0.001). The grade of emphysema on computed tomography scan is the best predictor of prolonged air leak that adversely influences early postoperative outcomes. We must take new measures against prolonged air leak in quantitative computed tomography-based high-risk patients. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Performance of materials used for biological personal protective equipment against blood splash penetration.

PubMed

Shimasaki, Noriko; Shinohara, Katsuaki; Morikawa, Hideki

2017-12-07

For occupational safety, healthcare workers must select and wear appropriate personal protective equipment (PPE), protective clothing, and masks as countermeasures against exposure to infectious body fluids and blood splash. It is important for healthcare workers to ensure the protective performance of each PPE against penetration of pathogens. The International Standards Organization (ISO) 22609 test evaluates the effectiveness of medical facemasks to protect against penetration of splashed synthetic blood. However, in this method, the protective performance is determined only visually, without quantification of leaked liquid volume. Therefore, in this study, we modified the ISO 22609 test method to quantify the volume of leaked liquid and obtain a more accurate assessment of the protection performance. We tested non-woven and woven materials used for masks or protective clothing, and the performance of each material was classified using this new method. We found that the quantity of leaked synthetic blood was dependent on the structural characteristics of each material. These findings will allow healthcare workers to select the most appropriate PPE for a given situation or task.

Performance of materials used for biological personal protective equipment against blood splash penetration

PubMed Central

SHIMASAKI, Noriko; SHINOHARA, Katsuaki; MORIKAWA, Hideki

2017-01-01

For occupational safety, healthcare workers must select and wear appropriate personal protective equipment (PPE), protective clothing, and masks as countermeasures against exposure to infectious body fluids and blood splash. It is important for healthcare workers to ensure the protective performance of each PPE against penetration of pathogens. The International Standards Organization (ISO) 22609 test evaluates the effectiveness of medical facemasks to protect against penetration of splashed synthetic blood. However, in this method, the protective performance is determined only visually, without quantification of leaked liquid volume. Therefore, in this study, we modified the ISO 22609 test method to quantify the volume of leaked liquid and obtain a more accurate assessment of the protection performance. We tested non-woven and woven materials used for masks or protective clothing, and the performance of each material was classified using this new method. We found that the quantity of leaked synthetic blood was dependent on the structural characteristics of each material. These findings will allow healthcare workers to select the most appropriate PPE for a given situation or task. PMID:28978815

Direct Endonasal Approach with Partial Upper Posterior Septectomy. A “Rescue Flap” Technique Modification

PubMed Central

Sotomayor-González, Arturo; Díaz-Martínez, Armando José; Radillo-Gil, Ramón; García-Estrada, Everardo; Morales-Gómez, Jesús Alberto; Palacios-Ortiz, Isaac Jair; Pérez-Cárdenas, Samuel; Arteaga-Treviño, Mauricio; De León, Ángel Martínez-Ponce

2016-01-01

Objective Report a modification of the “rescue flap” technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design Prospective study. Setting Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León. Main Outcome Measures Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below. Results Nineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak. Conclusion Direct endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed. PMID:28321383

Direct Endonasal Approach with Partial Upper Posterior Septectomy. A "Rescue Flap" Technique Modification.

PubMed

Sotomayor-González, Arturo; Díaz-Martínez, Armando José; Radillo-Gil, Ramón; García-Estrada, Everardo; Morales-Gómez, Jesús Alberto; Palacios-Ortiz, Isaac Jair; Pérez-Cárdenas, Samuel; Arteaga-Treviño, Mauricio; De León, Ángel Martínez-Ponce

2017-04-01

Objective  Report a modification of the "rescue flap" technique using a direct endonasal approach with a partial superior septectomy for approaching pituitary tumors developed in our institution. Design  Prospective study. Setting  Hospital Universitario "Dr. José Eleuterio González," Universidad Autónoma de Nuevo León. Main Outcome Measures  Since April 2015, we have performed 19 cases employing a direct endonasal approach with partial superior septectomy. Results and a technical note are described below. Results  Nineteen patients were included in this report. Six patients presented transoperatory cerebrospinal fluid (CSF) leak, so a nasoseptal rescue flap was harvested. No patients developed postoperative CSF leak in this group. Two patients were submitted to a second surgical procedure. Nasoseptal flap was harvested without complications. In both patients, the size of the flap was enough to cover the dural defect and avoid CSF leak. Conclusion  Direct endonasal approach with a partial posterior septectomy allows enough exposition of the sphenoidal sinus while preserving the nasoseptal septum with the possibility of a successful rescue flap when needed.

The ISS 2B PVTCS Ammonia Leak: An Operational History

NASA Technical Reports Server (NTRS)

Vareha, Anthony

2014-01-01

In 2006, the Photovoltaic Thermal Control System (PVTCS) for the International Space Station's 2B power channel began leaking ammonia at a rate of approximately 1.5lbm/year (out of a starting approximately 53lbm system ammonia mass). Initially, the operations strategy was "feed the leak," a strategy successfully put into action via Extra Vehicular Activity during the STS-134 mission. During this mission the system was topped off with ammonia piped over from a separate thermal control system. This recharge was to have allowed for continued power channel operation into 2014 or 2015, at which point another EVA would have been required. Without these periodic EVAs to refill the 2B coolant system, the channel would eventually leak enough fluid as to risk pump cavitation and system failure, resulting in the loss of the 2B power channel - the most critical of the Space Station's 8 power channels. In mid-2012, the leak rate increased to approximately 5lbm/year. Once discovered, an EVA was planned and executed within a 5 week timeframe to drastically alter the architecture of the PVTCS via connection to a dormant thermal control system not intended to be utilized as anything other than spare components. The purpose of this rerouting of the TCS was to increase system volume and to isolate the photovoltaic radiator, thought to be the likely leak source. This EVA was successfully executed on November 1st, 2012 and left the 2B PVTCS in a configuration where the system was now being adequately cooled via a totally different radiator than what the system was designed to utilize. Unfortunately, data monitoring over the next several months showed that the isolated radiator was not leaking, and the system itself continued to leak steadily until May 9th, 2013. It was on this day that the ISS crew noticed the visible presence of ammonia crystals escaping from the 2B channel's truss segment, signifying a rapid acceleration of the leak from 5lbm/year to 5lbm/day. Within 48 hours of the crew noticing the leak, an EVA was in progress to replace the coolant pump - the only other replaceable leak source. This paper will explore the management of the 2B PVTCS leak from the operations perspective. It will discuss the methodology of performing the STS-134 refill, the considerations and contingency plans which went into the architectural overhaul of the system in 2012, and the unprecedented effort which went into the EVA response to the visible leak of May 2013. In particular the paper will focus on the techniques utilized by flight controllers to monitor the system health and to respond to such instances as the rapid May 2013 leak by putting the electrical system in a safe configuration for loss of cooling, and will use recorded telemetry of these events to describe system response to EVA crew and ground actions. It will discuss the innovative design for redundancy of the integrated truss structure's cooling systems which allowed for this leak to be managed with minimal impact to other ISS operations and electrical services, contrasted against the real unintended operations consequences of utilizing the flexibility of the spacecraft's design in this manner. The paper will discuss how the training of the crew and flight controller personnel has adapted to the changing architecture of the power system and the unpredictable nature of the 2B leak.

Prospective randomized trial compares suction versus water seal for air leaks.

PubMed

Cerfolio, R J; Bass, C; Katholi, C R

2001-05-01

Surgeons treat air leaks differently. Our goal was to evaluate whether it is better to place chest tubes on suction or water seal for stopping air leaks after pulmonary surgery. A second goal was to evaluate a new classification system for air leaks that we developed. Patients were prospectively randomized before surgery to receive suction or water seal to their chest tubes on postoperative day (POD) #2. Air leaks were described and quantified daily by a classification system and a leak meter. The air-leak meter scored leaks from 1 (least) to 7 (greatest). The group randomized to water seal stayed on water seal unless a pneumothorax developed. On POD #2, 33 of 140 patients had an air leak. Eighteen patients had been preoperatively randomized to water seal and 15 to suction. Air leaks resolved in 12 (67%) of the water seal patients by the morning of POD #3. All 6 patients whose air leak did not stop had a leak that was 4/7 or greater (p < 0.0001) on the leak meter. Of the 15 patients randomized to suction, only 1 patient's air leak (7%) resolved by the morning of POD #3. The randomization aspect of the trial was ended and statistical analysis showed water seal was superior (p = 0.001). The remaining 14 patients were then placed to water seal and by the morning of POD #4, 13 patients' leaks had stopped. Of the 32 total patients placed to seal, 7 (22%) developed a pneumothorax and 6 of these 7 patients had leaks that were 4/7 or greater (p = 0.001). Placing chest tubes on water seal seems superior to wall suction for stopping air leaks after pulmonary resection. However, water seal does not stop expiratory leaks that are 4/7 or greater. Pneumothorax may occur when chest tubes are placed on seal with leaks this large.

Glacial uplift: fluid injection beneath an elastic sheet on a poroelastic substrate

NASA Astrophysics Data System (ADS)

Neufeld, Jerome; Hewitt, Duncan; Chini, Greg

2016-11-01

Supraglacial lakes can drain to the base of glaciers extremely rapidly, causing localised uplift of the surrounding glacier and affecting its sliding velocity. The means by which large volumes of drained water interact with and leak into the subglacial hydrological system is unclear, as is the role of the basal till. A theoretical study of the spread of fluid injected below an elastic sheet (the ice) is presented, where the ice lies above, and initially compresses, a deformable poroelastic layer. As pressurized fluid is injected, the deformable layer swells to accommodate more fluid. If sufficient fluid is injected, a 'blister' of fluid forms above the layer, causing the overburden to lift off the base. The flow is controlled by the local pressure drop across the tip of this blister, which depends subtly on both the flow of fluid through the porous layer below the tip, and on poroelastic deformation in the till ahead of the tip. The spreading behaviour and dependence on key parameters is analysed. Predictions of the model are compared to field measurements of uplift from draining glacial lakes in Greenland.

40 CFR 60.482-2a - Standards: Pumps in light liquid service.

Code of Federal Regulations, 2011 CFR

2011-07-01

... routed to a process or fuel gas system or connected by a closed vent system to a control device that... sensor that will detect failure of the seal system, the barrier fluid system, or both. (4)(i) Each pump... indications of liquids dripping as a leak. (5)(i) Each sensor as described in paragraph (d)(3) is checked...

Anastomotic leaks in stage IV colorectal cancer.

PubMed

Ng, Suat Chin; Stupart, Douglas; Bartolo, David; Watters, David

2018-06-12

The purpose of this study was to determine the anastomotic leak rate for colorectal cancer resections in patients with metastases (compared to those without), and to determine the impact of anastomotic leaks on survival. This is a retrospective analysis of all patients who underwent resection and primary anastomosis for colorectal adenocarcinoma at a single institution between January 2002 and December 2014. A total of 843 patients underwent a resection and primary anastomosis for colorectal adenocarcinoma (661 colon and 182 rectal). Of these, 135 (16%) had metastases and 708 (84%) did not. Anastomotic leaks occurred in 17 of 135 (13%) patients with metastases, and in 37 of 798 (5.2%) patients without metastases (P = 0.003). Peri-operative mortality occurred in 13 of 135 (9.6%) patients with metastases, compared with 19 of 708 (2.7%) patients without metastases (P = 0.0003). Anastomotic leak was associated with a reduction in overall survival (median survival 121 months without anastomotic leak versus 66 months in patients who had an anastomotic leak (P = 0.02)). If the patients who died peri-operatively are excluded from this analysis, however, long-term mortality was similar (125 months versus 101 months; P = 0.70). Metastatic disease was associated with an increased risk of anastomotic leak and a higher peri-operative mortality rate after colorectal resections for cancer. Patients with anastomotic leaks had a higher peri-operative mortality rate, but long-term survival was unaffected beyond the peri-operative phase. © 2018 Royal Australasian College of Surgeons.

Fluids and sepsis: changing the paradigm of fluid therapy: a case report.

PubMed

Hariyanto, Hori; Yahya, Corry Quando; Widiastuti, Monika; Wibowo, Primartanto; Tampubolon, Oloan Eduard

2017-02-04

Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner. An 86-year-old previously healthy Sundanese man was admitted to the intensive care unit at our institution with septic shock, acute kidney injury, and respiratory distress. Standard care was implemented during his initial care in the high-care unit; nevertheless, his condition worsened, and he was transferred to the intensive care unit. We describe the timing of fluid administration and elaborate on the amount of fluids needed using a conservative fluid regimen in a continuum of resuscitated sepsis. Because fluid depletion in septic shock is caused by capillary leak and pathologic vasoplegia, continuation of fluid administration will drive intravascular fluid into the interstitial space, thereby producing marked tissue edema and disrupting vital oxygenation. Thus, fluids have the power to heal or kill. Therefore, management of patients with sepsis should entail early vasopressors with adequate fluid resuscitation followed by a conservative fluid regimen.

The selective V1a receptor agonist selepressin (FE 202158) blocks vascular leak in ovine severe sepsis

PubMed Central

Wiśniewska, Halina; Traber, Lillian D.; Lin, ChiiDean; Fan, Juanjuan; Hawkins, Hal K.; Cox, Robert A.; Wiśniewski, Kazimierz; Schteingart, Claudio D.; Landry, Donald W.; Rivière, Pierre J.-M.; Traber, Daniel L.

2014-01-01

Objective To determine if the selective vasopressin type 1a receptor (V1aR) agonist selepressin (FE 202158) is as effective as the mixed V1a/V2 receptor (V1aR/V2R) agonist vasopressor hormone arginine vasopressin (AVP) when used as a titrated first-line vasopressor therapy in an ovine model of Pseudomonas aeruginosa pneumonia-induced severe sepsis. Design Prospective, randomized, controlled laboratory experiment. Setting University animal research facility. Subjects Forty-five chronically instrumented sheep. Interventions Sheep were anesthetized, insufflated with cooled cotton smoke via tracheostomy, and P. aeruginosa were instilled into their airways. They were then placed on assisted ventilation, awakened, and resuscitated with lactated Ringer's solution titrated to maintain hematocrit ± 3% from baseline levels. If, despite fluid management, mean arterial pressure (MAP) fell by > 10 mm Hg from baseline levels, a continuous i.v. infusion of AVP or selepressin was titrated to raise and maintain MAP within 10 mm Hg of baseline. Effects of combination treatment of selepressin with the selective V2R agonist desmopressin were similarly investigated. Measurements and Main Results In septic sheep, MAP fell by ~30 mm Hg, systemic vascular resistance index (SVRI) decreased by ~50%, and ~7 L of fluid were retained over 24 h; this fluid accumulation was partially reduced by AVP and almost completely blocked by selepressin; combined infusion of selepressin and desmopressin increased fluid accumulation to levels similar to AVP treatment. Conclusions Resuscitation with the selective V1aR agonist selepressin blocked vascular leak more effectively than the mixed V1aR/V2R agonist AVP because of its lack of agonist activity at the V2R. PMID:24674922

Reversal of Progressive Conscious Disturbance with Epidural Blood Patch for Cerebrospinal Fluid Leakage at C2 Level.

PubMed

Lai, Yi-Chen; Chia, Yuan-Yi; Lien, Wei-Hung

2017-03-01

Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech. Magnetic resonance imaging demonstrated diffuse dural enhancement on the postcontrast study, sagging of the midbrain, and CSF leakage over right lateral posterior thecal sac at C2 level. We performed EBP at the level of T10-T11. We injected 14 mL of autologous blood slowly in the Trendelenburg position. Within 30 minutes, he became alert and oriented to people, place, and time. We chose thoracic EBP as first line treatment in consideration of the risk of cervical EBP such as spinal cord and nerve root compression or puncture, chemical meningitis. Also we put our patient in Trendelenburg position to make blood travel towards the site of the leak. Untreated IHS may delay the course of resolution and affect the patient's consciousness. Delivery of EBP via an epidural catheter inserted from the thoracic spine is familiar with most of anesthesiologists. It can be a safe and effective treatment for patients with IHS caused by CSF leak even at C2.Key words: Anaesthetic techniques, regional, thoracic; cerebrospinal fluid leakage; epidural blood patch; heavily T2-weighted magnetic resonance myelography; intracranial hypotension syndrome; Trendelenburg position.

High pressure mechanical seal

NASA Technical Reports Server (NTRS)

Babel, Henry W. (Inventor); Anderson, Raymond H. (Inventor)

1996-01-01

A relatively impervious mechanical seal is formed between the outer surface of a tube and the inside surface of a mechanical fitting of a high pressure fluid or hydraulic system by applying a very thin soft metal layer onto the outer surface of the hard metal tube and/or inner surface of the hard metal fitting. The thickness of such thin metal layer is independent of the size of the tube and/or fittings. Many metals and alloys of those metals exhibit the requisite softness, including silver, gold, tin, platinum, indium, rhodium and cadmium. Suitably, the coating is about 0.0025 millimeters (0.10 mils) in thickness. After compression, the tube and fitting combination exhibits very low leak rates on the order or 10.sup.-8 cubic centimeters per second or less as measured using the Helium leak test.

A Randomized Controlled Trial to Determine the Appropriate Time to Initiate Peritoneal Dialysis after Insertion of Catheter (Timely PD Study).

PubMed

Ranganathan, Dwarakanathan; John, George T; Yeoh, Edward; Williams, Nicola; O'Loughlin, Barry; Han, Thin; Jeyaseelan, Lakshmanan; Ramanathan, Kavitha; Healy, Helen

2017-01-01

The optimal time for the commencement of peritoneal dialysis (PD) after PD catheter insertion is unclear. If dialysis is started too soon after insertion, dialysate leaks and infection could occur. However, by starting PD earlier, morbidity and costs can be reduced through lesser hemodialysis requirements. This is the first randomized controlled trial to determine the safest and shortest interval to commence PD after catheter insertion. All consecutive patients undergoing PD catheter insertion at the Royal Brisbane and Women's Hospital and Rockhampton Hospital from 1 March 2008 to 31 May 2013 who met the inclusion and exclusion criteria were invited to participate in the trial. Participants were randomized to 1 of 3 groups. Group 1 (G1) commenced PD at 1 week, group 2 (G2) at 2 weeks and group 3 (G3) at 4 weeks after PD catheter insertion. These groups were stratified by hospital and the presence of diabetes. Primary outcomes were the incidence of peritoneal fluid leaks or PD-related infection during the 4 weeks after commencement of PD. In total 122 participants were recruited, 39, 42, and 41 randomized to G1, G2, and G3, respectively. The primary outcome catheter leak was significantly higher in G1 (28.2%) compared with G3 (2.4%, p = 0.001) but not compared with G2 (9.5%, p = 0.044), based on intention to treat analysis. These differences were even more marked when analyzed with per protocol method: G1 had a significantly higher percentage (32.4 %) compared with G3 (3.3%, p = 0.003) but not compared with G2 (10.5%, p = 0.040). Event percentages of leak were statistically higher in G1 and occurred significantly earlier compared with other groups ( p = 0.002). Amongst diabetics, technique failure was significantly higher (28.6%) in G3 compared with 0% in G1 and 7.1% in G2 ( p = 0.036) and earlier in G3 at 163.2 days vs 176.8 and 175.8 ( p = 0.037) for G1 and G2, respectively. Leaks were higher in participants commencing PD at 1 week after catheter insertion compared with the other 2 groups, and technique failure was higher in diabetics starting PD at 4 weeks. Copyright © 2017 International Society for Peritoneal Dialysis.

Development and verification of methods for predicting flow rates through leaks in valves and couplings

NASA Technical Reports Server (NTRS)

Russell, John M.

1993-01-01

This is the final report of a research effort which addresses the title problem. The report discusses two broad models of flows, which represent the following extreme cases: (1) inertia-dominated flow, where friction is relatively insignificant; and (2) friction-dominated flow where inertia is insignificant. In class (2), the leak channel might consist of the gap between a scratch in a plastic seal and a polished metal plate against which the seal is pressed. Here, the cross section of the leak channel is modeled as a flat bottomed crescent. A publication generated under the present grant period presents an exact solution of the equations of fully-developed laminar pipe flow of a liquid in the case of a crescent beneath a hyperbolic arc. A Master's thesis project supported by the present grant presents the corresponding solution beneath a circular arc. A second publication reviews the flow of a gas through the same channel, which may be analyzed by a standard one-dimensional model (Fanno flow) for an engineering approximation. Finally, the report discusses the design and progress in the fabrication of a leak-test cell, in which one may measure the flow of fluid through a controlled flaw in a seal. The aim of such measurements is to furnish data for comparison with the predictions of the theory.

Endoscopic Repair of CSF Fistulae: A Ten Year Experience

PubMed Central

Alexander, Arun; Mathew, John; Varghese, Ajoy Mathew

2016-01-01

Introduction Cerebrospinal Fluid (CFF) fistulae are repaired endoscopically with varying degrees of success around the world. Large series are still uncommon, and the results varied primarily because of the different techniques by different surgeons and also because of a variation in the patient profile in each series, for example, many series deal primarily with traumatic CSF leaks where the defects are larger and outcomes poorer. Aim To analyse the surgical outcomes of Endoscopic CSF rhinorrhea closure. Materials and Methods This is a series of 34 cases operated upon primarily by one surgeon in two different centres over a period of 10 years. Results Of the 34 cases, 76% of the patients were women. Among the patients only 20.6% patients had a history of trauma preceding the CSF leak. The most common site of leak was in the fovea ethmoidalis in 19 (55.8%) followed by 10 (29.4%) in the cribriform plate. An overlay technique of placing the multiple layers of fascia and mucosa was used in 26 (76.5%) patients and underlay technique in the remaining. Postoperative lumbar drain was used in all patients. Conclusion Based on the treatment outcome of the 34 patients, it can be concluded that the success rate of a single endoscopic procedure in our experience is 97% and 100% following the second. Endoscopic approach for closure of CSF leak is safe with minimal complications and little morbidity. PMID:27656471

Prolonged air leak following lobectomy can be predicted in lung cancer patients.

PubMed

Okada, Satoru; Shimada, Junichi; Kato, Daishiro; Tsunezuka, Hiroaki; Inoue, Masayoshi

2017-08-01

The purpose of this study was to identify the factors associated with prolonged air leak (PAL) following pulmonary lobectomy for lung cancer. The data of 146 patients who underwent pulmonary lobectomy for lung cancer between August 2010 and July 2015 were retrospectively reviewed. Air leaks were assessed daily by a visual evaluation and were categorized as follows: forced expiratory only (Grade 1), expiratory only (Grade 2), or continuous (Grade 3). Logistic regression analyses were performed to identify the predictors of PAL (>5 days). PAL occurred in 23 patients (16%). An air leak at rest (Grade ≥ 2) was detected on postoperative day (POD) 1 in 48% of the patients with PAL and 7% of the patients without PAL. A univariate analysis demonstrated that PAL was significantly associated with male sex, a smoking history of ≥ 40 pack years, a serum albumin level of ≤4.0 mg/dL, and an air leak on POD1 (Grade ≥ 2). A multivariate analysis demonstrated that a serum albumin level of ≤4.0 mg/dL (p = 0.027) and an air leak on POD1 (p = 0.006) were independent predictors of PAL. PAL occurred in 75% of the patients with these two risk factors. The preoperative serum albumin level and the presence of a visually evaluated air leak on POD1 may be useful indicators for the perioperative management of air leaks.

Cryogenic fluid management experiment

NASA Technical Reports Server (NTRS)

Eberhardt, R. N.; Bailey, W. J.; Fester, D. A.

1981-01-01

The cryogenic fluid management experiment (CFME), designed to characterize subcritical liquid hydrogen storage and expulsion in the low-q space environment, is discussed. The experiment utilizes a fine mesh screen fluid management device to accomplish gas-free liquid expulsion and a thermodynamic vent system to intercept heat leak and control tank pressure. The experiment design evolved from a single flight prototype to provision for a multimission (up to 7) capability. A detailed design of the CFME, a dynamic test article, and dedicated ground support equipment were generated. All materials and parts were identified, and components were selected and specifications prepared. Long lead titanium pressurant spheres and the flight tape recorder and ground reproduce unit were procured. Experiment integration with the shuttle orbiter, Spacelab, and KSC ground operations was coordinated with the appropriate NASA centers, and experiment interfaces were defined. Phase 1 ground and flight safety reviews were conducted. Costs were estimated for fabrication and assembly of the CFME, which will become the storage and supply tank for a cryogenic fluid management facility to investigate fluid management in space.

On the thermal runaway of combustible fluids in lagging material

NASA Astrophysics Data System (ADS)

McIntosh, A. C.; Griffiths, J. F.

1995-01-01

This paper presents the mathematical foundations for a simple theory for investigating the phenomenon of ignition of flammable fluids in lagging material that are used for insulation of hot pipework, for transport of heat transfer fluids, or other similar situations. Experiments with porous material impregnated with a flammable fluid have simulated the self-heating known to occur when combustible liquids leak from a hot pipe into lagging surrounding the pipe or are split from another source on to the lagging. A theory to explain these findings is presented which shows that there is a watershed temperature beyond which substantial self-heating will take place. Although the theory does not take account of diffusion, it simulates the main physics of the phenomenon-that is, combustible fluid, which normally in the open air would evaporate and not be a hazard, can, within a porous medium, remain dispersed within the porous structure long enough for the exothermic oxidation to develop into ignition.

Protein vs electrolytes and all of the Starling forces.

PubMed

Peters, R M; Hargens, A R

1981-10-01

Hemodilution-induced reductions of the intravascular protein concentration in patients and experimental animals with intact capillaries do not lead to pulmonary edema, despite significant increases in the amount of extravascular water in the systemic interstitial space. The protective factors are a drop in the extravascular concentration of protein, a rise in interstitial tissue pressure, and an increase in lymph flow. If the capillary endothelium is damaged, protein leaks into the extravascular space, and protein infusion has a diminished effect on fluid exchange across the capillary. Whether capillaries are intact or injured, prevention of increases in capillary hydrostatic pressure is the most important factor in preventing pulmonary edema. Administration of hypertonic fluids may provide a useful method of limiting total fluid infusion and reducing cell swelling after blood loss.

Packaged peristaltic micropump for controlled drug delivery application

NASA Astrophysics Data System (ADS)

Vinayakumar, K. B.; Nadiger, Girish; R. Shetty, Vikas; Dinesh, N. S.; Nayak, M. M.; Rajanna, K.

2017-01-01

Micropump technology has evolved significantly in the last two decades and is finding a variety of applications ranging from μTAS (micro Total Analysis System) to drug delivery. However, the application area of the micropump is limited owing to: simple pumping mechanism, ease of handling, controlled (microliter to milliliter) delivery, continuous delivery, and accuracy in flow rate. Here, the author presents the design, development, characterization, and precision flow controlling of a DC-motor driven peristaltic pump for controlled drug delivery application. All the micropump components were fabricated using the conventional fabrication technique. The volume flow variation of the pump has been characterized for different viscous fluids. The change in volume flow due to change in back pressure has been presented in detail. The fail-safe mode operation of the pump has been tested and leak rate was measured (˜0.14% leak for an inlet pressure of 140 kPa) for different inlet pressures. The precision volume flow of the pump has been achieved by measuring the pinch cam position and load current. The accuracy in the volume flow has been measured after 300 rotations. Finally, the complete system has been integrated with the necessary electronics and an android application has been developed for the self-administration of bolus and basal delivery of insulin.

U.S. strategic petroleum reserve Big Hill 114 leak analysis 2012.

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

Lord, David L.; Roberts, Barry L.; Lord, Anna C. Snider

2013-06-01

This report addresses recent well integrity issues related to cavern 114 at the Big Hill Strategic Petroleum Reserve site. DM Petroleum Operations, M&O contractor for the U.S. Strategic Petroleum Reserve, recognized an apparent leak in Big Hill cavern well 114A in late summer, 2012, and provided written notice to the State of Texas as required by law. DM has since isolated the leak in well A with a temporary plug, and is planning on remediating both 114 A- and B-wells with liners. In this report Sandia provides an analysis of the apparent leak that includes: (i) estimated leak volume, (ii)more » recommendation for operating pressure to maintain in the cavern between temporary and permanent fixes for the well integrity issues, and (iii) identification of other caverns or wells at Big Hill that should be monitored closely in light of the sequence of failures there in the last several years.« less

Noble Gas Leak Detector for Use in the SNS Neutron Electric Dipole Moment Experiment

NASA Astrophysics Data System (ADS)

Barrow, Chad; Huffman, Paul; Leung, Kent; Korobkina, Ekaterina; White, Christian; nEDM Collaboration Collaboration

2017-09-01

Common practice for leak-checking high vacuum systems uses helium as the probing gas. However, helium may permeate some materials at room temperature, making leak characterization difficult. The experiment to find a permanent electric dipole moment of the neutron (nEDM), to be conducted at Oak Ridge National Laboratories, will employ a large volume of liquid helium housed by such a helium-permeable composite material. It is desirable to construct a leak detector that can employ alternative test gases. The purpose of this experiment is to create a leak detector that can quantify the argon gas flux in a high vacuum environment and interpret this flux as a leak-rate. This apparatus will be used to check the nEDM volumes for leaks at room temperature before cooling down to cryogenic temperatures. Our leak detector uses a residual gas analyzer and a vacuum pumping station to characterize the gas present in an evacuated volume. The introduction of argon gas into the system is interpreted as a leak-rate into the volume. The device has been calibrated with NIST certified calibrated leaks and the machine's sensitivity has been calculated using background gas analysis. As a result of the device construction and software programming, we are able to leak-check composite and polyamide volumes This work was supported in part by the US Department of Energy under Grant No. DE-FG02-97ER41042.

A simple web-based risk calculator (www.anastomoticleak.com) is superior to the surgeon's estimate of anastomotic leak after colon cancer resection.

PubMed

Sammour, T; Lewis, M; Thomas, M L; Lawrence, M J; Hunter, A; Moore, J W

2017-01-01

Anastomotic leak can be a devastating complication, and early prediction is difficult. The aim of this study is to prospectively validate a simple anastomotic leak risk calculator and compare its predictive value with the estimate of the primary operating surgeon. Consecutive patients undergoing elective or emergency colon cancer surgery with a primary anastomosis over a 1-year period were prospectively included. A recently published anastomotic leak risk nomogram was converted to an online calculator ( www.anastomoticleak.com ). The calculator-derived risk of anastomotic leak and the risk estimated by the primary operating surgeon were recorded at the completion of surgery. The primary outcome was anastomotic leak within 90 days as defined by previously published criteria. Area under receiver operating characteristic curve analysis (AUROC) was performed for both risk estimates. A total of 105 patients were screened for inclusion during the study period, of whom 83 met the inclusion criteria. The overall anastomotic leak rate was 9.6%. The anastomotic leak calculator was highly predictive of anastomotic leak (AUROC 0.84, P = 0.002), whereas the surgeon estimate was not predictive (AUROC 0.40, P = 0.243). A simple anastomotic leak risk calculator is significantly better at predicting anastomotic leak than the estimate of the primary surgeon. Further external validation on a larger data set is required.

Cerebrospinal fluid rhinorrhoea following transsphenoidal surgery for pituitary adenoma: experience in a Chinese centre.

PubMed

Zhang, C; Ding, X; Lu, Y; Hu, L; Hu, G

2017-08-01

The aim of this study was to elucidate the risk factors for cerebrospinal fluid (CSF) rhinorrhoea following transsphenoidal surgery and discuss its prevention and treatments. We retrospectively reviewed 474 consecutive cases of pituitary adenoma treated with 485 transsphenoidal surgical procedures from January 2008 to December 2011 in our department. We analysed the incidence of intra- and post-operative CSF leakage and outcomes of various repair strategies. Intra-operative CSF leakage was encountered in 85 cases (17.9%), and post-operative CSF rhinorrhoea in 13 cases (2.7%). Seven of the 13 patients with post-operative CSF rhinorrhoea did not experience intra-operative CSF leakage; three of these patients had adrenocorticotropic hormone-secreting adenomas. Of the remaining 6 patients with both intra- and post-operative CSF leakage, 2 were treated for giant invasive prolactinomas, and 2 had previously undergone transsphenoidal surgery. In eight patients, the leak was resolved by lumbar puncture, lumbar external drainage, resting in a semi-reclining position, or other conservative treatment. Two CSF leaks were repaired with gelatine foam and fibrin glue using a transsphenoidal approach, and two with autologous fat graft and sellar floor reconstruction using a transnasal endoscopic approach. After undergoing two transnasal endoscopic repairs, one patient with post-operative CSF rhinorrhoea was successfully treated by further lumbar subarachnoid drainage. In conclusion, procedures using gelatine foam, fibrin glue and autologous fat graft are common and effective techniques for the management of CSF rhinorrhoea after transsphenoidal surgery. When a CSF leak is detected during transsphenoidal surgery, thorough sellar reconstruction and long-term follow-up are necessary. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

Helium Mass Spectrometer Leak Detection: A Method to Quantify Total Measurement Uncertainty

NASA Technical Reports Server (NTRS)

Mather, Janice L.; Taylor, Shawn C.

2015-01-01

In applications where leak rates of components or systems are evaluated against a leak rate requirement, the uncertainty of the measured leak rate must be included in the reported result. However, in the helium mass spectrometer leak detection method, the sensitivity, or resolution, of the instrument is often the only component of the total measurement uncertainty noted when reporting results. To address this shortfall, a measurement uncertainty analysis method was developed that includes the leak detector unit's resolution, repeatability, hysteresis, and drift, along with the uncertainty associated with the calibration standard. In a step-wise process, the method identifies the bias and precision components of the calibration standard, the measurement correction factor (K-factor), and the leak detector unit. Together these individual contributions to error are combined and the total measurement uncertainty is determined using the root-sum-square method. It was found that the precision component contributes more to the total uncertainty than the bias component, but the bias component is not insignificant. For helium mass spectrometer leak rate tests where unit sensitivity alone is not enough, a thorough evaluation of the measurement uncertainty such as the one presented herein should be performed and reported along with the leak rate value.

Influence of wetting effect at the outer surface of the pipe on increase in leak rate - experimental results and discussion

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

Isozaki, Toshikuni; Shibata, Katsuyuki

1997-04-01

Experimental and computed results applicable to Leak Before Break analysis are presented. The specific area of investigation is the effect of the temperature distribution changes due to wetting of the test pipe near the crack on the increase in the crack opening area and leak rate. Two 12-inch straight pipes subjected to both internal pressure and thermal load, but not to bending load, are modelled. The leak rate was found to be very susceptible to the metal temperature of the piping. In leak rate tests, therefore, it is recommended that temperature distribution be measured precisely for a wide area.

The hydrocarbon cycle and its role in hyperthermals, ocean anoxic events and mass extinctions

NASA Astrophysics Data System (ADS)

Dahlgren, Torbjørn

2016-04-01

Release of light isotopic carbon, ocean oxygen deficiency and extinction characterizes the Paleocene-Eocene Thermal Maximum (PETM). The PETM carbon isotope excursion (CIE) has been linked to gas hydrate decomposition and/or methane release due to igneous intrusions in sedimentary basins. In reviewing the published geological and geochemical data it became apparent that the majority of observations are in fact compatible with a different source(s) of the light isotopic carbon, namely, that of fluids trapped in sedimentary basins. Here I make a connection between the drilled paleo-accumulations of oil and gas in the Barents Sea, their burial and tectonic history, and published data of the PETM that may be reinterpreted as to reflect large scale leakage of oil and gas accumulations. I focus on oil, as leaked oil has a preservation potential in the sedimentary record. In contrast, gas from either leaked gas accumulations or exsolution from pore waters has little preservation potential other than contributing to the CIE. Sedimentary records compatible with leaked oil is present in the Arctic Ocean and Spitsbergen as fluorescent bitumen/amorphous organic matter (AOM) with carbon isotope ratios and biomarker signatures similar to those recorded in Barents Sea oil samples. Bitumen/AOM-rich immature sediments are also found in the North Sea and unresolved complex organic matter compatible with highly weathered oil has been found as far south as Walvis Ridge, offshore Namibia. Large scale fluid leakage from sedimentary basins can also explain the increase in radiogenic Osmium and Rhenium that mimic the CIE. Also biological evidence such as the extinction of North Atlantic benthic foraminifera lineages, the A. Augustum bloom and the occurrence of malformed micro/nanno-fossils may be linked to large scale leakage of oil and diagenetically altered porewaters. The leaked oil and gas was partially re-cycled into an organic rich shale (source rock) suggesting a 'hydrocarbon cycle' exists. Based on previously noted similarities between the PETM, the Toarcian OAE and the Triassic-Jurassic and Permian-Triassic events, it is inferred that also these may have been associated with catastrophic leakage of hydrocarbons trapped in sedimentary basins.

Failure analysis of fuze power supply

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

Menke, J.T.

1996-10-01

Batteries in storage which were used in electronic fuzes were found to be leaking after 5 years. The leaking battery ampules were made of copper and contained mixture of fluoboric acid and methylene bromide. The corrosion mechanism is described along with the testing/analysis required to simulate the field failures.

Can the intraoperative leak test prevent postoperative leakage of esophagojejunal anastomosis after total gastrectomy?

PubMed

Kanaji, Shingo; Ohyama, Masato; Yasuda, Takashi; Sendo, Hiroyoshi; Suzuki, Satoshi; Kawasaki, Kentaro; Tanaka, Kenichi; Fujino, Yasuhiro; Tominaga, Masahiro; Kakeji, Yoshihiro

2016-07-01

Anastomotic failures that cannot be detected during surgery often lead to postoperative leakage. There have been no detailed reports on the intraoperative leak test for esophagojejunal anastomosis. Our purpose was to investigate the utility of routine intraoperative leak testing to prevent postoperative anastomotic leakage after performing esophagojejunostomy. We prospectively performed routine air leak tests and reviewed the records of 185 consecutive patients with gastric cancer who underwent open total gastrectomy followed by esophagojejunostomy. A positive leak test was found for six patients (3.2 %). These patients with positive leak tests were subsequently treated with additional suturing, and they developed no postoperative anastomotic leakage. However, anastomotic leakage occurred in nine patients (4.9 %) with negative leak tests. A multivariate analysis demonstrated that a patient age >75 years and the surgeon's experience <30 cases were risk factors for anastomotic leakage. Intraoperative leak testing can detect some physical dehiscence, and additional suturing may prevent anastomotic leakage. However, it cannot prevent all anastomotic leakage caused by other factors, such as the surgeons' experience and patients' age.

Orthostatic headache as the presenting symptom of cervical spine metastasis.

PubMed

Kim, Ji Hyun; Choi, Jeong-Yoon; Kim, Ho-Jung; Oh, Kyungmi

2008-01-01

Orthostatic headache is a key symptom of intracranial hypotension; however, not all orthostatic headaches are caused by cerebrospinal fluid leaks leading to intracranial hypotension. We report here the unusual case of a 68-year-old man presenting with orthostatic headache in which compression of the C3 spinal nerve root by metastatic tumor invasion may contribute to the development of his orthostatic headache.

Capillary pressure – saturation relationships for gas shales measured using a water activity meter

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

Donnelly, B.; Perfect, E.; McKay, L. D.

Hydraulic fracturing of gas shale formations involves pumping a large volume of fracking fluid into a hydrocarbon reservoir to fracture the rock and thus increase its permeability. The majority of the fracking fluid introduced is never recovered and the fate of this lost fluid, often called “leak off,” has become the source of much debate. Information on the capillary pressure – saturation relationship for each wetting phase is needed to simulate leak off using numerical reservoir models. The petroleum industry commonly employs air – water capillary pressure – saturation curves to predict these relationships for mixed wet reservoirs. Traditional methodsmore » of measuring this curve are unsuitable for gas shales due to high capillary pressures associated with the small pores present. Still, a possible alternative method is the water activity meter which is used widely in the soil sciences for such measurements. However, its application to lithified material has been limited. Here, this study utilized a water activity meter to measure air – water capillary pressures (ranging from 1.3 to 219.6 MPa) at several water saturation levels in both the wetting and drying directions. Water contents were measured gravimetrically. Seven types of gas producing shale with different porosities (2.5–13.6%) and total organic carbon contents (0.4–13.5%) were investigated. Nonlinear regression was used to fit the resulting capillary pressure – water saturation data pairs for each shale type to the Brooks and Corey equation. Data for six of the seven shale types investigated were successfully fitted (median R 2 = 0.93), indicating this may be a viable method for parameterizing capillary pressure – saturation relationships for inclusion in numerical reservoir models. As expected, the different shale types had statistically different Brooks and Corey parameters. However, there were no significant differences between the Brooks and Corey parameters for the wetting and drying measurements, suggesting that hysteresis may not need to be taken into account in leak off simulations.« less

Capillary pressure – saturation relationships for gas shales measured using a water activity meter

DOE PAGES

Donnelly, B.; Perfect, E.; McKay, L. D.; ...

2016-05-10

Hydraulic fracturing of gas shale formations involves pumping a large volume of fracking fluid into a hydrocarbon reservoir to fracture the rock and thus increase its permeability. The majority of the fracking fluid introduced is never recovered and the fate of this lost fluid, often called “leak off,” has become the source of much debate. Information on the capillary pressure – saturation relationship for each wetting phase is needed to simulate leak off using numerical reservoir models. The petroleum industry commonly employs air – water capillary pressure – saturation curves to predict these relationships for mixed wet reservoirs. Traditional methodsmore » of measuring this curve are unsuitable for gas shales due to high capillary pressures associated with the small pores present. Still, a possible alternative method is the water activity meter which is used widely in the soil sciences for such measurements. However, its application to lithified material has been limited. Here, this study utilized a water activity meter to measure air – water capillary pressures (ranging from 1.3 to 219.6 MPa) at several water saturation levels in both the wetting and drying directions. Water contents were measured gravimetrically. Seven types of gas producing shale with different porosities (2.5–13.6%) and total organic carbon contents (0.4–13.5%) were investigated. Nonlinear regression was used to fit the resulting capillary pressure – water saturation data pairs for each shale type to the Brooks and Corey equation. Data for six of the seven shale types investigated were successfully fitted (median R 2 = 0.93), indicating this may be a viable method for parameterizing capillary pressure – saturation relationships for inclusion in numerical reservoir models. As expected, the different shale types had statistically different Brooks and Corey parameters. However, there were no significant differences between the Brooks and Corey parameters for the wetting and drying measurements, suggesting that hysteresis may not need to be taken into account in leak off simulations.« less

Characterization of transsphenoidal complications in patients with acromegaly: an analysis of inpatient data in the United States from 2002 to 2010.

PubMed

Raikundalia, Milap D; Pines, Morgan J; Svider, Peter F; Baredes, Soly; Folbe, Adam J; Liu, James K; Eloy, Jean Anderson

2015-05-01

Transsphenoidal surgery (TSS) is a common procedure for a variety of pituitary lesions. This procedure can be associated with complications related to the surgery or specific pathology. In this study, we evaluate inpatient postoperative complications among patients who underwent TSS for growth hormone adenomas using a nationally representative database, and compare patient characteristics and complications to patients who underwent TSS for other benign pituitary neoplasms. Analysis of the Nationwide Inpatient Sample revealed 13,070 TSS patients (including 892 with acromegaly) between 2002 and 2010. Complication rates, outcomes, patient demographics, hospital stay, and total charges were evaluated among TSS patients with and without acromegaly. There was an increase in TSS performed in both cohorts from 2002 to 2010. Acromegaly patients were younger, had shorter hospital stays, and incurred fewer charges. Acromegaly patients had a lower occurrence of postoperative urinary/renal complications (0.2% vs 1.1%), thromboembolic events (0% vs 0.4%), fluid/electrolyte abnormalities (5.7% vs 9.1%), and iatrogenic hypopituitarism (0.3% vs 1.1%) compared to other TSS patients (all p < 0.05). After adjusting for age, acromegalic patients maintained a statistically lower occurrence of fluid/electrolyte abnormalities (p = 0.007). Cerebrospinal fluid leak occurrence in acromegaly patients was 2.6% vs 1.7% in non-acromegaly patients, a result that did not reach significance (p = 0.054). Upon comparison of inpatient hospitalizations for patients undergoing TSS for growth hormone adenomas and other benign pituitary neoplasms, acromegaly patients had a significantly lower occurrence of postoperative fluid/electrolyte abnormalities. Acromegaly patients had shorter hospitalizations and subsequently fewer total charges. © 2015 ARS-AAOA, LLC.

Mathematical modeling and simulation analysis of hydraulic fracture propagation in three-layered poro-elastic media

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

Moon, H.Y.; Advani, S.H.; Lee, T.S.

1992-11-01

Hydraulic fracturing plays a pivotal role in the enhancement of oil and gas production recovery from low permeability reservoirs. The process of hydraulic fracturing entails the generation of a fracture by pumping fluids blended with special chemicals and proppants into the payzone at high injection rates and pressures to extend and wedge fractures. The mathematical modeling of hydraulically induced fractures generally incorporates coupling between the formation elasticity, fracture fluid flow, and fracture mechanics equations governing the formation structural responses, fluid pressure profile, and fracture growth. Two allied unsymmetric elliptic fracture models are developed for fracture configuration evolutions in three-layered rockmore » formations. The first approach is based on a Lagrangian formulation incorporating pertinent energy components associated with the formation structural responses and fracture fluid flow. The second model is based on a generalized variational principle, introducing an energy rate related functional. These models initially simulate a penny-shaped fracture, which becomes elliptic if the crack tips encounters (upper and/or lower) barriers with differential reservoir properties (in situ stresses, 16 elastic moduli, and fracture toughness-contrasts and fluid leak-off characteristics). The energy rate component magnitudes are determined to interpret the governing hydraulic fracture mechanisms during fracture evolution. The variational principle is extended to study the phenomenon and consequences of fluid lag in fractures. Finally, parametric sensitivity and energy rate investigations to evaluate the roles of controllable hydraulic treatment variables and uncontrollable reservoir property characterization parameters are performed. The presented field applications demonstrate the overall capabilities of the developed models. These studies provide stimulation treatment guidelines for fracture configuration design, control, and optimization.« less

Fluid flow measurements by means of vibration monitoring

NASA Astrophysics Data System (ADS)

Campagna, Mauro M.; Dinardo, Giuseppe; Fabbiano, Laura; Vacca, Gaetano

2015-11-01

The achievement of accurate fluid flow measurements is fundamental whenever the control and the monitoring of certain physical quantities governing an industrial process are required. In that case, non-intrusive devices are preferable, but these are often more sophisticated and expensive than those which are more common (such as nozzles, diaphrams, Coriolis flowmeters and so on). In this paper, a novel, non-intrusive, simple and inexpensive methodology is presented to measure the fluid flow rate (in a turbulent regime) whose physical principle is based on the acquisition of transversal vibrational signals induced by the fluid itself onto the pipe walls it is flowing through. Such a principle of operation would permit the use of micro-accelerometers capable of acquiring and transmitting the signals, even by means of wireless technology, to a control room for the monitoring of the process under control. A possible application (whose feasibility will be investigated by the authors in a further study) of this introduced technology is related to the employment of a net of micro-accelerometers to be installed on pipeline networks of aqueducts. This apparatus could lead to the faster and easier detection and location of possible leaks of fluid affecting the pipeline network with more affordable costs. The authors, who have previously proven the linear dependency of the acceleration harmonics amplitude on the flow rate, here discuss an experimental analysis of this functional relation with the variation in the physical properties of the pipe in terms of its diameter and constituent material, to find the eventual limits to the practical application of the measurement methodology.

Investigative techniques used to locate the liquid hydrogen leakage on the Space Shuttle Main Propulsion System

NASA Technical Reports Server (NTRS)

Hammock, William R., Jr.; Cota, Phillip E., Jr.; Rosenbaum, Bernard J.; Barrett, Michael J.

1991-01-01

Standard leak detection methods at ambient temperature have been developed in order to prevent excessive leakage from the Space Shuttle liquid oxygen and liquid hydrogen Main Propulsion System. Unacceptable hydrogen leakage was encountered on the Columbia and Atlantis flight vehicles in the summer of 1990 after the standard leak check requirements had been satisfied. The leakage was only detectable when the fuel system was exposed to subcooled liquid hydrogen during External Tank loading operations. Special instrumentation and analytical tools were utilized during a series of propellant tanking tests in order to identify the sources of the hydrogen leakage. After the leaks were located and corrected, the physical characteristics of the leak sources were analyzed in an effort to understand how the discrepancies were introduced and why the leakage had evaded the standard leak detection methods. As a result of the post-leak analysis, corrective actions and leak detection improvements have been implemented in order to preclude a similar incident.

Two-stream Convolutional Neural Network for Methane Emissions Quantification

NASA Astrophysics Data System (ADS)

Wang, J.; Ravikumar, A. P.; McGuire, M.; Bell, C.; Tchapmi, L. P.; Brandt, A. R.

2017-12-01

Methane, a key component of natural gas, has a 25x higher global warming potential than carbon dioxide on a 100-year basis. Accurately monitoring and mitigating methane emissions require cost-effective detection and quantification technologies. Optical gas imaging, one of the most commonly used leak detection technology, adopted by Environmental Protection Agency, cannot estimate leak-sizes. In this work, we harness advances in computer science to allow for rapid and automatic leak quantification. Particularly, we utilize two-stream deep Convolutional Networks (ConvNets) to estimate leak-size by capturing complementary spatial information from still plume frames, and temporal information from plume motion between frames. We build large leak datasets for training and evaluating purposes by collecting about 20 videos (i.e. 397,400 frames) of leaks. The videos were recorded at six distances from the source, covering 10 -60 ft. Leak sources included natural gas well-heads, separators, and tanks. All frames were labeled with a true leak size, which has eight levels ranging from 0 to 140 MCFH. Preliminary analysis shows that two-stream ConvNets provides significant accuracy advantage over single steam ConvNets. Spatial stream ConvNet can achieve an accuracy of 65.2%, by extracting important features, including texture, plume area, and pattern. Temporal stream, fed by the results of optical flow analysis, results in an accuracy of 58.3%. The integration of the two-stream ConvNets gives a combined accuracy of 77.6%. For future work, we will split the training and testing datasets in distinct ways in order to test the generalization of the algorithm for different leak sources. Several analytic metrics, including confusion matrix and visualization of key features, will be used to understand accuracy rates and occurrences of false positives. The quantification algorithm can help to find and fix super-emitters, and improve the cost-effectiveness of leak detection and repair programs.

Portable Dual-comb Spectrometer for Stable Detection of Methane Leaks over Kilometer Scale Paths at Oil and Natural Gas Production Site

NASA Astrophysics Data System (ADS)

Coburn, S.; Wright, R.; Cossel, K.; Truong, G. W.; Baumann, E.; Coddington, I.; Newbury, N.; Alden, C. B.; Ghosh, S.; Prasad, K.; Rieker, G. B.

2016-12-01

Newly proposed EPA regulations on volatile organic compound (VOC) emissions from oil and gas production facilities have been expanded to include methane, making the detection of this important trace gas a topic of growing interest to the oil and gas industry, regulators, and the scientific community in general. Reliable techniques that enable long-term monitoring of entire production facilities are needed in order to fully characterize the temporal and spatial trends of emissions from these sites. Recent advances in the development of compact and robust fiber frequency combs are enabling the use of this powerful spectroscopic tool outside of the laboratory, presenting opportunities for kilometer-scale open-path sensing of emissions at remote locations. Here we present the characterization and field deployment of a dual comb spectrometer (DCS) system with the potential to locate and size methane leaks from oil and gas production sites from long range. The DCS is a laser-based system that enables broad spectral absorption measurements (>50 nm) with high spectral resolution (<0.002 nm). Together these properties enable measurement of methane and other trace gas concentrations (e.g., H2O for deriving dry mole fractions) with high sensitivity and long-term stability from distances of 1 km or more. Field testing of this instrument has taken place at locations near Boulder, CO, demonstrating sensitivities of better than 2 ppb-km for methane. In addition, path integrated methane measurements from the DCS are coupled with an atmospheric inversion utilizing local meteorology and a high resolution fluid dynamics simulation to determine leak location and also derive a leak rate from simulated methane leaks

The posterior nasoseptal flap: A novel technique for closure after endoscopic transsphenoidal resection of pituitary adenomas

PubMed Central

Barger, James; Siow, Matthew; Kader, Michael; Phillips, Katherine; Fatterpekar, Girish; Kleinberg, David; Zagzag, David; Sen, Chandranath; Golfinos, John G.; Lebowitz, Richard; Placantonakis, Dimitris G.

2018-01-01

Background: While effective for the repair of large skull base defects, the Hadad-Bassagasteguy nasoseptal flap increases operative time and can result in a several-week period of postoperative crusting during re-mucosalization of the denuded nasal septum. Endoscopic transsphenoidal surgery for pituitary adenoma resection is generally not associated with large dural defects and high-flow cerebrospinal fluid (CSF) leaks requiring extensive reconstruction. Here, we present the posterior nasoseptal flap as a novel technique for closure of skull defects following endoscopic resection of pituitary adenomas. This flap is raised in all surgeries during the transnasal exposure using septal mucoperiosteum that would otherwise be discarded during the posterior septectomy performed in binostril approaches. Methods: We present a retrospective, consecutive case series of 43 patients undergoing endoscopic transsphenoidal resection of a pituitary adenoma followed by posterior nasoseptal flap placement and closure. Main outcome measures were extent of resection and postoperative CSF leak. Results: The mean extent of resection was 97.16 ± 1.03%. Radiographic measurement showed flap length to be adequate. While a defect in the diaphragma sellae and CSF leak were identified in 21 patients during surgery, postoperative CSF leak occurred in only one patient. Conclusions: The posterior nasoseptal flap provides adequate coverage of the surgical defect and is nearly always successful in preventing postoperative CSF leak following endoscopic transsphenoidal resection of pituitary adenomas. The flap is raised from mucoperiosteum lining the posterior nasal septum, which is otherwise resected during posterior septectomy. Because the anterior septal cartilage is not denuded, raising such flaps avoids the postoperative morbidity associated with the larger Hadad-Bassagasteguy nasoseptal flap. PMID:29527390

SSME propellant path leak detection real-time

NASA Technical Reports Server (NTRS)

Crawford, R. A.; Smith, L. M.

1994-01-01

Included are four documents that outline the technical aspects of the research performed on NASA Grant NAG8-140: 'A System for Sequential Step Detection with Application to Video Image Processing'; 'Leak Detection from the SSME Using Sequential Image Processing'; 'Digital Image Processor Specifications for Real-Time SSME Leak Detection'; and 'A Color Change Detection System for Video Signals with Applications to Spectral Analysis of Rocket Engine Plumes'.

Fractal modeling of fluidic leakage through metal sealing surfaces

NASA Astrophysics Data System (ADS)

Zhang, Qiang; Chen, Xiaoqian; Huang, Yiyong; Chen, Yong

2018-04-01

This paper investigates the fluidic leak rate through metal sealing surfaces by developing fractal models for the contact process and leakage process. An improved model is established to describe the seal-contact interface of two metal rough surface. The contact model divides the deformed regions by classifying the asperities of different characteristic lengths into the elastic, elastic-plastic and plastic regimes. Using the improved contact model, the leakage channel under the contact surface is mathematically modeled based on the fractal theory. The leakage model obtains the leak rate using the fluid transport theory in porous media, considering that the pores-forming percolation channels can be treated as a combination of filled tortuous capillaries. The effects of fractal structure, surface material and gasket size on the contact process and leakage process are analyzed through numerical simulations for sealed ring gaskets.

Anastomotic leak after colorectal resection: A population-based study of risk factors and hospital variation.

PubMed

Nikolian, Vahagn C; Kamdar, Neil S; Regenbogen, Scott E; Morris, Arden M; Byrn, John C; Suwanabol, Pasithorn A; Campbell, Darrell A; Hendren, Samantha

2017-06-01

Anastomotic leak is a major source of morbidity in colorectal operations and has become an area of interest in performance metrics. It is unclear whether anastomotic leak is associated primarily with surgeons' technical performance or explained better by patient characteristics and institutional factors. We sought to establish if anastomotic leak could serve as a valid quality metric in colorectal operations by evaluating provider variation after adjusting for patient factors. We performed a retrospective cohort study of colorectal resection patients in the Michigan Surgical Quality Collaborative. Clinically relevant patient and operative factors were tested for association with anastomotic leak. Hierarchical logistic regression was used to derive risk-adjusted rates of anastomotic leak. Of 9,192 colorectal resections, 244 (2.7%) had a documented anastomotic leak. The incidence of anastomotic leak was 3.0% for patients with pelvic anastomoses and 2.5% for those with intra-abdominal anastomoses. Multivariable analysis showed that a greater operative duration, male sex, body mass index >30 kg/m 2 , tobacco use, chronic immunosuppressive medications, thrombocytosis (platelet count >400 × 10 9 /L), and urgent/emergency operations were independently associated with anastomotic leak (C-statistic = 0.75). After accounting for patient and procedural risk factors, 5 hospitals had a significantly greater incidence of postoperative anastomotic leak. This population-based study shows that risk factors for anastomotic leak include male sex, obesity, tobacco use, immunosuppression, thrombocytosis, greater operative duration, and urgent/emergency operation; models including these factors predict most of the variation in anastomotic leak rates. This study suggests that anastomotic leak can serve as a valid metric that can identify opportunities for quality improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

What is the optimal management of an intra-operative air leak in a colorectal anastomosis?

PubMed

Mitchem, J B; Stafford, C; Francone, T D; Roberts, P L; Schoetz, D J; Marcello, P W; Ricciardi, R

2018-02-01

An airtight anastomosis on intra-operative leak testing has been previously demonstrated to be associated with a lower risk of clinically significant postoperative anastomotic leak following left-sided colorectal anastomosis. However, to date, there is no consistently agreed upon method for management of an intra-operative anastomotic leak. Therefore, we powered a noninferiority study to determine whether suture repair alone was an appropriate strategy for the management of an intra-operative air leak. This is a retrospective cohort analysis of prospectively collected data from a tertiary care referral centre. We included all consecutive patients with left-sided colorectal or ileorectal anastomoses and evidence of air leak during intra-operative leak testing. Patients were excluded if proximal diversion was planned preoperatively, a pre-existing proximal diversion was present at the time of surgery or an anastomosis was ultimately unable to be completed. The primary outcome measure was clinically significant anastomotic leak, as defined by the Surgical Infection Study Group at 30 days. From a sample of 2360 patients, 119 had an intra-operative air leak during leak testing. Sixty-eight patients underwent suture repair alone and 51 underwent proximal diversion or anastomotic reconstruction. The clinically significant leak rate was 9% (6/68; 95% CI: 2-15%) in the suture repair alone arm and 0% (0/51) in the diversion or reconstruction arm. Suture repair alone does not meet the criteria for noninferiority for the management of intra-operative air leak during left-sided colorectal anastomosis. Further repair of intra-operative air leak by suture repair alone should be reconsidered given these findings. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

What Is the Risk of Anastomotic Leak After Repeat Intestinal Resection in Patients With Crohn's Disease?

PubMed

Johnston, W Forrest; Stafford, Caitlin; Francone, Todd D; Read, Thomas E; Marcello, Peter W; Roberts, Patricia L; Ricciardi, Rocco

2017-12-01

Approximately half of Crohn's patients require intestinal resection, and many need repeat resections. The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn's disease. This was a retrospective analysis of prospectively collected departmental data with 100% capture. The study was conducted at the department of colorectal surgery in a tertiary care teaching hospital between July 2007 and March 2016. A cohort of consecutive patients with Crohn's disease who were treated with intestinal resection and anastomosis, excluding patients with proximal fecal diversion, were included. The cohort was divided into 2 groups, those with no previous resection compared with those with previous resection. Clinical anastomotic leak within 30 days of surgery was measured. Of the 206 patients who met criteria, 83 patients had previous intestinal resection (40%). The 2 groups were similar in terms of patient factors, immune-suppressing medication use, and procedural factors. Overall, 20 clinical anastomotic leaks were identified (10% leak rate). There were 6 leaks (5%) detected in patients with no previous intestinal resection and 14 leaks (17%) detected in patients with a history of previous intestinal resection (p < 0.005). The OR of anastomotic leak in patients with Crohn's disease with previous resection compared with no previous resection was 3.5 (95% CI, 1.3-9.4). Patients with 1 previous resection (n = 53) had a leak rate of 13%, whereas patients with ≥2 previous resections (n = 30) had a leak rate of 23%. The number of previous resections correlated with increasing risk for clinical anastomotic leak (correlation coefficient = 0.998). This was a retrospective study with limited data to perform a multivariate analysis. Repeat intestinal resection in patients with Crohn's disease is associated with an increased rate of anastomotic leakage when compared with initial resection despite similar patient, medication, and procedural factors. See Video Abstract at http://links.lww.com/DCR/A459.

Technical factors associated with anastomotic leak after Roux-en-Y gastric bypass.

PubMed

Smith, Mark D; Adeniji, Abidemi; Wahed, Abdus S; Patterson, Emma; Chapman, William; Courcoulas, Anita P; Dakin, Gregory; Flum, David; McCloskey, Carol; Mitchell, James E; Pomp, Alfons; Staten, Myrlene; Wolfe, Bruce

2015-01-01

Anastomotic leak is one of the most serious complications after Roux-en-Y gastric bypass (RYGB). Our objective was to examine the relationship between technical factors and incidence of clinically relevant anastomotic leak after RYGB in longitudinal assessment of bariatric surgery (LABS). The setting of the study was 11 bariatric centers in the United States, university, and private practice. Patient characteristics, technical factors of surgery, and postoperative outcomes were assessed by trained researchers using standardized protocols. Correlation of surgical factors of patients undergoing RYGB (n = 4444) with the incidence of postoperative anastomotic leak was assessed by univariate χ(2) analysis. Forty-four participants (1.0%, 95% CI .7%-1.3%) experienced a clinically relevant anastomotic leak. Of these, 39 (89%) underwent abdominal reoperation and 3 (7%) died. Technical factors associated with anastomotic leak were open surgery (P<.0001), revision surgery (P<.0001), and use of an abdominal drain (P = .02). Provocative leak testing, method of gastrojejunostomy, and use of fibrin sealant were not associated with anastomotic leak. Anastomotic leak after RYGB was rare (1.0%). Most cases required reintervention; however, the majority (93%) recovered from this event. Open surgery, revision surgery, and routine drain placement were associated with increased leak rate. Some of these findings may be due to differences in preoperative patient risk. Copyright © 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Leak rate measurements for satellite subsystems and residual gas analysis during space environment tests. [thermal vacuum and solar simulation tests

NASA Technical Reports Server (NTRS)

Nuss, H. E.

1975-01-01

The measuring and evaluation procedure for the determination of leak rates of satellite subsystems with a quadrupole mass spectrometer, and the results of the residual gas analysis are described. The method selected for leak rate determination was placing the system into a vacuum chamber and furnishing the chamber with a mass spectrometer and calibrated leaks. The residual gas of a thermal vacuum test facility, in which the thermal balance test radiation input was simulated by a heated canister, was analyzed with the mass spectrometer in the atomic mass unit range up to 300 amu. In addition to the measurements during the space environment tests, mass spectrometric studies were performed with samples of spacecraft materials. The studies were carried out during tests for the projects HELIOS, AEROS B and SYMPHONIE.

The use of image-guidance during transsphenoidal pituitary surgery in the United States

PubMed Central

Chung, Thomas K.; Riley, Kristen O.

2015-01-01

Background: Intraoperative image guidance is a useful modality for transsphenoidal pituitary surgery. However, the outcomes associated with this technology have not been systematically evaluated. Objective: The purpose of the study was to quantify complication rates with and without the use of image guidance during transsphenoidal pituitary surgery using a nationwide database with broadly applicable results. Methods: A retrospective analysis of the Nationwide Inpatient Sample was performed from 2007 to 2011. Transsphenoidal pituitary resections for adenomas were identified by International Classification of Diseases-9th Revision, Clinical Modification code. The effect of image guidance on cerebrospinal fluid (CSF) leak complications and cost-benefit was analyzed. Results: A total of 48,848 transsphenoidal pituitary resections were identified, of which 77.5% were partial resections and 22.5% were complete. Pathologic indications included benign (89.3%), malignant primary (0.6%), and malignant secondary (0.4%). Complications included same-stay death (0.4%), CSF leak (8.8%), postoperative CSF rhinorrhea (1.9%), diabetes insipidus (12.4%), and meningitis (0.4%). Image guidance was employed in 7% (n = 3401) of all cases. When analyzed by modality, computed tomography (CT)-assisted procedures had lower CSF rhinorrhea rates (1.1%) compared with cases with no image guidance (1.9%), whereas magnetic resonance (MR)-assisted procedures had the highest rates (2.7%, χ2 p < 0.001). Rates of CSF leak demonstrated a similar pattern (CT 6.4%, no image guidance 8.9%, MR 9.2%, χ2 p < 0.001). CT-assisted surgery had significantly shorter length of stay (2.9 days) versus no image guidance (3.7 days, p < 0.001), lower total charges ($47,589 versus $62,629, p < 0.001), and lower total cost ($16,748 versus $20,530, p < 0.001). Conclusions: CT-assisted surgery is associated with a lower rate of CSF leak, shorter length of stay, and lower cost compared with patients without image guidance. Further studies that control for severity and extent of disease are warranted to confirm this finding. PMID:25975254

Experimental validation of a novel stictionless magnetorheological fluid isolator

NASA Astrophysics Data System (ADS)

Kelso, Shawn P.; Denoyer, Keith K.; Blankinship, Ross M.; Potter, Kenneth; Lindler, Jason E.

2003-07-01

Magnetorheological (MR) fluid damper design typically constitutes a piston/dashpot configuration. During reciprocation, the fluid is circulated through the device with the generated pressure providing viscous damping. In addition, the damper is also intended to accommodate off-axis loading; i.e., rotation moments and lateral loads orthogonal to the axis of operation. Typically two sets of seals, one where the piston shaft enters and exits the device and one between the piston and the cylinder wall, maintain alignment of the damper and seal the fluid from leaking. With MR fluid, these seals can act as sources of non-linear friction effects (stiction) and oftentimes possess a shorter lifespan due to the abrasive nature of the ferrous particles suspended in the fluid. Intelligently controlling damping forces must also accommodate the non-linear stiction behavior, which degrades performance. A new, unique MR fluid isolator was designed, fabricated and tested that directly addresses these concerns. The goal of this research was the development of a stiction-free MR isolator whose damping force can be predicted and precisely controlled. This paper presents experimental results for a prototype device and compares those results to model predictions.

Military Forges Path Forward to Reduce Contingency Basing Energy Requirements

DTIC Science & Technology

2011-09-01

for environmental control. Unlike earlier phase change materials APChICs replace fluid modules with capillary structures that reduce bulk and...potential leaks. Initial test results indicate the power demand to heat and cool a shelter can be significantly reduced using composite insulation...instrumented our 18 month Joint Net Zero study at the National Training Center and captured on separate recorders, data on power draw of HVAC units and

Determining Methane Leak Locations and Rates with a Wireless Network Composed of Low-Cost, Printed Sensors

NASA Astrophysics Data System (ADS)

Smith, C. J.; Kim, B.; Zhang, Y.; Ng, T. N.; Beck, V.; Ganguli, A.; Saha, B.; Daniel, G.; Lee, J.; Whiting, G.; Meyyappan, M.; Schwartz, D. E.

2015-12-01

We will present our progress on the development of a wireless sensor network that will determine the source and rate of detected methane leaks. The targeted leak detection threshold is 2 g/min with a rate estimation error of 20% and localization error of 1 m within an outdoor area of 100 m2. The network itself is composed of low-cost, high-performance sensor nodes based on printed nanomaterials with expected sensitivity below 1 ppmv methane. High sensitivity to methane is achieved by modifying high surface-area-to-volume-ratio single-walled carbon nanotubes (SWNTs) with materials that adsorb methane molecules. Because the modified SWNTs are not perfectly selective to methane, the sensor nodes contain arrays of variously-modified SWNTs to build diversity of response towards gases with adsorption affinity. Methane selectivity is achieved through advanced pattern-matching algorithms of the array's ensemble response. The system is low power and designed to operate for a year on a single small battery. The SWNT sensing elements consume only microwatts. The largest power consumer is the wireless communication, which provides robust, real-time measurement data. Methane leak localization and rate estimation will be performed by machine-learning algorithms built with the aid of computational fluid dynamics simulations of gas plume formation. This sensor system can be broadly applied at gas wells, distribution systems, refineries, and other downstream facilities. It also can be utilized for industrial and residential safety applications, and adapted to other gases and gas combinations.

A new intelligent bed care system for hospital and home patients.

PubMed

Yonezawa, Yoshiharu; Miyamoto, Yasuaki; Maki, Hiromichi; Ogawa, Hidekuni; Ninomiya, Ishio; Sada, Kouji; Hamada, Shingo; Caldwell, W Morton

2005-01-01

An intelligent bed-care system has been developed for monitoring patient movements and behavior in the hospital and at home in order to prevent injuries from falls, a major problem in health care facilities. Falls, as well as patient activity immediately preceding falls (i.e. exiting the bed), are especially dangerous when infusion extubation also occurs. This new system detects in-bed infusion fluid leaks, bleeding due to infusion-tube pullout, and urine resulting from incontinence. It employs stainless steel tape and wire noncontacting electrodes, several linear integrated circuits, and a low-power, 8-bit single-chip microcomputer The electrodes are installed between the bed mattress and sheet to record changes in an always-present alternating current (AC) voltage, which is induced on the patient's body by electrostatic coupling from a 100-V, 60-Hz alternating current power line around the bed. The microcomputer uses changes in the induced alternating current voltage to detect the patient's movements before and after leaving the bed, as well as any fluid leakage. The microcomputer alerts the nursing station, via the nurse call system or personal handy phone (PHS), that the patient is in an active state; has a dangerous posture on the bed; is contaminating the sheet due to leaking, bleeding or incontinence; or is out of bed.

Laparoscopic repair of traumatic perforation of the urinary bladder.

PubMed

Cottam, D; Gorecki, P J; Curvelo, M; Shaftan, G W

2001-12-01

Laparoscopy as a diagnostic modality in trauma has been reported. However, therapeutic laparoscopy for trauma remains a controversial subject. We present a case of laparoscopic repair of a traumatic bladder rupture. A 25-year-old man was brought to the emergency room after a head-on collision. Physical examination was unremarkable with the exception of gross hematuria upon insertion of a urinary catheter. Computed tomography scan of the abdomen demonstrated a small amount of free intraperitoneal fluid. An anteroposterior cystogram was obtained which showed no intraperitoneal or extraperitoneal leak. Repeat examinations of the abdomen revealed a mild tenderness in the lower abdomen. Because of the presence of unexplained free intraperitoneal fluid and equivocal signs of peritoneal irritation, exploratory laparoscopy was performed. Three 5-mm ports and a 5-mm laparoscope were used. Laparoscopic examination of the abdomen revealed a 4-cm rupture at the dome of the bladder. The laceration was sutured in two layers using an intracorporeal technique. The patient was discharged on the second postoperative day with indwelling urinary catheter. Eight days after the operation, a repeated cystogram revealed no evidence of leak. We believe that laparoscopic exploration for trauma in hemodynamically stable patients is feasible. The repair of simple intraabdominal injuries such as bladder rupture can be safely performed.

Impact of anastomotic leak on recurrence and survival after colorectal cancer surgery: a BioGrid Australia analysis.

PubMed

Sammour, Tarik; Hayes, Ian P; Jones, Ian T; Steel, Malcolm C; Faragher, Ian; Gibbs, Peter

2018-01-01

There is conflicting evidence regarding the oncological impact of anastomotic leak following colorectal cancer surgery. This study aims to test the hypothesis that anastomotic leak is independently associated with local recurrence and overall and cancer-specific survival. Analysis of prospectively collected data from multiple centres in Victoria between 1988 and 2015 including all patients who underwent colon or rectal resection for cancer with anastomosis was presented. Overall and cancer-specific survival rates and rates of local recurrence were compared using Cox regression analysis. A total of 4892 patients were included, of which 2856 had completed 5-year follow-up. The overall anastomotic leak rate was 4.0%. Cox regression analysis accounting for differences in age, sex, body mass index, American Society of Anesthesiologists score and tumour stage demonstrated that anastomotic leak was associated with significantly worse 5-year overall survival (χ 2 = 6.459, P = 0.011) for colon cancer, but only if early deaths were included. There was no difference in 5-year colon cancer-specific survival (χ 2 = 0.582, P = 0.446) or local recurrence (χ 2 = 0.735, P = 0.391). For rectal cancer, there was no difference in 5-year overall survival (χ 2 = 0.266, P = 0.606), cancer-specific survival (χ 2 = 0.008, P = 0.928) or local recurrence (χ 2 = 2.192, P = 0.139). Anastomotic leak may reduce 5-year overall survival in colon cancer patients but does not appear to influence the 5-year overall survival in rectal cancer patients. There was no effect on local recurrence or cancer-specific survival. © 2016 Royal Australasian College of Surgeons.

Determinants of Unintentional Leaks During CPAP Treatment in OSA.

PubMed

Lebret, Marius; Arnol, Nathalie; Martinot, Jean-Benoît; Lambert, Loïc; Tamisier, Renaud; Pepin, Jean-Louis; Borel, Jean-Christian

2018-04-01

Unintentional leakage from the mouth or around the mask may lead to cessation of CPAP treatment; however, the causes of unintentional leaks are poorly understood. The objectives of this study were (1) to identify determining factors of unintentional leakage and (2) to determine the effect of the type of mask (nasal/oronasal) used on unintentional leakage. Seventy-four polysomnograms from patients with OSA syndrome treated with auto-CPAP were analyzed (23 women; 56 ± 13 years; BMI, 32.9 kg/m 2 (range, 29.0-38.0 kg/m 2 ). Polysomnographic recordings were obtained under auto-CPAP, and mandibular behavior was measured with a magnetic sensor. After sleep and respiratory scoring, polysomnographic signals were computed as mean values over nonoverlapping 10-s intervals. The presence/absence of unintentional leakage was dichotomized for each 10-s interval (yes/no). Univariate and multivariate conditional regression models estimated the risk of unintentional leaks during an interval "T" based on the explanatory variables from the previous interval "T-1." A sensitivity analysis for the type of mask was then conducted. The univariate analysis showed that mandibular lowering (mouth opening), a high level of CPAP, body position (other than supine), and rapid eye movement (REM) sleep increased the risk of unintentional leaks and microarousal decreased it. In the multivariate analysis, the same variables remained independently associated with an increased risk of unintentional leakage. The sensitivity analysis showed that oronasal masks reduced the risk of unintentional leaks in cases of mouth opening and REM sleep. Mouth opening, CPAP level, sleep position, and REM sleep independently contribute to unintentional leakage. These results provide a strong rationale for the definition of phenotypes and the individual management of leaks during CPAP treatment. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Fault tree analysis for exposure to refrigerants used for automotive air conditioning in the United States.

PubMed

Jetter, J J; Forte, R; Rubenstein, R

2001-02-01

A fault tree analysis was used to estimate the number of refrigerant exposures of automotive service technicians and vehicle occupants in the United States. Exposures of service technicians can occur when service equipment or automotive air-conditioning systems leak during servicing. The number of refrigerant exposures of service technicians was estimated to be 135,000 per year. Exposures of vehicle occupants can occur when refrigerant enters passenger compartments due to sudden leaks in air-conditioning systems, leaks following servicing, or leaks caused by collisions. The total number of exposures of vehicle occupants was estimated to be 3,600 per year. The largest number of exposures of vehicle occupants was estimated for leaks caused by collisions, and the second largest number of exposures was estimated for leaks following servicing. Estimates used in the fault tree analysis were based on a survey of automotive air-conditioning service shops, the best available data from the literature, and the engineering judgement of the authors and expert reviewers from the Society of Automotive Engineers Interior Climate Control Standards Committee. Exposure concentrations and durations were estimated and compared with toxicity data for refrigerants currently used in automotive air conditioners. Uncertainty was high for the estimated numbers of exposures, exposure concentrations, and exposure durations. Uncertainty could be reduced in the future by conducting more extensive surveys, measurements of refrigerant concentrations, and exposure monitoring. Nevertheless, the analysis indicated that the risk of exposure of service technicians and vehicle occupants is significant, and it is recommended that no refrigerant that is substantially more toxic than currently available substitutes be accepted for use in vehicle air-conditioning systems, absent a means of mitigating exposure.

Optimal sensor placement for leak location in water distribution networks using genetic algorithms.

PubMed

Casillas, Myrna V; Puig, Vicenç; Garza-Castañón, Luis E; Rosich, Albert

2013-11-04

This paper proposes a new sensor placement approach for leak location in water distribution networks (WDNs). The sensor placement problem is formulated as an integer optimization problem. The optimization criterion consists in minimizing the number of non-isolable leaks according to the isolability criteria introduced. Because of the large size and non-linear integer nature of the resulting optimization problem, genetic algorithms (GAs) are used as the solution approach. The obtained results are compared with a semi-exhaustive search method with higher computational effort, proving that GA allows one to find near-optimal solutions with less computational load. Moreover, three ways of increasing the robustness of the GA-based sensor placement method have been proposed using a time horizon analysis, a distance-based scoring and considering different leaks sizes. A great advantage of the proposed methodology is that it does not depend on the isolation method chosen by the user, as long as it is based on leak sensitivity analysis. Experiments in two networks allow us to evaluate the performance of the proposed approach.

Optimal Sensor Placement for Leak Location in Water Distribution Networks Using Genetic Algorithms

PubMed Central

Casillas, Myrna V.; Puig, Vicenç; Garza-Castañón, Luis E.; Rosich, Albert

2013-01-01

This paper proposes a new sensor placement approach for leak location in water distribution networks (WDNs). The sensor placement problem is formulated as an integer optimization problem. The optimization criterion consists in minimizing the number of non-isolable leaks according to the isolability criteria introduced. Because of the large size and non-linear integer nature of the resulting optimization problem, genetic algorithms (GAs) are used as the solution approach. The obtained results are compared with a semi-exhaustive search method with higher computational effort, proving that GA allows one to find near-optimal solutions with less computational load. Moreover, three ways of increasing the robustness of the GA-based sensor placement method have been proposed using a time horizon analysis, a distance-based scoring and considering different leaks sizes. A great advantage of the proposed methodology is that it does not depend on the isolation method chosen by the user, as long as it is based on leak sensitivity analysis. Experiments in two networks allow us to evaluate the performance of the proposed approach. PMID:24193099

Reusable Solid Rocket Motor Nozzle Joint-4 Thermal Analysis

NASA Technical Reports Server (NTRS)

Clayton, J. Louie

2001-01-01

This study provides for development and test verification of a thermal model used for prediction of joint heating environments, structural temperatures and seal erosions in the Space Shuttle Reusable Solid Rocket Motor (RSRM) Nozzle Joint-4. The heating environments are a result of rapid pressurization of the joint free volume assuming a leak path has occurred in the filler material used for assembly gap close out. Combustion gases flow along the leak path from nozzle environment to joint O-ring gland resulting in local heating to the metal housing and erosion of seal materials. Analysis of this condition was based on usage of the NASA Joint Pressurization Routine (JPR) for environment determination and the Systems Improved Numerical Differencing Analyzer (SINDA) for structural temperature prediction. Model generated temperatures, pressures and seal erosions are compared to hot fire test data for several different leak path situations. Investigated in the hot fire test program were nozzle joint-4 O-ring erosion sensitivities to leak path width in both open and confined joint geometries. Model predictions were in generally good agreement with the test data for the confined leak path cases. Worst case flight predictions are provided using the test-calibrated model. Analysis issues are discussed based on model calibration procedures.

Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients.

PubMed

Aurora, Alexander R; Khaitan, Leena; Saber, Alan A

2012-06-01

Sleeve gastrectomy has become a popular stand-alone bariatric procedure with comparable weight loss and resolution of comorbidities to that of laparoscopic gastric bypass. The simplicity of the procedure and the decreased long-term risk profile make this surgery more appealing. Nonetheless, the ever present risk of a staple-line leak is still of great concern and needs further investigation. An electronic literature search of MEDLINE database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications was completed. Keywords used in the search were "sleeve gastrectomy" OR "gastric sleeve" AND "leak." We analyzed 29 publications, including 4,888 patients. We analyzed the frequency of leak after sleeve gastrectomy and its associated risks of causation. The risk of leak after sleeve gastrectomy in all comers was 2.4%. This risk was 2.9% in the super-obese [body mass index (BMI) > 50 kg/m(2)] and 2.2% for BMI < 50 kg/m(2). Staple height and use of buttressing material did not affect leak rate. The use of a size 40-Fr or greater bougie was associated with a leak rate of 0.6% compared with those who used smaller sizes whose leak rate was 2.8%. Leaks were found at the proximal third of the stomach in 89% of cases. Most leaks were diagnosed after discharge. Endoscopic management is a viable option for leaks and was documented in 11% of cases as successful. Sleeve gastrectomy has become an important surgical option for the treatment of the ever growing morbidly obese population. The risk of leak is low at 2.4%. Attention to detail specifically at the esophagogastric junction cannot be stressed enough. Careful patient selection (BMI < 50 kg/m(2)) and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak. Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge.

A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy.

PubMed

Bingham, Jason; Kaufman, Jedediah; Hata, Kai; Dickerson, James; Beekley, Alec; Wisbach, Gordon; Swann, Jacob; Ahnfeldt, Eric; Hawkins, Devon; Choi, Yong; Lim, Robert; Martin, Matthew

2017-09-01

Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. To determine the efficacy of IOLT and if routine use has any benefit over selective use. Eight teaching hospitals, including private, university, and military facilities. A multicenter, retrospective analysis over a 5-year period. The efficacy of the IOLT for identifying unsuspected staple line defects and for predicting postoperative leaks was evaluated. An anonymous survey was also collected reflecting surgeons' practices and beliefs regarding IOLT. From January 2010 through December 2014, 4284 patients underwent sleeve gastrectomy. Of these, 37 patients (.9%) developed a postoperative leak, and 2376 patients (55%) received an IOLT. Only 2 patients (0.08%) had a positive finding. Subsequently, 21 patients with a negative IOLT developed a leak. IOLT demonstrated a sensitivity of only 8.7%. There was a nonsignificant trend toward increased leak rates when an IOLT was performed versus when IOLT was not performed. Leak rates were not statistically different between centers that routinely perform IOLT versus those that selectively perform IOLT. Routine IOLT had very poor sensitivity and was negative in 91% of patients who later developed postoperative leaks. The use of IOLT was not associated with a decrease in the incidence of postoperative leaks, and routine IOLT had no benefit over selective leak testing. IOLT should not be used as a quality indicator or "best practice" for bariatric surgery. Published by Elsevier Inc.

Influence of anti-adhesive agent on incidence of bile leakage after liver resection: A prospective cohort study.

PubMed

Yu, Young-Dong; Kim, Dong-Sik; Jung, Sung-Won; Han, Jae-Hyun; Suh, Sung-Ock

2016-07-01

Anti-adhesive agents are increasingly used to reduce the incidence of postoperative adhesions following abdominal surgery. Bile leakage after liver resection remains a major cause of postoperative morbidity. The aim of this study was to examine the effect of anti-adhesive agent on bile leakage after liver resection. 77 patients were enrolled to receive an anti-adhesive agent (study group) during liver resection between May 2012 and August 2013. The study group was compared to a match-paired control group. Clinical data were collected including bilirubin concentration in serum and drain fluid and bile leakage rate. In addition, a separate analysis was performed between patients with and without postoperative bile leakage. There was no difference in bile leakage rate or hospital stay between the study group (n = 77) and control group (n = 77). Of the total number of patients (n = 154), there were 29 patients with postoperative bile leak and 125 patients without bile leak. On univariate analysis, patients without history of hepatitis were significantly associated with bile leakage. In addition, liver resection with broader cut surface area was associated with bile leakage. Application of anti-adhesive agent was not associated with bile leakage. On multivariate analysis, resection with broader cut surface area (OR = 2.788, p = 0.026) and patients without history of hepatitis (OR = 5.153, p = 0.039) were significantly associated with bile leakage. Larger area of cut-surface and patients without history of hepatitis were significant risk factors for bile leakage. The use of anti-adhesive agent was not associated with increased risk of bile leakage. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Spontaneous Intracranial Hypotension: A Review and Introduction of an Algorithm For Management.

PubMed

Davidson, Benjamin; Nassiri, Farshad; Mansouri, Alireza; Badhiwala, Jetan H; Witiw, Christopher D; Shamji, Mohammed F; Peng, Philip W; Farb, Richard I; Bernstein, Mark

2017-05-01

Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid volume and pressure caused by a leak of cerebrospinal fluid through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, because they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. We review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH. Copyright © 2017 Elsevier Inc. All rights reserved.

The potential for spills and leaks of hydraulic fracturing related fluids on well sites and from road incidents.

NASA Astrophysics Data System (ADS)

Clancy, Sarah; Worrall, Fred; Davies, Richard; Gluyas, Jon

2017-04-01

The potential growth of shale gas developments within Europe has raised concerns of the possibility of spills and leaks from shale gas sites and from liquid transportation via roads and pipelines. Data from a range of sources has been examined to estimate the likelihood of an incident. From the US, the Texas Railroad Commission and the Colorado Oil and Gas Commission have maintained records of the quantity; reasons for the spill; and reported impacts. For the UK, the Environment Agency pollution incident database and transport statistics from the UKs Department for Transport have also been analysed and used as an analogy to determine the likelihood of an incident or spill on the road. Data were used as an analogue to predict the potential number of spills and leaks that might occur at a well site, or in transport operation, under different shale gas development scenarios if fracking was to go forward in the UK. Since 2014 the Colorado Oil and Gas Commission has recorded 3874 spills in the State of Colorado, the majority of these (1941) consisted of produced water, whereas 835 recorded oil spills. Of all the spills recorded 1809 spilt more than 0.79 m3, with 1356 of these leaking outside the berm of the well site, and three sites requiring construction of an emergency pits to contain the spillage. During 2015, there were 53054 active wells; the percentage of produced oil spilt was 0.001%, whilst the percentage of produced water spilt was 0.009%. Data from the Texas Railroad Commission shows the number of reported spills over 0.16 m3 in Texas since 2009 has increased year on year, with 675 reported in 2009 and 1485 in 2015. The greatest loss each year was of crude oil, with 14176 m3 being spilt in 2015, which is equivalent to 0.0089% of the oil produced. Clean-up operations recover some of the lost fluid; however, much is left unrecovered, annually 60% of the crude oil spilt is recovered, 65% of production fluid is recovered, whereas just 30% of liquid gas is recovered. The most common cause of leakage each year is equipment failure; these results highlight the need for good regulation and maintenance onsite. The UK's Institute of Directors suggests several shale gas production scenarios for the UK and how this would influence truck movement. One of their scenarios suggests the development of well pads with 10-wells and 40 laterals (one well pad with 10 well each with 4 laterals). This type of well pad would be projected to use 544,000 m3 of water, which would generate between 11155-31288 truck movements over 20 years, or 6.1-17.1 per day if averaged over 5 years. Dairy farmers in the UK produce 11 million m3 of milk a year, which if the tanker has a capacity of 30 m3, equates to approximately 366667 milk tanker journeys a year. This study assesses the number of road incidents and milk tanker spills and predicts the likelihood of such events for fluids involved in hydraulic fracturing.

Effect of lung resection on pleuro-pulmonary mechanics and fluid balance.

PubMed

Salito, C; Bovio, D; Orsetti, G; Salati, M; Brunelli, A; Aliverti, A; Miserocchi, G

2016-01-15

The aim of the study was to determine in human patients the effect of lung resection on lung compliance and on pleuro-pulmonary fluid balance. Pre and post-operative values of compliance were measured in anesthetized patients undergoing resection for lung cancer (N=11) through double-lumen bronchial intubation. Lung compliance was measured for 10-12 cm H2O increase in alveolar pressure from 5 cm H2O PEEP in control and repeated after resection. No air leak was assessed and pleural fluid was collected during hospital stay. A significant negative correlation (r(2)=0.68) was found between compliance at 10 min and resected mass. Based on the pre-operative estimated lung weight, the decrease in compliance following lung resection exceeded by 10-15% that expected from resected mass. Significant negative relationships were found by relating pleural fluid drainage flow to the remaining lung mass and to post-operative lung compliance. Following lung re-expansion, data suggest a causative relationship between the decrease in compliance and the perturbation in pleuro-pulmonary fluid balance. Copyright © 2015 Elsevier B.V. All rights reserved.

High pressure mechanical seal

NASA Technical Reports Server (NTRS)

Babel, Henry W. (Inventor); Fuson, Phillip L. (Inventor); Chickles, Colin D. (Inventor); Jones, Cherie A. (Inventor); Anderson, Raymond H. (Inventor)

1995-01-01

A relatively impervious mechanical seal is formed between the outer surface of a tube and the inside surface of a mechanical fitting of a high pressure fluid or hydraulic system by applying a very thin soft metal layer onto the outer surface of the hard metal tube and/or inner surface of the hard metal fitting, prior to swaging the fitting onto the tube. The thickness of such thin metal layer is independent of the size of the tube and/or fittings. Many metals and alloys of those metals exhibit the requisite softness, including silver, gold, nickel, tin, platinum, indium, rhodium and cadmium. Suitably, the coating is about 0.0025 millimeters (0.10 mils) in thickness. After swaging, the tube and fitting combination exhibits very low leak rates on the order or 10.sup.-8 cubic centimeters per second or less as meaured using the Helium leak test.

APPARATUS FOR DETECTING AND LOCATING PRESENCE OF FLUIDS

DOEpatents

Williamson, R.R.

1958-09-16

A system is described fur detecting water leaks in water-cooled neutronic reactors by utilizing an electrical hygrometer having a resistance element variable with the moisture content. The graphite blocks, forming the moderator in many types of reactors, coniain ducts in which helium gas is circulated. When a leak occurs in a coolant tube, the water will seep through the graphite until it oozes into one of the helium ducts, where it will be swept along with the helium into a system of pipes that connect each of the helium ducts. By inserting an electric hygrometer in each of these pipes and connecting it to an alarm system, the moisture content of the helium will cause a change in the electrical resistance of the hygrometer which will initiate a signal alarm indicating the presence and position of the leaky water tube in the reactor.

Performance evaluation of cryogenic counter-flow heat exchangers with longitudinal conduction, heat in-leak and property variations

NASA Astrophysics Data System (ADS)

Jiang, Q. F.; Zhuang, M.; Zhu, Z. G.; Y Zhang, Q.; Sheng, L. H.

2017-12-01

Counter-flow plate-fin heat exchangers are commonly utilized in cryogenic applications due to their high effectiveness and compact size. For cryogenic heat exchangers in helium liquefaction/refrigeration systems, conventional design theory is no longer applicable and they are usually sensitive to longitudinal heat conduction, heat in-leak from surroundings and variable fluid properties. Governing equations based on distributed parameter method are developed to evaluate performance deterioration caused by these effects. The numerical model could also be applied in many other recuperators with different structures and, hence, available experimental data are used to validate it. For a specific case of the multi-stream heat exchanger in the EAST helium refrigerator, quantitative effects of these heat losses are further discussed, in comparison with design results obtained by the common commercial software. The numerical model could be useful to evaluate and rate the heat exchanger performance under the actual cryogenic environment.

Prevention of Postoperative Bile Leak in Partial Cystectomy for Hydatid Liver Disease: Tricks of the Trade.

PubMed

Peker, Kivanc Derya; Gumusoglu, Alpen Yahya; Seyit, Hakan; Kabuli, Hamit Ahmet; Salik, Aysun Erbahceci; Gonenc, Murat; Kapan, Selin; Alis, Halil

2015-12-01

The presence of postoperative bile leak is the major outcome measure for the assessment of operative success in partial cystectomy for hydatid liver disease. However, the optimal operative strategy to reduce the postoperative bile leak rate is yet to be defined. Medical records of patients who underwent partial cystectomy for hydatid liver disease between January 2013 and January 2015 were reviewed in this retrospective analysis. All patients were managed with a specific operative protocol. The primary outcome measure was the rate of persistent postoperative bile leak. The secondary outcome measures were the morbidity and mortality rate, and the length of hospital stay. Twenty-eight patients were included in the study. Only one patient (3.6 %) developed persistent postoperative bile leak. The overall morbidity and mortality rate was 17.8 and 0 %, respectively. The median length of hospital stay was 5 days. Aggressive preventative surgical measures have led to low persistent bile leak rates with low morbidity and mortality.

Leak Rate Quantification Method for Gas Pressure Seals with Controlled Pressure Differential

NASA Technical Reports Server (NTRS)

Daniels, Christopher C.; Braun, Minel J.; Oravec, Heather A.; Mather, Janice L.; Taylor, Shawn C.

2015-01-01

An enhancement to the pressure decay leak rate method with mass point analysis solved deficiencies in the standard method. By adding a control system, a constant gas pressure differential across the test article was maintained. As a result, the desired pressure condition was met at the onset of the test, and the mass leak rate and measurement uncertainty were computed in real-time. The data acquisition and control system were programmed to automatically stop when specified criteria were met. Typically, the test was stopped when a specified level of measurement uncertainty was attained. Using silicone O-ring test articles, the new method was compared with the standard method that permitted the downstream pressure to be non-constant atmospheric pressure. The two methods recorded comparable leak rates, but the new method recorded leak rates with significantly lower measurement uncertainty, statistical variance, and test duration. Utilizing this new method in leak rate quantification, projects will reduce cost and schedule, improve test results, and ease interpretation between data sets.

The simulation of air recirculation and fire/explosion phenomena within a semiconductor factory.

PubMed

I, Yet-Pole; Chiu, Yi-Long; Wu, Shi-Jen

2009-04-30

The semiconductor industry is the collection of capital-intensive firms that employ a variety of hazardous chemicals and engage in the design and fabrication of semiconductor devices. Owing to its processing characteristics, the fully confined structure of the fabrication area (fab) and the vertical airflow ventilation design restrict the applications of traditional consequence analysis techniques that are commonly used in other industries. The adverse situation also limits the advancement of a fire/explosion prevention design for the industry. In this research, a realistic model of a semiconductor factory with a fab, sub-fabrication area, supply air plenum, and return air plenum structures was constructed and the computational fluid dynamics algorithm was employed to simulate the possible fire/explosion range and its severity. The semiconductor factory has fan module units with high efficiency particulate air filters that can keep the airflow uniform within the cleanroom. This condition was modeled by 25 fans, three layers of porous ceiling, and one layer of porous floor. The obtained results predicted very well the real airflow pattern in the semiconductor factory. Different released gases, leak locations, and leak rates were applied to investigate their influence on the hazard range and severity. Common mitigation measures such as a water spray system and a pressure relief panel were also provided to study their potential effectiveness to relieve thermal radiation and overpressure hazards within a fab. The semiconductor industry can use this simulation procedure as a reference on how to implement a consequence analysis for a flammable gas release accident within an air recirculation cleanroom.

CTP (Cochlin-tomoprotein) detection in the profuse fluid leakage (gusher) from cochleostomy.

PubMed

Ikezono, Tetsuo; Sugizaki, Kazuki; Shindo, Susumu; Sekiguchi, Satomi; Pawankar, Ruby; Baba, Shunkichi; Yagi, Toshiaki

2010-08-01

By testing 125 samples, we confirmed that Cochlin-tomoprotein (CTP) is present in the perilymph, not in cerebrospinal fluid (CSF). Perilymph and CSF exist in two distinct compartments, even in the case of a malformed inner ear with a bony defect in the lamina cribrosa, as described here. Cochleostomy might have suddenly decreased the perilymph pressure, allowing the influx of CSF into the inner ear resulting in profuse fluid leakage, first perilymph then CSF. The first purpose of this study was to further confirm the specificity of the perilymph-specific protein CTP that we reported recently. Secondly, we assessed the nature of the fluid leakage from the cochleostomy using the CTP detection test. A standardized CTP detection test was performed on 65 perilymph and 60 CSF samples. Samples of profuse fluid leakage collected from cochleostomy during cochlear implantation surgery of one patient with branchio-oto-renal (BOR) syndrome were also tested by the CTP detection test. CTP was detected in 60 of 65 perilymph samples but not in any of the CSF samples. The leaked fluid was shown to contain CTP, i.e. perilymph, at the outset, and then the CTP detection signals gradually disappeared as time elapsed.

Globe stability during simulated vitrectomy with valved and non-valved trocar cannulas

PubMed Central

Abulon, Dina Joy; Charles, Martin; Charles, Daniel E

2015-01-01

Purpose To compare the effects of valved and non-valved cannulas on intraocular pressure (IOP), fluid leakage, and vitreous incarceration during simulated vitrectomy. Methods Three-port pars plana incisions were generated in six rubber eyes using 23-, 25-, and 27-gauge valved and non-valved trocar cannulas. The models were filled with air and IOP was measured. Similar procedures were followed for 36 acrylic eyes filled with saline solution. Vitreous incarceration was analyzed in eleven rabbit and twelve porcine cadaver eyes. Results In the air-filled model, IOP loss was 89%–94% when two non-valved cannulas were unoccupied versus 1%–5% when two valved cannulas were unoccupied. In the fluid-filled model, with non-valved cannulas, IOP dropped while fluid leaked from the open ports. With two open ports, the IOP dropped to 20%–30% of set infusion pressure, regardless of infusion pressure and IOP compensation. The IOP was maintained in valved cannulas when one or two ports were left open, regardless of IOP compensation settings. There was no or minimal fluid leakage through open ports at any infusion pressure. Direct microscopic analysis of rabbit eyes showed that vitreous incarceration was significantly greater with 23-gauge non-valved than valved cannulas (P<0.005), and endoscopy of porcine eyes showed that vitreous incarceration was significantly greater with 23-gauge (P<0.05) and 27-gauge (P<0.05) non-valved cannulas. External observation of rabbit eyes showed vitreous prolapse through non-valved, but not valved, cannulas. Conclusion Valved cannulas surpassed non-valved cannulas in maintaining IOP, preventing fluid leakage, and reducing vitreous incarceration during simulated vitrectomy. PMID:26445520

Leakage detection on CT myelography for targeted epidural blood patch in spontaneous cerebrospinal fluid leaks: calcified or ossified spinal lesions ventral to the thecal sac.

PubMed

Yoshida, Hiroki; Takai, Keisuke; Taniguchi, Makoto

2014-09-01

The purpose of this study was to describe significant CT myelography findings for determination of the leak site and outcome of targeted epidural blood patch (EBP) in patients with spontaneous CSF leaks. During 2005-2013, spontaneous CSF leaks were diagnosed for 12 patients with orthostatic headaches. The patients received targeted EBP on the basis of CT myelography assessments. Computed tomography myelograms revealed ventral extradural collection of contrast medium distributed over multiple spinal levels (average 16 levels). Intraforaminal contrast medium extravasations were observed at multiple spinal levels (average 8.2 levels). For 8 (67%) of 12 patients, spinal lesions were noted around the thecal sac and included calcified discs with osteophytes, an ossified posterior longitudinal ligament, and an ossified yellow ligament; lesions were mostly located ventral to the thecal sac and were in close contact with the dura mater. The levels of these spinal lesions were considered potential leak sites and were targeted for EBP. For the remaining 4 patients who did not have definite spinal lesions around the thecal sac, leak site determination was based primarily on the contrast gradient hypothesis. The authors hypothesized that the concentration of extradural contrast medium would be the greatest and the same as that of intradural contrast medium at the leak site but that it would decrease with increased distance from the leak site according to the contrast gradient. Epidural blood patch was placed at the level of spinal lesions and/or of the greatest and same concentration of contrast medium between the intradural and extradural spaces. For 10 of the 12 patients, the orthostatic headaches decreased significantly within a week of EBP and disappeared within a month. For the remaining 2 patients, headaches persisted and medical treatment was required for several months. For 3 patients, thick chronic subdural hematomas caused severe headaches and/or disturbed consciousness because of the mass effect of the hematomas, which were removed by bur hole drainage surgery. For 1 patient, bur hole drainage before EBP on the day of admission to hospital resulted in subdural tension pneumocephalus. The patient's headache immediately disappeared after EBP, and the hematoma did not recur. The other 2 patients underwent EBP followed by bur hole drainage, which resulted in improvements and disappearance of the hematomas. Over the follow-up period (mean 39 months), no CSF leaks or chronic subdural hematomas had recurred in any patient after EBP; by the final follow-up visit, all patients had returned to their jobs. The most significant finding of this study was that spinal ventral calcified or ossified lesions, which may be associated with a dural tear, were present in approximately 70% of patients. Targeted EBP to these lesions resulted in good outcomes.

Analytical study of the performance of a geomembrane leak detection system.

PubMed

Lugli, Francesco; Mahler, Claudio Fernando

2016-05-01

The electrical detection of leaks in geomembranes is a method that allows identifying leakage of contaminants in lined facilities (e.g. sanitary landfills, pollutant ponds, etc.). The procedure in the field involves placing electrodes above and below the geomembrane, to generate an electrical current, which in turn engenders an electric potential distribution in the protective layer (generally a clayey soil). The electric potential will be greater in areas with higher current density, i.e. near leaks. In this study, we combined models from the literature to carry out a parametric analysis to identify the variables that most influence the amplitude of the electrical signals produced by leaks. The basic hypothesis is that the electrical conduction phenomena in a liner system could be depicted by a direct current circuit. After determining the value of the current at the leak, we calculated the electric potential distribution according to the model of Darilek and Laine. This enabled analysing the sensitivity of the parameters, which can be useful in the design of landfills and facilitate the location of leaks. This study showed that geomembranes with low electrical resistance (owing to low thickness, low resistivity, or extensive area) can hinder the leak detection process. In contrast, low thickness and high resistivity of the protection layer magnify the leak signal. © The Author(s) 2016.

Early-onset Infectious Complications among Penetrating and Severe Closed Traumatic Brain Injury in Active Duty Deployed during OIF and OEF, 2008-2013

DTIC Science & Technology

2015-02-01

seizures, hydrocephalus, cerebral spinal fluid (CSF) leaks, infections inside the skull, vascular injuries, and cranial nerve injuries. 9-11 The...bacterial infection ). Neurosurgical procedures were based on ICD-9-CM procedure codes used to describe interventions related to severe TBI. 21 The...study of critical care trauma patients, traumatic shock was the only admission characteristic associated with infection , and infection developed

Alternative working fluids for unitary equipment: A research perspective

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

Baxter, V.D.

This paper deals with present and planned ORNL activities to characterize alternatives to R-22 for unitary heat pump and air-conditioning applications. Results of small-scale bread-board tests of potential alternatives R-32, R-134a, R-152a and R-143a are discussed. Portions of the AFEAS/DOE global warming impact study dealing with the unitary application are summarized. Methods for leak detection with the new refrigerants are discussed.

Retrospective review of previous minor leak before major subarachnoid hemorrhage diagnosed by MRI as a predictor of occurrence of symptomatic delayed cerebral ischemia.

PubMed

Oda, Shinri; Shimoda, Masami; Hirayama, Akihiro; Imai, Masaaki; Komatsu, Fuminari; Shigematsu, Hideaki; Nishiyama, Jun; Hotta, Kazuko; Matsumae, Mitsunori

2018-02-01

OBJECTIVE This study attempted to determine whether a previous minor leak correlated with the occurrence of symptomatic delayed cerebral ischemia (sDCI). METHODS The authors retrospectively evaluated sDCI-related clinical features and findings from MRI, including T1-weighted imaging (T1WI)-FLAIR mismatch at the time of admission, in 151 patients admitted with subarachnoid hemorrhage (SAH) within 48 hours of ictus. RESULTS The overall incidence of sDCI was 23% (35 of 151 patients). In all subjects, multivariate analysis revealed that World Federation of Neurosurgical Societies Grades II-V, age 70 years or older, presence of rebleeding after admission, a previous minor leak before the major SAH attack as diagnosed by T1WI-FLAIR mismatch, acute infarction on diffusion-weighted imaging, and CT SAH score were significantly associated with occurrence of sDCI. In patients with no previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was only 7% (7 of 97 patients). CONCLUSIONS A previous minor leak before major SAH as diagnosed by T1WI-FLAIR mismatch represents an important sDCI-related factor. When the analysis was restricted to patients with true acute SAH without a previous minor leak diagnosed by T1WI-FLAIR mismatch, the incidence of sDCI was extremely low.

Coupled Model for CO2 Leaks from Geological Storage: Geomechanics, Fluid Flow and Phase Transitions

NASA Astrophysics Data System (ADS)

Gor, G.; Prevost, J.

2013-12-01

Deep saline aquifers are considered as a promising option for long-term storage of carbon dioxide. However, risk of CO2 leakage from the aquifers through faults, natural or induced fractures or abandoned wells cannot be disregarded. Therefore, modeling of various leakage scenarios is crucial when selecting a site for CO2 sequestration and choosing proper operational conditions. Carbon dioxide is injected into wells at supercritical conditions (t > 31.04 C, P > 73.82 bar), and these conditions are maintained in the deep aquifers (at 1-2 km depth) due to hydrostatic pressure and geothermal gradient. However, if CO2 and brine start to migrate from the aquifer upward, both pressure and temperature will decrease, and at the depth of 500-750 m, the conditions for CO2 will become subcritical. At subcritical conditions, CO2 starts boiling and the character of the flow changes dramatically due to appearance of the third (vapor) phase and latent heat effects. When modeling CO2 leaks, one needs to couple the multiphase flow in porous media with geomechanics. These capabilities are provided by Dynaflow, a finite element analysis program [1]; Dynaflow has already showed to be efficient for modeling caprock failure causing CO2 leaks [2, 3]. Currently we have extended the capabilities of Dynaflow with the phase transition module, based on two-phase and three-phase isenthalpic flash calculations [4]. We have also developed and implemented an efficient method for solving heat and mass transport with the phase transition using our flash module. Therefore, we have developed a robust tool for modeling CO2 leaks. In the talk we will give a brief overview of our method and illustrate it with the results of simulations for characteristic test cases. References: [1] J.H. Prevost, DYNAFLOW: A Nonlinear Transient Finite Element Analysis Program. Department of Civil and Environmental Engineering, Princeton University, Princeton, NJ. http://www.princeton.edu/~dynaflow/ (last update 2013), 1981. [2] M. Preisig, J.H. Prevost, Coupled multi-phase thermo-poromechanical effects. Case study: CO2 injection at In Salah, Algeria, International Journal of Greenhouse Gas Control, 5 (2011) 1055-1064. [3] G.Y. Gor, T.R. Elliot, J.H. Prevost, Effects of thermal stresses on caprock integrity during CO2 storage, International Journal of Greenhouse Gas Control, 12 (2013) 300-309. [4] M.L. Michelsen, J.M. Mollerup, Thermodynamic Models: Fundamentals and Computational Aspects. 2nd Edition, Tie-Line Publications, 2007.

Technical basis for inner container leak detection sensitivity goals in 3013 DE surveillance

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

Berg, John M.

Helium leak checking of 3013 inner container lids is under consideration for addition to DE Surveillance tasks as an improved means to detect any through-wall flaws that may have formed during storage. This white paper evaluates whether leak checking at DE could replace and improve upon the current method of comparing gas compositions and pressures within the inner and outer containers. We have used viscous and molecular flow equations in ANSI N14.5 to calculate what the measured standard helium leak rate would be for hypothetical leaks of three different sizes. For comparison, we have also calculated the effects on gasmore » composition and pressure differences as a function of pre-DE storage time for the same three leak sizes, using molecular and viscous flow equations as well as diffusion equations to predict the relevant gas transport. For a hypothetical leak that would be measured at 1x10 -7 std cc/sec, likely an achievable sensitivity using helium leak checking at DE, the calculations predict no measurable effect on pressure difference or gas composition as measured by DE gas analysis. We also calculate that it would take over 200 years for water vapor to diffuse through a 10 -7 std cc/sec leak enough to raise the RH outer container to half the RH value in the inner container. A leak 100 times larger, which would be measured at 1x10 -5 std cc/sec, the same water vapor diffusion would take at least 14 years. Our conclusion is that helium leak checking will be useful even at a sensitivity of 1x10 -5 std cc/sec, and a significant improvement over current DE methods at a sensitivity of 1x10 -7 std cc/sec.« less

Hydraulic fluids and jet engine oil: pyrolysis and aircraft air quality.

PubMed

van Netten, C; Leung, V

2001-01-01

Incidents of smoke in aircraft cabins often result from jet engine oil and/or hydraulic fluid that leaks into ventilation air, which can be subjected to temperatures that exceed 500 degrees C. Exposed flight-crew members have reported symptoms, including dizziness, nausea, disorientation, blurred vision, and tingling in the legs and arms. In this study, the authors investigated pyrolysis products of one jet engine oil and two hydraulic fluids at 525 degrees C. Engine oil was an important source of carbon monoxide. Volatile agents and organophosphate constituents were released from all the agents tested; however, the neurotoxin trimethyl propane phosphate was not found. The authors hypothesized that localized condensation of pyrolysis products in ventilation ducts, followed by mobilization when cabin heat demand was high, accounted for mid-flight incidents. The authors recommended that carbon monoxide data be logged continuously to capture levels during future incidents.

Pleural Effusion Developing in Two Patients on Continuous Ambulatory Peritoneal Dialysis.

PubMed

Asim, Muhammad

2016-11-01

Two patients with end-stage-renal-disease on continuous ambulatory peritoneal dialysis (CAPD) presented with pleural effusions. The aspirated fluid was categorised as transudate, based on alkaline pH, low protein and lactic dehydrogenase level. A striking feature of the pleural fluid was, its very high glucose content that resulted from translocation of dextrose containing peritoneal dialysate into the pleural space via a pleuroperitoneal connection. One patient was transferred to hemodialysis, which led to complete resolution of pleural effusion. The other patient was switched to automated peritoneal dialysis, using small dwell volumes with consequent reduction in size of the pleural effusion. Pleuroperitoneal leak should always be considered in the differential diagnosis of pleural effusion in CAPD patients. Although isotopic peritoneography can demonstrate reflux of the tracer in the pleural space, measurement of pleural fluid glucose is a simpler and reliable way of diagnosing pleuroperitoneal communication.

VEGF inhibitors in the treatment of cerebral edema in patients with brain cancer

PubMed Central

Gerstner, Elizabeth R.; Duda, Dan G.; di Tomaso, Emmanuelle; Ryg, Peter A.; Loeffler, Jay S.; Sorensen, A. Gregory; Ivy, Percy; Jain, Rakesh K.; Batchelor, Tracy T.

2016-01-01

Most brain tumors oversecrete vascular endothelial growth factor (VEGF), which leads to an abnormally permeable tumor vasculature. This hyperpermeability allows fluid to leak from the intravascular space into the brain parenchyma, which causes vasogenic cerebral edema and increased interstitial fluid pressure. Increased interstitial fluid pressure has an important role in treatment resistance by contributing to tumor hypoxia and preventing adequate tumor penetration of chemotherapy agents. In addition, edema and the corticosteroids needed to control cerebral edema cause significant morbidity and mortality. Agents that block the VEGF pathway are able to decrease vascular permeability and, thus, cerebral edema, by restoring the abnormal tumor vasculature to a more normal state. Decreasing cerebral edema minimizes the adverse effects of corticosteroids and could improve clinical outcomes. Anti-VEGF agents might also be useful in other cancer-related conditions that increase vascular permeability, such as malignant pleural effusions or ascites. PMID:19333229

Gas chromatographic-mass spectrometric investigation of n-alkanes and carboxylic acids in bottom sediments of the northern Caspian Sea

NASA Astrophysics Data System (ADS)

Kenzhegaliev, Akimgali; Zhumagaliev, Sagat; Kenzhegalieva, Dina; Orazbayev, Batyr

2018-03-01

Prior to the start of experimental oil production in the Kashagan field (northern part of the Caspian Sea), n-alkanes and carboxylic acids contained in samples obtained from bottom sediments in the area of artificial island "D" were investigated by gas chromatography-mass spectrometry. Concentrations of 10 n-alkanes (composed of C10-C13, C15-C20) and 11 carboxylic acids (composed of C6-C12, C14-C16) were identified and measured. Concentrations of individual alkanes and carboxylic acids in bottom sediments of the various samples varied between 0.001 ÷ 0.88 μg/g and 0.001 ÷ 1.94 μg/g, respectively. Mass spectra, in particular the M+ molecular ion peak and the most intense peaks of fragment ions, are given. The present study illustrates the stability of molecular ions to electronic ionisation and the main fragment ions to the total ion current and shows that the initial fragmentation of alkanes implies radical cleavage of C2H5 rather than CH3. All aliphatic monocarboxylic acids studied were characterised by McLafferty rearrangement leading to the formation of F4 cation-radical with m/z 60 and F3 cation-radical with m/z 88 in the case of ethylhexanoic acid. The formation of oxonium ions presents another important aspect of acid fragmentation. Using mass numbers of oxonium ions and rearrangement ions allows determination of the substitution character in α- and β- C atoms. The essence of our approach is to estimate the infiltration of hydrocarbon fluids from the enclosing formation into sea water, comprising an analysis of derivatives of organic compounds in bottom sediments. Thus, concentrations of derived organic molecules can serve as a basis for estimates of the depth at which hydrocarbon fluids leak, i.e., to serve as an auxiliary technique in the search for hydrocarbon deposits and to repair well leaks.

Appropriate fluid regimens to prevent bronchopulmonary dysplasia.

PubMed

Tammela, O K

1995-01-01

Pulmonary oedema is an important problem in premature neonates with surfactant deficiency because of fluid accumulation in the lung interstitium and reduced urine output. Some retrospective reports suggest that excessive early hydration might increase the risk of bronchopulmonary dysplasia (BPD). Only three prospective studies evaluating low or conventional fluid administration regimens to very low birth weight infants have been published. According to their results no significant differences in the incidence of BPD have been shown. However, fluid restriction seems to improve the outcome of the infants because of decreased incidence of haemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, pulmonary air leaks and decreased mortality. The appropriate amount of sodium in the intravenous fluids during the first days of life needs further evaluation. In tiny infants with birth weights from 500 to 800g intensive monitoring of fluid balance is essential to control the extremely high fluid losses due to evaporation. Undernutrition is a risk factor of BPD and therefore it is important to start parenteral nutrition early. The benefit of the use of colloids as volume expanders is controversial. According to some retrospective reports there might be an association with increased use of colloidal fluids during the first days of life and the development of BPD. Early excessive fluid administration might constitute a potential risk for low birth weight infants with hyaline membrane disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Zero-Boil-Off Tank (ZBOT) Experiment: Ground-Based Validation of Self-Pressurization and Pressure Control Two-Phase CFD Model

NASA Technical Reports Server (NTRS)

Kassemi, Mohammad; Hylton, Sonya; Kartuzova, Olga

2017-01-01

Integral to all phases of NASA's projected space and planetary expeditions is affordable and reliable cryogenic fluid storage for use in propellant or life support systems. Cryogen vaporization due to heat leaks into the tank from its surroundings and support structure can cause self-pressurization relieved through venting. This has led to a desire to develop innovative pressure control designs based on mixing of the bulk tank fluid together with some form of active or passive cooling to allow storage of the cryogenic fluid with zero or reduced boil-off. The Zero-Boil-Off Tank (ZBOT) Experiments are a series of small scale tank pressurization and pressure control experiments aboard the International Space Station (ISS) that use a transparent volatile simulant fluid in a transparent sealed tank to delineate various fundamental fluid flow, heat and mass transport, and phase change phenomena that control storage tank pressurization and pressure control in microgravity. The hardware for ZBOT-1 flew to ISS on the OA-7 flight in April 2017 and operations are planned to begin in September 2017, encompassing more than 90 tests. This paper presents preliminary results from ZBOT's ground-based research delineating both pressurization and pressure reduction trends in the sealed test tank. Tank self-pressurization tests are conducted under three modes: VJ heating, strip heating and simultaneous VJ and strip heating in attempt to simulate heat leaks from the environment, the support structure and both. The jet mixing pressure control studies are performed either from an elevated uniform temperature condition or from thermally stratified conditions following a self-pressurization run. Jet flow rates are varied from 2-25 cm/s spanning a range of jet Re number in laminar, transitional, and turbulent regimes and a range of Weber numbers covering no ullage penetration, partial penetration and complete ullage penetration and break-up (only in microgravity). Numerical prediction of a two-phase CFD model are compared to experimental 1g results to both validate the model and also indicate the effect of the residual non-condensable gas on evolution of pressure and temperature distributions in the tank during pressurization and pressure control.

Localization of a continuous CO2 leak from an isotropic flat-surface structure using acoustic emission detection and near-field beamforming techniques

NASA Astrophysics Data System (ADS)

Yan, Yong; Cui, Xiwang; Guo, Miao; Han, Xiaojuan

2016-11-01

Seal capacity is of great importance for the safety operation of pressurized vessels. It is crucial to locate the leak hole timely and accurately for reasons of safety and maintenance. This paper presents the principle and application of a linear acoustic emission sensor array and a near-field beamforming technique to identify the location of a continuous CO2 leak from an isotropic flat-surface structure on a pressurized vessel in the carbon capture and storage system. Acoustic signals generated by the leak hole are collected using a linear high-frequency sensor array. Time-frequency analysis and a narrow-band filtering technique are deployed to extract effective information about the leak. The impacts of various factors on the performance of the localization technique are simulated, compared and discussed, including the number of sensors, distance between the leak hole and sensor array and spacing between adjacent sensors. Experiments were carried out on a laboratory-scale test rig to assess the effectiveness and operability of the proposed method. The results obtained suggest that the proposed method is capable of providing accurate and reliable localization of a continuous CO2 leak.

A risk score to predict the incidence of prolonged air leak after video-assisted thoracoscopic lobectomy: An analysis from the European Society of Thoracic Surgeons database.

PubMed

Pompili, Cecilia; Falcoz, Pierre Emmanuel; Salati, Michele; Szanto, Zalan; Brunelli, Alessandro

2017-04-01

The study objective was to develop an aggregate risk score for predicting the occurrence of prolonged air leak after video-assisted thoracoscopic lobectomy from patients registered in the European Society of Thoracic Surgeons database. A total of 5069 patients who underwent video-assisted thoracoscopic lobectomy (July 2007 to August 2015) were analyzed. Exclusion criteria included sublobar resections or pneumonectomies, lung resection associated with chest wall or diaphragm resections, sleeve resections, and need for postoperative assisted mechanical ventilation. Prolonged air leak was defined as an air leak more than 5 days. Several baseline and surgical variables were tested for a possible association with prolonged air leak using univariable and logistic regression analyses, determined by bootstrap resampling. Predictors were proportionally weighed according to their regression estimates (assigning 1 point to the smallest coefficient). Prolonged air leak was observed in 504 patients (9.9%). Three variables were found associated with prolonged air leak after logistic regression: male gender (P < .0001, score = 1), forced expiratory volume in 1 second less than 80% (P < .0001, score = 1), and body mass index less than 18.5 kg/m 2 (P < .0001, score = 2). The aggregate prolonged air leak risk score was calculated for each patient by summing the individual scores assigned to each variable (range, 0-4). Patients were then grouped into 4 classes with an incremental risk of prolonged air leak (P < .0001): class A (score 0 points, 1493 patients) 6.3% with prolonged air leak, class B (score 1 point, 2240 patients) 10% with prolonged air leak, class C (score 2 points, 1219 patients) 13% with prolonged air leak, and class D (score >2 points, 117 patients) 25% with prolonged air leak. An aggregate risk score was created to stratify the incidence of prolonged air leak after video-assisted thoracoscopic lobectomy. The score can be used for patient counseling and to identify those patients who can benefit from additional intraoperative preventative measures. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Payload and Components Real-Time Automated Test System (PACRATS), Data Acquisition of Leak Rate and Pressure Data Test Procedure

NASA Technical Reports Server (NTRS)

Rinehart, Maegan L.

2011-01-01

The purpose of this activity is to provide the Mechanical Components Test Facility (MCTF) with the capability to obtain electronic leak test and proof pressure data, Payload and Components Real-time Automated Test System (PACRATS) data acquisition software will be utilized to display real-time data. It will record leak rates and pressure/vacuum level(s) simultaneously. This added functionality will provide electronic leak test and pressure data at specified sampling frequencies. Electronically stored data will provide ES61 with increased data security, analysis, and accuracy. The tasks performed in this procedure are to verify PACRATS only, and are not intended to provide verifications for MCTF equipment.

A quantitative risk-assessment system (QR-AS) evaluating operation safety of Organic Rankine Cycle using flammable mixture working fluid.

PubMed

Tian, Hua; Wang, Xueying; Shu, Gequn; Wu, Mingqiang; Yan, Nanhua; Ma, Xiaonan

2017-09-15

Mixture of hydrocarbon and carbon dioxide shows excellent cycle performance in Organic Rankine Cycle (ORC) used for engine waste heat recovery, but the unavoidable leakage in practical application is a threat for safety due to its flammability. In this work, a quantitative risk assessment system (QR-AS) is established aiming at providing a general method of risk assessment for flammable working fluid leakage. The QR-AS covers three main aspects: analysis of concentration distribution based on CFD simulations, explosive risk assessment based on the TNT equivalent method and risk mitigation based on evaluation results. A typical case of propane/carbon dioxide mixture leaking from ORC is investigated to illustrate the application of QR-AS. According to the assessment results, proper ventilation speed, safe mixture ratio and location of gas-detecting devices have been proposed to guarantee the security in case of leakage. The results revealed that this presented QR-AS was reliable for the practical application and the evaluation results could provide valuable guidance for the design of mitigation measures to improve the safe performance of ORC system. Copyright © 2017 Elsevier B.V. All rights reserved.

Oblique Intrathecal Injection in Lumbar Spine Surgery: A Technical Note.

PubMed

Jewett, Gordon A E; Yavin, Daniel; Dhaliwal, Perry; Whittaker, Tara; Krupa, JoyAnne; Du Plessis, Stephan

2017-09-01

Intrathecal morphine (ITM) is an efficacious method of providing postoperative analgesia and reducing pain associated complications. Despite adoption in many surgical fields, ITM has yet to become a standard of care in lumbar spine surgery. Spine surgeons' reticence to make use of the technique may in part be attributed to concerns of precipitating a cerebrospinal fluid (CSF) leak. Herein we describe a method for oblique intrathecal injection during lumbar spine surgery to minimize risk of CSF leak. The dural sac is penetrated obliquely at a 30° angle to offset dural and arachnoid puncture sites. Oblique injection in instances of limited dural exposure is made possible by introducing a 60° bend to a standard 30-gauge needle. The technique was applied for injection of ITM or placebo in 104 cases of lumbar surgery in the setting of a randomized controlled trial. Injection was not performed in two cases (2/104, 1.9%) following preinjection dural tear. In the remaining 102 cases no instances of postoperative CSF leakage attributable to oblique intrathecal injection occurred. Three cases (3/102, 2.9%) of transient CSF leakage were observed immediately following intrathecal injection with no associated sequelae or requirement for postsurgical intervention. In two cases, the observed leak was repaired by sealing with fibrin glue, whereas in a single case the leak was self-limited requiring no intervention. Oblique dural puncture was not associated with increased incidence of postoperative CSF leakage. This safe and reliable method of delivery of ITM should therefore be routinely considered in lumbar spine surgery.

Phase Field Model of Hydraulic Fracturing in Poroelastic Media: Fracture Propagation, Arrest, and Branching Under Fluid Injection and Extraction

NASA Astrophysics Data System (ADS)

Santillán, David; Juanes, Ruben; Cueto-Felgueroso, Luis

2018-03-01

The simulation of fluid-driven fracture propagation in a porous medium is a major computational challenge, with applications in geosciences and engineering. The two main families of modeling approaches are those models that represent fractures as explicit discontinuities and solve the moving boundary problem and those that represent fractures as thin damaged zones, solving a continuum problem throughout. The latter family includes the so-called phase field models. Continuum approaches to fracture face validation and verification challenges, in particular grid convergence, well posedness, and physical relevance in practical scenarios. Here we propose a new quasi-static phase field formulation. The approach fully couples fluid flow in the fracture with deformation and flow in the porous medium, discretizes flow in the fracture on a lower-dimension manifold, and employs the fluid flux between the fracture and the porous solid as coupling variable. We present a numerical assessment of the model by studying the propagation of a fracture in the quarter five-spot configuration. We study the interplay between injection flow rate and rock properties and elucidate fracture propagation patterns under the leak-off toughness dominated regime as a function of injection rate, initial fracture length, and poromechanical properties. For the considered injection scenario, we show that the final fracture length depends on the injection rate, and three distinct patterns are observed. We also rationalize the system response using dimensional analysis to collapse the model results. Finally, we propose some simplifications that alleviate the computational cost of the simulations without significant loss of accuracy.

Suction on chest drains following lung resection: evidence and practice are not aligned.

PubMed

Lang, Peter; Manickavasagar, Menaka; Burdett, Clare; Treasure, Tom; Fiorentino, Francesca

2016-02-01

A best evidence topic in Interactive CardioVascular and Thoracic Surgery (2006) looked at application of suction to chest drains following pulmonary lobectomy. After screening 391 papers, the authors analysed six studies (five randomized controlled trials [RCTs]) and found no evidence in favour of postoperative suction in terms of air leak duration, time to chest drain removal or length of stay. Indeed, suction was found to be detrimental in four studies. We sought to determine whether clinical practice is consistent with published evidence by surveying thoracic units nationally and performing a meta-analysis of current best evidence. We systematically searched MEDLINE, EMBASE and CENTRAL for RCTs, comparing outcomes with and without application of suction to chest drains after lung surgery. A meta-analysis was performed using RevMan(©) software. A questionnaire concerning chest drain management and suction use was emailed to a clinical representative in every thoracic unit. Eight RCTs, published 2001-13, with 31-500 participants, were suitable for meta-analysis. Suction prolonged length of stay (weighted mean difference [WMD] 1.74 days; 95% confidence interval [CI] 1.17-2.30), chest tube duration (WMD 1.77 days; 95% CI 1.47-2.07) and air leak duration (WMD 1.47 days; 95% CI 1.45-2.03). There was no difference in occurrence of prolonged air leak. Suction was associated with fewer instances of postoperative pneumothorax. Twenty-five of 39 thoracic units responded to the national survey. Suction is routinely used by all surgeons in 11 units, not by any surgeon in 5 and by some surgeons in 9. Of the 91 surgeons represented, 62 (68%) routinely used suction. Electronic drains are used in 15 units, 10 of which use them routinely. Application of suction to chest drains following non-pneumonectomy lung resection is common practice. Suction has an effect in hastening the removal of air and fluid in clinical experience but a policy of suction after lung resection has not been shown to offer improved clinical outcomes. Clinical practice is not aligned with Level 1a evidence. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Craniofacial Trauma in Pediatric Patients Following Winnowing Blade Injury-review of Literature

PubMed Central

Huliyappa, Harsha; Ojha, Balakrishna; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij

2018-01-01

In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for “fan blade injury” showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone. Two patients had eye injury with visual loss. Seven underwent debridement craniectomy, five augmentation duroplasty and three contusectomy. All had vegetable material, sand particles. Complications in 66.6% with two cases of CSF leak settled with lumbar drain, one case of CSF otorrohea, 22.2% of wound infection, 44.4% wound dehiscence requiring redebridement and suturing in five patients. Two patients had postoperative seizures, two patients had hemiparesis both improved. Two low Glasgow Coma Scale remained so on postoperative period. One case of subdural empyema needed debridement and duroplasty with glue. No mortality noted. These findings were consistent with previous reports. Follow-up at 1.5 months showed good functional recovery. Early surgery debridement, steps to minimize postoperative infections, identifying putative risk factors early in the management are the principles of a successful treatment regimen. PMID:29682010

Craniofacial Trauma in Pediatric Patients Following Winnowing Blade Injury-review of Literature.

PubMed

Huliyappa, Harsha; Ojha, Balakrishna; Chandra, Anil; Singh, Sunil Kumar; Srivastava, Chhitij

2018-01-01

In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone. Two patients had eye injury with visual loss. Seven underwent debridement craniectomy, five augmentation duroplasty and three contusectomy. All had vegetable material, sand particles. Complications in 66.6% with two cases of CSF leak settled with lumbar drain, one case of CSF otorrohea, 22.2% of wound infection, 44.4% wound dehiscence requiring redebridement and suturing in five patients. Two patients had postoperative seizures, two patients had hemiparesis both improved. Two low Glasgow Coma Scale remained so on postoperative period. One case of subdural empyema needed debridement and duroplasty with glue. No mortality noted. These findings were consistent with previous reports. Follow-up at 1.5 months showed good functional recovery. Early surgery debridement, steps to minimize postoperative infections, identifying putative risk factors early in the management are the principles of a successful treatment regimen.

Pedicled Extranasal Flaps in Skull Base Reconstruction

PubMed Central

Kim, Grace G.; Hang, Anna X.; Mitchell, Candace; Zanation, Adam M.

2013-01-01

Cerebrospinal fluid (CSF) leaks most commonly arise during or after skull base surgery, although they occasionally present spontaneously. Recent advances in the repair of CSF leaks have enabled endoscopic endonasal surgery to become the preferred option for management of skull base pathology. Small defects (<1cm) can be repaired by multilayered free grafts. For large defects (>3cm), pedicled vascular flaps are the repair method of choice, resulting in much lower rates of postoperative CSF leaks. The pedicled nasoseptal flap (NSF) constitutes the primary reconstructive option for the vast majority of skull base defects. It has a large area of potential coverage and high rates of success. However, preoperative planning is required to avoid sacrificing the NSF during resection. In cases where the NSF is unavailable, often due to tumor involvement of the septum or previous resection removing or compromising the flap, other flaps may be considered. These flaps include intranasal options—inferior turbinate (IT) or middle turbinate (MT) flaps—as well as regional pedicled flaps: pericranial flap (PCF), temporoparietal fascial flap (TPFF), or palatal flap (PF). More recently, novel alternatives such as the pedicled facial buccinator flap (FAB) and the pedicled occipital galeopericranial flap (OGP) have been added to the arsenal of options for skull base reconstruction. Characteristics of and appropriate uses for each flap are described. PMID:23257554

Pediatric and young adult exposure to chemiluminescent glow sticks.

PubMed

Hoffman, Robert J; Nelson, Lewis S; Hoffman, Robert S

2002-09-01

Although chemiluminescent plastic rods, commonly called "glow sticks" or "light sticks," are typically considered to be minimally toxic or nontoxic, published data about exposure to these products are scarce. To test our hypothesis that exposure to chemiluminescent products is unlikely to result in significant morbidity or mortality and to describe factors associated with exposure by reviewing reports to our urban poison control center of human exposure to chemiluminescent products. Pediatric and young adult exposure to chemiluminescent products reported between January 1, 2000, and April 1, 2001, to our poison control center were evaluated with regard to demographic group, type of product involved, circumstances of exposure, symptoms, and management. Reported routes of exposure (n = 118) included ingestion (n = 108), ocular (n = 9), and dermal exposure (n = 1). Only patients exposed to chemiluminescent fluid from a leaking container reported symptoms (n = 27). Symptoms were limited to transient irritation of the exposure site, and no systemic toxicity occurred. All adults (n = 4) inadvertently ruptured or swallowed intact light sticks while at a dance club or dance party. Most exposure and all adult exposure occurred on holidays or weekends. Most incidences of exposure to chemiluminescent products involve asymptomatic ingestion of fluid that leaks from glow sticks or ingestion of an intact glow stick. Symptoms occur after exposure to chemiluminescent fluid and consist of transient irritation at the site of exposure. The clustering of reported exposure on weekends and in dance clubs and parties coupled with a lack of occupational or workplace exposure suggest that recreational use is a major contributory factor. Exposure to chemiluminescent products infrequently resulted in symptoms and the symptoms reported were minor. Exposure to chemiluminescent products as described is unlikely to cause significant morbidity or mortality.

Air-Leak Effects on Ear-Canal Acoustic Absorbance

PubMed Central

Rasetshwane, Daniel M.; Kopun, Judy G.; Gorga, Michael P.; Neely, Stephen T.

2015-01-01

Objective: Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Design: Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1–0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. Results: The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1–0.2 and 0.2–0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on air-leak size. Low-frequency admittance phase and CV/PV decreased, while low-frequency absorbance and the air-leak resonance frequency increased. Conclusion: The effect of air leaks can be significant when their equivalent diameter exceeds 0.01 in. The observed effects were greatest at low frequencies where air leaks caused absorbance to increase. Recommended criteria for detecting air leaks include the following: when the frequency range of interest extends as low as 0.1 kHz, low-frequency absorbance should be ≤0.20 and low-frequency admittance phase ≥61 degrees. For frequency ranges as low as 0.2 kHz, low-frequency absorbance should be ≤0.29 and low-frequency admittance phase ≥44 degrees. PMID:25170779

Air-leak effects on ear-canal acoustic absorbance.

PubMed

Groon, Katherine A; Rasetshwane, Daniel M; Kopun, Judy G; Gorga, Michael P; Neely, Stephen T

2015-01-01

Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1-0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1-0.2 and 0.2-0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on air-leak size. Low-frequency admittance phase and CV/PV decreased, while low-frequency absorbance and the air-leak resonance frequency increased. The effect of air leaks can be significant when their equivalent diameter exceeds 0.01 in. The observed effects were greatest at low frequencies where air leaks caused absorbance to increase. Recommended criteria for detecting air leaks include the following: when the frequency range of interest extends as low as 0.1 kHz, low-frequency absorbance should be ≤0.20 and low-frequency admittance phase ≥61 degrees. For frequency ranges as low as 0.2 kHz, low-frequency absorbance should be ≤0.29 and low-frequency admittance phase ≥44 degrees.

Single cell rheometry with a microfluidic constriction: Quantitative control of friction and fluid leaks between cell and channel walls

PubMed Central

Preira, Pascal; Valignat, Marie-Pierre; Bico, José; Théodoly, Olivier

2013-01-01

We report how cell rheology measurements can be performed by monitoring the deformation of a cell in a microfluidic constriction, provided that friction and fluid leaks effects between the cell and the walls of the microchannels are correctly taken into account. Indeed, the mismatch between the rounded shapes of cells and the angular cross-section of standard microfluidic channels hampers efficient obstruction of the channel by an incoming cell. Moreover, friction forces between a cell and channels walls have never been characterized. Both effects impede a quantitative determination of forces experienced by cells in a constriction. Our study is based on a new microfluidic device composed of two successive constrictions, combined with optical interference microscopy measurements to characterize the contact zone between the cell and the walls of the channel. A cell squeezed in a first constriction obstructs most of the channel cross-section, which strongly limits leaks around cells. The rheological properties of the cell are subsequently probed during its entry in a second narrower constriction. The pressure force is determined from the pressure drop across the device, the cell velocity, and the width of the gutters formed between the cell and the corners of the channel. The additional friction force, which has never been analyzed for moving and constrained cells before, is found to involve both hydrodynamic lubrication and surface forces. This friction results in the existence of a threshold for moving the cells and leads to a non-linear behavior at low velocity. The friction force can nevertheless be assessed in the linear regime. Finally, an apparent viscosity of single cells can be estimated from a numerical prediction of the viscous dissipation induced by a small step in the channel. A preliminary application of our method yields an apparent loss modulus on the order of 100 Pa s for leukocytes THP-1 cells, in agreement with the literature data. PMID:24404016

Liquid Hydrogen Sensor Considerations for Space Exploration

NASA Technical Reports Server (NTRS)

Moran, Matthew E.

2006-01-01

The on-orbit management of liquid hydrogen planned for the return to the moon will introduce new considerations not encountered in previous missions. This paper identifies critical liquid hydrogen sensing needs from the perspective of reliable on-orbit cryogenic fluid management, and contrasts the fundamental differences in fluid and thermodynamic behavior for ground-based versus on-orbit conditions. Opportunities for advanced sensor development and implementation are explored in the context of critical Exploration Architecture operations such as on-orbit storage, docking, and trans-lunar injection burn. Key sensing needs relative to these operations are also examined, including: liquid/vapor detection, thermodynamic condition monitoring, mass gauging, and leak detection. Finally, operational aspects of an integrated system health management approach are discussed to highlight the potential impact on mission success.

Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid—A Case Report

PubMed Central

Nguyen, Emilie T; Tudtud-Hans, Leah A

2017-01-01

Introduction We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. Case Presentation A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. Discussion The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management. PMID:28678688

Contact mechanics for layered materials with randomly rough surfaces.

PubMed

Persson, B N J

2012-03-07

The contact mechanics model of Persson is applied to layered materials. We calculate the M function, which relates the surface stress to the surface displacement, for a layered material, where the top layer (thickness d) has different elastic properties than the semi-infinite solid below. Numerical results for the contact area as a function of the magnification are presented for several cases. As an application, we calculate the fluid leak rate for laminated rubber seals.

Cost-effectiveness analysis of stent type in endoscopic treatment of gastric leak after laparoscopic sleeve gastrectomy.

PubMed

Cosse, C; Rebibo, L; Brazier, F; Hakim, S; Delcenserie, R; Regimbeau, J M

2018-04-01

Gastric leak is the most feared surgical postoperative complication after sleeve gastrectomy. An endoscopic procedure is usually required to treat the leak. No data are available on the cost-effectiveness of different stent types in this procedure. Between April 2005 and July 2016, patients with a confirmed gastric leak undergoing endoscopic treatment using a covered stent (CS) or double-pigtail stent (DPS) were included. The primary objective of the study was to assess overall costs of the stent types after primary sleeve gastrectomy. Secondary objectives were the cost-effectiveness of each stent type expressed as an incremental cost-effectiveness ratio (ICER); the incremental net benefit; the probability of efficiency, defined as the probability of being cost-effective at a threshold of €30 000, and identification of the key drivers of ICER derived from a multivariable analysis. One hundred and twelve patients were enrolled. The overall mean costs of gastric leak were €22 470; the mean(s.d.) cost was €24 916(12 212) in the CS arm and €20 024(3352) in the DPS arm (P = 0·018). DPS was more cost-effective than CS (ICER €4743 per endoscopic procedure avoided), with an incremental net benefit of €25 257 and a 27 per cent probability of efficiency. Key drivers of the ICER were the inpatient ward after diagnosis of gastric leak (surgery versus internal medicine), type of institution (private versus public) and duration of hospital stay per endoscopic procedure. DPS for the treatment of gastric leak is more cost-effective than CS and should be proposed as the standard regimen whenever possible. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note.

PubMed

Dolci, Ricardo Landini Lutaif; Todeschini, Alexandre Bossi; Santos, Américo Rubens Leite Dos; Lazarini, Paulo Roberto

2018-04-19

One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy. Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach. Both patients achieved a gross total resection: subsequent reconstruction of the anterior skull base was performed with the nasoseptal and pericranial flaps onlay and a fascia lata free graft inlay. Both patients showed an excellent recovery, no signs of cerebrospinal fluid leak, meningitis, flap necrosis, chronic meningeal or sinonasal inflammation or cerebral herniation having developed. This endoscopic double flap technique we have described is a viable, versatile and safe option for anterior skull base reconstructions, decreasing the incidence of complications in endoscopic endonasal approaches. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Pressure Monitoring to Detect Fault Rupture Due to CO 2 Injection

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

Keating, Elizabeth; Dempsey, David; Pawar, Rajesh

The capacity for fault systems to be reactivated by fluid injection is well-known. In the context of CO 2 sequestration, however, the consequence of reactivated faults with respect to leakage and monitoring is poorly understood. Using multi-phase fluid flow simulations, this study addresses key questions concerning the likelihood of ruptures, the timing of consequent upward leakage of CO 2, and the effectiveness of pressure monitoring in the reservoir and overlying zones for rupture detection. A range of injection scenarios was simulated using random sampling of uncertain parameters. These include the assumed distance between the injector and the vulnerable fault zone,more » the critical overpressure required for the fault to rupture, reservoir permeability, and the CO 2 injection rate. We assumed a conservative scenario, in which if at any time during the five-year simulations the critical fault overpressure is exceeded, the fault permeability is assumed to instantaneously increase. For the purposes of conservatism we assume that CO 2 injection continues ‘blindly’ after fault rupture. We show that, despite this assumption, in most cases the CO 2 plume does not reach the base of the ruptured fault after 5 years. As a result, one possible implication of this result is that leak mitigation strategies such as pressure management have a reasonable chance of preventing a CO 2 leak.« less

Delayed clearance of cerebrospinal fluid tracer from entorhinal cortex in idiopathic normal pressure hydrocephalus: A glymphatic magnetic resonance imaging study.

PubMed

Eide, Per K; Ringstad, Geir

2018-01-01

The glymphatic system plays a key role for clearance of waste solutes from the rodent brain. We recently found evidence of glymphatic circulation in the human brain when using magnetic resonance imaging (MRI) contrast agent as cerebrospinal fluid (CSF) tracer in conjunction with multiple MRI acquisitions (gMRI). The present study explored the hypothesis that reduced glymphatic clearance in entorhinal cortex (ERC) may be instrumental in idiopathic normal pressure hydrocephalus (iNPH) dementia. gMRI acquisitions were obtained over a 24-48 h time span in cognitively affected iNPH patients and non-cognitively affected patients with suspected CSF leaks. The CSF tracer enrichment was determined as changes in normalized MRI T1 signal units. The study included 30 patients with iNPH and 8 individuals with suspected CSF leaks (i.e. reference individuals). Compared to reference individuals, iNPH patients presented with higher medial temporal lobe atrophy score and Evan's index and inferior ERC thickness. We found delayed clearance of the intrathecal CSF tracer gadobutrol from CSF, the ERC and adjacent white matter, suggesting impaired glymphatic circulation. Reduced clearance and accumulation of toxic waste product such as amyloid-β may be a mechanism behind dementia in iNPH. Glymphatic MRI (gMRI) may become a tool for assessment of early dementia.

Pressure Monitoring to Detect Fault Rupture Due to CO 2 Injection

DOE PAGES

Keating, Elizabeth; Dempsey, David; Pawar, Rajesh

2017-08-18

The capacity for fault systems to be reactivated by fluid injection is well-known. In the context of CO 2 sequestration, however, the consequence of reactivated faults with respect to leakage and monitoring is poorly understood. Using multi-phase fluid flow simulations, this study addresses key questions concerning the likelihood of ruptures, the timing of consequent upward leakage of CO 2, and the effectiveness of pressure monitoring in the reservoir and overlying zones for rupture detection. A range of injection scenarios was simulated using random sampling of uncertain parameters. These include the assumed distance between the injector and the vulnerable fault zone,more » the critical overpressure required for the fault to rupture, reservoir permeability, and the CO 2 injection rate. We assumed a conservative scenario, in which if at any time during the five-year simulations the critical fault overpressure is exceeded, the fault permeability is assumed to instantaneously increase. For the purposes of conservatism we assume that CO 2 injection continues ‘blindly’ after fault rupture. We show that, despite this assumption, in most cases the CO 2 plume does not reach the base of the ruptured fault after 5 years. As a result, one possible implication of this result is that leak mitigation strategies such as pressure management have a reasonable chance of preventing a CO 2 leak.« less

Bowel perforation detection using metabolic fluorescent chlorophylls

NASA Astrophysics Data System (ADS)

Han, Jung Hyun; Jo, Young Goun; Kim, Jung Chul; Choi, Sujeong; Kang, Hoonsoo; Kim, Yong-Chul; Hwang, In-Wook

2016-03-01

Thus far, there have been tries of detection of disease using fluorescent materials. We introduce the chlorophyll derivatives from food plants, which have longer-wavelength emissions (at >650 nm) than those of fluorescence of tissues and organs, for detection of bowel perforation. To figure out the possibility of fluorescence spectroscopy as a monitoring sensor of bowel perforation, fluorescence from organs of rodent models, intestinal and peritoneal fluids of rodent models and human were analyzed. In IVIS fluorescence image of rodent abdominal organ, visualization of perforated area only was possible when threshold of image is extremely finely controlled. Generally, both perforated area of bowel and normal bowel which filled with large amount of chlorophyll derivatives were visualized with fluorescence. The fluorescence from chlorophyll derivatives penetrated through the normal bowel wall makes difficult to distinguish perforation area from normal bowel with direct visualization of fluorescence. However, intestinal fluids containing chlorophyll derivatives from food contents can leak from perforation sites in situation of bowel perforation. It may show brighter and longer-wavelength regime emissions of chlorophyll derivatives than those of pure peritoneal fluid or bioorgans. Peritoneal fluid mixed with intestinal fluids show much brighter emissions in longer wavelength (at>650 nm) than those of pure peritoneal fluid. In addition, irrigation fluid, which is used for the cleansing of organ and peritoneal cavity, made of mixed intestinal and peritoneal fluid diluted with physiologic saline also can be monitored bowel perforation during surgery.

Microseismic response characteristics modeling and locating of underground water supply pipe leak

NASA Astrophysics Data System (ADS)

Wang, J.; Liu, J.

2015-12-01

In traditional methods of pipeline leak location, geophones must be located on the pipe wall. If the exact location of the pipeline is unknown, the leaks cannot be identified accurately. To solve this problem, taking into account the characteristics of the pipeline leak, we propose a continuous random seismic source model and construct geological models to investigate the proposed method for locating underground pipeline leaks. Based on two dimensional (2D) viscoacoustic equations and the staggered grid finite-difference (FD) algorithm, the microseismic wave field generated by a leaking pipe is modeled. Cross-correlation analysis and the simulated annealing (SA) algorithm were utilized to obtain the time difference and the leak location. We also analyze and discuss the effect of the number of recorded traces, the survey layout, and the offset and interval of the traces on the accuracy of the estimated location. The preliminary results of the simulation and data field experiment indicate that (1) a continuous random source can realistically represent the leak microseismic wave field in a simulation using 2D visco-acoustic equations and a staggered grid FD algorithm. (2) The cross-correlation method is effective for calculating the time difference of the direct wave relative to the reference trace. However, outside the refraction blind zone, the accuracy of the time difference is reduced by the effects of the refracted wave. (3) The acquisition method of time difference based on the microseismic theory and SA algorithm has a great potential for locating leaks from underground pipelines from an array located on the ground surface. Keywords: Viscoacoustic finite-difference simulation; continuous random source; simulated annealing algorithm; pipeline leak location

Anastomotic Leaks After Restorative Resections for Rectal Cancer Compromise Cancer Outcomes and Survival.

PubMed

Lu, Zheqin R; Rajendran, Nirooshun; Lynch, A Craig; Heriot, Alexander G; Warrier, Satish K

2016-03-01

Anastomotic leaks after restorative resections for rectal cancer may lead to worse long-term outcomes. The purpose of this study was to evaluate the best current evidence assessing anastomotic leaks in rectal cancer resections with curative intent and their impact on survival and cancer recurrence. A meta-analysis was performed using MEDLINE, EMBASE, and Cochrane search engines for relevant studies published between January 1982 and January 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was used to screen and select relevant studies for the review using key words "colorectal surgery; colorectal neoplasm; rectal neoplasm" and "anastomotic leak." Anastomotic leak groups were compared with nonanastomotic leak groups. ORs were calculated from binary data for local recurrence, distant recurrence, and cancer-specific mortality. A random-effects model was then used to calculate pooled ORs with 95% CIs. Eleven studies with 13,655 patients met the inclusion criteria. This included 5 prospective cohort and 6 retrospective cohort studies. Median follow-up was 60 months. Higher cancer-specific mortality was noted in the leak group with an OR of 1.30 (95% CI, 1.04-1.62; p < 0.05). Local recurrences were more likely in rectal cancer resections complicated by anastomotic leaks (OR = 1.61 (95% CI, 1.25-2.09); p < 0.001). Distant recurrence was not more likely in the anastomotic leak group (OR = 1.07 (95% CI, 0.87-1.33); p = 0.52). All 11 studies are level 3 evidence cohort studies. Additional sensitivity analyses were performed to minimize cross-study heterogeneity. Anastomotic leaks after restorative resections for rectal cancer adversely impact cancer-specific mortality and local recurrence.

The diagnostic performance of leak-plugging automated segmentation versus manual tracing of breast lesions on ultrasound images.

PubMed

Xiong, Hui; Sultan, Laith R; Cary, Theodore W; Schultz, Susan M; Bouzghar, Ghizlane; Sehgal, Chandra M

2017-05-01

To assess the diagnostic performance of a leak-plugging segmentation method that we have developed for delineating breast masses on ultrasound images. Fifty-two biopsy-proven breast lesion images were analyzed by three observers using the leak-plugging and manual segmentation methods. From each segmentation method, grayscale and morphological features were extracted and classified as malignant or benign by logistic regression analysis. The performance of leak-plugging and manual segmentations was compared by: size of the lesion, overlap area ( O a ) between the margins, and area under the ROC curves ( A z ). The lesion size from leak-plugging segmentation correlated closely with that from manual tracing ( R 2 of 0.91). O a was higher for leak plugging, 0.92 ± 0.01 and 0.86 ± 0.06 for benign and malignant masses, respectively, compared to 0.80 ± 0.04 and 0.73 ± 0.02 for manual tracings. Overall O a between leak-plugging and manual segmentations was 0.79 ± 0.14 for benign and 0.73 ± 0.14 for malignant lesions. A z for leak plugging was consistently higher (0.910 ± 0.003) compared to 0.888 ± 0.012 for manual tracings. The coefficient of variation of A z between three observers was 0.29% for leak plugging compared to 1.3% for manual tracings. The diagnostic performance, size measurements, and observer variability for automated leak-plugging segmentations were either comparable to or better than those of manual tracings.

Space Station Freedom seal leakage rate analysis and testing summary: Air leaks in ambient versus vacuum exit conditions

NASA Technical Reports Server (NTRS)

Rodriguez, P. I.; Markovitch, R.

1992-01-01

This report is intended to reveal the apparent relationship of air seal leakage rates between 2 atmospheres (atm) to 1 atm and 1 atm to vacuum conditions. Gas dynamics analysis is provided as well as data summarizing the MSFC test report, 'Space Station Freedom (S.S. Freedom) Seal Flaw Study With Delta Pressure Leak Rate Comparison Test Report'.

Does Preoperative Radio(chemo)therapy Increase Anastomotic Leakage in Rectal Cancer Surgery? A Meta-Analysis of Randomized Controlled Trials

PubMed Central

Qin, Changjiang; Ren, Xuequn; Xu, Kaiwu; Chen, Zhihui; He, Yulong; Song, Xinming

2014-01-01

Objective. Preoperative radio(chemo)therapy (pR(C)T) appears to increase postoperative complications of rectal cancer resection, but clinical trials have reported conflicting results. The objective of this meta-analysis was performed to assess the effects of pR(C)T on anastomotic leak after rectal cancer resection. Methods. PubMed, Embase, and the Cochrane Library were searched from January 1980 to January 2014. Randomized controlled trials included all original articles reporting anastomotic leak in patients with rectal cancer, among whom some received preoperative radiotherapy or chemoradiotherapy while others did not. The analysed end-points were the anastomotic leak. Result. Seven randomized controlled trials with 3375 patients were included in the meta-analysis. 1660 forming the group undergoing preoperative radiotherapy or chemoradiotherapy versus 1715 patients undergoing without preoperative radiotherapy or chemoradiotherapy. The meta-analyses found that pR(C)T was not an independent risk factor for anastomotic leakage (OR 1.02, 95% CI 0.80–1.30; P = 0.88). Subgroups analysis was performed and the result was not altered. Conclusions. Current evidence demonstrates that pR(C)T did not increase the risk of postoperative anastomotic leak after rectal cancer resection in patients. PMID:25477955

Of Detection Limits and Effective Mitigation: The Use of Infrared Cameras for Methane Leak Detection

NASA Astrophysics Data System (ADS)

Ravikumar, A. P.; Wang, J.; McGuire, M.; Bell, C.; Brandt, A. R.

2017-12-01

Mitigating methane emissions, a short-lived and potent greenhouse gas, is critical to limiting global temperature rise to two degree Celsius as outlined in the Paris Agreement. A major source of anthropogenic methane emissions in the United States is the oil and gas sector. To this effect, state and federal governments have recommended the use of optical gas imaging systems in periodic leak detection and repair (LDAR) surveys to detect for fugitive emissions or leaks. The most commonly used optical gas imaging systems (OGI) are infrared cameras. In this work, we systematically evaluate the limits of infrared (IR) camera based OGI system for use in methane leak detection programs. We analyze the effect of various parameters that influence the minimum detectable leak rates of infrared cameras. Blind leak detection tests were carried out at the Department of Energy's MONITOR natural gas test-facility in Fort Collins, CO. Leak sources included natural gas wellheads, separators, and tanks. With an EPA mandated 60 g/hr leak detection threshold for IR cameras, we test leak rates ranging from 4 g/hr to over 350 g/hr at imaging distances between 5 ft and 70 ft from the leak source. We perform these experiments over the course of a week, encompassing a wide range of wind and weather conditions. Using repeated measurements at a given leak rate and imaging distance, we generate detection probability curves as a function of leak-size for various imaging distances, and measurement conditions. In addition, we estimate the median detection threshold - leak-size at which the probability of detection is 50% - under various scenarios to reduce uncertainty in mitigation effectiveness. Preliminary analysis shows that the median detection threshold varies from 3 g/hr at an imaging distance of 5 ft to over 150 g/hr at 50 ft (ambient temperature: 80 F, winds < 4 m/s). Results from this study can be directly used to improve OGI based LDAR protocols and reduce uncertainty in estimated mitigation effectiveness. Furthermore, detection limits determined in this study can be used as standards to compare new detection technologies.

Annular Air Leaks in a liquid hydrogen storage tank

NASA Astrophysics Data System (ADS)

Krenn, AG; Youngquist, RC; Starr, SO

2017-12-01

Large liquid hydrogen (LH2) storage tanks are vital infrastructure for NASA, the DOD, and industrial users. Over time, air may leak into the evacuated, perlite filled annular region of these tanks. Once inside, the extremely low temperatures will cause most of the air to freeze. If a significant mass of air is allowed to accumulate, severe damage can result from nominal draining operations. Collection of liquid air on the outer shell may chill it below its ductility range, resulting in fracture. Testing and analysis to quantify the thermal conductivity of perlite that has nitrogen frozen into its interstitial spaces and to determine the void fraction of frozen nitrogen within a perlite/frozen nitrogen mixture is presented. General equations to evaluate methods for removing frozen air, while avoiding fracture, are developed. A hypothetical leak is imposed on an existing tank geometry and a full analysis of that leak is detailed. This analysis includes a thermal model of the tank and a time-to-failure calculation. Approaches to safely remove the frozen air are analyzed, leading to the conclusion that the most feasible approach is to allow the frozen air to melt and to use a water stream to prevent the outer shell from chilling.

Technical factors that affect anastomotic integrity following esophagectomy: systematic review and meta-analysis.

PubMed

Markar, Sheraz R; Arya, Shobhit; Karthikesalingam, Alan; Hanna, George B

2013-12-01

Due to the significant contribution of anastomotic leak, with its disastrous consequences to patient morbidity and mortality, multiple parameters have been proposed and individually meta-analyzed for the formation of the ideal esophagogastric anastomosis following cancer resection. The purpose of this pooled analysis was to examine the main technical parameters that impact on anastomotic integrity. Medline, Embase, trial registries, and conference proceedings were searched. Technical factors evaluated included hand-sewn versus stapled esophagogastric anastomosis (EGA), cervical versus thoracic EGA, minimally invasive versus open esophagectomy, anterior versus posterior route of reconstruction and ischemic conditioning of the gastric conduit. The outcome of interest was the incidence of anastomotic leak, for which pooled odds ratios were calculated for each technical factor. No significant difference in the incidence of anastomotic leak was demonstrated for the following technical factors: hand-sewn versus stapled EGA, minimally invasive versus open esophagectomy, anterior versus posterior route of reconstruction and ischemic conditioning of the gastric conduit. Four randomized, controlled trials comprising 298 patients were included that compared cervical and thoracic EGA. Anastomotic leak was seen more commonly in the cervical group (13.64 %) than in the thoracic group (2.96 %). Pooled analysis demonstrated a significantly increased incidence of anastomotic leak in the cervical group (pooled odds ratio = 4.73; 95 % CI 1.61-13.9; P = 0.005). A tailored surgical approach to the patient's physiology and esophageal cancer stage is the most important factor that influences anastomotic integrity after esophagectomy.

Hyperthyroidism stimulates mitochondrial proton leak and ATP turnover in rat hepatocytes but does not change the overall kinetics of substrate oxidation reactions.

PubMed

Harper, M E; Brand, M D

1994-08-01

Thyroid hormones have well-known effects on oxidative phosphorylation, but there is little quantitative information on their important sites of action. We have used top-down elasticity analysis, an extension of metabolic control analysis, to identify the sites of action of thyroid hormones on oxidative phosphorylation in rat hepatocytes. We divided the oxidative phosphorylation system into three blocks of reactions: the substrate oxidation subsystem, the phosphorylating subsystem, and the mitochondrial proton leak subsystem and have identified those blocks of reactions whose kinetics are significantly changed by hyperthyroidism. Our results show significant effects on the kinetics of the proton leak and the phosphorylating subsystems. Quantitative analyses revealed that 43% of the increase in resting respiration rate in hyperthyroid hepatocytes compared with euthyroid hepatocytes was due to differences in the proton leak and 59% was due to differences in the activity of the phosphorylating subsystem. There were no significant effects on the substrate oxidation subsystem. Changes in nonmitochondrial oxygen consumption accounted for -2% of the change in respiration rate. Top-down control analysis revealed that the distribution of control over the rates of mitochondrial oxygen consumption, ATP synthesis and consumption, and proton leak and over mitochondrial membrane potential (delta psi m) was similar in hepatocytes from hyperthyroid and littermate-paired euthyroid controls. The results of this study include the first complete top-down elasticity and control analyses of oxidative phosphorylation in hepatocytes from hyperthyroid rats.

Fracture Propagation, Fluid Flow, and Geomechanics of Water-Based Hydraulic Fracturing in Shale Gas Systems and Electromagnetic Geophysical Monitoring of Fluid Migration

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

Kim, Jihoon; Um, Evan; Moridis, George

2014-12-01

We investigate fracture propagation induced by hydraulic fracturing with water injection, using numerical simulation. For rigorous, full 3D modeling, we employ a numerical method that can model failure resulting from tensile and shear stresses, dynamic nonlinear permeability, leak-off in all directions, and thermo-poro-mechanical effects with the double porosity approach. Our numerical results indicate that fracture propagation is not the same as propagation of the water front, because fracturing is governed by geomechanics, whereas water saturation is determined by fluid flow. At early times, the water saturation front is almost identical to the fracture tip, suggesting that the fracture is mostlymore » filled with injected water. However, at late times, advance of the water front is retarded compared to fracture propagation, yielding a significant gap between the water front and the fracture top, which is filled with reservoir gas. We also find considerable leak-off of water to the reservoir. The inconsistency between the fracture volume and the volume of injected water cannot properly calculate the fracture length, when it is estimated based on the simple assumption that the fracture is fully saturated with injected water. As an example of flow-geomechanical responses, we identify pressure fluctuation under constant water injection, because hydraulic fracturing is itself a set of many failure processes, in which pressure consistently drops when failure occurs, but fluctuation decreases as the fracture length grows. We also study application of electromagnetic (EM) geophysical methods, because these methods are highly sensitive to changes in porosity and pore-fluid properties due to water injection into gas reservoirs. Employing a 3D finite-element EM geophysical simulator, we evaluate the sensitivity of the crosswell EM method for monitoring fluid movements in shaly reservoirs. For this sensitivity evaluation, reservoir models are generated through the coupled flow-geomechanical simulator and are transformed via a rock-physics model into electrical conductivity models. It is shown that anomalous conductivity distribution in the resulting models is closely related to injected water saturation, but not closely related to newly created unsaturated fractures. Our numerical modeling experiments demonstrate that the crosswell EM method can be highly sensitive to conductivity changes that directly indicate the migration pathways of the injected fluid. Accordingly, the EM method can serve as an effective monitoring tool for distribution of injected fluids (i.e., migration pathways) during hydraulic fracturing operations« less

Surface tension of dilute alcohol-aqueous binary fluids: n-Butanol/water, n-Pentanol/water, and n-Hexanol/water solutions

NASA Astrophysics Data System (ADS)

Cheng, Kuok Kong; Park, Chanwoo

2017-07-01

Surface tension of pure fluids, inherently decreasing with regard to temperature, creates a thermo-capillary-driven (Marangoni) flow moving away from a hot surface. It has been known that few high-carbon alcohol-aqueous solutions exhibit an opposite behavior of the surface tension increasing with regard to temperature, such that the Marangoni flow moves towards the hot surface (self-rewetting effect). We report the surface tensions of three dilute aqueous solutions of n-Butanol, n-Pentanol and n-Hexanol as self-rewetting fluids measured for ranges of alcohol concentration (within solubility limits) and fluid temperatures (25-85 °C). A maximum bubble pressure method using a leak-tight setup was used to measure the surface tension without evaporation losses of volatile components. It was found from this study that the aqueous solutions with higher-carbon alcohols exhibit a weak self-rewetting behavior, such that the surface tensions remain constant or slightly increases above about 60 °C. These results greatly differ from the previously reported results showing a strong self-rewetting behavior, which is attributed to the measurement errors associated with the evaporation losses of test fluids during open-system experiments.

Impact of the Surgical Experience on Leak Rate After Laparoscopic Sleeve Gastrectomy.

PubMed

Noel, Patrick; Nedelcu, Marius; Gagner, Michel

2016-08-01

Laparoscopic sleeve gastrectomy (LSG) has become one of the most commonly performed bariatric procedures, largely due to several advantages it carries over more complex bariatric procedures. LSG is generally considered a straightforward procedure, but one of the major concerns is a staple line leak. The objectives of this study are to evaluate the correlation between surgeon's experience and leak rate and to assess the different risk factors for developing a gastric leak after LSG. Private hospital, France. The analysis of a single surgeon's yearly leak rate since the introduction of LSG for possible risk factors was done. A total of 2012 LSGs were performed in between September, 2005 and December, 2014. Twenty cases (1 %) of gastric leak were recorded. Of these, 17 patients were women (94.4 %) with a mean age of 39.4 years (range 22-61) and mean body mass index (BMI) 41.2 kg/m(2) (range 34.8-57.1). On a yearly basis, the leak rate was 4.8 % (2006), 5.7 % (2007), 0 (2008), 2.6 % (2009), 2 % (2010), 0.8 % (2011), 0.6 % (2012), 0.2 % (2013), and 0 (2014). In the first 1000 cases (group A), there were 18 cases of gastric leak and in the last 1000 cases, there were 800 with GORE® SEAMGUARD® Bioabsorbable Staple Line Reinforcement (group B) 2 cases of gastric leak (p = 0.009). A revisional LSG, 395 patients after gastric banding and 61 patients re-sleeve gastrectomy, was performed in 456 cases (22.7 %). There were 3 cases of leak (0.65 %). There were two deaths. LSG can be performed with a low complication rate. This large series of a single surgeon's experience demonstrated that the leak rate after LSG could be significantly decreased over time with changes in techniques.

Prognostic Factors and Significance of Gastrointestinal Leak After Cytoreductive Surgery (CRS) with Heated Intraperitoneal Chemotherapy (HIPEC).

PubMed

Chouliaras, Konstantinos; Levine, Edward A; Fino, Nora; Shen, Perry; Votanopoulos, Konstantinos I

2017-04-01

Gastrointestinal leak (GIL) after cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) is associated with significant morbidity and mortality. This study aimed to identify GIL prognostic factors and its impact on overall survival. A retrospective analysis of a prospectively maintained database comprising 1270 CRS/HIPEC procedures was performed. Type of GIL, functional and resection status, morbidity, mortality, and survival were reviewed. Gastrointestinal leaks were identified in 8.7% (110/1270) of CRS/HIPEC procedures, including 53 anastomotic leaks (4.2%), 53 hollow viscus perforations (4.2%), and four leaks at unknown sites. The multivariate predictors of leak were Eastern Cooperative Oncology Group (ECOG) functional status (ECOG 1 vs. 0: odds ratio [OR] 2.12, p = 0.009; ECOG 2 vs. 0: OR 2.90, p = 0.004), and number of anastomoses (OR 5.34; p < 0.0001). The in-hospital mortality rate for the GIL cohort was 21.8% (24/110), with a 72% (80/110) reoperation rate. The leak cohort had a higher major morbidity rate (88.3 vs. 23.3%; p < 0.0001), a longer hospital stay (39.0 vs. 9.9 days; p < 0.0001), and a longer intensive care unit (ICU) stay (7.7 vs. 1.7 days; p = 0.0003). After surgical mortality was excluded, the overall survival periods for the leak and no-leak patients with complete cytoreduction were respectively 1.5 and 4.98 years (p = 0.0001). Clinically significant decreases in survival were observed for all primary malignancies. Gastrointestinal leak after CRS/HIPEC is a source of significant mortality, with a decrease in overall survival even after complete CRS. Preoperative functional status and number of anastomoses are predictors of leak for CRS/HIPEC patients.

Sodium leak channel, non-selective contributes to the leak current in human myometrial smooth muscle cells from pregnant women.

PubMed

Reinl, Erin L; Cabeza, Rafael; Gregory, Ismail A; Cahill, Alison G; England, Sarah K

2015-10-01

Uterine contractions are tightly regulated by the electrical activity of myometrial smooth muscle cells (MSMCs). These cells require a depolarizing current to initiate Ca(2+) influx and induce contraction. Cationic leak channels, which permit a steady flow of cations into a cell, are known to cause membrane depolarization in many tissue types. Previously, a Gd(3+)-sensitive, Na(+)-dependent leak current was identified in the rat myometrium, but the presence of such a current in human MSMCs and the specific ion channel conducting this current was unknown. Here, we report the presence of a Na(+)-dependent leak current in human myometrium and demonstrate that the Na(+)-leak channel, NALCN, contributes to this current. We performed whole-cell voltage-clamp on fresh and cultured MSMCs from uterine biopsies of term, non-laboring women and isolated the leak currents by using Ca(2+) and K(+) channel blockers in the bath solution. Ohmic leak currents were identified in freshly isolated and cultured MSMCs with normalized conductances of 14.6 pS/pF and 10.0 pS/pF, respectively. The myometrial leak current was significantly reduced (P < 0.01) by treating cells with 10 μM Gd(3+) or by superfusing the cells with a Na(+)-free extracellular solution. Reverse transcriptase PCR and immunoblot analysis of uterine biopsies from term, non-laboring women revealed NALCN messenger RNA and protein expression in the myometrium. Notably, ∼90% knockdown of NALCN protein expression with lentivirus-delivered shRNA reduced the Gd(3+)-sensitive leak current density by 42% (P < 0.05). Our results reveal that NALCN, in part, generates the leak current in MSMCs and provide the basis for future research assessing NALCN as a potential molecular target for modulating uterine excitability. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Influence of preoperative radiation field on postoperative leak rates in esophageal cancer patients after trimodality therapy.

PubMed

Juloori, Aditya; Tucker, Susan L; Komaki, Ritsuko; Liao, Zhongxing; Correa, Arlene M; Swisher, Stephen G; Hofstetter, Wayne L; Lin, Steven H

2014-04-01

Postoperative morbidities, such as anastomotic leaks, are common after trimodality therapy (chemoradiation followed by surgery) for esophageal cancer. We investigated for factors associated with an increased incidence of anastomotic leaks. Data from 285 esophageal cancer patients treated from 2000 to 2011 with trimodality therapy were analyzed. Anastomotic location relative to preoperative radiation field was assessed using postoperative computed tomographic imaging. Logistic regression was used to evaluate for factors associated with any or clinically relevant (CR) (≥ grade 2) leaks. Overall anastomotic leak rate was 11% (31 of 285), and CR leak rate was 6% (17 of 285). Multivariable analysis identified body mass index (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.00-1.17; OR, 1.11, 95% CI, 1.01-1.22), three-field surgery (OR, 10.01; 95% CI, 3.83-26.21; OR, 4.83; 95% CI, 1.39-16.71), and within radiation field ("in-field") anastomosis (OR, 5.37; 95% CI, 2.21-13.04; OR, 8.63; 95% CI, 2.90-25.65) as independent predictors of both all grade and CR leaks, respectively. While patients with distal esophageal tumors and Ivor-Lewis surgery had the lowest incidence of all grade (6.5%) and CR leaks (4.2%), most of the leaks were associated with the anastomosis constructed within the field of radiation (in-field: 39% and 30% versus out-of-field: 2.6% and 1.0%, respectively, for total and CR leaks, p less than 0.0001, Fisher's exact test). Esophagogastric anastomosis placed within the preoperative radiation field was a very strong predictor for anastomotic leaks in esophageal cancer patients treated with trimodality therapy, among other factors. Surgical planning should include a critical evaluation of the preoperative radiation fields to ensure proper anastomotic placement after chemoradiation therapy.

A risk-based approach to flammable gas detector spacing.

PubMed

Defriend, Stephen; Dejmek, Mark; Porter, Leisa; Deshotels, Bob; Natvig, Bernt

2008-11-15

Flammable gas detectors allow an operating company to address leaks before they become serious, by automatically alarming and by initiating isolation and safe venting. Without effective gas detection, there is very limited defense against a flammable gas leak developing into a fire or explosion that could cause loss of life or escalate to cascading failures of nearby vessels, piping, and equipment. While it is commonly recognized that some gas detectors are needed in a process plant containing flammable gas or volatile liquids, there is usually a question of how many are needed. The areas that need protection can be determined by dispersion modeling from potential leak sites. Within the areas that must be protected, the spacing of detectors (or alternatively, number of detectors) should be based on risk. Detector design can be characterized by spacing criteria, which is convenient for design - or alternatively by number of detectors, which is convenient for cost reporting. The factors that influence the risk are site-specific, including process conditions, chemical composition, number of potential leak sites, piping design standards, arrangement of plant equipment and structures, design of isolation and depressurization systems, and frequency of detector testing. Site-specific factors such as those just mentioned affect the size of flammable gas cloud that must be detected (within a specified probability) by the gas detection system. A probability of detection must be specified that gives a design with a tolerable risk of fires and explosions. To determine the optimum spacing of detectors, it is important to consider the probability that a detector will fail at some time and be inoperative until replaced or repaired. A cost-effective approach is based on the combined risk from a representative selection of leakage scenarios, rather than a worst-case evaluation. This means that probability and severity of leak consequences must be evaluated together. In marine and offshore facilities, it is conventional to use computational fluid dynamics (CFD) modeling to determine the size of a flammable cloud that would result from a specific leak scenario. Simpler modeling methods can be used, but the results are not very accurate in the region near the release, especially where flow obstructions are present. The results from CFD analyses on several leak scenarios can be plotted to determine the size of a flammable cloud that could result in an explosion that would generate overpressure exceeding the strength of the mechanical design of the plant. A cloud of this size has the potential to produce a blast pressure or flying debris capable of causing a fatality or subsequent damage to vessels or piping containing hazardous material. In cases where the leak results in a fire, rather than explosion, CFD or other modeling methods can estimate the size of a leak that would cause a fire resulting in subsequent damage to the facility, or would prevent the safe escape of personnel. The gas detector system must be capable of detecting a gas release or vapor cloud, and initiating action to prevent the leak from reaching a size that could cause injury or severe damage upon ignition.

MEASUREMENT AND ANALYSIS OF ADSISTOR AND FIGARO GAS SENSORS USED FOR UNDERGROUND STORAGE TANK LEAK DETECTION

EPA Science Inventory

Two different sensor technologies and their properties were analyzed. he nalysis simulated a leak which occurs from an underground storage tank. igaro gas sensors and the Adsistor gas sensor were tested in simulated underground storage tank nvironments using the Carnegie Mellon R...

Cryogenic Fluid Management Technology and Nuclear Thermal Propulsion

NASA Technical Reports Server (NTRS)

Taylor, Brian D.; Caffrey, Jarvis; Hedayat, Ali; Stephens, Jonathan; Polsgrove, Robert

2016-01-01

Cryogenic fluid management (CFM) is critical to the success of future nuclear thermal propulsion powered vehicles. While this is an issue for any propulsion system utilizing cryogenic propellants, this is made more challenging by the radiation flux produced by the reactor in a nuclear thermal rocket (NTR). Managing the cryogenic fuel to prevent propellant loss to boil off and leakage is needed to limit the required quantity of propellant to a reasonable level. Analysis shows deposition of energy into liquid hydrogen fuel tanks in the vicinity of the nuclear thermal engine. This is on top of ambient environment sources of heat. Investments in cryogenic/thermal management systems (some of which are ongoing at various organizations) are needed in parallel to nuclear thermal engine development in order to one day see the successful operation of an entire stage. High durability, low thermal conductivity insulation is one developmental need. Light weight cryocoolers capable of removing heat from large fluid volumes at temperatures as low as approx. 20 K are needed to remove heat leak from the propellant of an NTR. Valve leakage is an additional CFM issue of great importance. Leakage rates of state of the art, launch vehicle size valves (which is approximately the size valves needed for a Mars transfer vehicle) are quite high and would result in large quantities of lost propellant over a long duration mission. Additionally, the liquid acquisition system inside the propellant tank must deliver properly conditioned propellant to the feed line for successful engine operation and avoid intake of warm or gaseous propellant. Analysis of the thermal environment and the CFM technology development are discussed in the accompanying presentation.

[Pneumococcal meningitis revealing dysplasia of the bony labyrinth in an infant].

PubMed

Louaib, D; François, M; Coderc, E; Dieu, S; Nathanson, M; Narcy, P; Gaudelus, J

1996-03-01

Dysplasias of the bony labyrinth are frequently associated with cerebrospinal fluid fistula and are usually discovered because of recurrent meningitis. A 1 year-old infant was admitted for a pneumococcal meningitis which appeared 2 days after the occurrence of a clear otorrhea from the right ear. The same organism was isolated from the otorrhea fluid, which also contained cerebrospinal fluid as confirmed cytochemically. The meningitis rapidly resolved with antibiotic treatment. Auditory brain stem responses were abolished from the right ear. CT of the temporal bones showed a pseudo-Mondini type labyrinth dysplasia at the right ear and Mondini type dysplasia at the left one. A translabyrinthine cerebrospinal fluid fistula was discovered by surgical exploration of the right ear, occurring through a perforation in the stapedial foot plate. The leak was cured by packing the vestibule and obturating both oval and round windows. Three years after the operation, the child did not experience any further episode of otorrhea or meningitis. Features suggesting a translabyrinthine fistula, especially otorrhea and deafness, should be systematically searched in any child with bacterial meningitis. Closure of these fistulas can prevent severe infectious recurrences.

An analysis of blood specimen container leakage.

PubMed Central

Lewis, S M; Wardle, J M

1978-01-01

Procedures have been designed to test specimen containers for leakage, using blood and aqueous fluorescein solution as indicators. They have been used in a trial evaluation of a number of commercially available containers intended for medical specimens. Glass bijou bottles, evacuated container systems, and several types of plastic container showed no significant leakage rate with either blood or aqueous solution when they were tested at room temperature, but a large proportion of the plastic containers leaked after being subjected to -20 degrees. C. These would thus be suitable and satisfactory for blood count specimens but not for specimens of serum and other body fluids, which are usually stored frozen. With all types of container tested there was spontaneous discharge of contents (blood or aqueous solution) on opening in a proportion of them; thus no container at present available seems to be entirely free from hazard. PMID:711921

An electromechanical attenuator/actuator for Space Station docking

NASA Technical Reports Server (NTRS)

Stokes, Lebarian; Glenn, Dean; Carroll, Monty B.

1987-01-01

The development of a docking system for aerospace vehicles has identified the need for reusable and variably controlled attenuators/actuators for energy absorption and compliance. One approach to providing both the attenuator and the actuator functions is by way of an electromechanical attenuator/actuator (EMAA) as opposed to a hydraulic system. The use of the electromechanical devices is considered to be more suitable for a space environment because of the absence of contamination from hydraulic fluid leaks and because of the cost effectiveness of maintenance. A smart EMAA that uses range/rate/attitude sensor information to preadjust a docking interface to eliminate misalignments and to minimize contact and stroking forces is described. A prototype EMAA was fabricated and is being tested and evaluated. Results of preliminary testing and analysis already performed have established confidence that this concept is feasible and will provide the desired reliability and low maintenance for repetitive long term operation typical of Space Station requirements.

Environmental Effects on Fatigue Crack Growth in High Performance Aluminum Alloys

DTIC Science & Technology

2009-03-13

tested for leaks to a rate of 2x 10൒ cm3/s with helium. All devices connected to the chamber, including pumps , gages and valves, are ultra-high- vacuum ...Pfeiffer TMU-262P), backed by a 5 L/s scroll pump (ULVAC DIS-250). This pump combination eliminates the possibility of contamination by pumping fluid used...both pumps are connected directly to the vacuum chamber to achieve optimum pump -down speeds. Pumping down the chamber is further facilitated by use of

Robots Would Couple And Uncouple Fluid And Electrical Lines

NASA Technical Reports Server (NTRS)

Del Castillo, Eduardo Lopez; Davis, Virgil; Ferguson, Bob; Reichle, Garland

1992-01-01

Robots make and break connections between umbilical plates and mating connectors on rockets about to be launched. Sensing and control systems include vision, force, and torque subsystems. Enhances safety by making it possible to couple and uncouple umbilical plates quickly, without exposing human technicians to hazards of leaking fuels and oxidizers. Significantly reduces time spent to manually connect umbilicals. Robots based on similar principles used in refueling of National AeroSpace Plane (NASP) and satellites and orbital transfer vehicles in space.

Eddy current damper

NASA Technical Reports Server (NTRS)

Ellis, R. C.; Fink, R. A.; Rich, R. W.

1989-01-01

A high torque capacity eddy current damper used as a rate limiting device for a large solar array deployment mechanism is discussed. The eddy current damper eliminates the problems associated with the outgassing or leaking of damping fluids. It also provides performance advantages such as damping torque rates, which are truly linear with respect to input speed, continuous 360 degree operation in both directions of rotation, wide operating temperature range, and the capability of convenient adjustment of damping rates by the user without disassembly or special tools.

Matrix heat exchanger including a liquid, thermal couplant

DOEpatents

Fewell, Thomas E.; Ward, Charles T.

1976-01-01

A tube-to-tube heat exchanger is disclosed with a thermally conductive matrix between and around the tubes to define annuli between the tubes and matrix. The annuli are filled to a level with a molten metal or alloy to provide a conductive heat transfer path from one tube through the matrix to the second tube. A matrix heat exchanger of this type is particularly useful for heat transfer between fluids which would react should one leak into the second.

Piping Connector

NASA Technical Reports Server (NTRS)

1993-01-01

A complex of high pressure piping at Stennis Space Center carries rocket propellants and other fluids/gases through the Center's Component Test Facility. Conventional clamped connectors tend to leak when propellant lines are chilled to extremely low temperatures. Reflange, Inc. customized an existing piping connector to include a secondary seal more tolerant of severe thermal gradients for Stennis. The T-Con connector solved the problem, and the company is now marketing a commercial version that permits testing, monitoring or collecting any emissions that may escape the primary seal during severe thermal transition.

Postoperative Central Nervous System Infection After Neurosurgery in a Modernized, Resource-Limited Tertiary Neurosurgical Center in South Asia.

PubMed

Chidambaram, Swathi; Nair, M Nathan; Krishnan, Shyam Sundar; Cai, Ling; Gu, Weiling; Vasudevan, Madabushi Chakravarthy

2015-12-01

Postoperative central nervous system infections (PCNSIs) are rare but serious complications after neurosurgery. The purpose of this study was to examine the prevalence and causative pathogens of PCNSIs at a modernized, resource-limited neurosurgical center in South Asia. A retrospective analysis was conducted of the medical records of all 363 neurosurgical cases performed between June 1, 2012, and June 30, 2013, at a neurosurgical center in South Asia. Data from all operative neurosurgical cases during the 13-month period were included. Cerebrospinal fluid (CSF) analysis indicated that 71 of the 363 surgical cases had low CSF glucose or CSF leukocytosis. These 71 cases were categorized as PCNSIs. The PCNSIs with positive CSF cultures (9.86%) all had gram-negative bacteria with Pseudomonas aeruginosa (n = 5), Escherichia coli (n = 1), or Klebsiella pneumoniae (n = 1). The data suggest a higher rate of death (P = 0.031), a higher rate of CSF leak (P < 0.001), and a higher rate of cranial procedures (P < 0.001) among the infected patients and a higher rate of CSF leak among the patients with culture-positive infections (P = 0.038). This study summarizes the prevalence, causative organism of PCNSI, and antibiotic usage for all of the neurosurgical cases over a 13-month period in a modernized yet resource-limited neurosurgical center located in South Asia. The results from this study highlight the PCNSI landscape in an area of the world that is often underreported in the neurosurgical literature because of the paucity of clinical neurosurgical research undertaken there. This study shows an increasing prevalence of gram-negative organisms in CSF cultures from PCNSIs, which supports a trend in the recent literature of increasing gram-negative bacillary meningitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Ward-based, nurse-led, outpatient chest tube management: analysis of impact, cost-effectiveness and patient safety.

PubMed

Tcherveniakov, Peter; De Siqueira, Jonathan; Milton, Richard; Papagiannopoulos, Kostas

2012-06-01

Prolonged drainage and air leaks are recognized complications of elective and acute thoracic surgery and carry significant burden on inpatient stay and outpatient resources. Since 2007, we have run a ward-based, nurse-led clinic for patients discharged with a chest drain in situ. The aim of this study is to assess its cost-effectiveness and safety. We present a retrospective review of the activity of the clinic for a period of 12 months (November 2009-10). An analysis of the gathered data is performed, focusing specifically on the duration of chest tube indwelling, the indications, complications and cost efficiency. The nurse-led clinic was housed in the thoracic ward with no additional fixed costs. Seventy-four patients were reviewed (53 males, 21 females, mean age of 59) and subsequently discharged from the clinic in this time period, accounting for 149 care episodes. Thirty-three (45%) of the patients underwent a video-assisted thoracoscopic surgery procedure, 35 (47%) of them a thoracotomy and 7 (9%) had a bedside chest tube insertion. Following hospital discharge, the chest tubes were removed after a median of 14 days (range 1-82 days). Fifty-eight percent of the patients were reviewed because of a prolonged air leak, 26% for persistent fluid drainage and 16% due to prolonged drainage following evacuation of empyemas. For the care episodes analysed, we estimate that the clinic has generated an income of €24,899 for the department. Hourly staffing costs for the service are significantly lower compared with those of the traditional outpatient clinic: €15 vs. €114. Our results show that a dedicated chest tube monitoring clinic is a safe and efficient alternative to formal outpatient clinic review. It can lead to shorter hospital stays and is cost effective.

Risk Factors for Gastrointestinal Leak after Bariatric Surgery: MBASQIP Analysis.

PubMed

Alizadeh, Reza Fazl; Li, Shiri; Inaba, Colette; Penalosa, Patrick; Hinojosa, Marcelo W; Smith, Brian R; Stamos, Michael J; Nguyen, Ninh T

2018-03-30

Gastrointestinal leak remains one of the most dreaded complications in bariatric surgery. We aimed to evaluate risk factors and the impact of common perioperative interventions on the development of leak in patients who underwent laparoscopic bariatric surgery. Using the 2015 database of accredited centers, data were analyzed for patients who underwent laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass (LRYGB). Emergent, revisional, and converted cases were excluded. Multivariate logistic regression was used to analyze risk factors for leak, including provocative testing of anastomosis, surgical drain placement, and use of postoperative swallow study. Data from 133,478 patients who underwent laparoscopic sleeve gastrectomy (n = 92,495 [69.3%]) and LRYGB (n = 40,983 [30.7%]) were analyzed. Overall leak rate was 0.7% (938 of 133,478). Factors associated with increased risk for leak were oxygen dependency (adjusted odds ratio [AOR] 1.97), hypoalbuminemia (AOR 1.66), sleep apnea (AOR 1.52), hypertension (AOR 1.36), and diabetes (AOR 1.18). Compared with LRYGB, laparoscopic sleeve gastrectomy was associated with a lower risk of leak (AOR 0.52; 95% CI 0.44 to 0.61; p < 0.01). Intraoperative provocative test was performed in 81.9% of cases and the leak rate was higher in patients with vs without a provocative test (0.8% vs 0.4%, respectively; p < 0.01). A surgical drain was placed in 24.5% of cases and the leak rate was higher in patients with vs without a surgical drain placed (1.6% vs 0.4%, respectively; p < 0.01). A swallow study was performed in 41% of cases and the leak rate was similar between patients with vs without swallow study (0.7% vs 0.7%; p = 0.50). The overall rate of gastrointestinal leak in bariatric surgery is low. Certain preoperative factors, procedural type (LRYGB), and interventions (intraoperative provocative test and surgical drain placement) were associated with a higher risk for leaks. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Endonasal Suturing of Nasoseptal Flap to Nasopharyngeal Fascia Using the V-Loc™ Wound Closure Device: 2-Dimensional Operative Video.

PubMed

Zwagerman, Nathan T; Geltzeiler, Mathew N; Wang, Eric W; Fernandez-Miranda, Juan C; Snyderman, Carl H; Gardner, Paul A

2018-05-30

We present a case of cerebrospinal fluid (CSF) leak after endoscopic endonasal resection of a large clival chordoma in an obese patient. The leak was at the lower reconstruction at the craniocervical junction and had failed repositioning. Using the V-Loc™ wound closure device (Covidien, New Haven, Connecticut) to suture the nasoseptal flap to the nasopharyngeal fascia, a water-tight seal was created and, along with a lumbar drain, the patient healed successfully.CSF leak after an endoscopic endonasal approach (EEA) to intradural pathologies remains one of the more common complications.1-4 Various closure techniques have been developed5-8 with success in mitigating this risk, but all have their limitations and rely on multiple layers including vascularized flaps like the nasoseptal flap.9-11 Endonasal suturing of graft materials offers the advantage of creating a water-tight seal. We present the use of the V-Loc™ wound closure device (Covidien) to successfully seal a postoperative CSF leak. The absorbable V-Loc™ wound closure device does not require the surgeon to tie knots, which is the most challenging step in a deep, 2-dimensional corridor. The suture is barbed and is anchored by threading the needle through a prefabricated loop at the end of the suture which locks in place. Each throw of the suture through tissue maintains the suture line as the barbs catch the tissue and prevent retraction. After successful closure, the needle can simply be cut off.The V-Loc™ wound closure device (Covidien) is a safe and effective adjunct to reconstruction after endoscopic endonasal skull base surgery as it provides an option for graft/flap suturing.A written release from the patient whose name or likeness is submitted as part of this Work is on file.

A mathematical model of intestinal oedema formation.

PubMed

Young, Jennifer; Rivière, Béatrice; Cox, Charles S; Uray, Karen

2014-03-01

Intestinal oedema is a medical condition referring to the build-up of excess fluid in the interstitial spaces of the intestinal wall tissue. Intestinal oedema is known to produce a decrease in intestinal transit caused by a decrease in smooth muscle contractility, which can lead to numerous medical problems for the patient. Interstitial volume regulation has thus far been modelled with ordinary differential equations, or with a partial differential equation system where volume changes depend only on the current pressure and not on updated tissue stress. In this work, we present a computational, partial differential equation model of intestinal oedema formation that overcomes the limitations of past work to present a comprehensive model of the phenomenon. This model includes mass and momentum balance equations which give a time evolution of the interstitial pressure, intestinal volume changes and stress. The model also accounts for the spatially varying mechanical properties of the intestinal tissue and the inhomogeneous distribution of fluid-leaking capillaries that create oedema. The intestinal wall is modelled as a multi-layered, deforming, poroelastic medium, and the system of equations is solved using a discontinuous Galerkin method. To validate the model, simulation results are compared with results from four experimental scenarios. A sensitivity analysis is also provided. The model is able to capture the final submucosal interstitial pressure and total fluid volume change for all four experimental cases, and provide further insight into the distribution of these quantities across the intestinal wall.

[Hospital variation in anastomotic leakage after rectal cancer surgery in the Spanish Association of Surgeons project: The contribution of hospital volume].

PubMed

Ortiz, Héctor; Biondo, Sebastiano; Codina, Antonio; Ciga, Miguel Á; Enríquez-Navascués, José; Espín, Eloy; García-Granero, Eduardo; Roig, José Vicente

2016-04-01

This multicentre observational study aimed to determine the anastomotic leak rate in the hospitals included in the Rectal Cancer Project of the Spanish Society of Surgeons and examine whether hospital volume may contribute to any variation between hospitals. Hospital variation was quantified using a multilevel approach on prospective data derived from the multicentre database of all adenocarcinomas of the rectum operated by an anterior resection at 84 surgical departments from 2006 to 2013. The following variables were included in the analysis; demographics, American Society of Anaesthesiologists classification, use of defunctioning stoma, tumour location and stage, administration of neoadjuvant treatment, and annual volume of elective surgical procedures. A total of 7231 consecutive patients were included. The rate of anastomotic leak was 10.0%. Stratified by annual surgical volume hospitals varied from 9.9 to 11.3%. In multilevel regression analysis, the risk of anastomotic leak increased in male patients, in patients with tumours located below 12 cm from the anal verge, and advanced tumour stages. However, a defunctioning stoma seemed to prevent this complication. Hospital surgical volume was not associated with anastomotic leak (OR: 0.852, [0.487-1.518]; P=.577). Furthermore, there was a statistically significant variation in anastomotic leak between all departments (MOR: 1.475; [1.321-1.681]; P<0.001). Anastomotic leak varies significantly among hospitals included in the project and this difference cannot be attributed to the annual surgical volume. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Development of a nondestructive leak testing method utilizing the head space analyzer for ampoule products containing ethanol-based solutions.

PubMed

Sudo, Hirotaka; O'driscoll, Michael; Nishiwaki, Kenji; Kawamoto, Yuji; Gammell, Philip; Schramm, Gerhard; Wertli, Toni; Prinz, Heino; Mori, Atsuhide; Sako, Kazuhiro

2012-01-01

The application of a head space analyzer for oxygen concentration was examined to develop a novel ampoule leak test method. Studies using ampoules filled with ethanol-based solution and with nitrogen in the headspace demonstrated that the head space analysis (HSA) method showed sufficient sensitivity in detecting an ampoule crack. The proposed method is the use of HSA in conjunction with the pretreatment of an overpressurising process known as bombing to facilitate the oxygen flow through the crack in the ampoule. The method was examined in comparative studies with a conventional dye ingress method, and the results showed that the HSA method exhibits sensitivity superior to the dye method. The results indicate that the HSA method in combination with the bombing treatment provides potential application as a leak test for the detection of container defects not only for ampoule products with ethanol-based solutions, but also for testing lyophilized products in vials with nitrogen in the head space. The application of a head space analyzer for oxygen concentration was examined to develop a novel ampoule leak test method. The proposed method is the use of head space analysis (HSA) in conjunction with the pretreatment of an overpressurising process known as bombing to facilitate oxygen flow through the crack in the ampoule for use in routine production. The result of the comparative study with a conventional dye leak test method indicates that the HSA method in combination with the bombing treatment can be used as a leak test method, enabling detection of container defects.

Is the routine use of a water-soluble contrast enema prior to closure of a loop ileostomy necessary? A review of a single institution experience.

PubMed

Dimitriou, Nikoletta; Panteleimonitis, Sofoklis; Dhillon, Ajit; Boyle, Kirsten; Norwood, Mike; Hemingway, David; Yeung, Justin; Miller, Andrew

2015-12-04

The aims of the study were to determine the radiological leak rate in those patients who had undergone a resection for left-sided colorectal cancer and to see if the presence of a leak can be related with the postoperative clinical period. We also aimed to identify any common factors between patients with leak. A retrospective analysis of prospectively collected data of all patients who underwent a left-sided colorectal cancer resection with formation of a defunctioning ileostomy was undertaken. Between 2005 and 2010, 418 such patients were identified. A water-soluble contrast enema was performed in 339 patients (81.1 %). Of these, 24 (7.1 %) were reported to show an anastomotic leak. Data for these 24 patients is presented in this study. Twenty-three (95.8 %) of the leaks occurred in patients who had undergone an anterior resection; 95.8 % of the patients with a leak were male. Fifteen (62.5 %) patients underwent neo-adjuvant radiation. The mean length of stay in those patients shown to have a subsequent radiological leak was 18.8 days (median), compared with the overall unit figures of 12 days. Only 29.2 % of the patients who had a leak identified had an uncomplicated postoperative period. Overall 87.5 % of the patients had a reversal of the ileostomy. Radiological leakage is not uncommon. The majority of patients, who were shown to have a radiological leak in this study, were male, had undergone an anterior resection, had received neo-adjuvant radiation, had a longer initial length of stay and had postoperative complications. Water-soluble contrast enemas could be selectively used in patients with these characteristics.

Experiences in Performing Posterior Calvarial Distraction.

PubMed

McMillan, Kevin; Lloyd, Mark; Evans, Martin; White, Nicholas; Nishikawa, Hiroshi; Rodrigues, Desiderio; Sharp, Melanie; Noons, Pete; Solanki, Guirish; Dover, Stephen

2017-05-01

The use of posterior calvarial distraction (PCD) for the management of craniosynostosis is well recognized. The advantages of using this technique include increased cranial volume, decreased intracranial pressure, relief of posterior fossa crowding, improved cerebrospinal fluid (CSF) circulation at the cranio-cervical junction with cessation, and possible resolution of syrinx.The authors retrospectively review their first 50 patients who have undergone PCD under the senior author's care in our unit.The demographics, diagnoses, intraoperative approach with techniques in distractor placement and outcomes of each patient were obtained through an electronic craniofacial database and written patient records. Analysis of complication rates (bleeding, distraction problems, CSF leaks, and infection) was included.A total of 31 boys and 19 girls underwent the procedure between October 2006 and September 2015 with a median age was 17.7 months (range 4 months to 19 years). Of those 50 children, 34 of the cohort were proven to be syndromic by genetic testing.The median length of inpatient stay was 9.4 days (range 3-43 days). Average distraction distance was 24 mm.Complications including CSF leaks, bleeding, distractor problems, and severe complications (recorded in 3 patients) are discussed. Our overall complication rate was 50%.Favorable outcomes included resolution of Chiari, syrinx, and raised intracranial pressure in the majority of patients where distraction was successful.The authors recommend that PCD should be considered the primary treatment for increasing calvarial volume. The authors discuss our experiences and technical innovations over the past decade.

Development of the Noise-Resistant and Sound Focusing Accessory of Ultrasonic Leak Detector for Spacecraft on Orbit

NASA Astrophysics Data System (ADS)

Sun, W.; Yan, R. X.; Sun, L. C.; Shao, R. P.

2017-12-01

Ultrasonic signal produced by the gas leak is so week that it is difficult to detect, and easily interfered. So developing the noise-resistant and sound focusing accessory for the ultrasonic leak detector is very important for improving ultrasonic leak detector sensitivity and noise-resistant capability. Based on the theory analysis of the leak ultrasonic signal reverberation and anacampsis, the 5A06 aluminium alloy and nylon were selected as the material of noise-resistant and sound focusing accessory by calculation and compare. Then the circular cone trumpet structure was design as the accessory main structure, and the nylon expansion port, nylon shrinking port and aluminium alloy expansion port structures were manufactured. The different structure characters were shown by the contrasting experiment. The results indicate that the nylon expansion circular cone trumpet structure has better sound focusing performance and it can improve the testing sound pressure amplitude 10 bigger than the detector without the accessory. And the aluminium alloy expansion circular cone trumpet structure has better noise-resistant ability than others. These conclusions are very important for the spacecraft leak detection and it can provide some references for the design of the noise-resistant and sound focusing structure.

Growth and characterization of III-V epitaxial films

NASA Astrophysics Data System (ADS)

Tripathi, A.; Adamski, J.

1991-11-01

Investigations were conducted on the growth of epitaxial layers using an Organo Metallic Chemical Vapor Deposition technique of selected III-V materials which are potentially useful for photonics and microwave devices. RL/ERX's MOCVD machine was leak checked for safety. The whole gas handling plumbing system has been leak checked and the problems were reported to the manufacturer, CVD Equipment Corporation of Dear Park, NY. CVD Equipment Corporation is making an effort to correct these problems and also supply the part according to our redesign specifications. One of the main emphasis during this contract period was understanding the operating procedure and writing an operating manual for this MOCVD machine. To study the dynamic fluid flow in the vertical reactor of this MOCVD machine, an experimental apparatus was designed, tested, and put together. This study gave very important information on the turbulent gas flow patterns in this vertical reactor. The turbulent flow affects the epitaxial growth adversely. This study will also help in redesigning a vertical reactor so that the turbulent gas flow can be eliminated.

Capillary Leak Syndrome Following Snakebite Envenomation

PubMed Central

Udayabhaskaran, V.; Arun Thomas, E. T.; Shaji, Bhagya

2017-01-01

Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases. Acute kidney injury often requiring dialysis is invariably present in all patients because of reduced renal perfusion and ischemic acute tubular necrosis as a result of hypotension. Management mainly involves aggressive fluid resuscitation to maintain adequate tissue perfusion. There are no other proven effective treatment modalities, except a few reports of successful treatment with plasmapheresis. Methylprednisolone pulse therapy, terbutaline, aminophylline, and intravenous immunoglobulin are other treatment modalities tried. PMID:29142382

State-of-the-art survey of joinability of materials for OTEC heat exchangers

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

Beaver, R. J.

1978-12-01

Literature and industrial sources were surveyed to assess, on the basis of apparent economics and reliability, the joinability of both shell-and-tube and compact ocean thermal energy conversion (OTEC) heat exchangers. A no-leak requirement is mandatory to prevent mixing seawater and the ammonia working fluid. The operating temperature range considered is 7 to 28/sup 0/C (45 to 82/sup 0/F). Materials evaluated were aluminum, titanium, copper--nickel, AL-6X austenitic stainless steel, singly and in combination with steel and concrete. Many types of welding and brazing processes, roller expansion, magnaforming, O-ring sealing, and adhesive bonding were considered. The automatic gas tungsten-arc welding process andmore » explosion welding processes are the only two joining processes that now appear to offer the high reliability required of no-leak shell-and-tube heat exchangers. Of these two processes, the gas tungsten-arc welding process appears to be the more economically attractive.« less

78 FR 25377 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

...We are adopting a new airworthiness directive (AD) for certain The Boeing Company Model 737-600, -700, -700C, -800, -900 and -900ER series airplanes. This AD was prompted by a report of leaking fuel from the wing leading edge area at the inboard end of the number 5 leading edge slat. This AD requires modifying the fluid drain path in the wing leading edge area, forward of the wing front spar, and doing all applicable related investigative and corrective actions; and installing new seal disks on the latches in the fuel shutoff valve access door. We are issuing this AD to prevent flammable fluids from accumulating in the wing leading edge, and draining inboard and onto the engine exhaust nozzle, which could result in a fire.

Turbo-alternator-compressor design for supercritical high density working fluids

DOEpatents

Wright, Steven A.; Fuller, Robert L.

2013-03-19

Techniques for generating power are provided. Such techniques involve a thermodynamic system including a housing, a turbine positioned in a turbine cavity of the housing, a compressor positioned in a compressor cavity of the housing, and an alternator positioned in a rotor cavity between the turbine and compressor cavities. The compressor has a high-pressure face facing an inlet of the compressor cavity and a low-pressure face on an opposite side thereof. The alternator has a rotor shaft operatively connected to the turbine and compressor, and is supported in the housing by bearings. Ridges extending from the low-pressure face of the compressor may be provided for balancing thrust across the compressor. Seals may be positioned about the alternator for selectively leaking fluid into the rotor cavity to reduce the temperature therein.

Low power integrated pumping and valving arrays for microfluidic systems

DOEpatents

Krulevitch, Peter A [Pleasanton, CA; Benett, William J [Livermore, CA; Rose, Klint A [Livermore, CA; Hamilton, Julie [Tracy, CA; Maghribi, Mariam [Davis, CA

2006-04-11

Low power integrated pumping and valving arrays which provide a revolutionary approach for performing pumping and valving approach for performing pumping and valving operations in microfabricated fluidic systems for applications such as medical diagnostic microchips. Traditional methods rely on external, large pressure sources that defeat the advantages of miniaturization. Previously demonstrated microfabrication devices are power and voltage intensive, only function at sufficient pressure to be broadly applicable. This approach integrates a lower power, high-pressure source with a polymer, ceramic, or metal plug enclosed within a microchannel, analogous to a microsyringe. When the pressure source is activated, the polymer plug slides within the microchannel, pumping the fluid on the opposite side of the plug without allowing fluid to leak around the plug. The plugs also can serve as microvalves.

Metallic positive expulsion diaphragms

NASA Technical Reports Server (NTRS)

Gleich, D.

1972-01-01

High-cycle life ring-reinforced hemispherical type positive expulsion diaphragm performance was demonstrated by room temperature fluid expulsion tests of 13" diameter, 8 mil thick stainless steel configurations. A maximum of eleven (11) leak-free, fluid expulsions were achieved by a 25 deg cone angle diaphragm hoop-reinforced with .110-inch cross-sectional diameter wires. This represents a 70% improvement in diaphragm reversal cycle life compared to results previously obtained. The reversal tests confirmed analytic predictions for diaphragm cycle life increases due to increasing values of diaphragm cone angle, radius to thickness ratio and material strain to necking capacity. Practical fabrication techniques were demonstrated for forming close-tolerance, thin corrugated shells and for obtaining closely controlled reinforcing ring stiffness required to maximize diaphragm cycle life. A non-destructive inspection technique for monitoring large local shell bending strains was developed.

An on-line acoustic fluorocarbon coolant mixture analyzer for the ATLAS silicon tracker

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

Bates, R.; Battistin, M.; Berry, S.

2011-07-01

The ATLAS silicon tracker community foresees an upgrade from the present octafluoro-propane (C{sub 3}F{sub 8}) evaporative cooling fluid - to a composite fluid with a probable 10-20% admixture of hexafluoro-ethane (C{sub 2}F{sub 6}). Such a fluid will allow a lower evaporation temperature and will afford the tracker silicon substrates a better safety margin against leakage current-induced thermal runaway caused by cumulative radiation damage as the luminosity profile at the CERN Large Hadron Collider increases. Central to the use of this new fluid is a new custom-developed speed-of-sound instrument for continuous real-time measurement of the C{sub 3}F{sub 8}/C{sub 2}F{sub 6} mixturemore » ratio and flow. An acoustic vapour mixture analyzer/flow meter with new custom electronics allowing ultrasonic frequency transmission through gas mixtures has been developed for this application. Synchronous with the emission of an ultrasound 'chirp' from an acoustic transmitter, a fast readout clock (40 MHz) is started. The clock is stopped on receipt of an above threshold sound pulse at the receiver. Sound is alternately transmitted parallel and anti-parallel with the vapour flow for volume flow measurement from transducers that can serve as acoustic transmitters or receivers. In the development version, continuous real-time measurement of C{sub 3}F{sub 8}/C{sub 2}F{sub 6} flow and calculation of the mixture ratio is performed within a graphical user interface developed in PVSS-II, the Supervisory, Control and Data Acquisition standard chosen for LHC and its experiments at CERN. The described instrument has numerous potential applications - including refrigerant leak detection, the analysis of hydrocarbons, vapour mixtures for semiconductor manufacture and anesthetic gas mixtures. (authors)« less

An On-Line Acoustic Fluorocarbon Coolant Mixture Analyzer for the ATLAS Silicon Tracker

NASA Astrophysics Data System (ADS)

Bates, R.; Battistin, M.; Berry, S.; Bitadze, A.; Bonneau, P.; Bousson, N.; Boyd, G.; Botelho-Direito, J.; DiGirolamo, B.; Doubek, M.; Egorov, K.; Godlewski, J.; Hallewell, G.; Katunin, S.; Mathieu, M.; McMahon, S.; Nagai, K.; Perez-Rodriguez, E.; Rozanov, A.; Vacek, V.; Vitek, M.

2012-10-01

The ATLAS silicon tracker community foresees an upgrade from the present octafluoropropane (C3F8) evaporative cooling fluid to a composite fluid with a probable 10-20% admixture of hexafluoroethane (C2F6). Such a fluid will allow a lower evaporation temperature and will afford the tracker silicon substrates a better safety margin against leakage current-induced thermal runaway caused by cumulative radiation damage as the luminosity profile at the CERN Large Hadron Collider increases. Central to the use of this new fluid is a new custom-developed speed-of-sound instrument for continuous real-time measurement of the C3F8/C2F6 mixture ratio and flow. An acoustic vapour mixture analyzer/flow meter with new custom electronics allowing ultrasonic frequency transmission through gas mixtures has been developed for this application. Synchronous with the emission of an ultrasound `chirp' from an acoustic transmitter, a fast readout clock (40 MHz) is started. The clock is stopped on receipt of an above threshold sound pulse at the receiver. Sound is alternately transmitted parallel and anti-parallel with the vapour flow for volume flow measurement from transducers that can serve as acoustic transmitters or receivers. In the development version, continuous real-time measurement of C3F8/C2F6 flow and calculation of the mixture ratio is performed within a graphical user interface developed in PVSS-II, the Supervisory, Control and Data Acquisition standard chosen for LHC and its experiments at CERN. The described instrument has numerous potential applications - including refrigerant leak detection, the analysis of hydrocarbons, vapour mixtures for semi-conductor manufacture and anesthetic gas mixtures.

Self-Expanding Metal Stents for the Treatment of Post-Surgical Esophageal Leaks: A Tertiary Referral Center Experience.

PubMed

Anderloni, Andrea; Genco, Chiara; Massidda, Marco; Di Leo, Milena; Fumagalli, Uberto Romario; Rosati, Riccardo; Correale, Loredana; Maselli, Roberta; Ferrara, Elisa Chiara; Jovani, Manol; Repici, Alessandro

2018-06-05

The study aimed to evaluate the effectiveness and safety of self-expanding metal stents (SEMS) in the management of post-surgical esophageal leaks. Retrospective data of consecutive patients with a post-surgical esophageal leak treated by means of a metal stent between January 2008 and December 2014 at the Humanitas Research Hospital (Milan, Italy) were extracted from a prospectively maintained register of SEMS used for benign indications, such as post-surgical benign esophageal strictures and/or leaks. The primary outcome of the study was to assess the rate of successful leak closure and to identify the variables associated with its achievement. As a secondary outcome, we evaluated the overall safety of SEMS placement and the efficacy and safety for different types of SEMS in this specific setting of patients. Leak resolution was documented with endoscopic and/or imaging studies. In the case of leak persistence, further attempts of esophageal stenting were carried out at the discretion of both endoscopists and surgeons. A total of 49 patients were included in the study (men 41 of 49, 83.7%, mean age 62.4 ± 11.9). One patient was excluded from analysis, because of death 1 day after stent insertion due to worsening of pre-existing mediastinitis. A total number of 82 stents were placed (mean number of stents per patient: 1.7) in 49 patients: 35 patients (71.4%) received a partially covered SEMS (PCSEMS) as the first stent positioned, while the remaining 14 (28.6%) received a fully covered SEMS (FCSEMS); but 1 patient (2%) died following stent insertion; therefore, data regarding therapeutic success were available for 48 patients. Stents were left in place for a mean period of 21.9 ± 15.2 days. Leak closure after the first stent placement was achieved in 22 of 48 (45.8%) patients. Of the 26 patients with failure of index stent placement, 18 patients underwent further stenting attempts (69.2%), and secondary closure of leak was achieved in 7 (38.9%) of these 18 patients. Thus, the overall success rate was 60.5% (29 of 48). On the basis of stent type, the success rate was 57.1% (8 of 14) for FCSEMS and 64.7% (22 of 34) for PCSEMS. Logistic regression analysis did not find any significant association between successful leak closure and analyzed variables. Overall mortality was 13.0%. Complication rate was 38.8% (19 of 49 patients). The use of SEMS is an effective and safe option for post-surgical esophageal leaks, with no evidence of any significant influence of stent type on outcome. © 2018 S. Karger AG, Basel.

How secure is subsurface CO2 storage? Controls on leakage in natural CO2 reservoirs

NASA Astrophysics Data System (ADS)

Miocic, Johannes; Gilfillan, Stuart; McDermott, Christopher; Haszeldine, Stuart

2014-05-01

Carbon Capture and Storage (CCS) is the only industrial scale technology available to directly reduce carbon dioxide (CO2) emissions from fossil fuelled power plants and large industrial point sources to the atmosphere. The technology includes the capture of CO2 at the source and transport to subsurface storage sites, such as depleted hydrocarbon reservoirs or saline aquifers, where it is injected and stored for long periods of time. To have an impact on the greenhouse gas emissions it is crucial that there is no or only a very low amount of leakage of CO2 from the storage sites to shallow aquifers or the surface. CO2 occurs naturally in reservoirs in the subsurface and has often been stored for millions of years without any leakage incidents. However, in some cases CO2 migrates from the reservoir to the surface. Both leaking and non-leaking natural CO2 reservoirs offer insights into the long-term behaviour of CO2 in the subsurface and on the mechanisms that lead to either leakage or retention of CO2. Here we present the results of a study on leakage mechanisms of natural CO2 reservoirs worldwide. We compiled a global dataset of 49 well described natural CO2 reservoirs of which six are leaking CO2 to the surface, 40 retain CO2 in the subsurface and for three reservoirs the evidence is inconclusive. Likelihood of leakage of CO2 from a reservoir to the surface is governed by the state of CO2 (supercritical vs. gaseous) and the pressure in the reservoir and the direct overburden. Reservoirs with gaseous CO2 is more prone to leak CO2 than reservoirs with dense supercritical CO2. If the reservoir pressure is close to or higher than the least principal stress leakage is likely to occur while reservoirs with pressures close to hydrostatic pressure and below 1200 m depth do not leak. Additionally, a positive pressure gradient from the reservoir into the caprock averts leakage of CO2 into the caprock. Leakage of CO2 occurs in all cases along a fault zone, indicating that faults play a major role when it comes to fluid migration from a reservoir. However, nearly 50% of the non-leaking studied reservoirs are also fault bound, demonstrating that faults are not always necessarily leakage pathways.

Economic optimization of the energy transport component of a large distributed solar power plant

NASA Technical Reports Server (NTRS)

Turner, R. H.

1976-01-01

A solar thermal power plant with a field of collectors, each locally heating some transport fluid, requires a pipe network system for eventual delivery of energy power generation equipment. For a given collector distribution and pipe network geometry, a technique is herein developed which manipulates basic cost information and physical data in order to design an energy transport system consistent with minimized cost constrained by a calculated technical performance. For a given transport fluid and collector conditions, the method determines the network pipe diameter and pipe thickness distribution and also insulation thickness distribution associated with minimum system cost; these relative distributions are unique. Transport losses, including pump work and heat leak, are calculated operating expenses and impact the total system cost. The minimum cost system is readily selected. The technique is demonstrated on six candidate transport fluids to emphasize which parameters dominate the system cost and to provide basic decision data. Three different power plant output sizes are evaluated in each case to determine severity of diseconomy of scale.

Rubber contact mechanics: adhesion, friction and leakage of seals.

PubMed

Tiwari, A; Dorogin, L; Tahir, M; Stöckelhuber, K W; Heinrich, G; Espallargas, N; Persson, B N J

2017-12-13

We study the adhesion, friction and leak rate of seals for four different elastomers: Acrylonitrile Butadiene Rubber (NBR), Ethylene Propylene Diene (EPDM), Polyepichlorohydrin (GECO) and Polydimethylsiloxane (PDMS). Adhesion between smooth clean glass balls and all the elastomers is studied both in the dry state and in water. In water, adhesion is observed for the NBR and PDMS elastomers, but not for the EPDM and GECO elastomers, which we attribute to the differences in surface energy and dewetting. The leakage of water is studied with rubber square-ring seals squeezed against sandblasted glass surfaces. Here we observe a strongly non-linear dependence of the leak rate on the water pressure ΔP for the elastomers exhibiting adhesion in water, while the leak rate depends nearly linearly on ΔP for the other elastomers. We attribute the non-linearity to some adhesion-related phenomena, such as dewetting or the (time-dependent) formation of gas bubbles, which blocks fluid flow channels. Finally, rubber friction is studied at low sliding speeds using smooth glass and sandblasted glass as substrates, both in the dry state and in water. The measured friction coefficients are compared to theory, and the origin of the frictional shear stress acting in the area of real contact is discussed. The NBR rubber, which exhibits the strongest adhesion both in the dry state and in water, also shows the highest friction both in the dry state and in water.

Panorama of Reconstruction of Skull Base Defects: From Traditional Open to Endonasal Endoscopic Approaches, from Free Grafts to Microvascular Flaps

PubMed Central

Reyes, Camilo; Mason, Eric; Solares, C. Arturo

2014-01-01

Introduction A substantial body of literature has been devoted to the distinct characteristics and surgical options to repair the skull base. However, the skull base is an anatomically challenging location that requires a three-dimensional reconstruction approach. Furthermore, advances in endoscopic skull base surgery encompass a wide range of surgical pathology, from benign tumors to sinonasal cancer. This has resulted in the creation of wide defects that yield a new challenge in skull base reconstruction. Progress in technology and imaging has made this approach an internationally accepted method to repair these defects. Objectives Discuss historical developments and flaps available for skull base reconstruction. Data Synthesis Free grafts in skull base reconstruction are a viable option in small defects and low-flow leaks. Vascularized flaps pose a distinct advantage in large defects and high-flow leaks. When open techniques are used, free flap reconstruction techniques are often necessary to repair large entry wound defects. Conclusions Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors associated with high-flow cerebrospinal fluid leaks. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can befall after these procedures need to be considered. Although endonasal techniques are being used with increasing frequency, open techniques are still necessary in selected cases. PMID:25992142

Repeated helicopter-based surveys of fugitive hydrocarbon emissions from tight oil operations: Persistence and driving factors

NASA Astrophysics Data System (ADS)

Englander, J. G.; Brandt, A. R.; Jackson, R. B.; Alvarez, R.; Lyon, D. R.

2016-12-01

A recent study used helicopters and optical gas imaging (infrared-based) to study hydrocarbon leaks [1] across numerous oil and gas producing basins. The appearance of leaks appeared to have small statistical correlations with factors such as age of wells, production rate, or water production. However, there have not been few if any attempts to observe the presence of leaks over time. In this work, we used the same helicopter-based optical gas imaging techniques to revisit wells in the Bakken formation that had previously been measured in 2014 [1] In this study, we visited 353 of the total 683 well pads in Bakken from the original study, and we also visited 50 randomly selected well pads that were newly developed between studies. We first examine the presence of leaks as a function of different factors, including: operator, number of wells, tanks, and treaters on a well pad; and numerous other possible emissions drivers. In addition, using the previous years observations as our prior, we conducted a Bayesian analysis to determine the likelihood of finding a leaking or non-leaking well pad and compared the observations to a Monte Carlo simulation of randomly distributed leaks. We find that the overall prevalence of observed emissions was similar for each year (11% for 2014 observations and 10% for 2015 observations). We also find whether a pad was found to be leaking in the first observation year had a statistically significant influence (4.9σ) on the presence of a leak in the following observation year. Similar levels of persistence are also apparent for non-leaking well pads. [1] D. R. Lyon, R. A. Alvarez, D. Zavala-Araiza, A. R. Brandt, R. B. Jackson, and S. P. Hamburg, "Aerial surveys of elevated hydrocarbon emissions from oil and gas production sites," Environ. Sci. Technol., p. acs.est.6b00705, Apr. 2016.

Transthoracic Anastomotic Leak After Esophagectomy: Current Trends.

PubMed

Ryan, Carrie E; Paniccia, Alessandro; Meguid, Robert A; McCarter, Martin D

2017-01-01

Leaks from intrathoracic esophagogastric anastomosis are thought to be associated with higher rates of morbidity and mortality than leaks from cervical anastomosis. We challenge this assumption and hypothesize that there is no significant difference in mortality based on the location of the esophagogastric anastomosis. A systematic literature search was conducted using PubMed and Embase databases on all studies published from January 2000 to June 2015, comparing transthoracic (TTE) and transhiatal (THE) esophagectomies. Studies using jejunal or colonic interposition were excluded. Outcomes analyzed were leak rate, leak-associated mortality, overall 30-day mortality, and overall morbidity. Meta-analyses were performed using Mantel-Haenszel statistical analyses on studies reporting leak rates of both approaches. Nominal data are presented as frequency and interquartile range (IQR); measures of the association between treatments and outcomes are presented as odds ratio (OR) with 95 % confidence interval. Twenty-one studies (3 randomized controlled trials) were analyzed comprising of 7167 patients (54 % TTE). TTE approach yields a lower anastomotic leak rate (9.8 %; IQR 6.0-12.2 %) than THE (12 %; IQR 11.6-22.1 %; OR 0.56 [0.34-0.92]), without any significant difference in leak associated mortality (7.1 % TTE vs. 4.6 % THE: OR 1.83 [0.39-8.52]). There was no difference in overall 30-day mortality (3.9 % TTE vs. 4.3 % THE; OR 0.86 [0.66-1.13]) and morbidity (59.0 % TTE vs. 66.6 % THE; OR 0.76 [0.37-1.59]). Based on meta-analysis, TTE is associated with a lower leak rate and does not result in higher morbidity or mortality than THE. The previously assumed higher rate of transthoracic anastomotic leak-associated mortality is overstated, thus supporting surgeon discretion and other factors to influence the choice of thoracic versus cervical anastomosis.

Rapid Surface Detection of CO2 Leaks from Geologic Sequestration Sites

NASA Astrophysics Data System (ADS)

Moriarty, D. M.; Krevor, S. C.; Benson, S. M.

2013-12-01

Carbon sequestration is becoming a viable option for global CO2 mitigation but effective monitoring methods are needed assure the carbon dioxide stays underground. Above surface monitoring using a mobile gas analyzer is one such method (e.g. Krevor et al., 2010). The Picarro gas analyzer uses wavelength-scanned cavity ring down spectroscopy to accurately identify concentrations of various atmospheric gases including their isotopic composition. These measurements can then be used for anomaly (leak) detection and source attribution. Leaks are detected by anomalous absolute concentration of CO2 and anomalous δ13C values. Source attribution is determined by the isotopic concentrations of the identified leaking gas. To distinguish between noise from ambient signals and leaks, a method based on mixing ratios has been developed. A newly acquired data set presented here has been collected from a 3.7km2 area with naturally occurring CO2 springs near Green River, Utah. All of the areas of known leakage were readily detected using this method along with several other areas that showed significant signs of leakage. In addition, testing on the Stanford campus has shown that this method is sensitive enough to distinguish between open fields and roadways. Another data set is being collected at Montana State University at the ZERT monitoring test site where an artificial leak has been created for the purpose of testing leak detection and quantification methods. Data collected from this site are being used for (1) assessing of detection levels and how they depend on environmental parameters such as wind speed, and acquisition variables such as sample rate and traverse speed, (2) optimizing acquisition parameters to increase detection levels and increase confidence in leak detection, (3) evaluating the potential for quantifying the magnitude of the leak and (4) spatial data analysis to identify the most probable leak locations.

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

Yang, Kyoung Mo; Jee, Kye Kwang; Pyo, Chang Ryul

The basis of the leak before break (LBB) concept is to demonstrate that piping will leak significantly before a double ended guillotine break (DEGB) occurs. This is demonstrated by quantifying and evaluating the leak process and prescribing safe shutdown of the plant on the basis of the monitored leak rate. The application of LBB for power plant design has reduced plant cost while improving plant integrity. Several evaluations employing LBB analysis on system piping based on DEGB design have been completed. However, the application of LBB on main steam (MS) piping, which is LBB applicable piping, has not been performedmore » due to several uncertainties associated with occurrence of steam hammer and dynamic strain aging (DSA). The objective of this paper is to demonstrate the applicability of the LBB design concept to main steam lines manufactured with SA106 Gr.C carbon steel. Based on the material properties, including fracture toughness and tensile properties obtained from the comprehensive material tests for base and weld metals, a parametric study was performed as described in this paper. The PICEP code was used to determine leak size crack (LSC) and the FLET code was used to perform the stability assessment of MS piping. The effects of material properties obtained from tests were evaluated to determine the LBB applicability for the MS piping. It can be shown from this parametric study that the MS piping has a high possibility of design using LBB analysis.« less

Tectonic impact on the dynamics of CO2-rich fluid migration in Utah

NASA Astrophysics Data System (ADS)

Nadine, E. Z.; Jean Luc, F.; Remy, D.; Battani, A.; Olivier, V.

2009-12-01

With the objective to rank the first order parameters acting in the long term CO2 storage, IFP is developing an integrated study based on the analytical results around the natural silici-clastic analogue of the Colorado Plateau in Utah. What are the dominant parameters which governed the fluid/gas migration in front of the Sevier fold-and-thrust Belt, particularly the CO2-enriched ones? Several sites have been investigated in Utah and Idaho provinces; in the Colorado Plateau, East and in front of the Sevier fold-and-thrust belt, as well as in the Basin & Range geological province North and South West of Salt Lake city (Sevier basin). As a first site selection, three distinct structural provinces have been analysed depending on their seal/reservoir characteristics for confinement: the Green River leaking area (Utah), where large WNW-ESE faults (Salt Wash, Little Wash F...) show several water, oil and gas (CO2, HC) seepages; the Basin & Range province (Utah & Idaho provinces) where low-angle normal faults are seismically active (leaking locally); and the Canyonlands zone (Utah), south of the Moab fault, where the system is well confined. The migration pathways used by composite gas and particularly CO2-enriched fluids (in the Green River area) combined with a reducing agent are locally easily recognisable by the bleaching effect where some reservoir levels or the faults pathways have been flushed. The architecture of the paleo and active fluid migration network can thus be mapped. As a second selective ranking, natural gas have been sampled either from oil/gas producing wells in the Moab area and Ferron Valley, or from natural seepages along leaking fault sections or from geysers along the Green-River fault system. The results, based on noble gas isotope analyses (Battani et al, AGU fall meeting 2009) show that 3 distinct provinces can be "isolated", either marked by the occurrence of mantle-derived CO2, or mixed mantle/crustal CO2 signature of varying ratio. How to explain the existence of these distinct provinces? Is it due to the physical properties of the reservoirs, to the evolution of the fracture and fault patterns changing through time in connection with paleostress fields, to the occurrence of a thick salt pillow in the Moab area which has driven the tectonic style and played as local seal, to the shale sealing properties when PCO2 increased at depth to the physical phase of the CO2 during migration or storage (dissolved, super-critical or gas), or finally to the seismic cyclicity. A possible strong linkage between the seismicity and the volcanic activity, corresponding to large CO2-rich gas expel, have been investigated. In order to constrain the architecture of the deep buried reservoirs and traps we analyzed the deformation through analogue models, the models have been acquired with X-Ray tomography at IFP. These parameters have been analysed for the three investigated areas, allowing to propose an integrated model of the local circulation and/or storage of the CO2-enriched fluid for each area.

Intestinal Tissues Induce an SNP Mutation in Pseudomonas aeruginosa That Enhances Its Virulence: Possible Role in Anastomotic Leak

PubMed Central

Olivas, Andrea D.; Shogan, Benjamin D.; Valuckaite, Vesta; Zaborin, Alexander; Belogortseva, Natalya; Musch, Mark; Meyer, Folker; L.Trimble, William; An, Gary; Gilbert, Jack

2012-01-01

The most feared complication following intestinal resection is anastomotic leakage. In high risk areas (esophagus/rectum) where neoadjuvant chemoradiation is used, the incidence of anastomotic leaks remains unacceptably high (∼10%) even when performed by specialist surgeons in high volume centers. The aims of this study were to test the hypothesis that anastomotic leakage develops when pathogens colonizing anastomotic sites become in vivo transformed to express a tissue destroying phenotype. We developed a novel model of anastomotic leak in which rats were exposed to pre-operative radiation as in cancer surgery, underwent distal colon resection and then were intestinally inoculated with Pseudomonas aeruginosa, a common colonizer of the radiated intestine. Results demonstrated that intestinal tissues exposed to preoperative radiation developed a significant incidence of anastomotic leak (>60%; p<0.01) when colonized by P. aeruginosa compared to radiated tissues alone (0%). Phenotype analysis comparing the original inoculating strain (MPAO1- termed P1) and the strain retrieved from leaking anastomotic tissues (termed P2) demonstrated that P2 was altered in pyocyanin production and displayed enhanced collagenase activity, high swarming motility, and a destructive phenotype against cultured intestinal epithelial cells (i.e. apoptosis, barrier function, cytolysis). Comparative genotype analysis between P1 and P2 revealed a single nucleotide polymorphism (SNP) mutation in the mexT gene that led to a stop codon resulting in a non-functional truncated protein. Replacement of the mutated mexT gene in P2 with mexT from the original parental strain P1 led to reversion of P2 to the P1 phenotype. No spontaneous transformation was detected during 20 passages in TSB media. Use of a novel virulence suppressing compound PEG/Pi prevented P. aeruginosa transformation to the tissue destructive phenotype and prevented anastomotic leak in rats. This work demonstrates that in vivo transformation of microbial pathogens to a tissue destroying phenotype may have important implications in the pathogenesis of anastomotic leak. PMID:22952955

Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

PubMed

Salusjärvi, Johannes M; Carpelan-Holmström, Monika A; Louhimo, Johanna M; Kruuna, Olli; Scheinin, Tom M

2018-03-01

An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications. 2.3 times more operated anastomotic leaks occurred when the colonic StO 2 was ≤ 90% (11/129 vs 11/293). The mean colonic StO 2 was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO 2 values ≤ 90%. Low intraoperative colonic StO 2 values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.

U-tube based near-surface environmental monitoring in the Shenhua carbon dioxide capture and storage (CCS) project.

PubMed

Li, Qi; Song, Ranran; Shi, Hui; Ma, Jianli; Liu, Xuehao; Li, Xiaochun

2018-04-01

The CO 2 injected into deep formations during implementation of carbon dioxide (CO 2 ) capture and storage (CCS) technology may leak and migrate into shallow aquifers or ground surfaces through a variety of pathways over a long period. The leaked CO 2 can threaten shallow environments as well as human health. Therefore, almost all monitoring programs for CCS projects around the world contain near-surface monitoring. This paper presents a U-tube based near-surface monitoring technology focusing on its first application in the Shenhua CCS demonstration project, located in the Ordos Basin, Inner Mongolia, China. First, background information on the site monitoring program of the Shenhua CCS demonstration project was provided. Then, the principle of fluid sampling and the monitoring methods were summarized for the U-tube sampler system, and the monitoring data were analyzed in detail. The U-tube based monitoring results showed that the U-tube sampler system is accurate, flexible, and representative of the subsurface fluid sampling process. The monitoring indicators for the subsurface water and soil gas at the Shenhua CCS site indicate good stratification characteristics. The concentration level of each monitoring indicator decreases with increasing depth. Finally, the significance of this near-surface environmental monitoring technology for CO 2 leakage assessments was preliminarily confirmed at the Shenhua CCS site. The application potential of the U-tube based monitoring technology was also demonstrated during the subsurface environmental monitoring of other CCS projects.

Transmastoid approach to temporal bone cerebrospinal fluid leaks.

PubMed

Oliaei, Sepehr; Mahboubi, Hossein; Djalilian, Hamid R

2012-01-01

The aim of the study was to evaluate various presentations and treatment options for spontaneous cerebrospinal fluid (CSF) leakage originating in the temporal bone. Clinical data and imaging results for 18 ears (15 patients) presenting with spontaneous CSF leakage originating in the temporal bone were reviewed. Average follow-up period was 13.5 months. The main outcome measure was presence of persistent CSF leak postoperatively. A standard postauricular mastoidectomy was performed. Fifteen patients diagnosed with spontaneous CSF leakage over an 8-year period including 3 treated for bilateral disease were included in the study. The age ranged between 33 and 83 years. Presenting symptoms included serous otitis media (44%), persistent otorrhea after tympanostomy tube placement (28%), and meningitis (28%). Preoperative diagnosis was made using imaging studies and was substantiated by observation of CSF leakage and dural herniation intraoperatively. Treatment was eustachian tube plugging (5%), mastoidectomy with fat obliteration (61%), middle fossa approach with extradural (17%), intradural repair (5%), or combined middle fossa and transmastoid (TM) approach (11%). Successful treatment was obtained in 17 of the 18 cases. The last 9 patients in the series underwent TM approach alone for repair with no treatment failures. Repair of defects in tegmen mastoideum and posterior fossa can be successfully achieved on an outpatient basis without regard to size and multitude of defects via TM approach. This approach obviates the need for a craniotomy or lumbar drain. Copyright © 2012 Elsevier Inc. All rights reserved.

Application of a new collagen-based sealant for the treatment of pancreatic injury.

PubMed

Rosen, Michael; Walsh, R Matthew; Goldblum, John R

2004-08-01

Pancreatic injury is the most frequent serious morbidity that can occur following laparoscopic splenectomy. The presumed mechanism of injury is direct trauma to the pancreatic tail during hilar dissection or transection with endovascular staplers. It was our aim to study the direct application of topical sealants to a pancreatic injury to prevent a pancreatic leak. A porcine model of pancreatic injury in a normal pancreas was developed. Fourteen animals underwent midline laparotomy and subtotal (8 cm) distal pancreatectomy. The pancreas was sharply divided and minimal cauterization used. A (1/4)-inch round Jackson Pratt drain was secured to the pancreatic stump in all animals. The control group (n = 7) underwent no further treatment. Two groups underwent treatment with a sealant. Group 1 (n = 3) had a hydrogel applied to the pancreatic remnant. Group 2 (n = 4) had a biodegradable sealant of PEG (polyethylene glycol)-collagen formulation applied to the pancreatic stump by aerosol. During the postoperative period, animals were fed 2.2 lb/d of a high fat (10% lard) diet to stimulate pancreatic exocrine function. Total daily drain outputs were recorded, and drain amylase content and serum amylase concentration were measured on postoperative days 3, 7, and 10. A significant pancreatic leak was defined as a drain to serum amylase content of greater than 3:1. Animals were killed on day 10 and explored for undrained fluid collections. The pancreas was removed for histologic evaluation. Control and treatment groups were compared using repeated measures ANOVA of log-transformed data. All animals survived until elective necropsy. In group 1, average total drain outputs were not significantly less than the controls (125 mL versus 269; P = .66). The mean drain/serum amylase concentration on days 3, 7, and 10 were not significantly different between group 1 and the control group. Group 2 had significantly less overall average drainage output than controls (40 mL versus 269 mL; P = .0006). Furthermore, group 2 had a significant reduction in pancreatic leaks on days 3, 7, and 10 as measured by mean drain/serum amylase concentration. No undrained fluid collections were identified at autopsy. Based on our experimental porcine model, a novel collagen-based, biodegradable hydrogel can prevent a ductal leak following pancreatic injury. These encouraging data have fostered application by aerosol treatment to the hilar bed at laparoscopic splenectomy to diminish capsular disruption from mechanical injury.

Prediction of magnitude of minimum horizontal stress from extended leak-off test conducted by the riser vessel CHIKYU

NASA Astrophysics Data System (ADS)

Lin, W.; Masago, H.; Yamamoto, K.; Kawamura, Y.; Saito, S.; Kinoshita, M.

2007-12-01

By means of introduction of the drilling vessel 'CHIKYU', riser drilling operations using mud fluid will be carried out in NanTroSEIZE Stage 2 for the first time as an oceanic scientific-drilling. For determining drilling operation parameter such as a mud density, a downhole experiment, leak-off test (LOT) or extended leak-off test (XLOT), is going to be implemented next to casing and cementing at each casing shoe during the drilling process. Data of the downhole experiment aimed for operation can also be used for an important scientific application to obtain in-situ stress information which is necessary for various cases of scientific drillings such as seismogenic zone drillings etc. In order to examine feasibility of the application of the LOT or XLOT data, we analyzed an example of XLOT conducted by the riser vessel CHIKYU during its Shimokita shakedown cruise, 2006; and then estimated magnitude of minimum principal stress in horizontal plane, Shmin. Moreover, we will propose the test procedures to possibly improve the quality of stress result from the applications of LOT or XLOT. The XLOT of Shimokita cruise was conducted under following conditions; 1180 m water depth, 525 mbsf (meter below seafloor) depth, 1030 kg/m3 fluid density (seawater) and 80 litter/min injection flow-rate. Estimated magnitude of the Shmin is equal to 18.3 MPa based on the assumption that fracture closure pressure balances with the minimum principal stress perpendicular to the fracture plane. For comparison, the vertical stress magnitude at the depth was estimated from density profile of core samples retrieved from the same borehole; and was equal to 20 MPa approximately. These two values can be considered to be not disagreement. Therefore, we can say that the XLOT data is valuable and practical for estimating the magnitude of minimum horizontal stress. From the viewpoint of determining stress magnitude, the XLOT is more essential rather than the LOT because it might be hardly to obtain reliable Shmin magnitude only by leak-off pressure which is exclusive stress-related parameter obtained from the latter. In addition, implementation of the LOT/XLOT multi-cycles (3 cycles) is preferable if possible. The first cycle with a lower maximum injection pressure is for knowing permeable property of the formation and for examining whether there is pre-existing fracture(s). The second cycle is a normal XLOT; and the third one is the repeat of the second one for confirm the pressure values obtained from the XLOTs.

Pharmaceutical container/closure integrity. II: The relationship between microbial ingress and helium leak rates in rubber-stoppered glass vials.

PubMed

Kirsch, L E; Nguyen, L; Moeckly, C S; Gerth, R

1997-01-01

Helium leak rate measurements were quantitatively correlated to the probability of microbial ingress for rubber-stoppered glass vials subjected to immersion challenge. Standard 10-mL tubing glass vials were modified by inserting micropipettes of various sizes (0.1 to 10 microns nominal diameter) into a side wall hole and securing them with epoxy. Butyl rubber closures and aluminum crimps were used to seal the vials. The test units were sealed in a helium-filled glove bag, then the absolute helium leak rates were determined. The test units were disassembled, filled with media, resealed, and autoclaved. The test units were thermally treated to eliminate airlocks within the micropipette lumen and establish a liquid path between microbial challenge media and the test units' contents. Microbial challenge was performed by immersing the test units in a 35 degrees C bath containing magnesium ion and 8 to 10 logs of viable P. diminuta and E. coli for 24 hours. The test units were then incubated at 35 degrees C for an additional 13 days. Microbial ingress was detected by turbidity and plating on blood agar. The elimination of airlocks was confirmed by the presence of magnesium ions in the vial contents by atomic absorption spectrometry. A total of 288 vials were subjected to microbial challenge testing. Those test units whose contents failed to show detectable magnesium ions were eliminated from further analysis. At large leak rates, the probability of microbial ingress approached 100% and at very low leak rates microbial ingress rates were 0%. A dramatic increase in microbial failure occurred in the leak rate region 10(-4.5) to 10(-3) std cc/sec, which roughly corresponded to leak diameters ranging from 0.4 to 2 microns. Below a leak rate of 10(-4.5) std cc/sec the microbial failure rate was < 10%. The critical leak rate in our studies, i.e. the value below which microbial ingress cannot occur because the leak is too small, was observed to be between 10(-5) and 10(-5.8) std cc/sec, which corresponds to an approximate leak diameter of 0.2-0.3 micron.

Single-Shell Tanks Leak Integrity Elements/ SX Farm Leak Causes and Locations - 12127

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

Girardot, Crystal; Harlow, Don; Venetz, Theodore

2012-07-01

Washington River Protection Solutions, LLC (WRPS) developed an enhanced single-shell tank (SST) integrity project in 2009. An expert panel on SST integrity was created to provide recommendations supporting the development of the project. One primary recommendation was to expand the leak assessment reports (substitute report or LD-1) to include leak causes and locations. The recommendation has been included in the M-045-91F Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) as one of four targets relating to SST leak integrity. The 241-SX Farm (SX Farm) tanks with leak losses were addressed on an individual tank basis as part of LD-1.more » Currently, 8 out of 23 SSTs that have been reported to having a liner leak are located in SX Farm. This percentage was the highest compared to other tank farms which is why SX Farm was analyzed first. The SX Farm is comprised of fifteen SSTs built 1953-1954. The tanks are arranged in rows of three tanks each, forming a cascade. Each of the SX Farm tanks has a nominal 1-million-gal storage capacity. Of the fifteen tanks in SX Farm, an assessment reported leak losses for the following tanks: 241-SX-107, 241-SX-108, 241-SX-109, 241-SX- 111, 241-SX-112, 241-SX-113, 241-SX-114 and 241-SX-115. The method used to identify leak location consisted of reviewing in-tank and ex-tank leak detection information. This provided the basic data identifying where and when the first leaks were detected. In-tank leak detection consisted of liquid level measurement that can be augmented with photographs which can provide an indication of the vertical leak location on the sidewall. Ex-tank leak detection for the leaking tanks consisted of soil radiation data from laterals and dry-wells near the tank. The in-tank and ex-tank leak detection can provide an indication of the possible leak location radially around and under the tank. Potential leak causes were determined using in-tank and ex-tank information that is not directly related to leak detection. In-tank parameters can include temperature of the supernatant and sludge, types of waste, and chemical determination by either transfer or sample analysis. Ex-tank information can be assembled from many sources including design media, construction conditions, technical specifications, and other sources. Five conditions may have contributed to SX Farm tank liner failure including: tank design, thermal shock, chemistry-corrosion, liner behavior (bulging), and construction temperature. Tank design did not apparently change from tank to tank for the SX Farm tanks; however, there could be many unknown variables present in the quality of materials and quality of construction. Several significant SX Farm tank design changes occurred from previous successful tank farm designs. Tank construction occurred in winter under cold conditions which could have affected the ductile to brittle transition temperature of the tanks. The SX Farm tanks received high temperature boiling waste from REDOX which challenged the tank design with rapid heat up and high temperatures. All eight of the leaking SX Farm tanks had relatively high rate of temperature rise. Supernatant removal with subsequent nitrate leaching was conducted in all but three of the eight leaking tanks prior to leaks being detected. It is possible that no one characteristic of the SX Farm tanks could in isolation from the others have resulted in failure. However, the application of so many stressors - heat up rate, high temperature, loss of corrosion protection, and tank design working jointly or serially resulted in their failure. Thermal shock coupled with the tank design, construction conditions, and nitrate leaching seem to be the overriding factors that can lead to tank liner failure. The distinction between leaking and sound SX Farm tanks seems to center on the waste types, thermal conditions, and nitrate leaching. (authors)« less

SINGLE-SHELL TANKS LEAK INTEGRITY ELEMENTS/SX FARM LEAK CAUSES AND LOCATIONS - 12127

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

VENETZ TJ; WASHENFELDER D; JOHNSON J

2012-01-25

Washington River Protection Solutions, LLC (WRPS) developed an enhanced single-shell tank (SST) integrity project in 2009. An expert panel on SST integrity was created to provide recommendations supporting the development of the project. One primary recommendation was to expand the leak assessment reports (substitute report or LD-1) to include leak causes and locations. The recommendation has been included in the M-045-9IF Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) as one of four targets relating to SST leak integrity. The 241-SX Farm (SX Farm) tanks with leak losses were addressed on an individual tank basis as part of LD-1.more » Currently, 8 out of 23 SSTs that have been reported to having a liner leak are located in SX Farm. This percentage was the highest compared to other tank farms which is why SX Farm was analyzed first. The SX Farm is comprised of fifteen SSTs built 1953-1954. The tanks are arranged in rows of three tanks each, forming a cascade. Each of the SX Farm tanks has a nominal I-million-gal storage capacity. Of the fifteen tanks in SX Farm, an assessment reported leak losses for the following tanks: 241-SX-107, 241-SX-108, 241-SX-109, 241-SX-111, 241-SX-112, 241-SX-113, 241-SX-114 and 241-SX-115. The method used to identify leak location consisted of reviewing in-tank and ex-tank leak detection information. This provided the basic data identifying where and when the first leaks were detected. In-tank leak detection consisted of liquid level measurement that can be augmented with photographs which can provide an indication of the vertical leak location on the sidewall. Ex-tank leak detection for the leaking tanks consisted of soil radiation data from laterals and drywells near the tank. The in-tank and ex-tank leak detection can provide an indication of the possible leak location radially around and under the tank. Potential leak causes were determined using in-tank and ex-tank information that is not directly related to leak detection. In-tank parameters can include temperature of the supernatant and sludge, types of waste, and chemical determination by either transfer or sample analysis. Ex-tank information can be assembled from many sources including design media, construction conditions, technical specifications, and other sources. Five conditions may have contributed to SX Farm tank liner failure including: tank design, thermal shock, chemistry-corrosion, liner behavior (bulging), and construction temperature. Tank design did not apparently change from tank to tank for the SX Farm tanks; however, there could be many unknown variables present in the quality of materials and quality of construction. Several significant SX Farm tank design changes occurred from previous successful tank farm designs. Tank construction occurred in winter under cold conditions which could have affected the ductile to brittle transition temperature of the tanks. The SX Farm tanks received high temperature boiling waste from REDOX which challenged the tank design with rapid heat up and high temperatures. All eight of the leaking SX Farm tanks had relatively high rate of temperature rise. Supernatant removal with subsequent nitrate leaching was conducted in all but three of the eight leaking tanks prior to leaks being detected. It is possible that no one characteristic of the SX Farm tanks could in isolation from the others have resulted in failure. However, the application of so many stressors - heat up rate, high temperature, loss of corrosion protection, and tank design - working jointly or serially resulted in their failure. Thermal shock coupled with the tank design, construction conditions, and nitrate leaching seem to be the overriding factors that can lead to tank liner failure. The distinction between leaking and sound SX Farm tanks seems to center on the waste types, thermal conditions, and nitrate leaching.« less

10 CFR 36.59 - Detection of leaking sources.

Code of Federal Regulations, 2013 CFR

2013-01-01

... alarm set-point to a higher level if necessary to operate the pool water purification system to clean up... certificate from a transferor that leak test has been done within the 6 months before the transfer. Water from... either by using a radiation monitor on a pool water circulating system or by analysis of a sample of pool...

10 CFR 36.59 - Detection of leaking sources.

Code of Federal Regulations, 2012 CFR

2012-01-01

... alarm set-point to a higher level if necessary to operate the pool water purification system to clean up... certificate from a transferor that leak test has been done within the 6 months before the transfer. Water from... either by using a radiation monitor on a pool water circulating system or by analysis of a sample of pool...

10 CFR 36.59 - Detection of leaking sources.

Code of Federal Regulations, 2011 CFR

2011-01-01

... alarm set-point to a higher level if necessary to operate the pool water purification system to clean up... certificate from a transferor that leak test has been done within the 6 months before the transfer. Water from... either by using a radiation monitor on a pool water circulating system or by analysis of a sample of pool...

10 CFR 36.59 - Detection of leaking sources.

Code of Federal Regulations, 2014 CFR

2014-01-01

... alarm set-point to a higher level if necessary to operate the pool water purification system to clean up... certificate from a transferor that leak test has been done within the 6 months before the transfer. Water from... either by using a radiation monitor on a pool water circulating system or by analysis of a sample of pool...

Dispersal and fallout simulations for urban consequences management (u)

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

Grinstein, Fernando F; Wachtor, Adam J; Nelson, Matt

2010-01-01

Hazardous chemical, biological, or radioactive releases from leaks, spills, fires, or blasts, may occur (intentionally or accidentally) in urban environments during warfare or as part of terrorist attacks on military bases or other facilities. The associated contaminant dispersion is complex and semi-chaotic. Urban predictive simulation capabilities can have direct impact in many threat-reduction areas of interest, including, urban sensor placement and threat analysis, contaminant transport (CT) effects on surrounding civilian population (dosages, evacuation, shelter-in-place), education and training of rescue teams and services. Detailed simulations for the various processes involved are in principle possible, but generally not fast. Predicting urban airflowmore » accompanied by CT presents extremely challenging requirements. Crucial technical issues include, simulating turbulent fluid and particulate transport, initial and boundary condition modeling incorporating a consistent stratified urban boundary layer with realistic wind fluctuations, and post-processing of the simulation results for practical consequences management. Relevant fluid dynamic processes to be simulated include, detailed energetic and contaminant sources, complex building vortex shedding and flows in recirculation zones, and modeling of particle distributions, including particulate fallout, as well as deposition, re-suspension and evaporation. Other issues include, modeling building damage effects due to eventual blasts, addressing appropriate regional and atmospheric data reduction.« less

The use of transmission line modelling to test the effectiveness of I-kaz as autonomous selection of intrinsic mode function

NASA Astrophysics Data System (ADS)

Yusop, Hanafi M.; Ghazali, M. F.; Yusof, M. F. M.; PiRemli, M. A.; Karollah, B.; Rusman

2017-10-01

Pressure transient signal occurred due to sudden changes in fluid propagation filled in pipelines system, which is caused by rapid pressure and flow fluctuation in a system, such as closing and opening valve rapidly. The application of Hilbert-Huang Transform (HHT) as the method to analyse the pressure transient signal utilised in this research. However, this method has the difficulty in selecting the suitable IMF for the further post-processing, which is Hilbert Transform (HT). This paper proposed the implementation of Integrated Kurtosis-based Algorithm for z-filter Technique (I-kaz) to kurtosis ratio (I-kaz-Kurtosis) for that allows automatic selection of intrinsic mode function (IMF) that’s should be used. This work demonstrated the synthetic pressure transient signal generates using transmission line modelling (TLM) in order to test the effectiveness of I-kaz as the autonomous selection of intrinsic mode function (IMF). A straight fluid network was designed using TLM fixing with higher resistance at some point act as a leak and connecting to the pipe feature (junction, pipefitting or blockage). The analysis results using I-kaz-kurtosis ratio revealed that the method can be utilised as an automatic selection of intrinsic mode function (IMF) although the noise level ratio of the signal is lower. I-kaz-kurtosis ratio is recommended and advised to be implemented as automatic selection of intrinsic mode function (IMF) through HHT analysis.

An in vitro comparison of tracheostomy tube cuffs

PubMed Central

Maguire, Seamus; Haury, Frances; Jew, Korinne

2015-01-01

Introduction The Shiley™ Flexible adult tracheostomy tube with TaperGuard™ cuff has been designed through its geometry, materials, diameter, and wall thickness to minimize micro-aspiration of fluids past the cuff and to provide an effective air seal in the trachea while also minimizing the risk of excessive contact pressure on the tracheal mucosa. The cuff also has a deflated profile that may allow for easier insertion through the stoma site. This unique design is known as the TaperGuard™ cuff. The purpose of the observational, in vitro study reported here was to compare the TaperGuard™ taper-shaped cuff to a conventional high-volume low-pressure cylindrical-shaped cuff (Shiley™ Disposable Inner Cannula Tracheostomy Tube [DCT]) with respect to applied tracheal wall pressure, air and fluid sealing efficacy, and insertion force. Methods Three sizes of tracheostomy tubes with the two cuff types were placed in appropriately sized tracheal models and lateral wall pressure was measured via pressure-sensing elements on the inner surface. Fluid sealing performance was assessed by inflating the cuffs within the tracheal models (25 cmH2O), instilling water above the cuff, and measuring fluid leakage past the cuff. To measure air leak, tubes were attached to a test lung and ventilator, and leak was calculated by subtracting the average exhaled tidal volume from the average delivered tidal volume. A tensile test machine was used to measure insertion force for each tube with the cuff deflated to simulate clinical insertion through a stoma site. Results The average pressure exerted on the lateral wall of the model trachea was lower for the taper-shaped cuff than for the cylindrical cuff under all test conditions (P<0.05). The taper-shaped cuff also demonstrated a more even, lower pressure distribution along the lateral wall of the model trachea. The average air and fluid seal performance with the taper-shaped cuff was significantly improved, when compared to the cylindrical-shaped cuff, for each tube size tested (P<0.05). The insertion force for the taper-shaped cuff was ~40% less than that for the cylindrical-shaped cuff. Conclusion In a model trachea, the Shiley™ Flexible Adult tracheostomy tube with TaperGuard™ cuff, when compared to the Shiley™ Disposable Inner Cannula Tracheostomy tube with cylindrical cuff, exerted a lower average lateral wall pressure and a more evenly distributed pressure. In addition, it provided more effective fluid and air seals and required less force to insert. PMID:25960679

Treatment of esophageal anastomotic leakage with self-expanding metal stents: analysis of risk factors for treatment failure

PubMed Central

Persson, Saga; Rouvelas, Ioannis; Kumagai, Koshi; Song, Huan; Lindblad, Mats; Lundell, Lars; Nilsson, Magnus; Tsai, Jon A.

2016-01-01

Background and study aim: The endoscopic placement of self-expandable metallic esophageal stents (SEMS) has become the preferred primary treatment for esophageal anastomotic leakage in many institutions. The aim of this study was to investigate possible risk factors for failure of SEMS-based therapy in patients with esophageal anastomotic leakage. Patients and methods: Beginning in 2003, all patients with an esophageal leak were initially approached and assessed for temporary closure with a SEMS. Until 2014, all patients at the Karolinska University Hospital with a leak from an esophagogastric or esophagojejunal anastomosis were identified. Data regarding the characteristics of the patients and leaks and the treatment outcomes were compiled. Failure of the SEMS treatment strategy was defined as death due to the leak or a major change in management strategy. The risk factors for treatment failure were analyzed with simple and multivariable logistic regression statistics. Results: A total of 447 patients with an esophagogastric or esophagojejunal anastomosis were identified. Of these patients, 80 (18 %) had an anastomotic leak, of whom 46 (58 %) received a stent as first-line treatment. In 29 of these 46 patients, the leak healed without any major change in treatment strategy. Continuous leakage after the application of a stent, decreased physical performance preoperatively, and concomitant esophagotracheal fistula were identified as independent risk factors for failure with multivariable logistic regression analysis. Conclusion: Stent treatment for esophageal anastomotic leakage is successful in the majority of cases. Continuous leakage after initial stent insertion, decreased physical performance preoperatively, and the development of an esophagotracheal fistula decrease the probability of successful treatment. PMID:27092321

Management of chest tubes after pulmonary resection: a systematic review and meta-analysis.

PubMed

Coughlin, Shaun M; Emmerton-Coughlin, Heather M A; Malthaner, Richard

2012-08-01

We performed a systematic review and meta-analysis to determine the effect of suction with water seal, compared with water seal alone, applied to intra pleural chest tubes on the duration of air leaks in patients undergoing pulmonary surgery. We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to find randomized controlled trials (RCTs) comparing the effect of the 2 methods on the duration of air leaks. Trials were systematically assessed for eligibility and validity. Data were extracted in duplicate and pooled across studies using a random-effects model. The search yielded 7 RCTs that met the eligibility criteria. No difference was identified between the 2 methods in duration of air leak (weighted mean difference [WMD] 1.15 days, favours water seal; 95% confidence interval [CI] -0.64 to 2.94), time to discharge (WMD 2.19 d, favours water seal; 95% CI -0.63 to 5.01), duration of chest tubes (WMD 0.96 d, favours water seal; 95% CI -0.12 to 2.05) or incidence of prolonged air leaks (absolute risk reduction [ARR] 0.04, favours water seal; 95% CI -0.01 to 0.09). Water seal was associated with a significantly increased incidence of postoperative pneumothorax (ARR -0.14, 95% CI -0.21 to -0.07). No differences were identified in terms of duration of air leak, incidence of prolonged air leak, duration of chest tubes and duration of hospital stay when chest tubes were placed to suction rather than water seal. Chest tube suction appears to be superior to water seal in reducing the incidence of pneumothorax; however, the clinical significance of this finding is unclear.

Hydraulic Fracture Measurements at Site C0009 of IODP Expedition 319, NanTroSEIZE

NASA Astrophysics Data System (ADS)

Kano, Y.; Ito, T.; Lin, W.; Flemings, P. B.; Boutt, D. F.; Doan, M.; McNeill, L. C.; Byrne, T.; Saffer, D. M.; Araki, E.; Eguchi, N. O.; Takahashi, K.; Toczko, S.; Scientists, E.

2009-12-01

The drilling vessel Chikyu completed the first riser-drilling in IODP history to a depth of 1603 mbsf (meter below seafloor) at Site C0009 in the landward Kumano forearc basin in the Nankai convergent margin, Japan.To measure in situ stress we performed two types of hydraulic fracturing: 1) as part of routine drilling operations, we estimated least principle stress from a leak off test (LOT); and 2) we used Schlumberger’s dual wireline packer, the Modular Dynamics Tester (MDT). Two LOT’s were performed at the base of 20 inch casing (703.9 mbsf) as a part of standard drilling operations; the outer annulus was closed by the blowout preventor (BOP), fluid was pumped at a constant rate of 2.3 m3/s, and pressure was measured at the cement pumps. The leak-off pressures were interpreted to lie at the break in slope in a graph of pressure vs volume-pumped. These values were found to be 30.22 and 30.25 MPa. These leak off pressure is interpreted to record fluids entering hydraulic fractures and is approximately the the least principal stress. There is considerable uncertainty in picking the slopes of the lines to determine the least principal stress (S3). The MDT dual packer tests were carried out at depth of 873.7 and 1532.7 mbsf. The dual packer module isolates a 1-m section of the borehole for testing. Zones free from pre-existing fractures and with near circular hole shape were chosen for the stress measurements. In the HF test at 873.7 m, the pressure cycle was repeated 5 times maintaining flow rate of 20 cm3/s. Periods of each cycles were 80-300 s. We determined the instantaneous shut in pressure to be 34.8 MPa. In the test at 1532.7 m, only one pressure cycle with a flow rate of 20 cm3/s was maintained, which yielded an instantaneous shut in pressure of 41.6 MPa. We interpret the shut-in pressure to record the least principal stress (S3). We do not know the orientation of fractures which were induced or activated by hydraulic fracturing, because no borehole images were taken after the HF tests. S3 at both test depths is less than Sv (the overburden stress). The stress ratio, K = (S3-Ph)/(Sv-Ph) where Ph is the hydrostatic pressure (calculated assuming a pore fluid density of 1023 kg/m3), was 0.44 for LOT and were 0.82 and 0.44, for MDT.

Cryogenic Two-Phase Flight Experiment: Results overview

NASA Technical Reports Server (NTRS)

Swanson, T.; Buchko, M.; Brennan, P.; Bello, M.; Stoyanof, M.

1995-01-01

This paper focuses on the flight results of the Cryogenic Two-Phase Flight Experiment (CRYOTP), which was a Hitchhiker based experiment that flew on the space shuttle Columbia in March of 1994 (STS-62). CRYOTP tested two new technologies for advanced cryogenic thermal control; the Space Heat Pipe (SHP), which was a constant conductance cryogenic heat pipe, and the Brilliant Eyes Thermal Storage Unit (BETSU), which was a cryogenic phase-change thermal storage device. These two devices were tested independently during the mission. Analysis of the flight data indicated that the SHP was unable to start in either of two attempts, for reasons related to the fluid charge, parasitic heat leaks, and cryocooler capacity. The BETSU test article was successfully operated with more than 250 hours of on-orbit testing including several cooldown cycles and 56 freeze/thaw cycles. Some degradation was observed with the five tactical cryocoolers used as thermal sinks, and one of the cryocoolers failed completely after 331 hours of operation. Post-flight analysis indicated that this problem was most likely due to failure of an electrical controller internal to the unit.

Influence of intraoperative hypotension on leaks after sleeve gastrectomy.

PubMed

Nienhuijs, Simon W; Kaymak, Uzay; Korsten, Erik; Buise, Marc P

2016-01-01

Leak after a sleeve gastrectomy (SG) is a severe complication. Risk factors, such as regional ischemia, increased intraluminal pressure, technical failure of the stapling device, and surgeon error, have been reported. It was hypothesized that intraoperative hypotension is another risk factor for leak, similar to that reported for colorectal surgery. Tertiary teaching hospital in The Netherlands. Results of a 7-year cohort of primary SGs were reviewed in relation to multiple intraoperative blood pressure measurements. The thresholds for the mean pressure were 40 to 70 mm Hg and for the systolic pressure 70 to 100 mm Hg. Only continuous episodes of 15 and 20 minutes were included. Twenty-four leaks were identified in a cohort of 1041 primary SGs. Episodes of systolic blood pressure<100 mm Hg for 15 min (P = .027) and 20 minutes (P = .008) were significantly related to a staple line leak. An episode of mean blood pressure<70 mm Hg for 20 min was significantly related to leak (P = .014). Episodes with lower thresholds of pressure occurred less frequently and revealed no significant differences. Other identified risk factors were smoking (P = .019), fast-track recovery program (P = .006), use of a tri-stapler (P = .004), and duration of surgery (P = .000). In a multivariate analysis, only intraoperative systolic pressure<100 mm Hg for 20 minutes remained significant (odds ratio, 2.45; P = .012). Intraoperative hypotension may contribute independently to a leak after SG. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

The endoscopic endonasal approach is not superior to the microscopic transcranial approach for anterior skull base meningiomas-a meta-analysis.

PubMed

Muskens, Ivo S; Briceno, Vanessa; Ouwehand, Tom L; Castlen, Joseph P; Gormley, William B; Aglio, Linda S; Zamanipoor Najafabadi, Amir H; van Furth, Wouter R; Smith, Timothy R; Mekary, Rania A; Broekman, Marike L D

2018-01-01

In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values. Of 1684 studies, 64 case series were included in the meta-analysis. Using the fixed-effects model, the GTR rate was significantly higher among mTCA patients for OGM (eTSA: 70.9% vs. mTCA: 88.5%, p-interaction < 0.01), but not significantly higher for TSM (eTSA: 83.0% vs. mTCA: 85.8%, p-interaction = 0.34). Despite considerable heterogeneity, visual improvement was higher for eTSA than mTCA for TSM (p-interaction < 0.01), but not for OGM (p-interaction = 0.33). CSF leak was significantly higher among eTSA patients for both OGM (eTSA: 25.1% vs. mTCA: 10.5%, p-interaction < 0.01) and TSM (eTSA: 19.3%, vs. mTCA: 5.81%, p-interaction < 0.01). Intraoperative arterial injury was higher among eTSA (4.89%) than mTCA patients (1.86%) for TSM (p-interaction = 0.03), but not for OGM resection (p-interaction = 0.10). Mortality was not significantly different between eTSA and mTCA patients for both TSM (p-interaction = 0.14) and OGM resection (p-interaction = 0.88). Random-effect models yielded similar results. In this meta-analysis, eTSA was not shown to be superior to mTCA for resection of both OGMs and TSMs.

Elevated body mass index and risk of postoperative CSF leak following transsphenoidal surgery

PubMed Central

Dlouhy, Brian J.; Madhavan, Karthik; Clinger, John D.; Reddy, Ambur; Dawson, Jeffrey D.; O’Brien, Erin K.; Chang, Eugene; Graham, Scott M.; Greenlee, Jeremy D. W.

2012-01-01

Object Postoperative CSF leakage can be a serious complication after a transsphenoidal surgical approach. An elevated body mass index (BMI) is a significant risk factor for spontaneous CSF leaks. However, there is no evidence correlating BMI with postoperative CSF leak after transsphenoidal surgery. The authors hypothesized that patients with elevated BMI would have a higher incidence of CSF leakage complications following transsphenoidal surgery. Methods The authors conducted a retrospective review of 121 patients who, between August 2005 and March 2010, underwent endoscopic endonasal transsphenoidal surgeries for resection of primarily sellar masses. Patients requiring extended transsphenoidal approaches were excluded. A multivariate statistical analysis was performed to investigate the association of BMI and other risk factors with postoperative CSF leakage. Results In 92 patients, 96 endonasal endoscopic transsphenoidal surgeries were performed that met inclusion criteria. Thirteen postoperative leaks occurred and required subsequent treatment, including lumbar drainage and/or reoperation. The average BMI of patients with a postoperative CSF leak was significantly greater than that in patients with no postoperative CSF leak (39.2 vs 32.9 kg/m2, p = 0.006). Multivariate analyses indicate that for every 5-kg/m2 increase in BMI, patients undergoing a transsphenoidal approach for a primarily sellar mass have 1.61 times the odds (95% CI 1.10–2.29, p = 0.016, by multivariate logistic regression) of having a postoperative CSF leak. Conclusions Elevated BMI is an independent predictor of postoperative CSF leak after an endonasal endoscopic transsphenoidal approach. The authors recommend that patients with BMI greater than 30 kg/m2 have meticulous sellar reconstruction at surgery and close monitoring postoperatively. PMID:22443502

Computational Analyses of Pressurization in Cryogenic Tanks

NASA Technical Reports Server (NTRS)

Ahuja, Vineet; Hosangadi, Ashvin; Mattick, Stephen; Lee, Chun P.; Field, Robert E.; Ryan, Harry

2008-01-01

A) Advanced Gas/Liquid Framework with Real Fluids Property Routines: I. A multi-fluid formulation in the preconditioned CRUNCH CFD(Registered TradeMark) code developed where a mixture of liquid and gases can be specified: a) Various options for Equation of state specification available (from simplified ideal fluid mixtures, to real fluid EOS such as SRK or BWR models). b) Vaporization of liquids driven by pressure value relative to vapor pressure and combustion of vapors allowed. c) Extensive validation has been undertaken. II. Currently working on developing primary break-up models and surface tension effects for more rigorous phase-change modeling and interfacial dynamics B) Framework Applied to Run-time Tanks at Ground Test Facilities C) Framework Used For J-2 Upper Stage Tank Modeling: 1) NASA MSFC tank pressurization: a) Hydrogen and oxygen tank pre-press, repress and draining being modeled at NASA MSFC. 2) NASA AMES tank safety effort a) liquid hydrogen and oxygen are separated by a baffle in the J-2 tank. We are modeling pressure rise and possible combustion if a hole develops in the baffle and liquid hydrogen leaks into the oxygen tank. Tank pressure rise rates simulated and risk of combustion evaluated.

The history of autologous fat graft use for prevention of cerebrospinal fluid rhinorrhea after transsphenoidal approaches.

PubMed

Ziu, Mateo; Jimenez, David F

2013-11-01

Presented herein is a review of the history of fat graft use in preventing iatrogenic cerebrospinal fluid (CSF) rhinorrhea after transsphenoidal surgery. Since the first transsphenoidal surgeries were described in the early 1900s, the techniques of sellar packing to prevent CSF leak have evolved. Kanavel, Halstead, and Cushing used bismuth- or iodine-soaked gauze. Under Dandy's influence, fascia lata was the first autologous material to be used for the repair and prevention of CSF rhinorrhea. The use of autologous fat graft for this purpose has only been reported in recent decades. Montgomery was the first to use abdominal fat to obliterate the middle ear cavity in 1964, and Collins reported the first transsphenoidal application of fat graft in 1973. Other reports by Kirchner, Tindall, and Wilson followed. Copyright © 2013. Published by Elsevier Inc.

Simulating Mobility of Chemical Contaminants from Unconventional Gas Development for Protection of Water Resources

NASA Astrophysics Data System (ADS)

Kanno, C.; Edlin, D.; Borrillo-Hutter, T.; McCray, J. E.

2014-12-01

Potential contamination of ground water and surface water supplies from chemical contaminants in hydraulic fracturing fluids or in natural gas is of high public concern. However, quantitative assessments have rarely been conducted at specific energy-producing locations so that the true risk of contamination can be evaluated. The most likely pathways for contamination are surface spills and faulty well bores that leak production fluids directly into an aquifer. This study conducts fate and transport simulations of the most mobile chemical contaminants, based on reactivity to subsurface soils, degradation potential, and source concentration, to better understand which chemicals are most likely to contaminate water resources, and to provide information to planners who wish to be prepared for accidental releases. The simulations are intended to be most relevant to the Niobrara shale formation.

Inspection work on THEMIS at Astrotech

NASA Image and Video Library

2002-01-01

At Astrotech Space Operations, technicians conduct black light inspection of the THEMIS probes. Black light inspection uses UVA fluorescence to detect possible particulate microcontamination, minute cracks or fluid leaks. THEMIS consists of five identical probes, the largest number of scientific satellites ever launched into orbit aboard a single rocket. This unique constellation of satellites will resolve the tantalizing mystery of what causes the spectacular sudden brightening of the aurora borealis and aurora australis - the fiery skies over the Earth's northern and southern polar regions. THEMIS is scheduled to launch Feb. 15 from Cape Canaveral Air Force Station.

Unilateral abducens and bilateral facial nerve palsies associated with posterior fossa exploration surgery

PubMed Central

Khalil, Ayman; Clerkin, James; Mandiwanza, Tafadzwa; Green, Sandra; Javadpour, Mohsen

2016-01-01

Multiple cranial nerves palsies following a posterior fossa exploration confined to an extradural compartment is a rare clinical presentation. This case report describes a young man who developed a unilateral abducens and bilateral facial nerve palsies following a posterior fossa exploration confined to an extradural compartment. There are different theories to explain this presentation, but the exact mechanism remains unclear. We propose that this patient cranial nerve palsies developed following cerebrospinal fluid (CSF) leak, potentially as a consequence of rapid change in CSF dynamics. PMID:26951144

The performance of components in the Skylab refrigeration system

NASA Technical Reports Server (NTRS)

Daniher, C. E., Jr.

1975-01-01

The on-orbit performance of the Skylab refrigeration system components is presented. Flight anomalies are analyzed and performance of the newly developed components is described. Nine months of orbit data proved the practicality of the leak-free coolant system design. Flight proven application of a thermal capacitor and development test results of the first all-mechanical, low temperature mixing valve represent a significant advance in single-phase, low temperature coolant loop design. System flight data suggest that additional instrumentation and fluid filters could have prevented system orbit performance anomalies.

Importance of limiting hohlraum leaks at cryogenic temperatures on NIF targets

DOE PAGES

Bhandarkar, Suhas; Teslich, Nick; Haid, Ben; ...

2017-08-18

Inertial confinement fusion targets are complex systems designed to allow fine control of temperature and pressure for making precise spherical ice layers of hydrogen isotopes at cryogenic temperatures. We discuss the various technical considerations for a maximum leak rate based on heat load considerations. This maximum flow rate turns out to bemore » $$5\\times 10^{-6}$$ standard cc per second, which can be caused by an orifice less than half a micron in diameter. This makes the identification of the location and resolution of the leak a significant challenge. To illustrate this, we showcase one example of a peculiar failure mode that appeared suddenly but persisted whereby target production yield was severely lowered. Identification of the leak source and the root cause requires very careful analysis of multiple thermomechanical aspects to ensure that the end solution is indeed the right remedy and is robust.« less