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Sample records for lumboperitoneal lp shunt

  1. Intra-bronchial migration of peritoneal catheter of lumboperitoneal shunt

    PubMed Central

    Kawahara, Takashi; Yanagi, Masakazu; Hirano, Hirofumi; Arita, Kazunori

    2015-01-01

    Background: A rare case of intra-bronchial migration of peritoneal catheter of lumboperitoneal (LP) shunt was treated under the bronchoscopic and fluoroscopic observation. Case Description: A 71-year-old man, who underwent LP shunt installation due to idiopathic normal pressure hydrocephalus a year before, presented with history of high fever and sputum production. Roentgenography and computed tomography of the chest revealed migration of distal end of the peritoneal catheter into the left main bronchus. Migrated catheter was gently extracted through the abdominal wound incision under the bronchoscopic and fluoroscopic observation. Contrast material infused into the catheter did not spread into the pleural cavity. The patient was free of the symptoms within 2 postoperative weeks. Moreover, he underwent the ventriculo-peritoneal shunt surgery 1-month later. Conclusion: This is the first case of the migration of peritoneal catheter of LP shunt into the main bronchus. PMID:26962468

  2. [Recurrent Hiccups Caused by Malposition of the Peritoneal Catheter of a Lumboperitoneal Shunt: A Case Report].

    PubMed

    Yoshida, Yuya; Nakajima, Yoshio; Tokuda, Kazuhiko; Kidani, Ryuichi

    2016-02-01

    A number of rare and unpredictable shunt-related complications after shunt placement to treat hydrocephalus have been described. Here a 78-year-old man who underwent lumboperitoneal (LP) shunt placement presented postoperatively with recurrent hiccups. Abdominal radiography and computed tomography performed at 7 days postoperative revealed that a peritoneal catheter had migrated into the upper abdominal cavity and contacted the diaphragm. The patient underwent LP shunt revision, during which the catheter was pulled back and repositioned within the lower abdominal cavity. The hiccups ceased completely. To our knowledge, the only other report of a similar complication was published in the 1980s. Here we describe a case in which a peritoneal catheter from an LP shunt migrated into the upper abdominal cavity and irritated the diaphragm, causing recurrent hiccups.

  3. Minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal shunt*

    PubMed Central

    Jia, Lu; Zhao, Zhong-xin; You, Chao; Liu, Jia-gang; Huang, Si-qing; He, Min; Ji, Pei-gang; Duan, Jie; Zeng, Yi-jun; Li, Guo-ping

    2011-01-01

    Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared), 25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP) shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications. PMID:21462385

  4. [Laparoscopy-assisted ventriculoperitoneal and lumboperitoneal shunt surgery].

    PubMed

    Aoki, Tsukasa; Ayuzawa, Satoshi; Matsuo, Ryota; Hosoo, Hisayuki; Tanno, Syougo; Miki, Shunichiro; Matsubara, Teppei; Matsumura, Akira

    2012-06-01

    Recently, laparoscopy (also referred to as minimally invasive surgery) has been used during peritoneal catheter implantation in shunt placement for hydrocephalus; however, the procedure and devices for this technique have not yet been well established. We adopted umbilical and paraumbilical laparoscopy for peritoneal catheter insertion. In this paper, we describe the technique we used and its clinical results and benefits. Ten consecutive patients with hydrocephalus who underwent laparoscopic shunt surgery (6 cases of ventriculoperitoneal shunt and 4 of lumboperitoneal shunt) were enrolled for this study. The follow-up period ranged from 21 to 434 days (mean, 263 days). After a standard cranial/spinal procedure, an approximately 5-mm incision was made in the lateral side of the umbilicus, where the abdominal catheter was introduced subcutaneously. Thereafter, we inserted a laparoscope into the peritoneal cavity via a small incision beneath or just on the umbilicus. A shunt catheter was laparoscopically inserted through a peel-off cannula and placed after taking note of the outflow of cerebrospinal fluid (CSF) from the catheter tip. In all patients, the shunt was inserted with no complications, and good patency was achieved. Laparoscopy allows implantation of the catheter into the peritoneal cavity, and the outflow of CSF can be confirmed intraoperatively. Furthermore, the abdominal surgical wounds are minimal, even for obese patients, and fascia/muscle incisions are not needed. Laparoscopy-assisted shunt surgery for hydrocephalus is effective and safe and also has cosmetic advantages.

  5. Delayed intracerebellar hemorrhage secondary to lumboperitoneal shunt insertion

    PubMed Central

    Er, Uygur; Akyol, Çetin; Bavbek, Murad

    2016-01-01

    Aim of this paper is to present and discuss a case of a delayed cerebellar parenchymal hemorrhage developing after L/P shunt placement with a NPH patient. A hypertensive patient admitted to our clinic with a diagnosis of NPH. The patient was placed a pressure adjustable L/P shunt without any surgical complication. He was discharged with an uneventful period. The patient was admitted to the emergency clinic of our hospital with a 1.5 × 1.5 cm diameter hematoma at the left cerebellar hemisphere on 2 days after his discharge. CSF drainage by an L/P shunt can generate intracerebellar hemorrhages especially in hypertensive patients. PMID:27695558

  6. The effects of lumboperitoneal and ventriculoperitoneal shunts on the cranial and spinal cerebrospinal fluid volume in a patient with idiopathic intracranial hypertension

    PubMed Central

    Nikić, Ines; Radoš, Milan; Frobe, Ana; Vukić, Miroslav; Orešković, Darko; Klarica, Marijan

    2016-01-01

    Lumboperitoneal (LP) and ventriculoperitoneal (VP) shunts are a frequent treatment modality for idiopathic intracranial hypertension (IIH). Although these shunts have been used for a long time, it is still not clear how they change the total craniospinal CSF volume and what portions of cranial and spinal CSF are affected. This report for the first time presents the results of a volumetric analysis of the total cranial and spinal CSF space in a patient with IIH. We performed an automated segmentation of the cranial and a manual segmentation of the spinal CSF space first with an LP shunt installed and again after the LP shunt was replaced by a VP shunt. When the LP shunt was in place, the total CSF volume was smaller than when the VP shunt was in place (222.4 cm3 vs 279.2 cm3). The difference was almost completely the result of the spinal CSF volume reduction (49.3 cm3 and 104.9 cm3 for LP and VP, respectively), while the cranial CSF volume was not considerably altered (173.2 cm3 and 174.2 cm3 for LP and VP, respectively). This report indicates that LP and VP shunts in IIH do not considerably change the cranial CSF volume, while the reduction of CSF volume after LP shunt placement affects almost exclusively the spinal part of the CSF system. Our results suggest that an analysis of both the cranial and the spinal part of the CSF space is necessary for therapeutic procedures planning and for an early recognition of numerous side effects that often arise after shunts placement in IIH patients. PMID:27374831

  7. Change of patient position using a transportation board during lumboperitoneal shunting. Technical note.

    PubMed

    Shimizu, Satoru; Hagiwara, Hiroyuki; Hattori, Satoshi; Nakayama, Kenji; Fujii, Kiyotaka

    2009-04-01

    Lumboperitoneal shunt placement requires access to the lumbar theca in the lateral position, followed by subsequent laparotomy in the supine position. This position change and repeat draping are bothersome, especially in heavy patients, so we developed a method that facilitates changing the patient position while keeping the surgical drapes in place. An oblong plastic board covered with Teflon-coated glassfiber cloth and surrounded by a nylon-cloth sleeve is used. The sleeve can be easily moved over the board, so patients can be moved in the transverse direction with minimal pushing force. The patient is placed in the lateral position on the board on the operating table and draped from the back to the abdomen. After catheter insertion into the lumbar theca and introduction of a subcutaneous tunnel to the flank, the patient is pushed in the ventral direction, moved to the opposite edge of the operating table, and the position is changed from lateral to supine, leaving the original drape intact. Finally, a catheter is placed by laparotomy. We were able to change position easily in 20 patients weighing 47-85 kg (mean 69.6 kg). This technique reduces the labor required for position change and preserves sterility.

  8. Shunt Devices for the Treatment of Adult Hydrocephalus: Recent Progress and Characteristics

    PubMed Central

    MIYAKE, Hiroji

    2016-01-01

    Various types of shunt valves have been developed during the past 50 years, most of which can be classified into the following categories: (1) fixed differential pressure valves; (2) fixed differential pressure (DP) valves with an antisiphon mechanism; (3) programmable DP valves; (4) programmable DP valves with an antisiphon mechanism; and (5) programmable antisiphon valves. When considering the myriad of possible postoperative condition changes, such as the onset of accidental non-related diseases or trauma in adults, and changes in normal physiological development or anticipation of future shunt removal in children, it has become standard to use the programmable valve as a first choice for cerebrospinal fluid shunting. However, it is still unclear what type of shunt valve is suitable for each individual case. Based on the results of SINPHONI and more recently SINPHONI 2 trials, the programmable DP valve is recommended as the first line shunt valve. The programmable DP valve with an antisiphon mechanism is thought to be beneficial for tall, slender patients, who have a tendency for easily developing complications of overdrainage, however, this type of valve must be used cautiously in obese patients because of the increased risk of underdrainage. Although the current evidence is still insufficient, the programmable antisiphon valve, which costs the same as the programmable DP valve, is also thought to be the first line shunt valve. The quick reference table is applicable for most shunt valves, and for patients with either the ventriculoperitoneal or the lumboperitoneal shunt. PMID:27041631

  9. Ventriculoperitoneal shunt

    MedlinePlus

    ... of ventriculoperitoneal shunt. In: Jandial R, McCormick PC, Black PM, eds. Core Techniques in Operative Neurosurgery . Philadelphia, PA: Elsevier Saunders; ... Updated by: Joseph V. Campellone, MD, Division of Neurology, Cooper University ...

  10. Ventriculoperitoneal shunt - discharge

    MedlinePlus

    ... ventriculoperitoneal - discharge; VP shunt - discharge; Shunt revision - discharge; Hydrocephalus shunt placement - discharge ... Your child has hydrocephalus and needed a shunt placed to drain excess fluid and relieve pressure in the brain. This buildup of brain ...

  11. Cryptococcal ventriculoperitoneal shunt infection.

    PubMed

    Viereck, Matthew J; Chalouhi, Nohra; Krieger, David I; Judy, Kevin D

    2014-11-01

    The standard treatment of hydrocephalus is placement of a ventriculoperitoneal (VP) shunt. While infection is a common complication, rarely are fungal organisms implicated. Cryptococcus neoformans has been reported in only nine cases of shunt infection to our knowledge. The timing from shunt placement to symptom onset varies widely from 10 days to 15 months. We present a patient who developed a cryptococcal infection of his VP shunt more than two decades following shunt placement.

  12. Ventriculomammary shunt: an unusual ventriculoperitoneal shunt complication.

    PubMed

    Chaudhry, Nauman S; Johnson, Jeremiah N; Morcos, Jacques J

    2015-02-01

    Ventriculoperitoneal (VP) shunt malfunctions are common and can result in significant consequences for patients. Despite the prevalence of breast augmentation surgery and breast surgery for other pathologies, few breast related VP shunt complications have been reported. A 54-year-old woman with hydrocephalus post-subarachnoid hemorrhage returned 1 month after VP shunt placement complaining of painful unilateral breast enlargement. After investigation, it was determined that the distal VP shunt catheter had migrated from the peritoneal cavity into the breast and wrapped around her breast implant. The breast enlargement was the result of cerebrospinal fluid retention. We detail this unusual case and review all breast related VP shunt complications reported in the literature. To avoid breast related complications related to VP shunt procedures, it is important to illicit pre-procedural history regarding breast implants, evade indwelling implants during catheter tunneling and carefully securing the abdominal catheter to prevent retrograde catheter migration to the breast.

  13. Distal splenorenal shunt

    MedlinePlus

    ... shunt; Cirrhosis - distal splenorenal; Liver failure - distal splenorenal; Portal vein pressure - distal splenorenal shunt ... vein from your spleen is removed from the portal vein. The vein is then attached to the ...

  14. CORN, LP Goldfield Approval

    EPA Pesticide Factsheets

    This November 19, 2015 letter from EPA approves the petition from CORN, LP, Goldfield facility, regarding non-grandfathered ethanol produced through a dry mill process, qualifying under the Clean Air Act for renewable fuel (D-code 6) RINs under the RFS pro

  15. Hydrocephalus and Shunts

    MedlinePlus

    ... or anesthesia. When ventricles start to get too big, it is a strong sign that the shunt is not working right. It is important to know that some people (between 5 and 15 percent) with Spina Bilda may have ...

  16. Ventriculoperitoneal shunt - slideshow

    MedlinePlus

    ... ency/presentations/100123.htm Ventriculoperitoneal shunt - series—Normal anatomy To use the sharing features on this page, ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  17. Shunt tube calcification as a late complication of ventriculoperitoneal shunting

    PubMed Central

    Salim, Abubakr Darrag; Elzain, Mohammed Awad; Mohamed, Haddab Ahmed; Ibrahim Zayan, Baha Eldin Mohamed

    2015-01-01

    Shunt calcification is a rare complication of ventriculoperitoneal shunting that occurs years later after the initial operation this condition is rarely reported in literature. Two patients with shunt calcifications were described. The first patient was 17-year-old lady who had congenital hydrocephalus and shunted in the early infancy, she was presented recently complaining of itching of the skin along the shunt track and limitation of neck movement. The patient was then operated with removal of the old peritoneal catheter and replacing it with a new one. The second patient was 17-year-old boy originally was a case of posterior fossa pilocytic astrocytoma associated with obstructive hydrocephalus, he was operated with both shunting for the hydrocephalus and tumor removal, 6 years later he presented with shunt exposure. Calcification of the shunt tube was discovered intraoperatively upon shunt removal. Shunt calcification has been observed mainly in barium-impregnated catheters. Introducing plain silicone-coated shunt tubing may reduce the rate of this condition. The usual complaints of the patients suffering from this condition are pain in the neck and chest wall along the shunt pathway and limitation of the neck movement due to shunt tube tethering, but features of shunt dysfunction and skin irritation above the shunt may be present. In this review, plain X-ray and operative findings showed that the most extensive calcification is present in the neck, where the catheters were subject to heavy mechanical stress. Disturbed calcium and phosphate metabolisms may be involved in this condition. Shunt calcification is a rare condition that occurs due to material aging presenting with features of shunt tethering, dysfunction or overlying skin irritation. Plain X-ray is needed to detect calcification while shunt removal, replacement or endoscopic third ventriculostomy may carry solution for this condition. PMID:26396620

  18. Shunt tube calcification as a late complication of ventriculoperitoneal shunting.

    PubMed

    Salim, Abubakr Darrag; Elzain, Mohammed Awad; Mohamed, Haddab Ahmed; Ibrahim Zayan, Baha Eldin Mohamed

    2015-01-01

    Shunt calcification is a rare complication of ventriculoperitoneal shunting that occurs years later after the initial operation this condition is rarely reported in literature. Two patients with shunt calcifications were described. The first patient was 17-year-old lady who had congenital hydrocephalus and shunted in the early infancy, she was presented recently complaining of itching of the skin along the shunt track and limitation of neck movement. The patient was then operated with removal of the old peritoneal catheter and replacing it with a new one. The second patient was 17-year-old boy originally was a case of posterior fossa pilocytic astrocytoma associated with obstructive hydrocephalus, he was operated with both shunting for the hydrocephalus and tumor removal, 6 years later he presented with shunt exposure. Calcification of the shunt tube was discovered intraoperatively upon shunt removal. Shunt calcification has been observed mainly in barium-impregnated catheters. Introducing plain silicone-coated shunt tubing may reduce the rate of this condition. The usual complaints of the patients suffering from this condition are pain in the neck and chest wall along the shunt pathway and limitation of the neck movement due to shunt tube tethering, but features of shunt dysfunction and skin irritation above the shunt may be present. In this review, plain X-ray and operative findings showed that the most extensive calcification is present in the neck, where the catheters were subject to heavy mechanical stress. Disturbed calcium and phosphate metabolisms may be involved in this condition. Shunt calcification is a rare condition that occurs due to material aging presenting with features of shunt tethering, dysfunction or overlying skin irritation. Plain X-ray is needed to detect calcification while shunt removal, replacement or endoscopic third ventriculostomy may carry solution for this condition.

  19. Shunting in cryptococcal meningitis.

    PubMed

    Cherian, Jacob; Atmar, Robert L; Gopinath, Shankar P

    2016-07-01

    OBJECT Patients with cryptococcal meningitis often develop symptomatic intracranial hypertension. The need for permanent CSF diversion in these cases remains unclear. METHODS Cases of cryptococcal meningitis over a 5-year period were reviewed from a single, large teaching hospital. Sources of identification included ICD-9 codes, operative logs, and microscopy laboratory records. RESULTS Fifty cases of cryptococcal meningitis were identified. Ninety-eight percent (49/50) of patients were HIV positive. Opening pressure on initial lumbar puncture diagnosing cryptococcal meningitis was elevated (> 25 cm H2O) in 33 cases and normal (≤ 25 cm H2O) in 17 cases. Thirty-eight patients ultimately developed elevated opening pressure over a follow-up period ranging from weeks to years. Serial lumbar punctures for relief of intracranial hypertension were performed in 29 cases. Thirteen of these patients ultimately had shunting procedures performed after failing to improve clinically. Two factors were significantly associated with the need for shunting: patients undergoing shunt placement were more likely to be women (5/13 vs 0/16; p = 0.01) and to have a pattern of increasing CSF cryptococcal antigen (10/13 vs 3/16 cases; p = 0.003). All patients re-presenting with mycological relapse either underwent or were offered shunt placement. CONCLUSIONS Neurosurgeons are often asked to consider CSF diversion in cases of cryptococcal meningitis complicated by intracranial hypertension. Most patients do well with serial lumbar punctures combined with antifungal therapy. When required, shunting generally provided sustained relief from intracranial hypertension symptoms. Ventriculoperitoneal shunts are the favored method of diversion. To the authors' knowledge, the present study is the largest series on diversionary shunts in primarily HIV-positive patients with this problem.

  20. residue and shunting pinholes

    NASA Astrophysics Data System (ADS)

    Gorji, Nima E.

    2014-09-01

    The present work considers two observable phenomena through the experimental fabrication and electrical characterization of the rf-sputtered CdS/CdTe thin film solar cells that extremely reduce the overall conversion efficiency of the device: CdCl2 residue on the surface of the semiconductor and shunting pinholes. The former happens through nonuniform treatment of the As-deposited solar cells before annealing at high temperature and the latter occurs by shunting pinholes when the cell surface is shunted by defects, wire-like pathways or scratches on the metallic back contact caused from the external contacts. Such physical problems may be quite common in the experimental activities and reduce the performance down to 4-5 % which leads to dismantle the device despite its precise fabrication. We present our electrical characterization on the samples that received wet CdCl2 surface treatment (uniform or nonuniform) and are damaged by the pinholes.

  1. TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT

    PubMed Central

    Patidar, Kavish R.; Sydnor, Malcolm; Sanyal, Arun J.

    2014-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the complications of portal hypertension. The largest body of evidence for its use has been supported for recurrent or refractory variceal bleeding and refractory ascites. Its use has also been advocated for acute variceal bleed, hepatic hydrothorax, and hepatorenal syndrome. With the replacement of bare metal stents with polytetrafluoroethylen (PTFE) covered stents, shunt patency has improved dramatically thus improving outcomes. Therefore, reassessment of its utility, management of its complications, and understanding of various TIPS techniques is important. PMID:25438287

  2. Registration of LP1-2581, LP1-2163H, LP3-1159, and LP640-1304 low phytate spring barley germplasm lines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Agricultural Research Service, U.S. Dept. of Agriculture (USDA-ARS) has developed and released four low-phytate spring barley (Hordeum vulgare L.) germplasm lines: LP1-2581 (Reg. No._____, PI 658245), LP1-2163H (Reg. No._____, PI 658248 ), LP3-1159 (Reg. No._____, PI 658247), and LP640-1304 (...

  3. 76 FR 9771 - SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ...; OR94-4-021; Docket No. IS06-215-003; Docket No. IS06-220-002] SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; Notice of Filing Take notice that on February 10, 2011, the SFPP, L.P. filed with the... shippers may be entitled to refunds pursuant to the Commission's orders dated December 8, 2006 (SFPP,...

  4. Laboratory study on "intracranial hypotension" created by pumping the chamber of a hydrocephalus shunt

    PubMed Central

    Bromby, Adam; Czosnyka, Zofia; Allin, David; Richards, Hugh K; Pickard, John D; Czosnyka, Marek

    2007-01-01

    Background It has been reported that pumping a shunt in situ may precipitate a proximal occlusion, and/or lead to ventricular over-drainage, particularly in the context of small ventricles. In the laboratory we measured the effect of pumping the pre-chamber of hydrocephalus shunts on intracranial hypotension. Materials and methods A simple physical model of the CSF space in a hydrocephalic patient was constructed with appropriate compliance, CSF production and circulation. This was used to test eleven different hydrocephalus shunts. The lowest pressure obtained, the number of pumps needed to reach this pressure, and the maximum pressure change with a single pump, were recorded. Results All models were able to produce negative pressures ranging from -11.5 mmHg (Orbis-Sigma valve) to -233.1 mmHg (Sinu-Shunt). The number of pumps required reaching these levels ranged from 21 (PS Medical LP Reservoir) to 315 (Codman Hakim-Programmable). The maximum pressure change per pump ranged from 0.39 mmHg (Orbis-Sigma valve) to 23.1 (PS Medical LP Reservoir). Conclusion Patients, carers and professionals should be warned that 'pumping' a shunt's pre-chamber may cause a large change in intracranial pressure and predispose the patient to ventricular catheter obstruction or other complications. PMID:17386089

  5. Coagulopathy post peritoneovenous shunt.

    PubMed Central

    LeVeen, H H; Ip, M; Ahmed, N; Hutto, R B; LeVeen, E G

    1987-01-01

    In 1942, 53% of medically treated patients with cirrhosis were dead 6 months after the onset of ascites. Only 30% survived 1 year. This dismal outlook has improved only slightly with advances in medicine. Yet, some internists reject the peritoneovenous shunt (PVS) for this fatal condition even if they are aware that a diminished blood volume causes the abnormal sodium retention responsible for ascites. Their objections are based on life-threatening complications of PVS, especially post shunt coagulopathy (PSC). Blood shed into the peritoneal cavity becomes incoagulable. Such blood is immediately coagulated by a protocoagulant (soluble collagen) and concurrently lysed by tissue plasminogen activator (TPA) secreted by the peritoneal serosa. Wide zones of lysis surround peritoneal tissue placed on fibrin plates. Large volumes of ascitic fluid infused into circulating blood simulates the fate of blood shed into the peritoneal cavity with lysis playing the major role. Addition of ascitic fluid to normal platelet-rich plasma in vitro initiates clot lysis on thromboelastogram (TEG). Epsilon-aminocaproic acid (EACA) counteracts this lysis. EACA and clotting factors normalize the TEG and arrest PSC. Disposal of ascitic fluid at surgery prevents or ameliorates PSC. Mild PSC was encountered only twice in 150+ consecutive patients (1.3%) with only one case being clinically significant (0.6%). Severe PSC occurred seven times in 98 early shunt patients whose ascitic fluid was not discarded. Severe PSC requires shunt interruption and control of bleeding with clotting factors and EACA. Peritoneal lavage with saline prevents the recurrence of PSC on reopening the shunt. In four patients, EACA and clotting factors were adequate to arrest coagulopathy. Three earlier patients died of PSC before its cause and treatment were understood. Proper management eliminates this life-threatening complication, and PSC cannot be considered a deterrent to PVS. Disseminated intravascular

  6. Spinal arteriovenous shunts in children.

    PubMed

    Davagnanam, Indran; Toma, Ahmed K; Brew, Stefan

    2013-11-01

    Pediatric spinal arteriovenous shunts are rare and, in contrast to those in adults, are often congenital or associated with underlying genetic disorders. These are thought to be a more severe and complete phenotypic spectrum of all spinal arteriovenous shunts seen in the overall spinal shunt population. The pediatric presentation thus accounts for its association with significant morbidity and, in general, a more challenging treatment process compared with the adult presentation.

  7. Transjugular intrahepatic portosystemic shunt (TIPS)

    MedlinePlus

    ... Transjugular intrahepatic portosystemic shunt. In: Mauro MA, Murphy KPJ, Thomson KR, Venbrux AC, Morgan RA, eds. Image- ... of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

  8. 49 CFR 236.838 - Wire, shunt.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Wire, shunt. 236.838 Section 236.838 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Wire, shunt. A wire forming part of a shunt circuit....

  9. 49 CFR 236.838 - Wire, shunt.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Wire, shunt. 236.838 Section 236.838 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Wire, shunt. A wire forming part of a shunt circuit....

  10. 49 CFR 236.838 - Wire, shunt.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Wire, shunt. 236.838 Section 236.838 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Wire, shunt. A wire forming part of a shunt circuit....

  11. 49 CFR 236.838 - Wire, shunt.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Wire, shunt. 236.838 Section 236.838 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Wire, shunt. A wire forming part of a shunt circuit....

  12. 49 CFR 236.838 - Wire, shunt.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Wire, shunt. 236.838 Section 236.838 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Wire, shunt. A wire forming part of a shunt circuit....

  13. An unusual cause of ventriculoperitoneal shunt infection.

    PubMed

    Esmaeilzadeh, Majid; Islamian, Ariyan Pirayesh; Lang, Josef M; Hornef, Mathias; Suerbaum, Sebastian; Krauss, Joachim K

    2015-08-01

    Infection associated with ventriculoperitoneal (VP) shunt implantation can be a significant problem. VP shunt infection with Serratia marcescens, a gram-negative anaerobic rod, usually is related to underlying abdominal disease. This article describes treatment of two patients suffering from a VP shunt infection with S. marcescens without underlying abdominal disease.

  14. Pulmonary hypertension in congenital shunts.

    PubMed

    Beghetti, Maurice; Tissot, Cecile

    2010-10-01

    Pulmonary arterial hypertension frequently arises in patients with congenital heart disease. The vast majority present with congenital cardiac shunts. Initially these may manifest as left-to-right (i.e. systemic-to-pulmonary) shunts. The natural history of disease progression involves vascular remodeling and dysfunction that lead to increased pulmonary vascular resistance and, finally, to the development of Eisenmenger's syndrome, which is the most advanced form. The anatomical, pathological and structural abnormalities occurring in the pulmonary circulation of these patients are, to some extent, similar to those observed in other forms of pulmonary arterial hypertension. This understanding has recently led to significant changes in the management of Eisenmenger's syndrome, with the introduction of treatment specifically targeting pulmonary vascular disease. Early closure of the cardiac shunt remains the best way of preventing pulmonary vascular lesions. However, it is still not clear which preoperative parameters predict safe and successful repair, though hemodynamic evaluation is still routinely used for assessment. Postoperative pulmonary hypertension, both in the immediate period after surgical repair and during long-term follow-up, remains a real therapeutic challenge. The clinical situation of a single ventricle with Fontan circulation also presents difficulties when pulmonary vascular lesions are present. This article reviews pulmonary hypertension associated with congenital shunts and discusses a number of the specific problems encountered.

  15. Students with Shunts: Program Considerations.

    ERIC Educational Resources Information Center

    French, Ron; And Others

    1997-01-01

    Examines how the medical condition of hydrocephalus can affect physical education students and physical education programs, and stresses the need to provide physical educators with information on students' medical conditions. Describes hydrocephalus and its treatment with ventricular peritoneal shunts, and offers suggestions on modifying…

  16. Reinfection following initial cerebrospinal fluid shunt infection

    PubMed Central

    Simon, Tamara D.; Hall, Matthew; Dean, J. Michael; Kestle, John R. W.; Riva-Cambrin, Jay

    2010-01-01

    Object Significant variation exists in the surgical and medical management of CSF shunt infection. The objectives of this study were to determine CSF shunt reinfection rates following initial CSF shunt infection in a large patient cohort and to determine management, patient, hospital, and surgeon factors associated with CSF shunt reinfection. Methods This retrospective cohort study included children who were in the Pediatric Health Information System (PHIS) database, who ranged in age from 0 to 18 years, and who underwent uncomplicated initial CSF shunt placement in addition to treatment for initial CSF shunt infection between January 1, 2001, and December 31, 2008. The outcome was CSF shunt reinfection within 6 months. The main predictor variable of interest was surgical approach to treatment of first infection, which was determined for 483 patients. Covariates included patient, hospital, surgeon, and other management factors. Results The PHIS database includes 675 children with initial CSF shunt infection. Surgical approach to treatment of the initial CSF shunt infection was determined for 483 children (71.6%). The surgical approach was primarily shunt removal/new shunt placement (in 286 children [59.2%]), but a substantial number underwent externalization (59 children [12.2%]), of whom a subset went on to have the externalized shunt removed and a new shunt placed (17 children [3.5% overall]). Other approaches included nonsurgical management (64 children [13.3%]) and complete shunt removal without shunt replacement (74 children [15.3%]). The 6-month reinfection rate was 14.8% (100 of 675 patients). The median time from infection to reinfection was 21 days (interquartile range [IQR] 5–58 days). Children with reinfection had less time between shunt placement and initial infection (median 50 vs 79 days, p = 0.06). No differences between those with and without reinfection were seen in patient factors (patient age at either shunt placement or initial infection, sex

  17. Ventriculopleural shunting with new technology valves.

    PubMed

    Martínez-Lage, J F; Torres, J; Campillo, H; Sanchez-del-Rincón, I; Bueno, F; Zambudio, G; Poza, M

    2000-12-01

    Ventriculoperitoneal shunting constitutes the standard procedure for draining cerebrospinal fluid (CSF) in children with hydrocephalus. Ventriculoatrial and ventriculopleural shunting are alternative methods of CSF drainage, which have gained less acceptance. Ventriculopleural shunts are seldom used owing to justified fears of pneumothorax and symptomatic effusions of CSF. The addition of an antisiphon device to standard shunt systems seems to have prevented CSF pleural effusion. From 1988 to 1998, we treated each of six hydrocephalic children with a ventriculopleural shunt. In five cases we used new-technology valves designed to prevent the effects of siphoning with current differential pressure valves. Peritoneal adhesions, recent peritonitis, ascites, and obstruction of a previous ventriculoatrial shunt were the indications for pleural shunting. After a mean follow-up period of 2.5 years all shunts were functioning adequately. Only one patient showed transient symptoms of CSF overdrainage, which were corrected by up-grading the valve setting with the magnet. A late death was unrelated to the pleural shunting procedure. The use of valves of a new design designed to prevent overdrainage seems to account for the satisfactory outcomes observed in this series. We suggest that ventriculopleural shunting should be considered as the preferred alternative to peritoneal drainage in children with intra-abdominal adhesions or with a history of recent peritoneal infection.

  18. Ventriculoperitoneal shunt perforations of the gastrointestinal tract.

    PubMed

    Thiong'o, Grace Muthoni; Luzzio, Christopher; Albright, A Leland

    2015-07-01

    OBJECT The purposes of this study were to evaluate the frequency with which children presented with ventriculoperitoneal (VP) shunt perforations of the gastrointestinal (GI) tract, to determine the type of shunts that caused the perforations, and to compare the stiffness of perforating catheters with the stiffness of catheters from other manufacturers. METHODS Medical records were reviewed of 197 children who were admitted with VP shunt malfunction. Catheter stiffness was evaluated by measuring relative resistance to cross-sectional compression, resistance to column buckling, and elasticity in longitudinal bending. Catheter frictional force was measured per unit length. RESULTS Six children were identified whose VP shunts had perforated the GI tract; 2 shunts subsequently protruded through the anal orifice, 1 protruded through the oral cavity, and 3 presented with subcutaneous abscesses that tracked upward from the intestine to the chest. All perforating shunts were Chhabra shunts. Catheter stiffness and resistance to bending were greatest with a Medtronic shunt catheter, intermediate with a Codman catheter, and least with a Chhabra catheter. Frictional force was greatest with a Chhabra catheter and least with a Medtronic catheter. CONCLUSIONS The frequency of perforations by Chhabra shunts appears to be higher than the frequency associated with other shunts. The increased frequency does not correlate with their stiffness but may reflect their greater frictional forces.

  19. Shunt regulation electric power system

    NASA Technical Reports Server (NTRS)

    Wright, W. H.; Bless, J. J. (Inventor)

    1971-01-01

    A regulated electric power system having load and return bus lines is described. A plurality of solar cells interconnected in a power supplying relationship and having a power shunt tap point electrically spaced from the bus lines is provided. A power dissipator is connected to the shunt tap point and provides for a controllable dissipation of excess energy supplied by the solar cells. A dissipation driver is coupled to the power dissipator and controls its conductance and dissipation and is also connected to the solar cells in a power taping relationship to derive operating power therefrom. An error signal generator is coupled to the load bus and to a reference signal generator to provide an error output signal which is representative of the difference between the electric parameters existing at the load bus and the reference signal generator. An error amplifier is coupled to the error signal generator and the dissipation driver to provide the driver with controlling signals.

  20. LP/SV Bladder Buoyancy Test Comparison

    DTIC Science & Technology

    2011-07-01

    The buoyant force of the British MK 30 LCX is also unknown; however, this flotation device utilizes a large bladder and may replace the LP/SV. Aim...following inflation using a 45g CO2 canister. Conclusion: In all trials, both flotation devices produced buoyant forces greater that 35 lbs. The British...2. The British use a very similar aircrew flotation device called the MK 30 LCX. It differs from the currently used LP/SV because it utilizes a

  1. Analysis of light curve of LP Camelopardalis

    NASA Astrophysics Data System (ADS)

    Prudil, Z.; Skarka, M.; Zejda, M.

    2016-05-01

    We present photometric analysis of the RRab type pulsating star LP Cam. The star was observed at Brno Observatory and Planetarium during nine nights. Measurements were calibrated to the Johnson photometric system. Four captured and thirteen previously published maxima timings allowed us to refine the pulsation period and the zero epoch. The light curve was Fourier decomposed to estimate physical parameters using empirical relations. Our results suggest that LP Cam is a common RR Lyrae star with high, almost solar metallicity.

  2. Cell shunt resistance and photovoltaic module performance

    SciTech Connect

    McMahon, T.J.; Basso, T.S.; Rummel, S.R.

    1996-09-01

    Shunt resistance of cells in photovoltaic modules can affect module power output and could indicate flawed manufacturing processes and reliability problems. The authors describe a two-terminal diagnostic method to directly measure the shunt resistance of individual cells in a series-connected module non-intrusively, without deencapsulation. Peak power efficiency vs. light intensity was measured on a 12-cell, series-connected, single crystalline module having relatively high cell shunt resistances. The module was remeasured with 0.5-, 1-, and 2-ohm resistors attached across each cell to simulate shunt resistances of several emerging technologies. Peak power efficiencies decreased dramatically at lower light levels. Using the PSpice circuit simulator, they verified that cell shunt and series resistances can indeed be responsible for the observed peak power efficiency vs. intensity behavior. They discuss the effect of basic cell diode parameters, i.e., shunt resistance, series resistance, and recombination losses, on PV module performance as a function of light intensity.

  3. Arterioportal shunts on dynamic computed tomography

    SciTech Connect

    Nakayama, T.; Hiyama, Y.; Ohnishi, K.; Tsuchiya, S.; Kohno, K.; Nakajima, Y.; Okuda, K.

    1983-05-01

    Thirty-two patients, 20 with hepatocelluar carcinoma and 12 with liver cirrhosis, were examined by dynamic computed tomography (CT) using intravenous bolus injection of contrast medium and by celiac angiography. Dynamic CT disclosed arterioportal shunting in four cases of hepatocellular carcinoma and in one of cirrhosis. In three of the former, the arterioportal shunt was adjacent to a mass lesion on CT, suggesting tumor invasion into the portal branch. In one with hepatocellular carcinoma, the shunt was remote from the mass. In the case with cirrhosis, there was no mass. In these last two cases, the shunt might have been caused by prior percutaneous needle puncture. In another case of hepatocellular carcinoma, celiac angiography but not CT demonstrated an arterioportal shunt. Thus, dynamic CT was diagnostic in five of six cases of arteriographically demonstrated arterioportal shunts.

  4. Asymptomatic bowel perforation by abandoned ventriculoperitoneal shunt.

    PubMed

    Rinker, Eric K; Osborn, Daniel A; Williams, Todd R; Spizarny, David L

    2013-09-01

    We report a case of an abandoned abdominal ventriculoperitoneal shunt that migrated into the gastric antrum, colonic hepatic flexure, and liver parenchyma, which was discovered incidentally on an abdominal CT obtained for renal stones. In regards to the migrated abandoned VP shunt, the patient was asymptomatic. Upon review of prior CT scans, these findings had progressed over approximately 7 years. We describe the case and discuss the clinical and radiologic findings, complications resulting from ventriculoperitoneal shunts, and possible approaches to their management.

  5. [Unusual abdominal complication of ventriculoperitoneal shunt].

    PubMed

    Guillén, A; Costa, J M; Castelló, I; Claramunt, E; Cardona, E

    2002-10-01

    The most common complications after CSF shunting to treat hydrocephalus are shunt infection and obstruction. Although ventriculoperitoneal (VP) diversion of the CSF using artificial shunt devices is an accepted method for the management of hydrocephalus, high rates of various complications have been reported, ranging from 24% to 47%. Among these, abdominal complications account for approximately 25%. The incidence of bowel perforation by shunt-catheter is known to be as low as 0.1-0.7%. We describe a case of migration af a peritoneal catheter through a congenital hernia of Morgagni.

  6. Radiological Insertion and Management of Peritoneovenous Shunt

    SciTech Connect

    Bratby, M. J.; Hussain, F. F. Lopez, A. J.

    2007-06-15

    The purpose of the study was to report our experience of the management of complications following the insertion of a peritoneovenous shunt for intractable malignant ascites. From June 1999 to January 2006, 26 patients underwent insertion of a peritoneovenous shunt for ascites by interventional radiologists. We have used ultrasound and shuntography to assist in the diagnosis of the cause of shunt blockage. Successful techniques for the restoration of the shunt function include port- pumping, stripping of any fibrin sheath, and revision of either the venous or peritoneal catheter. The procedure was initially successful in all patients with continued patency until death in 17. A further four patients are still alive with a functioning shunt. There was one rapid postprocedure death resulting from pulmonary edema. Two patients developed pneumothorax, managed successfully with either a chest drain or aspiration. Shunt dysfunction occurred eight times in seven patients. There were five successful revisions in four patients. Overall, shunt patency has been maintained in 80.1% of patients. Shunt dysfunction is seen in a significant number of patients, but successful revision of the shunt can be achieved in the majority.

  7. 76 FR 53440 - Freeport LNG Development, LP; Freeport LNG Expansion, LP; FLNG Liquefaction LLC; Notice of Intent...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... Energy Regulatory Commission Freeport LNG Development, LP; Freeport LNG Expansion, LP; FLNG Liquefaction... construction and operation of facilities proposed by Freeport LNG Development, LP, Freeport LNG Expansion, LP... liquefied natural gas (LNG) import terminal on Quintana Island in Brazoria County, Texas. The Project...

  8. 77 FR 43589 - Freeport LNG Development, L.P., Freeport LNG Expansion, L.P., FLNG Liquefaction LLC; Supplemental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-25

    ... Energy Regulatory Commission Freeport LNG Development, L.P., Freeport LNG Expansion, L.P., FLNG... proposed by Freeport LNG Development, L.P., Freeport LNG Expansion, L.P, and FLNG Liquefaction LLC... existing liquefied natural gas (LNG) import terminal on Quintana Island in Brazoria County, Texas....

  9. 78 FR 22872 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings Take notice that on April 5, 2013, the applicants listed above submitted an amendment to...

  10. 78 FR 25262 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings Take notice that on April 23, 2013, the applicants listed above submitted an amendment to...

  11. Cerebral arteriovenous shunts in children.

    PubMed

    Toma, Ahmed K; Davagnanam, Indran; Ganesan, Vijeya; Brew, Stefan

    2013-11-01

    Intracranial arteriovenous shunts (AVSs) in children can be divided into pial arteriovenous malformations, vein of Galen malformations, and arteriovenous fistulae (AVF). Dural AVF and dural sinus malformations are rare entities within this group. The relative immaturity of the anatomy and physiology of the neonatal and infant brain results in the inability of the hydrovenous system to compensate in the face of such disorders. Thus, the clinical presentation reflects this difference in the underlying anatomy, physiology, and disorder between children and adults. In this article, we briefly review the presentation, natural history and management of these entities.

  12. 75 FR 39680 - Houston Pipe Line Company LP, Worsham-Steed Gas Storage, L.P., Energy Transfer Fuel, LP, Mid...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-12

    ... Storage, L.P., Energy Transfer Fuel, LP, Mid Continent Market Center, L.L.C., Oasis Pipeline, LP (Not... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR10-44-000; Docket No. PR10-46-000; Docket No....

  13. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  14. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  15. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION..., Inspection, and Testing Maintenance Standards § 234.229 Shunting sensitivity. Each highway-rail...

  16. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  17. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION..., Inspection, and Testing Maintenance Standards § 234.229 Shunting sensitivity. Each highway-rail...

  18. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  19. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  20. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt. (a) Identification. An endolymphatic shunt is a device that consists of a tube or sheet intended to be implanted to relieve the symptons of vertigo. The device permits the unrestricted flow of excess endolymph from...

  1. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt. (a) Identification. An endolymphatic shunt is a device that consists of a tube or sheet intended to be implanted to relieve the symptons of vertigo. The device permits the unrestricted flow of excess endolymph from...

  2. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  3. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  4. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  5. Congenital Portosystemic Shunt: Our Experience

    PubMed Central

    Timpanaro, Tiziana; Passanisi, Stefano; Sauna, Alessandra; Trombatore, Claudia; Pennisi, Monica; Petrillo, Giuseppe; Smilari, Pierluigi; Greco, Filippo

    2015-01-01

    Introduction. Congenital portosystemic venous malformations are rare abnormalities in which the portal blood drains into a systemic vein and which are characterized by extreme clinical variability. Case Presentations. The authors present two case reports of a congenital extrahepatic portosystemic shunt (Type II). In the first patient, apparently nonspecific symptoms, such as headache and fatigue, proved to be secondary to hypoglycemic episodes related to the presence of a portosystemic shunt, later confirmed on imaging. During portal vein angiography, endovascular embolization of the portocaval fistula achieved occlusion of the anomalous venous tract. In the second patient, affected by Down's syndrome, the diagnosis of a portosystemic malformation was made by routine ultrasonography, performed to rule out concurrent congenital anomalies. Because of the absence of symptoms, we chose to observe this patient. Conclusions. These two case reports demonstrate the clinical heterogeneity of this malformation and the need for a multidisciplinary approach. As part of a proper workup, clinical evaluation must always be followed by radiographic diagnosis. PMID:25709849

  6. Mycobacterium abscessus ventriculoperitoneal shunt infection and review of the literature.

    PubMed

    Montero, Jose A; Alrabaa, Sally F; Wills, Todd S

    2016-04-01

    A 30-year-old man with history of neonatal hydrocephalus requiring ventriculoperitoneal shunt placement presented with Mycobacterium abscessus shunt infection despite no shunt manipulation over 10 years prior to presentation. Cure was not achieved until complete removal of all CNS shunt foreign body was performed despite initial adequate antimicrobial therapy.

  7. Subtotal laryngectomy with myomucosal shunt.

    PubMed

    Chandrachud, H R; Chaurasia, M K; Sinha, K P

    1989-05-01

    This is a modified subtotal laryngectomy. On the tumour-free side of the larynx, some posterior structures, with their neurovascular supply are preserved. The endolaryngeal mucosa is tubed in continuity with the trachea below and projects into the pharynx above. Thus a myomucosal shunt is formed. Air is directed into it by finger occlusion of the tracheal stoma. The voice production is highly satisfactory. Aspiration is prevented by constriction of the thyroarytenoid muscle which provides a valved upper end of the tube. The possibility of leaving tumour in the laryngeal remnant is eliminated by careful selection of patients, and re-confirmation of tumour extent intra-operatively and a frozen section. Eleven such operations have been performed since October 1983 for squamous cell carcinoma, some previously irradiated. None of the patients had local recurrence. Only one had an aspiration problem which later resolved. All acquired a satisfactory voice.

  8. Ventriculoperitoneal Shunting Surgery with Open Distal Shunt Catheter Placement in the Treatment of Hydrocephalus.

    PubMed

    Zhang, Yang; Zhu, Xiaobo; Zhao, Jinchuan; Hou, Kun; Gao, Xianfeng; Sun, Yang; Wang, Wei; Zhang, Xiaona

    2015-11-01

    Ventriculoperitoneal shunting (VPS) is a major therapy for hydrocephalus, but has a significant risk of device malfunctioning. In this study, we explored a novel distal shunt catheter placement method in VPS for the treatment of hydrocephalus. Five patients with different etiologies of hydrocephalus underwent VPS with open distant shunt catheter attached outside. We analyzed different variables (age, gender, medical history, clinical presentation, indication for surgery and surgical technique, postoperative complications) and occurrence of shunt failure and infection. All hydrocephalus patients who received the distal shunt catheter placed outside can undergo regular VPS again after the condition improves. The modified VPS in the treatment of hydrocephalus with the distal shunt catheter placed outside could potentially reduce the necessity of repeat surgery for addressing the complications caused by catheter obstruction and infections, reduce the chance of adhesions, and would be of benefit to those patients who need future revisions.

  9. Fasciocutaneous flap in esophageal stricture with ventriculoperitoneal shunt.

    PubMed

    Seong, Yong Won; Kang, Chang Hyun; Chang, Hak; Park, In Kyu; Kim, Young Tae

    2014-01-01

    Abdominal surgery in a patient with ventriculoperitoneal shunt may increase the risk of shunt malfunction and infection. We present a successful case of resection and reconstruction of the cervical esophagus by rolled lateral thoracic artery fasciocutaneous flap in a patient with corrosive esophageal stricture and preexisting ventriculoperitoneal shunt. Follow-up esophagogastroscopy after 3 months revealed wide patent graft. Rolled fasciocutaneous flap may be a safe alternative treatment without risk of shunt-associated complications in a patient with ventriculoperitoneal shunt.

  10. 77 FR 20015 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application Take notice that on March 19, 2012, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas.... Connolly, General Manager, Rates & Certificates, Texas Eastern Transmission, LP, P.O. Box 1642,...

  11. 78 FR 43874 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application On July 2, 2013, Texas Eastern Transmission, LP (Texas Eastern) filed with the Federal Energy Regulatory Commission (Commission... Eastern Transmission, LP, P.O. Box 1642, Houston, Texas, 77251-1642, or by calling (713) 627-4102; by...

  12. 76 FR 49760 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-11

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application Take notice that on July 29, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas... directed to Lisa A. Connolly, General Manager, Rates & Certificates, Texas Eastern Transmission, LP,...

  13. 77 FR 26534 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application Take notice that on April 19, 2012, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas... directed to Marcy F. Collins, Associate General Counsel, Texas Eastern Transmission, LP, P.O. Box...

  14. Arne Torkildsen and the ventriculocisternal shunt: the first clinically successful shunt for hydrocephalus.

    PubMed

    Eide, Per Kristian; Lundar, Tryggve

    2016-05-01

    Arne Torkildsen was a pioneering Norwegian neurosurgeon who introduced the ventriculocisternal shunt, the first clinically successful shunt for CSF diversion in hydrocephalus. The procedure, usually referred to as ventriculocisternostomy (VCS), Torkildsen's operation, orTorkildsen's shunt, became internationally recognized as an efficient operation for the treatment of noncommunicating hydrocephalus. The operation gained widespread use in the 1940s and 1950s before the introduction of extracranial shunts. In this paper, the authors look more closely at Torkildsen's development of the VCS and examine how this surgical approach differed from other procedures for treating hydrocephalus before World War II. Long-term results of the VCS are presented.

  15. Laparoscopic revision of a ventriculoperitoneal shunt.

    PubMed

    Turner, Raymond; Chahlavi, Ali; Rasmussen, Peter; Brody, Fred

    2004-10-01

    Ventriculoperitoneal (VP) shunts are the most common treatment modality for hydrocephalus. Distal catheter malfunction represents a surgical emergency and a significant cause of procedural morbidity. We report the case of a patient with acute abdominal pain following VP shunt insertion. On examination she had a tender, irreducible bulge at the abdominal laparotomy site. Exploratory laparoscopy of the abdomen yielded no abdominal wall abnormalities. At the same time, the distal catheter was noted to be absent. The abdominal bulge was incised along the laparotomy scar and clear cerebrospinal fluid was encountered. The incision was explored and the distal catheter was coiled and knotted within the preperitoneal space. The catheter was laparoscopically returned to the peritoneal cavity. This case exemplifies the utility of laparoscopy for VP shunt revision and we present a review of laparoscopic shunt revision.

  16. Bilateral pneumothorax during subdural-peritoneal shunting.

    PubMed

    Solmaz, Ilker; Tehli, Ozkan; Kaya, Serdar; Erdogan, Ersin; Izci, Yusuf

    2011-01-01

    Pneumothorax is a very rare complication of ventriculoperitoneal shunting in children. We report a case of an iatrogenic bilateral tension pneumothorax during the placement of a subdural-peritoneal shunting. After the placement of peritoneal catheter, oxygen saturation of the patient quickly decreased, hypotension and bradycardia occurred. Intraoperative x-rays showed the pneumothorax. A thoracostomy tube was inserted and attached to an underwater seal. Vital signs improved in a short time period. The radiological improvement had been achieved in four days. Early diagnosis and prompt intervention are life-saving for this complication. To avoid this complication, the tip of the shunt tunneler should be always palpable during the placement of the peritoneal catheter, especially in children's shunt surgery.

  17. Cerebrospinal fluid eosinophilia associated with intraventricular shunts.

    PubMed

    Bezerra, Sofia; Frigeri, Thomas More; Severo, Carlos Marcelo; Santana, João Carlos Batista; Graeff-Teixeira, Carlos

    2011-06-01

    CSF eosinophilia (CSF-eo) is uncommon and is usually caused by helminthic infections. However, it has also been found in ∼30% of patients experiencing intraventricular shunt malfunctions. We present a case report and review the conditions associated with CSF-eo and their prophylaxis. An 8 year-old boy with tetraventricular hydrocephalus has had several shunt malfunctions over the last three years. During hospitalization in January 2009 for shunt revision, a transient 30% eosinophilia was detected in his cerebral spinal fluid (CSF) concomitant with Staphylococcus epidermidis infection and long term vancomycin administration. After several shunt replacements and antibiotic treatment, CSF-eo eventually disappeared with good overall clinical response. CSF-eo is a transient and focal event mainly associated with infection, reactions to foreign substances, particles or blood, or obstruction of tubing by normal or fibro-granulomatous tissues. Infection associated with CSF-eo is usually caused by S. epidermidis and Propioniumbacterium acnes. In addition to infection, allergy to silicone and other foreign materials may also be a cause of CSF-eo. We review the diversity of conditions and proposed mechanisms associated with CSF-eo, as well as recommendations for the care of patients with shunts. Detection of CSF-eo has been shown to be a useful indicator of shunt malfunction. As such, it provides physicians with an indicator of a hypersensitivity reaction that is underway or the need to identify bacterial infection. We also highlight the need for improved biocompatibility of shunt hardware and describe strategies to avoid conditions leading to shunt malfunction.

  18. 78 FR 36182 - APL SouthTex Transmission Company LP, Formerly TEAK Texana Transmission Company, LP; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission APL SouthTex Transmission Company LP, Formerly TEAK Texana Transmission Company, LP; Notice of Filing Take notice that on June 7, 2013, APL SouthTex Transmission Company LP (APL SouthTex) filed to notify the...

  19. Cell shunt resistance and photovoltaic module performance

    SciTech Connect

    McMahon, T.J.; Basso, T.S.; Rummel, S.R.

    1996-05-01

    Shunt resistance of cells in photovoltaic modules can affect module power output and could indicate flawed manufacturing processes and reliability problems. The authors describe a two-terminal diagnostic method to directly measure the shunt resistance of individual cells in a series-connected module non-intrusively, without deencapsulation. Peak power efficiency vs. light intensity was measured on a 12-cell, series-connected, single crystalline module having relatively high cell shunt resistances. The module was remeasured with 0.5-, 1-, and 2-ohm resistors attached across each cell to simulate shunt resistances of several emerging technologies. Peak power efficiencies decreased dramatically at lower light levels. Using the PSpice circuit simulator, the authors verified that cell shunt and series resistances can indeed be responsible for the observed peak power efficiency vs. intensity behavior. The authors discuss the effect of basic cell diode parameters, i.e., shunt resistance, series resistance, and recombination losses, on PV module performance as a function of light intensity.

  20. Endoscopic third ventriculostomy in previously shunted children.

    PubMed

    Brichtova, Eva; Chlachula, Martin; Hrbac, Tomas; Lipina, Radim

    2013-01-01

    Endoscopic third ventriculostomy (ETV) is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P) shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%). There were two serious complications (4.7%)-one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

  1. 77 FR 2293 - AmeriGas Propane, L.P., AmeriGas Propane, Inc., Energy Transfer Partners, L.P., and Energy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... AmeriGas Propane, L.P., AmeriGas Propane, Inc., Energy Transfer Partners, L.P., and Energy Transfer...'') with AmeriGas Propane, L.P. (``AmeriGas''), AmeriGas Propane, Inc., Energy Transfer Partners, L.P. (``ETP''), and Energy Transfer Partners GP, L.P. (``ETP GP''), which is designed to guard...

  2. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

    PubMed Central

    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  3. An unusual ventriculoperitoneal shunt complication: spontaneous knot formation.

    PubMed

    Borcek, Alp Ozgun; Civi, Soner; Golen, Mustafa; Emmez, Hakan; Baykaner, M Kemali

    2012-01-01

    This article aims to describe an extraordinary complication of a ventriculoperitoneal shunt system that formed a knot spontaneously and lead to a shunt malfunction. A 3-year-old male patient was operated due to posttraumatic hydrocephalus. After an uneventful follow-up period of 34 months, he presented with shunt malfunction. During the shunt revision surgery, the peritoneal catheter was found to form a loop over itself. There are various complications of ventriculoperitoneal shunt systems. Migration to body cavities is among the most interesting ones. This is the fifth report describing this rare complication. Hydrocephalic patients should be closely followed up after shunt surgery for various extraordinary complications.

  4. Simulation model for port shunting yards

    NASA Astrophysics Data System (ADS)

    Rusca, A.; Popa, M.; Rosca, E.; Rosca, M.; Dragu, V.; Rusca, F.

    2016-08-01

    Sea ports are important nodes in the supply chain, joining two high capacity transport modes: rail and maritime transport. The huge cargo flows transiting port requires high capacity construction and installation such as berths, large capacity cranes, respectively shunting yards. However, the port shunting yards specificity raises several problems such as: limited access since these are terminus stations for rail network, the in-output of large transit flows of cargo relatively to the scarcity of the departure/arrival of a ship, as well as limited land availability for implementing solutions to serve these flows. It is necessary to identify technological solutions that lead to an answer to these problems. The paper proposed a simulation model developed with ARENA computer simulation software suitable for shunting yards which serve sea ports with access to the rail network. Are investigates the principal aspects of shunting yards and adequate measures to increase their transit capacity. The operation capacity for shunting yards sub-system is assessed taking in consideration the required operating standards and the measure of performance (e.g. waiting time for freight wagons, number of railway line in station, storage area, etc.) of the railway station are computed. The conclusion and results, drawn from simulation, help transports and logistics specialists to test the proposals for improving the port management.

  5. Palliation of malignant ascites by the Denver peritoneovenous shunt.

    PubMed Central

    Downing, R.; Black, J.; Windsor, C. W.

    1984-01-01

    Five out of 8 Denver peritoneovenous shunts placed in 7 patients provided excellent palliation of malignant ascites. Subclinical consumptive coagulopathy was detected after placement of 6 shunts, but no patient developed overt bleeding. Images Fig. 1 Fig. 2 PMID:6207757

  6. The Land Processes Distributed Active Archive Center (LP DAAC)

    USGS Publications Warehouse

    Golon, Danielle K.

    2016-10-03

    The Land Processes Distributed Active Archive Center (LP DAAC) operates as a partnership with the U.S. Geological Survey and is 1 of 12 DAACs within the National Aeronautics and Space Administration (NASA) Earth Observing System Data and Information System (EOSDIS). The LP DAAC ingests, archives, processes, and distributes NASA Earth science remote sensing data. These data are provided to the public at no charge. Data distributed by the LP DAAC provide information about Earth’s surface from daily to yearly intervals and at 15 to 5,600 meter spatial resolution. Data provided by the LP DAAC can be used to study changes in agriculture, vegetation, ecosystems, elevation, and much more. The LP DAAC provides several ways to access, process, and interact with these data. In addition, the LP DAAC is actively archiving new datasets to provide users with a variety of data to study the Earth.

  7. Oculogyric crisis masquerading as ventriculoperitoneal shunt dysfunction.

    PubMed

    AlAzwary, Nail H; Muayqil, Taim; Siddiqi, Zaeem A; Ahmed, S Nizam

    2008-11-01

    Oculogyric crisis (OGC) is an underrecognized oculodystonic reaction associated with several medications including carbamazepine. The authors present a patient who had presented to the emergency department on multiple occasions with a questionable ventriculoperitoneal (VP) shunt dysfunction. Symptoms included nausea, vomiting, altered level of consciousness, ataxia, and vertical eye deviation. The patient underwent multiple revisions of the VP shunt with transient and questionable improvement. During her visit to the neurology clinic, OGC from carbamazepine was suspected, and the dose was reduced. The patient has been completely asymptomatic for the past 18 months. The authors report this case to increase the awareness of carbamazepine-induced OGC as one of the differential diagnoses for VP shunt dysfunction.

  8. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    SciTech Connect

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggrregated albumin (/sup 99m/Tc MAA) labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cutaneous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  9. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    SciTech Connect

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary vasculature resulting in intrapulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggregated albumin labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cuntaeous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  10. Arteriovenous shunts resembling patent ductus arteriosus in dogs: 3 cases.

    PubMed

    Fujii, Yoko; Aoki, Takuma; Takano, Hiroshi; Ishikawa, Ryokichi; Wakao, Yoshito

    2009-12-01

    Three dogs presented for the evaluation of cardiac murmurs were diagnosed with aberrant arteriovenous shunts. All cases demonstrated the following findings: 1) relatively soft continuous murmur loudest at the left heart base resembling patent ductus arteriosus (PDA); 2) shunt flow signals in the pulmonary artery on echocardiography; and 3) no PDA on selective angiography, but evidence of anomalous shunting vessels from thoracic aorta to pulmonary vasculature. An aberrant arteriovenous shunt should be considered when a continuous murmur of relatively small intensity is heard.

  11. Ventricular shunt infections: Immunopathogenesis and clinical management

    PubMed Central

    Gutierrez-Murgas, Yenis; Snowden, Jessica N.

    2014-01-01

    Ventricular shunts are the most common neurosurgical procedure performed in the United States. This hydrocephalus treatment is often complicated by infection of the device with biofilm-forming bacteria. In this review, we discuss the pathogenesis of shunt infection, as well as the implications of the biofilm formation on treatment and prevention of these infections. Many questions remain, including the contribution of glia and the impact of inflammation on developmental outcomes following infection. Immune responses within the CNS must be carefully regulated to contain infection while minimizing bystander damage; further study is needed to design optimal treatment strategies for these patients. PMID:25156073

  12. Recovery from confabulation after normotensive hydrocephalus shunting.

    PubMed

    Dalla Barba, Gianfranco; Barbera, Claudia; Brazzarola, Marta; Marangoni, Sara

    2016-02-01

    Confabulation, the production of statements and actions that are unintentionally incongruous to the subject's history, background, present and future situation, is observed in several conditions affecting the nervous system, but it has never been described in normotensive hydrocephalus. In this article we report on a patient with normotensive hydrocephalus who suffered from an amnesic-confabulatory syndrome. After hydrocephalus shunting, both amnesia and confabulation cleared up abruptly. We discuss this finding in terms of a possible disconnection of the hippocampus, due to transitory white matter damage, which may have recovered after hydrocephalus shunting.

  13. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Shunt and fouling wires. 236.57 Section 236.57...: All Systems Track Circuits § 236.57 Shunt and fouling wires. (a) Except as provided in paragraph (b) of this section, shunt wires and fouling wires hereafter installed or replaced shall consist of...

  14. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Shunt and fouling wires. 236.57 Section 236.57...: All Systems Track Circuits § 236.57 Shunt and fouling wires. (a) Except as provided in paragraph (b) of this section, shunt wires and fouling wires hereafter installed or replaced shall consist of...

  15. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunt and fouling wires. 236.57 Section 236.57...: All Systems Track Circuits § 236.57 Shunt and fouling wires. (a) Except as provided in paragraph (b) of this section, shunt wires and fouling wires hereafter installed or replaced shall consist of...

  16. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Shunt and fouling wires. 236.57 Section 236.57...: All Systems Track Circuits § 236.57 Shunt and fouling wires. (a) Except as provided in paragraph (b) of this section, shunt wires and fouling wires hereafter installed or replaced shall consist of...

  17. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunt and fouling wires. 236.57 Section 236.57...: All Systems Track Circuits § 236.57 Shunt and fouling wires. (a) Except as provided in paragraph (b) of this section, shunt wires and fouling wires hereafter installed or replaced shall consist of...

  18. [Intraabdominal metastasis of cerebellar medulloblastoma through ventriculoperitoneal shunt].

    PubMed

    Carrasco Torrents, R; Sancho, M A; Juliá, V; Montaner, A; Costa, J M; Morales, L

    2001-01-01

    We present a 6-year-old girl with cerebellar medulloblastoma causing obstructive hydrocephalus that was treated by ventriculoperitoneal shunting. The patient subsequently underwent surgical excision of the tumor followed by adjuvant craniospinal radiotherapy. Nine months after shunting, multiple intraabdominal metastatic lesions were found. Although the risk is low, ventriculoperitoneal shunting may facilitate the spread of malignant cells.

  19. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  20. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  1. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  2. 49 CFR 236.104 - Shunt fouling circuit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunt fouling circuit. 236.104 Section 236.104 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Inspections and Tests; All Systems § 236.104 Shunt fouling circuit. Shunt fouling...

  3. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  4. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  5. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shunt system implantation instrument. 882.4545... implantation instrument. (a) Identification. A shunt system implantation instrument is an instrument used in the implantation of cerebrospinal fluid shunts, and includes tunneling instruments for passing...

  6. Complete genome sequence of Lutibacter profundi LP1(T) isolated from an Arctic deep-sea hydrothermal vent system.

    PubMed

    Wissuwa, Juliane; Bauer, Sven Le Moine; Steen, Ida Helene; Stokke, Runar

    2017-01-01

    Lutibacter profundi LP1(T) within the family Flavobacteriaceae was isolated from a biofilm growing on the surface of a black smoker chimney at the Loki's Castle vent field, located on the Arctic Mid-Ocean Ridge. The complete genome of L. profundi LP1(T) is the first genome to be published within the genus Lutibacter. L. profundi LP1(T) consists of a single 2,966,978 bp circular chromosome with a GC content of 29.8%. The genome comprises 2,537 protein-coding genes, 40 tRNA species and 2 rRNA operons. The microaerophilic, organotrophic isolate contains genes for all central carbohydrate metabolic pathways. However, genes for the oxidative branch of the pentose-phosphate-pathway, the glyoxylate shunt of the tricarboxylic acid cycle and the ATP citrate lyase for reverse TCA are not present. L. profundi LP1(T) utilizes starch, sucrose and diverse proteinous carbon sources. In accordance, the genome harbours 130 proteases and 104 carbohydrate-active enzymes, indicating a specialization in degrading organic matter. Among a small arsenal of 24 glycosyl hydrolases, which offer the possibility to hydrolyse diverse poly- and oligosaccharides, a starch utilization cluster was identified. Furthermore, a variety of enzymes may be secreted via T9SS and contribute to the hydrolytic variety of the microorganism. Genes for gliding motility are present, which may enable the bacteria to move within the biofilm. A substantial number of genes encoding for extracellular polysaccharide synthesis pathways, curli fibres and attachment to surfaces could mediate adhesion in the biofilm and may contribute to the biofilm formation. In addition to aerobic respiration, the complete denitrification pathway and genes for sulphide oxidation e.g. sulphide:quinone reductase are present in the genome. sulphide:quinone reductase and denitrification may serve as detoxification systems allowing L. profundi LP1(T) to thrive in a sulphide and nitrate enriched environment. The information gained from the

  7. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  8. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  9. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  10. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... neovascular glaucoma or with glaucoma when medical and conventional surgical treatments have failed....

  11. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... neovascular glaucoma or with glaucoma when medical and conventional surgical treatments have failed....

  12. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... neovascular glaucoma or with glaucoma when medical and conventional surgical treatments have failed....

  13. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... neovascular glaucoma or with glaucoma when medical and conventional surgical treatments have failed....

  14. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... neovascular glaucoma or with glaucoma when medical and conventional surgical treatments have failed....

  15. Platypnea-Orthodeoxia Syndrome: To Shunt or Not to Shunt, That is the Question.

    PubMed

    Klein, Michael R; Kiefer, Todd L; Velazquez, Eric J

    2016-06-01

    Platypnea-orthodeoxia syndrome is a rare disease defined by dyspnea and deoxygenation, induced by an upright position, and relieved by recumbency. Causes include shunting through a patent foramen ovale and pulmonary arteriovenous malformations. A 79-year-old woman experienced 2 syncopal episodes at rest and presented at another hospital. In the emergency department, she was hypoxic, needing 6 L/min of oxygen. Her chest radiograph showed nothing unusual. Transthoracic echocardiograms with saline microcavitation evaluation were mildly positive early after agitated-saline administration, suggesting intracardiac shunting. She was then transferred to our center. Right-sided heart catheterization revealed no oximetric evidence of intracardiac shunting while the patient was supine and had a low right atrial pressure. However, her oxygen saturation dropped to 78% when she sat up. Repeat transthoracic echocardiography while sitting revealed a dramatically positive early saline microcavitation-uptake into the left side of the heart. Transesophageal echocardiograms showed a patent foramen ovale, with right-to-left shunting highly dependent upon body position. The patient underwent successful percutaneous patent foramen ovale closure, and her oxygen supplementation was suspended. In patients with unexplained or transient hypoxemia in which a cardiac cause is suspected, it is important to evaluate shunting in both the recumbent and upright positions. In this syndrome, elevated right atrial pressure is not necessary for significant right-to-left shunting. Percutaneous closure, if feasible, is first-line therapy in these patients.

  16. Advantages of temporary venoatrial shunt using centrifugal pump during bidirectional cavopulmonary shunt.

    PubMed

    Kotani, Yasuhiro; Honjo, Osami; Ishino, Kozo; Osaki, Satoru; Kuroko, Yosuke; Kawabata, Takuya; Ugaki, Shinya; Yoshizumi, Ko; Kasahara, Shingo; Kawada, Masaaki; Sano, Shunji

    2006-01-01

    Single-ventricle palliation without the use of cardiopulmonary bypass carries advantages that reduce systemic edema and inflammatory responses; however, simple clamping of the superior vena cava (SVC) without a temporary shunt leads to increase in cerebral venous pressure and subsequent decrease in cerebral blood flow during bidirectional cavopulmonary shunt (BCPS). We report our experience of BCPS, using a centrifugal pump-assisted temporary shunt. The criteria included an unrestrictive interatrial communication, the absence of atrioventricular valve regurgitation, and the existence of an antegrade pulmonary blood flow. From August 2000, 14 children with single-ventricle physiology met the criteria. The mean age was 1.0 +/- 0.9 years, and the mean weight was 8.4 +/- 2.6 kg. A temporary shunt was established between the SVC and the right atrium with right-angle cannulae, which were connected to a centrifugal pump to accelerate the blood flow from the SVC to the right atrium. All patients tolerated the procedure. Mean central venous pressure was 17 +/- 4 mm Hg, and transcutaneous oxygen saturation was maintained at 77 +/- 8% during anastomosis. No patients required blood transfusion. There were no postoperative neurological complications. The centrifugal pump-assisted temporary shunt offered safer and more effective circulatory support than other shunt systems, with excellent venous drainage in pediatric patients undergoing BCPS.

  17. Clinical peritonitis from allergy to silicone ventriculoperitoneal shunt.

    PubMed

    Kurin, Michael; Lee, Kenneth; Gardner, Paul; Fajt, Merritt; Umapathy, Chandraprakash; Fasanella, Kenneth

    2017-03-06

    Silicones are inorganic compounds that have been used for the purpose of shunting ventricular fluid since the mid-20th century [1]. Complications of ventriculoperitoneal shunts have rarely been attributed to silicone allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms. It can be diagnosed by detection of antisilicone antibodies and is treated with removal of the shunt and replacement, if needed, with a polyurethane shunt system. We report the first case of suspected silicone allergy presenting as clinical peritonitis without overt colonic perforation.

  18. Intraparenchymal pericatheter cyst following disconnection of ventriculoperitoneal shunt system.

    PubMed

    Balasubramaniam, S; Tyagi, D K; Sawant, H V

    2013-01-01

    Ventriculoperitoneal (VP) shunt is one of the most commonly performed procedures in neurosurgery, but it is also the procedure, which is most prone to complications. Spread of cerebrospinal fluid (CSF) into the brain parenchyma is a rare complication of VP shunt and can take the form of CSF edema or a porencephalic cyst. We describe a case of a 1½-year-old child who presented to us with seizures. Computed tomography scan revealed pericatheter porencephalic cyst. Surgical exploration revealed a disconnected VP shunt system. Patient was neurologically observed after shunt extraction. He was seizure free and radiological follow-up showed resolution of cyst. Ours is the first case to document the presence of pericatheter cyst following complete disconnection of shunt system. Though shunt revision is the accepted treatment modality, careful neurological observation can be done after shunt removal especially in asymptomatic cases with compensated hydrocephalus.

  19. Passively Shunted Piezoelectric Damping of Centrifugally-Loaded Plates

    NASA Technical Reports Server (NTRS)

    Duffy, Kirsten P.; Provenza, Andrew J.; Trudell, Jeffrey J.; Min, James B.

    2009-01-01

    Researchers at NASA Glenn Research Center have been investigating shunted piezoelectric circuits as potential damping treatments for turbomachinery rotor blades. This effort seeks to determine the effects of centrifugal loading on passively-shunted piezoelectric - damped plates. Passive shunt circuit parameters are optimized for the plate's third bending mode. Tests are performed both non-spinning and in the Dynamic Spin Facility to verify the analysis, and to determine the effectiveness of the damping under centrifugal loading. Results show that a resistive shunt circuit will reduce resonant vibration for this configuration. However, a tuned shunt circuit will be required to achieve the desired damping level. The analysis and testing address several issues with passive shunt circuit implementation in a rotating system, including piezoelectric material integrity under centrifugal loading, shunt circuit implementation, and tip mode damping.

  20. 76 FR 68745 - Seneca Power Partners, L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ...] Seneca Power Partners, L.P. v. New York Independent System Operator, Inc.; Notice of Complaint Take notice that on October 27, 2011, pursuant to sections 206 and 306 of the Federal Power Act, 16 U.S.C... and Procedures, 18 CFR 385.206, Seneca Power Partners, L.P. (Complainant) filed a complaint...

  1. 76 FR 41238 - Regency Intrastate Gas LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Regency Intrastate Gas LP; Notice of Filing Take notice that on July 7, 2011, Regency Intrastate Gas LP, (Regency) filed to revise its Operating Statement. Regency states this...

  2. 76 FR 34974 - Regency Intrastate Gas LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Regency Intrastate Gas LP; Notice of Filing Take notice that on June 7, 2011, Regency Intrastate Gas LP, (Regency) filed to revise its Operating Statement. Regency states...

  3. 78 FR 45592 - DeltaPoint Capital IV, LP;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ... ADMINISTRATION DeltaPoint Capital IV, LP; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that DeltaPoint Capital IV, L.P., 45 East Avenue... Business Administration (``SBA'') Rules and Regulations (13 CFR 107.730). DeltaPoint Capital IV,...

  4. 78 FR 16846 - Notice of Application; Equitrans, L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... Energy Regulatory Commission Notice of Application; Equitrans, L.P. Take notice that on March 1, 2013, Equitrans, L.P. (Equitrans), 625 Liberty Avenue, Suite 1700, Pittsburgh, Pennsylvania 15222, filed in Docket...: 5:00 p.m. Eastern Time on April 2, 2013. Dated: March 12, 2013. Kimberly D. Bose, Secretary....

  5. 76 FR 9341 - Equitrans, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Equitrans, L.P.; Notice of Application Take notice that on January 27, 2011, Equitrans, L.P. (``Equitrans''), having its principal place of business at 625 Liberty Avenue, Suite...

  6. 76 FR 50881 - Airworthiness Directives; M7 Aerospace LP Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ...-025-AD; Amendment 39-16771; AD 2011-17-07] RIN 2120-AA64 Airworthiness Directives; M7 Aerospace LP.... SUMMARY: We are adopting a new airworthiness directive (AD) for certain M7 Aerospace LP Models SA226-T... AD, contact M7 Aerospace, LC, 10823 NE. Entrance Road, San Antonio, Texas 78216; telephone (210)...

  7. 75 FR 27551 - Keystone Energy Partners, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Keystone Energy Partners, LP; Notice of Filing May 10, 2010. Take notice that on December 16, 2009, Keystone Energy Partners, LP submit for filing an Updated Market Power Analysis, Request for Category 1 Status,...

  8. 75 FR 45611 - Texas Eastern Transmission LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... Energy Regulatory Commission Texas Eastern Transmission LP; Notice of Application July 27, 2010. Take notice that on July 15, 2010, Texas Eastern Transmission (Texas Eastern), P.O. Box 1642, Houston, Texas... Eastern Transmission, LP, P.O. Box 1642, Houston, Texas 77251-1642, or by calling (713)...

  9. 76 FR 38381 - Texas Eastern Transmission, LP; Notice of Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Amendment Take notice that on June 13, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056... Application should be directed to Berk Donaldson, Director, Rates and Certificates, Texas Eastern...

  10. LP based approach to optimal stable matchings

    SciTech Connect

    Teo, Chung-Piaw; Sethuraman, J.

    1997-06-01

    We study the classical stable marriage and stable roommates problems using a polyhedral approach. We propose a new LP formulation for the stable roommates problem. This formulation is non-empty if and only if the underlying roommates problem has a stable matching. Furthermore, for certain special weight functions on the edges, we construct a 2-approximation algorithm for the optimal stable roommates problem. Our technique uses a crucial geometry of the fractional solutions in this formulation. For the stable marriage problem, we show that a related geometry allows us to express any fractional solution in the stable marriage polytope as convex combination of stable marriage solutions. This leads to a genuinely simple proof of the integrality of the stable marriage polytope. Based on these ideas, we devise a heuristic to solve the optimal stable roommates problem. The heuristic combines the power of rounding and cutting-plane methods. We present some computational results based on preliminary implementations of this heuristic.

  11. 78 FR 21491 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... ADMINISTRATION DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption... that DeltaPoint Capital IV, L.P. and DeltaPoint Capital IV (New York), L.P., 45 East Avenue, 6th Floor... Business Administration (``SBA'') Rules and Regulations (13 CFR 107.730). DeltaPoint Capital IV,...

  12. Free floating ventricular shunt catheter between lateral ventricles: a case report of an unusual ventriculoperitoneal shunt complication.

    PubMed

    Erol, Fatih Serhat; Cakin, Hakan; Ozturk, Sait; Donmez, Osman; Kaplan, Metin

    2013-01-01

    Ventriculoperitoneal (VP) shunt proximal tip disconnection is rarely seen as a shunt complication. Shunt dysfunction and hydrocephaly can develop due to this disconnection. Presented here is a case of a disconnection of the ventricular catheter from the shunt valve, which passed between both lateral ventricles by free floating in the brain CT. The patient was operated on for hydrocephaly. The dysfunctional shunt valve and peritoneal catheter were removed and a new VP shunt system was implemented. Although some publications report that the ventricular catheter can be disconnected from the shunt valve, can adhere to the intraventricular structures, and can be a source of infection, no studies similar to the current case were found in the literature reporting a free floating ventricular catheter between the lateral ventricles.

  13. 77 FR 74179 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Baseline Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Baseline Filings Take notice that on December 6, 2012, the applicants listed above submitted a...

  14. Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt

    PubMed Central

    He, Fuliang; Dai, Shan; Xiao, Zhibo; Wang, Lei; Yue, Zhendong; Zhao, Hongwei; Zhao, Mengfei; Lin, Qiushi; Dong, Xiaoqun

    2016-01-01

    Background. Transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE); previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS. Methods. We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012. Results. Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466–5.592; P = 0.002), HE comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P < 0.001), or higher MELD score (95% CI, 1.298–1.731; P < 0.001). Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141–12.501; P < 0.001), higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355–4.359; P = 0.003), and higher MELD score (95% CI, 1.711–2.406; P < 0.001). Conclusion. The pathological features can predict individual susceptibility to shunt stenosis and HE. PMID:27975051

  15. Mycobacterium fortuitum infection of ventriculoperitoneal shunt.

    PubMed

    Midani, S; Rathore, M H

    1999-07-01

    Mycobacterium fortuitum is one of the rapidly growing mycobacteria found in soil, dust, and water. It can be isolated as a normal colonizing organism, but as a pathogen this organism causes mainly skin and soft tissue infection preceded by trauma. A wide variety of infections can occur in individuals with predisposing conditions. Central nervous system infection with M fortuitum is rare, and meningitis occurs after surgery or trauma. We believe that ventriculoperitoneal (VP) shunt infection with this organism has not been reported in the literature. Practitioners should be aware of this rare entity and should suspect it in the presence of cerebrospinal fluid pleocytosis with sterile culture, and after trauma, surgery, or manipulation of the VP shunt hardware. Mycobacterium fortuitum is resistant to most first-line and second-line antituberculous drugs, and treatment should include surgical debridement in addition to prolonged antimicrobial therapy.

  16. An alternative to the glyoxylate shunt.

    PubMed

    Schink, Bernhard

    2009-09-01

    A cycle remains a cycle only as long as the spokes of the wheel are not stolen. To keep the citric acid cycle going requires anaplerotic reactions such as the glyoxylate shunt to restore the cycle intermediates that are withdrawn for the biosynthesis of cell constituents, e.g. amino acids and haemin precursors. The article by Erb et al. in this issue of Molecular Microbiology documents an alternative path that replenishes four-carbon intermediates during growth on acetate in the absence of the glyoxylate shunt. The reaction sequence forms malate and succinyl-CoA from three acetyl-CoA, one CO(2) and one HCO(3) in a linear pathway. This new pathway was discovered in phototrophic anoxygenic bacteria and in few aerobic bacteria, but it is probably widespread among many metabolic groups of bacteria.

  17. Incisional Hernia Following Ventriculoperitoneal Shunt Positioning.

    PubMed

    Bonatti, Matteo; Vezzali, Norberto; Frena, Antonio; Bonatti, Giampietro

    2016-06-01

    Incisional hernia represents a rare complication after ventriculoperitoneal shunt positioning due to failure of the fascial suture in the site of abdominal entrance of ventriculoperitoneal catheter. Clinical presentation can be extremely variable, according to patient's performance status, herniated material constitution (i.e. mesenteric fat, bowel loops or both) and complication occurrence (e.g. strangulation or intestinal obstruction). Early diagnosis is fundamental in order to surgically repair the defect and prevent further complications. We present the case of a paucisymptomatic incisional hernia following ventriculoperitoneal shunt positioning. Diagnosis was made by means of ultrasound and confirmed by means of computed tomography. The patient was successfully managed by means of surgical repositioning of herniated loop and re-suture.

  18. [Congenital portosystemic shunt in dogs and cats].

    PubMed

    Grevel, V; Schmidt, S; Lettow, E; Suter, P F; Schmidt, G U

    1987-01-01

    An overview of the circulation of the liver and of the pathogenesis of hepatic encephalopathy as a result of portal vascular anomalies is given. Clinical signs associated with portal systemic shunts are described on the basis of 16 cases, 14 dogs and 2 cats. These animals ranged in age at the time of presentation from 4 months to 7 years. The predominant abnormality observed were central nervous signs, which differed in severity. The different techniques of contrast angiography allowing demonstration of a portal systemic shunt are presented along with a discussion of the pros and cons of each. Additionally the significance of making portal venous pressure measurements prior to each angiography is also explained. In most cases mesenteric portography was chosen. Based on their location the anomalies could be categorized as intrahepatic (4 dogs) or extrahepatic (10 dogs, 2 cats). In both groups breeds of various size are represented. The extrahepatic shunts could be further described as portal-caval (n = 5), portal-phrenic (n = 4) and portal-azygos (n = 3). In five of the older animals angiography showed in addition some hepatic perfusion by the portal vein. Laboratory evaluation revealed increased resting blood ammonia concentrations (greater than 200-912 micrograms/100 ml) in all animals. Seven dogs had definitely subnormal BUN concentrations (less than 10 mg%) and ten dogs low total plasma protein levels (less than 5.4 g%). Free amino acids (24) were determined in four dogs and a lowered hepatic encephalopathy index (less than 1.64) found. Medical palliative therapy to control the clinical signs is discussed. The only effective long term therapy is, however, surgery. The shunt vessel is narrowed so that a greater volume of portal blood reaches the liver. Experience gained from the surgical therapy of 14 animals is presented. Ten of these survived well without requiring further therapy at a later time. Finally the etiology, prognosis, and differential diagnosis are

  19. Active shunt capacitance cancelling oscillator circuit

    DOEpatents

    Wessendorf, Kurt O.

    2003-09-23

    An oscillator circuit is disclosed which can be used to produce oscillation using a piezoelectric crystal, with a frequency of oscillation being largely independent of any shunt capacitance associated with the crystal (i.e. due to electrodes on the surfaces of the crystal and due to packaging and wiring for the crystal). The oscillator circuit is based on a tuned gain stage which operates the crystal at a frequency, f, near a series resonance frequency, f.sub.S. The oscillator circuit further includes a compensation circuit that supplies all the ac current flow through the shunt resistance associated with the crystal so that this ac current need not be supplied by the tuned gain stage. The compensation circuit uses a current mirror to provide the ac current flow based on the current flow through a reference capacitor that is equivalent to the shunt capacitance associated with the crystal. The oscillator circuit has applications for driving piezoelectric crystals for sensing of viscous, fluid or solid media by detecting a change in the frequency of oscillation of the crystal and a resonator loss which occur from contact of an exposed surface of the crystal by the viscous, fluid or solid media.

  20. Quantitative evaluation fo cerebrospinal fluid shunt flow

    SciTech Connect

    Chervu, S.; Chervu, L.R.; Vallabhajosyula, B.; Milstein, D.M.; Shapiro, K.M.; Shulman, K.; Blaufox, M.D.

    1984-01-01

    The authors describe a rigorous method for measuring the flow of cerebrospinal fluid (CSF) in shunt circuits implanted for the relief of obstructive hydrocephalus. Clearance of radioactivity for several calibrated flow rates was determined with a Harvard infusion pump by injecting the Rickham reservoir of a Rickham-Holter valve system with 100 ..mu..Ci of Tc-99m as pertechnetate. The elliptical and the cylindrical Holter valves used as adjunct valves with the Rickham reservoir yielded two different regression lines when the clearances were plotted against flow rats. The experimental regression lines were used to determine the in vivo flow rates from clearances calculated after injecting the Rickham reservoirs of the patients. The unique clearance characteristics of the individual shunt systems available requires that calibration curves be derived for an entire system identical to one implanted in the patient being evaluated, rather than just the injected chamber. Excellent correlation between flow rates and the clinical findings supports the reliability of this method of quantification of CSF shunt flow, and the results are fully accepted by neurosurgeons.

  1. [Percutaneous endoscopic gastrostomy in children with ventriculoperitoneal shunt].

    PubMed

    Valletta, E; Angelini, G; Castagnini, A; Fontana, E; Piccoli, R; Ulmi, D

    2003-01-01

    The complications of percutaneous endoscopic gastrostomy (PEG) placement or replacement or of home management of gastrostomy, must be taken in account in patients with hydrocephalus and ventriculoperitoneal shunt. In this report we describe four children with spastic quadriplegia and ventriculoperitoneal shunt who had a median follow-up of 15 months (range 4-32 months) after PEG placement. Intravenous antibiotic prophylaxis was always used during routine procedures and no shunt infection was observed. In a patient, during accidental PEG dislodgement, peritoneal infection developed that required temporary diversion of the catheter. A second dislodgement, in the same individual, determined a large amount of serous peritoneal fluid that needed to be evacuated but no shunt infection or malfunction. In nobody of our patients, the shunt, located in the upper left abdomen, interfered with gastrostomy placement. Our experience confirms that PEG is not contraindicated in patients with ventriculoperitoneal shunt, provided that the risks of catheter infection are known and prevented.

  2. Liver transplant in a patient with a ventriculoperitoneal shunt.

    PubMed

    Faybush, Elisa; Mulligan, David C; Birch, Barry D; Sirven, Joseph I; Balan, Vijayan

    2005-04-01

    There are no published accounts of patients with ventriculoperitoneal shunts undergoing liver transplantation in the literature. Because patients with ventriculoperitoneal shunts are prone to infections, this may be a theoretical contraindication to transplantation. We present a case of a patient with cirrhosis who had a ventriculoperitoneal shunt placed many years prior to transplantation. The patient had no neurological complications and the shunt was intact and functioning. Prior to transplantation, the patient underwent a ventriculoperitoneal to ventriculopleural shunt conversion that was reversed posttransplantation. Apart from some minor complications, the patient has done remarkably well from a graft and neurological perspective. In conclusion, patients who have ventriculoperitoneal shunts may be considered for liver transplantation as the risk of infectious and neurological complications is low and there are no deleterious effects on graft survival.

  3. Shunt current loss of the vanadium redox flow battery

    NASA Astrophysics Data System (ADS)

    Xing, Feng; Zhang, Huamin; Ma, Xiangkun

    The shunt current loss is one of main factors to affect the performance of the vanadium redox flow battery, which will shorten the cycle life and decrease the energy transfer efficiency. In this paper, a stack-level model based on the circuit analog method is proposed to research the shunt current loss of the vanadium redox flow battery, in which the SOC (state of charge) of electrolyte is introduced. The distribution of shunt current is described in detail. The sensitive analysis of shunt current is reported. The shunt current loss in charge/discharge cycle is predicted with the given experimental data. The effect of charge/discharge pattern on the shunt current loss is studied. The result shows that the reduction of the number of single cells in series, the decrease of the resistances of manifold and channel and the increase of the power of single cell will be the further development for the VRFB stack.

  4. Ventriculoperitoneal shunt infection following uterine instrumentation for dysfunctional uterine bleeding.

    PubMed

    Shaw, Andrew B; Marlin, Evan S; Ikeda, Daniel S; Ammirati, Mario

    2014-08-01

    Shunt infections are most common within the first 6 months following implantation. A shunt infection 19 years after implantation secondary to uterine ablation has not been reported to our knowledge. Office hysteroscopic procedures have become commonplace in gynecologic practice. Infectious complication rates are low, but peritonitis has been described. We present a patient with a ventriculoperitoneal shunt infection following a uterine ablation for dysfunctional uterine bleeding. Three days following the ablation she developed abdominal pain. CT scan of the abdomen 5 months after the procedure revealed a pseudocyst. She then underwent removal of her shunt with intra-operative cultures revealing Streptococcus agalactiae. Definitive treatment consisted of shunt explantation and antibiotic treatment with complete resolution of her pain and pseudocyst. Consideration for prophylactic antibiotics should be made when a patient with a ventriculoperitoneal shunt undergoes any transvaginal procedure.

  5. Reduction of ventricular size after shunting for normal pressure hydrocephalus related to CSF dynamics before shunting.

    PubMed Central

    Tans, J T; Poortvliet, D C

    1988-01-01

    Reduction of ventricular size was determined by repeated computed tomography in 30 adult patients shunted for normal pressure hydrocephalus (NPH) and related to the pressure-volume index (PVI) and resistance to outflow of cerebrospinal fluid (Rcsf) measured before shunting. Rapid and marked reduction of ventricular size (n = 10) was associated with a significantly lower PVI than slow and moderate to marked (n = 13) or minimal to mild reduction (n = 7). Otherwise no relationship could be found between the reduction of ventricular size and PVI or Rcsf. It is concluded that both rate and magnitude of reduction of ventricular size after shunting for NPH are extremely variable. High brain elasticity seems to be the best predictor of rapid and marked reduction. PMID:3379425

  6. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    PubMed

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  7. Characterization of multiple acquired portosystemic shunts using transplenic portal scintigraphy.

    PubMed

    Morandi, Federica; Sura, Patricia A; Sharp, Dorothy; Daniel, Gregory B

    2010-01-01

    We describe the scintigraphic patterns observed in 14 patients with confirmed multiple portosystemic shunts imaged via transplenic portal scintigraphy. Parameters evaluated included presence of multiple anomalous vessels, presence of hepatofugal flow caudal to spleen, and/or to cranial margin of the kidneys, slow absorption resulting in longer spleen to heart transit time, and presence of biphasic or fragmented bolus. Twenty-eight additional patients, 14 with a confirmed single portocaval and 14 with a portoazygos shunt, were used for comparison. Nine of 14 (64.3%) patients with multiple shunts had multiple vessels, five (35.7%) had a biphasic bolus, 13 (92.9%) had hepatofugal flow caudal to the cranial margin of the kidneys. In all single portocaval shunts, a single anomalous vessel was identified. None had hepatofugal flow caudal to the border of the kidneys. Among portoazygos shunts, 4/14 (28.6%) had flow caudal to the injection site. Six portoazygos and one portocaval shunts had biphasic bolus. Median transit time from spleen to heart was significantly longer (1.9 s) in patients with multiple shunts than in patients with a portocaval shunt (1.0 s), but not in patients with a portoazygos shunt (1.3 s). Although a distinct plexus of anomalous vessels is not detected in all patients with multiple shunts imaged using transplenic portal scintigraphy, findings of hepatofugal flow caudal to the margin of the kidneys, and longer transit time compared with single portocaval shunts were characteristic. Flow caudal to the splenic injection site but cranial to the kidneys and biphasic bolus can also be seen with a single congenital shunt.

  8. Ventriculoperitoneal shunt for intracranial hypertension in cryptococcal meningitis without hydrocephalus.

    PubMed

    Petrou, Panayota; Moscovici, Samuel; Leker, Ronen R; Itshayek, Eyal; Gomori, John M; Cohen, José E

    2012-08-01

    The use of a ventriculoperitoneal (VP) shunt to treat uncontrollable intracranial hypertension in patients with cryptococcal meningitis without hydrocephalus is somewhat unusual and still largely unreported. However, uncontrollable intracranial hypertension without hydrocephalus in these patients is a potentially life-threatening condition. Early diagnosis and shunt placement are essential to improve survival and neurological function. We report uncontrollable intracranial hypertension without hydrocephalus in a 23-year-old woman, which was successfully managed by VP shunt placement.

  9. A compact, coaxial shunt current diagnostic for X pinches.

    PubMed

    Wang, Liangping; Zhang, Jinhai; Li, Mo; Zhang, Xinjun; Zhao, Chen; Zhang, Shaoguo

    2015-08-01

    A compact coaxial shunt was applied in X-pinches experiments on Qiangguang pulsed power generator. The coaxial shunt was designed to have a compact construction for smaller inductance and more, for conveniently assembling upon the X pinch load structure. The coaxial shunt is also a cheap current probe and was easily built by research groups. The shunt can monitor a 100 kA high current with a 100 ns rise time. The calibration results showed that the probe used in the experiments has a resistance of 3.2 mΩ with an uncertainty of 3%, and its response time to the step signal is less than 7 ns.

  10. Superconducting fault current-limiter with variable shunt impedance

    DOEpatents

    Llambes, Juan Carlos H; Xiong, Xuming

    2013-11-19

    A superconducting fault current-limiter is provided, including a superconducting element configured to resistively or inductively limit a fault current, and one or more variable-impedance shunts electrically coupled in parallel with the superconducting element. The variable-impedance shunt(s) is configured to present a first impedance during a superconducting state of the superconducting element and a second impedance during a normal resistive state of the superconducting element. The superconducting element transitions from the superconducting state to the normal resistive state responsive to the fault current, and responsive thereto, the variable-impedance shunt(s) transitions from the first to the second impedance. The second impedance of the variable-impedance shunt(s) is a lower impedance than the first impedance, which facilitates current flow through the variable-impedance shunt(s) during a recovery transition of the superconducting element from the normal resistive state to the superconducting state, and thus, facilitates recovery of the superconducting element under load.

  11. Laparoscopy for a Ventriculoperitoneal Shunt Tube Dislocated into the Colon

    PubMed Central

    Detzner, Michael; Heiss, Markus M.; Weber, Friedrich; Bulian, Dirk R.

    2013-01-01

    Introduction: Implantation of a ventriculoperitoneal (VP) shunt is a standard procedure for hydrocephalus. Different complications can occur, one of them being migration of the distal end of the tube. Case Description: The abdominal end of a VP shunt tube had migrated into the descending colon. In a laparoscopic procedure, the shunt was retrieved, and the colonic perforation site was resected. The patient had a favorable outcome. Discussion: Laparoscopy can play a key role and is recommended not only to make an exact diagnosis, but also for definite, safe, and trauma-minimizing treatment of intraabdominal VP shunt dysfunction. PMID:24398218

  12. Ventriculoperitoneal shunt malfunction caused by proximal catheter fat obstruction.

    PubMed

    Mizrahi, Cezar José; Spektor, Sergey; Margolin, Emil; Shoshan, Yigal; Ben-David, Eliel; Cohen, José E; Moscovici, Samuel

    2016-08-01

    Ventriculoperitoneal (VP) shunt placement is the mainstay of treatment for hydrocephalus, yet shunts remain vulnerable to a variety of complications. Although fat droplet migration into the subarachnoid space and cerebrospinal fluid pathways following craniotomy has been observed, a VP shunt obstruction with fat droplets has never been reported to our knowledge. We present the first reported case of VP shunt catheter obstruction by migratory fat droplets in a 55-year-old woman who underwent suboccipital craniotomy for removal of a metastatic tumor of the left medullocerebellar region, without fat harvesting. A VP shunt was inserted 1month later due to communicating hydrocephalus. The patient presented with gait disturbance, intermittent confusion, and pseudomeningocele 21days after shunt insertion. MRI revealed retrograde fat deposition in the ventricular system and VP shunt catheter, apparently following migration of fat droplets from the fatty soft tissue of the craniotomy site. Spinal tap revealed signs of aseptic meningitis. Steroid treatment for aseptic "lipoid" meningitis provided symptom relief. MRI 2months later revealed partial fat resorption and resolution of the pseudomeningocele. VP shunt malfunction caused by fat obstruction of the ventricular catheter should be acknowledged as a possible complication in VP shunts after craniotomy, even in the absence of fat harvesting.

  13. Intracranial calcified pseudocyst reaction to a shunt catheter.

    PubMed

    Yowtak, June; Hughes, Douglas; Heger, Ian; Macomson, Samuel D

    2014-02-01

    A 9-year-old boy with spina bifida, Chiari II malformation, and hydrocephalus presented with signs of increased intracranial pressure consistent with a shunt malfunction. Radiological investigations revealed an intracranial calcified lesion along the ventricular catheter. A shunt tap revealed a translucent milky white fluid. The patient underwent a ventriculostomy and, eventually, a shunt revision. Pathology findings were consistent with the formation of dystrophic calcification and a pseudocyst around the shunt catheter. Postoperatively, the patient returned to his neurological baseline. This is, to the best of the authors' knowledge, the first report of an intracranial calcified pseudocyst in a patient with normal renal function.

  14. 78 FR 64933 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ..., for a certificate of public convenience and necessity to construct its Emerald Longwall Mine Panel D1... Emerald Coal Resources, LP (Emerald) in Greene County, Pennsylvania in Panel D1 of Emerald's mine,...

  15. Radial Fourier multipliers of Lp(R2)

    PubMed Central

    Carbery, Anthony; Gasper, George; Trebels, Walter

    1984-01-01

    We give sufficient conditions (in terms of differentiability and growth properties) for a radial function to be an Lp(R2) Fourier multiplier. These conditions are in the nature of best possible. PMID:16593468

  16. Rate of shunt revision as a function of age in patients with shunted hydrocephalus due to myelomeningocele.

    PubMed

    Dupepe, Esther B; Hopson, Betsy; Johnston, James M; Rozzelle, Curtis J; Jerry Oakes, W; Blount, Jeffrey P; Rocque, Brandon G

    2016-11-01

    OBJECTIVE It is generally accepted that cerebrospinal fluid shunts fail most frequently in the first years of life. The purpose of this study was to describe the risk of shunt failure for a given patient age in a well-defined cohort with shunted hydrocephalus due to myelomeningocele (MMC). METHODS The authors analyzed data from their institutional spina bifida research database including all patients with MMC and shunted hydrocephalus. For the entire population, the number of shunt revisions in each year of life was determined. Then the number of patients at risk for shunt revision during each year of life was calculated, thus enabling them to calculate the rate of shunt revision per patient in each year of life. In this way, the timing of all shunt revision operations for the entire clinic population and the likelihood of having a shunt revision during each year of life were calculated. RESULTS A total of 655 patients were enrolled in the spina bifida research database, 519 of whom had a diagnosis of MMC and whose mean age was 17.48 ± 11.7 years (median 16 years, range 0-63 years). Four hundred seventeen patients had had a CSF shunt for the treatment of hydrocephalus and thus are included in this analysis. There were 94 shunt revisions in the 1st year of life, which represents a rate of 0.23 revisions per patient in that year. The rate of shunt revision per patient-year initially decreased as age increased, except for an increase in revision frequency in the early teen years. Shunt revisions continued to occur as late as 43 years of age. CONCLUSIONS These data substantiate the idea that shunt revision surgeries in patients with MMC are most common in the 1st year of life and decrease thereafter, except for an increase in the early teen years. A persistent risk of shunt failure was observed well into adult life. These findings underscore the importance of routine follow-up of all MMC patients with shunted hydrocephalus and will aid in counseling patients and

  17. Clinical and laboratory experience with heparin-impregnated silicone shunts for carotid endarterectomy.

    PubMed

    Piepgras, D G; Sundt, T M

    1976-11-01

    Our experience with use of a Silastic shunt for carotid endarterectomy is reviewed briefly, and the complication of shunt thrombosis despite intraoperative administration of heparin is noted. Of obvious importance are the reduction of blood flow and the possibility of embolization caused by accumulating thrombus. Shunt thrombosis has been abolished by the use of heparin-impregnated Silastic shunts. In experiments in dogs, such heparin-treated shunts showed greater thromboresistance than did untreated shunts.

  18. Intrapulmonary and intracardiac shunting with exercise at altitude.

    PubMed

    Imray, Chris H E; Pattinson, Kyle T S; Myers, Steve; Chan, Colin W; Hoar, Helen; Brearey, Steve; Collins, Phil; Wright, Alex D

    2008-01-01

    Recent studies in normal participants have shown that right to left shunt blood vessels in the lung open up during exercise. We describe the first field study to investigate this phenomenon at altitude. This study aimed to assess the effect of altitude and partial acclimatization on inducible right to left shunting at rest and with exercise. A contrast-enhanced transcranial Doppler imaging technique to detect microbubbles after injection of blood and saline agitated with air was used to measure right to left shunting in 10 normal participants at rest and immediately after exercising to maximum oxygen consumption (VO(2max)) at 80 m, on acute exposure to 3450 m, and finally after a week above 3450 m. At 80 m, exercising resulted in right to left shunting via patent foramen ovale in 2 participants, but there was no evidence of shunting in the remaining 8 participants. Cerebral microbubbles were detected at rest in the 2 participants with patent foramen ovale on acute exposure to 3450 m, and the shunting increased on exercise (P = .04). In 5 of the remaining 8 participants without patent foramen ovale, cerebral microbubbles were detected on exercise (P = .04) but not at rest. Partial acclimatization had minimal effect on the prevalence or magnitude of the intrapulmonary or intracardiac shunts. Oxygenation was similar in those with shunts compared with those without shunts. Intrapulmonary shunting occurs on exercise at altitude, but the clinical and physiologic significances have yet to be determined. Despite the occurrence of shunting in most participants, our results suggest that this phenomenon is not a significant factor in altitude and exercise-induced hypoxia.

  19. LP(01)-LP(02) interferometric fiber-optic sensing using phase-dependent loss in a light tap.

    PubMed

    Sharma, A; Posey, R; Phillips, L; Diggs, D

    1996-07-15

    The intensity of light radiated from a fiber-optic light tap is observed to depend sensitively on the phase difference between LP(01) and LP(02) modes in a few-mode fiber. This observation is used to design a novel dual-mode interferometer in which light loss through the light tap is monitored, eliminating the need for a bulky spatial filter at the exit end of the fiber. Application of the device as an interferometric temperature sensor is described.

  20. Quantization of inductively shunted superconducting circuits

    NASA Astrophysics Data System (ADS)

    Smith, W. C.; Kou, A.; Vool, U.; Pop, I. M.; Frunzio, L.; Schoelkopf, R. J.; Devoret, M. H.

    2016-10-01

    We present a method for calculating the energy levels of superconducting circuits that contain highly anharmonic, inductively shunted modes with arbitrarily strong coupling. Our method starts by calculating the normal modes of the linearized circuit and proceeds with numerical diagonalization in this basis. As an example, we analyze the Hamiltonian of a fluxonium qubit inductively coupled to a readout resonator. While elementary, this simple example is nontrivial because it cannot be efficiently treated by the method known as "black-box quantization," numerical diagonalization in the bare harmonic oscillator basis, or perturbation theory. Calculated spectra are compared to measured spectroscopy data, demonstrating excellent quantitative agreement between theory and experiment.

  1. Spontaneous Intrahepatic Portal Venous Shunt: Presentation and Endovascular Treatment.

    PubMed

    Sheth, Nakul; Sabbah, Nathanael; Contractor, Sohail

    2016-07-01

    Spontaneous intrahepatic portal venous shunts are rare with only few case reports published. Treatments using various endovascular techniques have been described, although no single technique has been shown to be preferred. We present a patient who was referred for treatment of a spontaneous portal venous shunt and describe our treatment approach and present a review on previously reported cases.

  2. Internal carotid artery rupture caused by carotid shunt insertion

    PubMed Central

    Illuminati, Giulio; Caliò, Francesco G.; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Introduction Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Discussion Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Conclusion Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. PMID:26255001

  3. Linezolid treatment of ventriculoperitoneal shunt infection without implant removal.

    PubMed

    Castro, P; Soriano, A; Escrich, C; Villalba, G; Sarasa, M; Mensa, J

    2005-09-01

    Ventriculoperitoneal shunt infection is a serious clinical problem for which implant removal is considered the treatment of choice. However, surgery is sometimes associated with considerable risks that may outweigh the benefits. Presented here is a case of ventriculoperitoneal shunt infection treated successfully with linezolid without implant removal. This case shows linezolid could be a therapeutic alternative when surgery is contraindicated.

  4. Neural tube defect repair and ventriculoperitoneal shunting: indications and outcome.

    PubMed

    Sinha, Shandip K; Dhua, Anjan; Mathur, Mohit Kumar; Singh, Sudhir; Modi, Manoj; Ratan, Simmi K

    2012-01-01

    Neural tube defect with its global involvement of nervous system has lot of implications. There is cotroversy in terms of timing of repair, simultaneous or metachronous ventriculoperitoneal shunt and criteria for shunt surgery in neonatal age. We are reporting our approach and results of management of this disease in neonatal period.

  5. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch...

  6. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch...

  7. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch...

  8. 49 CFR 236.724 - Circuit, shunt fouling.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Circuit, shunt fouling. 236.724 Section 236.724... Circuit, shunt fouling. The track circuit in the fouling section of a turnout, connected in multiple with the track circuit in the main track....

  9. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  10. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  11. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  12. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  13. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure... for the treatment of intractable ascites. (b) Classification. Class II. The special controls for this...) Backflow specification and testing to prevent reflux of blood into the shunt....

  14. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure... for the treatment of intractable ascites. (b) Classification. Class II. The special controls for this...) Backflow specification and testing to prevent reflux of blood into the shunt....

  15. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure... for the treatment of intractable ascites. (b) Classification. Class II. The special controls for this...) Backflow specification and testing to prevent reflux of blood into the shunt....

  16. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch...

  17. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Switch shunting circuit; use restricted. 236.60 Section 236.60 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch...

  18. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endolymphatic shunt tube with valve. 874.3850... tube with valve. (a) Identification. An endolymphatic shunt tube with valve is a device that consists of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  19. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endolymphatic shunt tube with valve. 874.3850... tube with valve. (a) Identification. An endolymphatic shunt tube with valve is a device that consists of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  20. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endolymphatic shunt tube with valve. 874.3850... tube with valve. (a) Identification. An endolymphatic shunt tube with valve is a device that consists of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  1. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endolymphatic shunt tube with valve. 874.3850... tube with valve. (a) Identification. An endolymphatic shunt tube with valve is a device that consists of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  2. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endolymphatic shunt tube with valve. 874.3850... tube with valve. (a) Identification. An endolymphatic shunt tube with valve is a device that consists of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  3. Shunt attachment and method for interfacing current collection systems

    DOEpatents

    Denney, P.E.; Iyer, N.C.; Hannan, W.F. III.

    1992-12-08

    A composite brush to shunt attachment wherein a volatile component of a composite but mostly metallic brush, used for current collection purposes, does not upon welding or brazing, adversely affect the formation of the interfacial bond with a conductive shunt which carries the current from the zone of the brush. The brush to shunt attachment for a brush material of copper-graphite composite and a shunt of copper, or substituting silver for copper as an alternative, is made through a hot isostatic pressing (HIP). The HIP process includes applying high pressure and temperature simultaneously at the brush to shunt interface, after it has been isolated or canned in a metal casing in which the air adjacent to the interface has been evacuated and the interfacial area has been sealed before the application of pressure and temperature. 6 figs.

  4. Shunt attachment and method for interfacing current collection systems

    DOEpatents

    Denney, Paul E.; Iyer, Natraj C.; Hannan, III, William F.

    1992-01-01

    A composite brush to shunt attachment wherein a volatile component of a composite but mostly metallic brush, used for current collection purposes, does not upon welding or brazing, adversely affect the formation of the interfacial bond with a conductive shunt which carries the current from the zone of the brush. The brush to shunt attachment for a brush material of copper-graphite composite and a shunt of copper, or substituting silver for copper as an alternative, is made through a hot isostatic pressing (HIP). The HIP process includes applying high pressure and temperature simultaneously at the brush to shunt interface, after it has been isolated or canned in a metal casing in which the air adjacent to the interface has been evacuated and the interfacial area has been sealed before the application of pressure and temperature.

  5. Choroid plexus cyst development and growth following ventricular shunting.

    PubMed

    Binning, Mandy J; Couldwell, William T

    2008-01-01

    Choroid plexus cysts are typically incidental, asymptomatic cysts. They have been reported to hemorrhage and grow, causing symptoms of obstruction. However, growth and multiplication has not been reported following ventriculoperitoneal shunt procedures. A 66-year-old woman initially underwent a suboccipital retrosigmoid craniotomy for resection of a large petroclival meningioma. Preoperatively, the patient had hydrocephalus. After surgery the patient required a ventriculoperitoneal shunt. Two years after the initial shunting procedure, imaging demonstrated significant growth of new bilateral choroid plexus cysts as compared with pre-shunt imaging. Post-shunt imaging also demonstrated evidence of diffuse dural enhancement characteristic of intracranial hypotension. Despite radiographic growth and multiplication of the cysts, the patient was clinically asymptomatic and had a good neurological outcome.

  6. Congenital intrahepatic portosystemic shunt diagnosed during intrauterine life

    PubMed Central

    Bellettini, Camila Vieira; Wagner, Rafaela; Balzanelo, Aleocídio Sette; Andretta, André Luis de Souza; de Moura, Arthur Nascimento; Fabris, Catia Carolina; Gubert, Eduardo Maranhão

    2016-01-01

    Abstract Objective: To report a patient with prenatal diagnosis of portosystemic shunt; a rare condition in humans. Case description: 17-Day-old female infant admitted for investigation of suspected diagnosis of portosystemic shunt, presumed in obstetric ultrasound. The hypothesis was confirmed after abdominal angiography and liver Doppler. Other tests such as echocardiography and electroencephalogram were performed to investigate possible co-morbidities or associated complications, and were normal. We chose conservative shunt treatment, as there were no disease-related complications and this was intrahepatic shunt, which could close spontaneously by the age of 2 years. Comments: Portosystemic shunt can lead to various complications such as hepatic encephalopathy, hypergalactosemia, liver tumors, and hepatopulmonary syndrome. Most diagnoses are done after one month of age, after such complications occur. The prenatal diagnosis of this patient provided greater security for the clinical picture management, as well as regular monitoring, which allows the anticipation of possible complications and perform interventional procedures when needed. PMID:27133713

  7. Percutaneous peritoneovenous shunt positioning: technique and preliminary results.

    PubMed

    Orsi, Franco; Grasso, Rosario Francesco; Bonomo, Guido; Monti, Cinzia; Marinucci, Irene; Bellomi, Massimo

    2002-05-01

    Nine peritoneovenous shunts were positioned by percutaneous technique in seven patients with advanced malignancy causing severe refractory ascites, and in two patients with hepatic cirrhosis (one with hepatocarcinoma). In all patients the shunts were percutaneously placed through the subclavian vein in the angiographic suite under digital fluoroscopic guide. No complications directly related to the procedure occurred. The shunt was successfully positioned in all patients in 60 min average time. No patient showed symptoms related to pulmonary overload or to disseminated intravascular coagulation. All patients had a significant improvement of the objective symptoms related to ascites such as respiratory symptoms, dyspepsia, and functional impairment to evacuation describing an improvement of their quality of life. Maximum shunt patency was 273 days. Percutaneous placement of peritoneovenous shunt is a safe, fast, and inexpensive procedure, extremely useful in resolution of refractory ascites, reducing symptoms, and allowing effective palliation, with a great improvement in quality of life.

  8. Biosynthetic route towards saxitoxin and shunt pathway

    PubMed Central

    Tsuchiya, Shigeki; Cho, Yuko; Konoki, Keiichi; Nagasawa, Kazuo; Oshima, Yasukatsu; Yotsu-Yamashita, Mari

    2016-01-01

    Saxitoxin, the most potent voltage-gated sodium channel blocker, is one of the paralytic shellfish toxins (PSTs) produced by cyanobacteria and dinoflagellates. Recently, putative biosynthetic genes of PSTs were reported in these microorganisms. We previously synthesized genetically predicted biosynthetic intermediates, Int-A’ and Int-C’2, and also Cyclic-C’ which was not predicted based on gene, and identified them all in the toxin-producing cyanobacterium Anabaena circinalis (TA04) and the dinoflagellate Alexandrium tamarense (Axat-2). This study examined the incorporation of 15N-labeled intermediates into PSTs (C1 and C2) in A. circinalis (TA04). Conversions from Int-A’ to Int-C’2, from Int-C’2 to Cyclic-C’, and from Int-A’ and Int-C’2 to C1 and C2 were indicated using high resolution-LC/MS. However, Cyclic-C’ was not converted to C1 and C2 and was detected primarily in the extracellular medium. These results suggest that Int-A’ and Int-C’2 are genuine precursors of PSTs, but Int-C’2 converts partially to Cyclic-C’ which is a shunt product excreted to outside the cells. This paper provides the first direct demonstration of the biosynthetic route towards saxitoxin and a shunt pathway. PMID:26842222

  9. Ventriculoperitoneal shunt infection with Listeria innocua.

    PubMed

    Karli, Arzu; Sensoy, Gulnar; Unal, Nevzat; Yanik, Keramettin; Cigdem, Halit; Belet, Nursen; Sofuoglu, Ayse

    2014-08-01

    Listeria species may cause life-threatening events including meningitis and invasive infection in newborns, pregnant women, older and immunodeficient people. The most common Listeria species that causes infection is L. monocytogenes. It is known that Listeria innocua has no pathogenicity. A 9-month-old baby had ventriculoperitoneal shunt and was treated with adrenocorticotropic hormone because of infantile spasms. He was brought to hospital with fever and vomiting. Upon physical examination, the patient seemed uncomfortable and had a temperature of 38.6°C. Laboratory results were as follows: hemoglobin, 6.7 g/dL; leukocyte count, 5420/mm(3) ; platelet count, 169,000/mm(3) ; and C-reactive protein, 100 mg/L (normal <5 mg/L). On analysis of cerebrospinal fluid (CSF), leukocyte count was 480/mm(3) , protein was 46 mg/dL and CSF glucose was 35 mg/dL. L. innocua was isolated in CSF culture. We describe this unusual case of ventriculoperitoneal shunt infection with L. innocua.

  10. Parylene MEMS patency sensor for assessment of hydrocephalus shunt obstruction.

    PubMed

    Kim, Brian J; Jin, Willa; Baldwin, Alexander; Yu, Lawrence; Christian, Eisha; Krieger, Mark D; McComb, J Gordon; Meng, Ellis

    2016-10-01

    Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment. The sensor was fabricated on a flexible polymer substrate to eventually allow integration into a shunt. In this study, the sensor was packaged for use with external ventricular drainage systems for clinical validation. Insights into the transduction mechanism of the sensor were obtained. The impact of electrode size, clinically relevant temperatures and flows, and hydrogen peroxide (H2O2) plasma sterilization on sensor function were evaluated. Sensor performance in the presence of static and dynamic obstruction was demonstrated using 3 different models of obstruction. Electrode size was found to have a minimal effect on sensor performance and increased temperature and flow resulted in a slight decrease in the baseline impedance due to an increase in ionic mobility. However, sensor response did not vary within clinically relevant temperature and flow ranges. H2O2 plasma sterilization also had no effect on sensor performance. This low power and simple format sensor was developed with the intention of future integration into shunts for wireless monitoring of shunt state and more importantly, a more accurate and timely diagnosis of shunt failure.

  11. Migration of Ventriculoperitoneal Shunt into a Hernia Sac: An Unusual Complication of Ventriculoperitoneal Shunt Surgery in Children.

    PubMed

    Singh, Sudhir; Pant, Nitin; Kumar, Piyush; Pandey, Anand; Khan, Tanvir Roshan; Gupta, Archika; Rawat, Jiledar

    2016-01-01

    We report 2 cases of ventriculoperitoneal (VP) shunt migration into an inguinal hernia sac. In both cases hernia manifested itself on the right side in late infancy. We attempted to analyse the anatomical and mechanical factors leading to shunt migration as seen in the X-rays of our cases.

  12. LP DAAC and MEaSUREs - Optimizing Collection Inception

    NASA Astrophysics Data System (ADS)

    Bennett, S.

    2013-12-01

    The Land Processes Distributed Active Archive Center (LP DAAC) is a selected NASA Earth Observing System (EOS) Data and Information System (EOSDIS) DAAC supporting the Making Earth System Data Records for Use in Research Environments (MEaSUREs) Program to contribute in providing long-term, consistent, and mature data products. The LP DAAC has identified three essential components for the MEaSUREs collection inception. The first component includes a framework of LP DAAC's data lifecycle including overall inception of products, curation of products, and long-term archiving of products. The second component fuses data producer and data provider operations, interleaving key personnel into key processes throughout the project. The third component integrates and evolves stakeholder elements into a standard methodology, alongside affording an overall homogeneous data delivery system for MEaSUREs collections. As an active participant on the Metadata Evolution for NASA Data Systems (MENDS) Tiger Team, the LP DAAC is working to categorize all data model elements into the ISO 19115 international metadata standard. This poster depicts how each of these three components optimizes the LP DAAC MEaSUREs collection inception process.

  13. Is the elapsed time following the placement of a ventriculoperitoneal shunt catheter an individual risk factor for shunt fractures?

    PubMed

    Kaplan, Metin; Cakin, Hakan; Ozdemir, Niyazi; Gocmez, Cuneyt; Ozturk, Sait; Erol, Fatih S

    2012-01-01

    In this study, we examined whether the resistance of peritoneal catheters against the retraction force changed over time following shunt placement, and the role of this resistance in shunt fracture is discussed. We investigated peritoneal catheters removed from patients treated with a ventriculoperitoneal shunt because of hydrocephalus; previously, patients underwent shunt revision. The maximum tension, maximum elongation and elongation percentages of the peritoneal catheters were measured. The mean and maximum tension values of the revised peritoneal catheters were increased compared to the unused catheters. The maximum elongation and elongation rates were significantly decreased. The changes in the maximum elongation, elongation rate and tension values were unrelated to the time elapsed after catheter insertion. This finding indicates that the time elapsed following peritoneal catheter placement was not an individual factor based on the strength of the response of the organism to the foreign body and the mechanical trauma exposed in shunt fractures.

  14. Vascular collateralization along ventriculoperitoneal shunt catheters in moyamoya disease.

    PubMed

    Singla, Amit; Lin, Ning; Ho, Allen L; Scott, R Michael; Smith, Edward R

    2013-06-01

    Surgically created openings such as bur holes can serve as avenues for the development of collateral blood supply to the brain in patients with moyamoya disease. When such collateralization occurs through preexisting shunt catheter sites, the potential exists for perioperative stroke if these vessels are damaged during revision of a ventricular catheter for shunt malfunction. In this paper the authors report on a series of patients with a history of ventriculoperitoneal (VP) shunts who later developed moyamoya disease and were found to have spontaneous transdural collateral vessels at ventricular catheter sites readily visualized on diagnostic angiography. A consecutive surgical series of 412 patients with moyamoya disease treated at Boston Children's Hospital from 1990 to 2010 were reviewed to identify patients with concomitant moyamoya and a VP shunt. The clinical records and angiograms of these patients were reviewed to determine the extent of bur hole collaterals through the shunt site. Three patients were identified who had VP shunts placed for hydrocephalus and subsequently developed moyamoya disease. All 3 patients demonstrated spontaneous transdural collaterals at the ventricular catheter bur hole, as confirmed by angiography during the workup for moyamoya disease. No patients required subsequent revision of their ventricular catheters following the diagnosis of moyamoya. All patients have remained stroke free and clinically stable following pial synangiosis. Although the association of moyamoya and shunted hydrocephalus is rare, it may present a significant potential problem for the neurosurgeon treating a shunt malfunction in this patient population, because shunt bur holes may become entry sites for the ingrowth of significant cortical transdural collateral blood supply to the underlying brain. Shunt revision might therefore be associated with an increased risk of postoperative stroke or operative-site hemorrhage in this population if this

  15. Tikhonov regularization in Lp applied to inverse medium scattering

    NASA Astrophysics Data System (ADS)

    Lechleiter, Armin; Kazimierski, Kamil S.; Karamehmedović, Mirza

    2013-07-01

    This paper presents Tikhonov- and iterated soft-shrinkage regularization methods for nonlinear inverse medium scattering problems. Motivated by recent sparsity-promoting reconstruction schemes for inverse problems, we assume that the contrast of the medium is supported within a small subdomain of a known search domain and minimize Tikhonov functionals with sparsity-promoting penalty terms based on Lp-norms. Analytically, this is based on scattering theory for the Helmholtz equation with the refractive index in Lp, 1 < p < ∞, and on crucial continuity and compactness properties of the contrast-to-measurement operator. Algorithmically, we use an iterated soft-shrinkage scheme combined with the differentiability of the forward operator in Lp to approximate the minimizer of the Tikhonov functional. The feasibility of this approach together with the quality of the obtained reconstructions is demonstrated via numerical examples.

  16. Hyperammonemia and orotic aciduria in portacaval-shunted rats.

    PubMed

    Steele, R D

    1984-01-01

    The effect of a portacaval shunt-induced alteration in liver function on nitrogen metabolism was studied in rats. Within a few days after surgery, portacaval-shunted rats grew with an average daily gain in body weight equal to sham-operated control rats. Within 1 week after surgery, portacaval-shunted rats excreted 20% more orotic acid in their urine compared to control rats. The difference increased to 37% after 3 weeks. Plasma ammonia levels were elevated by 78% in portacaval-shunted rats compared to control rats after 2 weeks. Portacaval-shunted rats injected with a challenging load of ammonium chloride (5 mmol/kg) excreted half as much orotic acid in their urine over a 24-hour period as similarly injected controls. The simultaneous injection of 1.5 mmol/kg of arginine prevented the ammonia-induced increase in orotic acid excretion in both shunted and control rats. However, feeding rats diets supplemented with 1% arginine did not prevent the chronic hyperammonemia and orotic aciduria produced by the construction of portacaval shunts. Similar experiments with diets supplemented with 1% sodium benzoate to induce alternative pathways for nitrogen excretion were also without effect. These results are in contrast to recent clinical studies reporting the effectiveness of sodium benzoate in treating hyperammonemia in patients with urea cycle enzyme defects.

  17. The hydrokinetic parameters of shunts for hydrocephalus might be inadequate

    PubMed Central

    Sotelo, Julio

    2012-01-01

    Long-term treatment of hydrocephalus continues to be dismal. Shunting is the neurosurgical procedure more frequently associated with complications, which are mostly related with dysfunctions of the shunting device, rather than to mishaps of the rather simple surgical procedure. Overdrainage and underdrainage are the most common dysfunctions; of them, overdrainage is a conspicuous companion of most devices. Even when literally hundreds of different models have been proposed, developed, and tested, overdrainage has plagued all shunts for the last 60 years. Several investigations have demonstrated that changes in the posture of the subject induce unavoidable and drastic differences of intraventricular hydrokinetic pressure and cerebrospinal fluid (CSF) drainage through the shunt. Of all the parameters that participate in the pathophysiology of hydrocephalus, the only invariable one is cerebrospinal fluid production at a constant rate of approximately 0.35 ml/min. However, this feature has not been considered in the design of currently available shunts. Our experimental and clinical studies have shown that a simple shunt, whose drainage capacity complies with this unique parameter, would prevent most complications of shunting for hydrocephalus. PMID:22530174

  18. [Selective portal-systemic shunts for bleeding portal hypertension].

    PubMed

    Orozco, H; Mercado, M A; Takahashi, T; García-Tsao, G; Guevara, L; Hernandez-Ortiz, J; Tielve, M

    1990-07-01

    At the beginning of the seventies, we began to perform regularly selective shunts for the treatment of portal hypertension. In a 15 year period, 177 patients (155 with liver cirrhosis) were operated with three kinds of selective shunts: 128 with a Warren shunt, 29 with an end to end renosplenic shunt and 20 with a splenocaval shunt. 167 cases were operated in an elective fashion. The 15 years global operative mortality, was 14.4%. Operative mortality of the Child A patients, was 11.6%. Survival for the Child A group was 74.6% at 1 year, 68.2% at 5 years and 64.6% at 15 years. Incapacitating encephalopathy was observed in 6.9%, rebleeding 6.2% and shunt thrombosis in 6.2%. Portal vein alterations in the postoperative period were observed: in 13.3% a reduction in diameter ocurred and in 20.5%, thrombosis was recorded. It is concluded that when feasible, the selective shunts are the treatment of choice for portal hypertension in those patients with good liver function.

  19. Exploration of nonlinearly shunted piezoelectrics as vibration absorbers

    NASA Astrophysics Data System (ADS)

    Zhou, B.; Zang, C.; Wang, X.

    2016-09-01

    Practical realization of a nonlinearly shunted piezoelectric vibration absorber is numerically explored in this research. It is widely known that the linear resonant piezoelectric shunting strategy, acting as a tuned mass damper, is limited by the massive inductance required in low-frequency cases and sensitivity to drifts in structural frequencies. In order to overcome this limitation, a nonlinear piezoelectric shunting strategy is proposed based on the nonlinear energy sink theory. The essential idea is to passively absorb vibrational energy from the host structure through the intentional use of nonlinearity in piezoelectric shunting. The nonlinearly shunted piezoelectrics are supposed to work over a broad frequency band with a smaller inductance requirement compared with the linear resonant shunting. The nonlinearly shunted piezoelectric vibration absorber is built and applied in a cantilevered beam. Major challenges coming from the nonlinear tuning design for an effective vibration absorber exempted from high isolated response curves will be covered in this research. This numerical study is supposed to pave the way for experimental investigations that are currently in process.

  20. A plasma polymerization technique to overcome cerebrospinal fluid shunt infections.

    PubMed

    Cökeliler, D; Caner, H; Zemek, J; Choukourov, A; Biederman, H; Mutlu, M

    2007-03-01

    Prosthetic devices, mainly shunts, are frequently used for temporary or permanent drainage of cerebrospinal fluid. The pathogenesis of shunt infection is a very important problem in modern medicine and generally this is characterized by staphylococcal adhesion to the cerebrospinal fluid shunt surfaces. In this paper, the prevention of the attachment of test microorganism Staphylococcus epidermidis on the cerebrospinal fluid shunt surfaces by 2-hydroxyethylmethacrylate (HEMA) precursor modification in the plasma polymerization system, is reported. Different plasma polymerization conditions (RF discharge power 10-20-30 W, exposure time 5-10-15 min) were employed during the surface modification. The surface chemistry and topology of unmodified and modified shunts was characterized by x-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM) and atomic force microscopy (AFM). Also, static contact angle measurements were performed to state the change of surface hydrophilicity. All samples were tested in vitro with Staphylococcus epidermidis. A plasma-polymerized HEMA film (PP HEMA) was found to be an alternative simple method to decrease the microorganism attachment and create bacterial anti-fouling surfaces. The attachment of the model microorganism Staphylococcus epidermidis on the shunt surface modified by PP HEMA at 20 W and 15 min was reduced 62.3% if compared to the unmodified control surface of the shunt.

  1. A shunt-excited inductive power link.

    PubMed

    Sylvan, K; Jordan, J R; Whittington, H W

    1989-01-01

    An alternative derivation of the separation-insensitive property of series-excited self-oscillating inductive power transfer circuits is presented. This analysis is based on network theory and does not include the explicit determination of frequency as a step in the derivation. The separation-insensitivity principle is extended to shunt-excited links which exhibit a theoretical voltage transfer function of unity while the coupling factor exceeds the reciprocal of the secondary quality factor. This requires the inclusion of a series resistor in the primary resonator's capacitive arm. Series RC elements are replaced by parallel forms in both the primary and secondary; this provides a more convenient output impedance level without the need for another transformer. A demonstration circuit is described and tested. It is found that separation-insensitivity occurs while the coupling factor exceeds the reciprocal of the loaded secondary quality factor. Somewhat inferior response is obtained from a simpler circuit having no added resistances in the primary.

  2. Delayed pneumocephalus following shunting for hydrocephalus.

    PubMed

    Honeybul, S; Bala, A

    2006-11-01

    Delayed pneumocephalus is a rare but well-reported complication of cerebrospinal fluid diversion procedures. In most cases the air enters the intracranial cavity via a skull base defect. We report a case of hydrocephalus secondary to aqueduct stenosis. The patient developed pneumocephalus 2 months after successful placement of a ventriculoperitoneal shunt. We describe an attempt at endoscopic diagnosis and repair of the fistula. This was unsuccessful, presumably because the defect was too small to localize even with the use of intrathecal fluorescein. We subsequently performed a conventional craniotomy and anterior fossa repair with placement of an antisiphon device. We suggest that in certain cases, when patients present with long-standing hydrocephalus, it may be advisable to insert either a high-pressure valve or antisiphon device as a primary measure.

  3. Ion beam sputter-etched ventricular catheter for hydrocephalus shunt

    NASA Technical Reports Server (NTRS)

    Banks, B. A. (Inventor)

    1983-01-01

    A cerebrospinal fluid shunt in the form of a ventricular catheter for controlling the condition of hydrocephalus by relieving the excessive cerebrospinal fluid pressure is described. A method for fabrication of the catheter and shunting the cerebral fluid from the cerebral ventricles to other areas of the body is also considered. Shunt flow failure occurs if the ventricle collapse due to improper valve function causing overdrainage. The ventricular catheter comprises a multiplicity of inlet microtubules. Each microtubule has both a large openings at its inlet end and a multiplicity of microscopic openings along its lateral surfaces.

  4. Intraabdominal Pseudocyst Developed after Ventriculoperitoneal Shunt: A Case Report.

    PubMed

    Ayan, Erdogan; Tanriverdi, Halil Ibrahim; Caliskan, Tezcan; Senel, Ufuk; Karaarslan, Numan

    2015-06-01

    Abdominal pseudocyst is a rare complication developing after ventriculoperitoneal shunt treatment. It is more commonly seen particularly in children. The underlying pathogenesis may be associated with repeat revisions or infections. Morphologically, it has no complete cyst wall, presenting only with a pseudocapsule among the intestinal loops, around the lower shunt tip. The principal problem appears to be the reduced peritoneal absorption capacity. The treatment is complicated and difficult. In this report, we present an 8-year-old abdominal pseudocyst case with a history of many shunt revisions.

  5. US EPA Testing of LP & MP UV Disinfection Technologies

    EPA Science Inventory

    Presentation will discuss the ongoing USEPA research on UV disinfection addressing the following objectives: Conservatively predict log inactivation and RED of adenovirus with surrogates; Conduct many (LP=61) UV reactor conditions challenged with Ad2, B. pumilus, and MS2 & conduc...

  6. 76 FR 44898 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... application pursuant to sections 7(b) and 7(c) of the Natural Gas Act (NGA) and part 157 of the Commission's... Berk Donaldson, Director, Rates and Certificates, Texas Eastern Transmission, LP, P.O. Box 1642... public record (eLibrary) for this proceeding, or issue a Notice of Schedule for Environmental Review....

  7. 76 FR 7833 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... 77056, filed in the above referenced docket an application under sections 7(b) and 7(c) of the Natural...) Authorization under NGA sections 7(b) and 7(c) to construct, own, operate, and maintain certain pipeline and... be directed to Berk Donaldson, Director, Rates and Certificates, Texas Eastern Transmission, LP,...

  8. Sunoco Pipeline, L.P. Clean Water Act Settlement - 2017

    EPA Pesticide Factsheets

    EPA, and the U.S. Department of Justice announced that Sunoco Pipeline, L.P. (Sunoco) has agreed to pay a civil penalty for alleged violation of the Clean Water Act stemming from a 2012 gasoline discharge near Wellington, Ohio.

  9. Fire Service Training. LP and Compressed Gas Emergencies.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Community Colleges, Raleigh.

    Part of a series of instructional outlines intended for use in a training program for firemen with no previous formal training, this curriculum guide discusses safety precautions for liquefied petroleum (LP) and compressed gas emergencies. During its twelve hours of instruction it covers (1) terminology; (2) the chemical composition of the gases;…

  10. Shunt capacitor effect on electrical distribution system reliability

    NASA Astrophysics Data System (ADS)

    Sallam, Abdelhay A.; Desouky, Mohamed; Desouky, Hussien

    1994-03-01

    To improve the security & reliability of a distribution system, as much power as feasible must go through a given transmission line. This can be achieved by using shunt capacitors as compensators. These shunt capacitive compensators improve the load carrying capability of the line by controlling the reactive power flow. Consequently, the capacitor existence can not be ignored in evaluating system reliability. The paper applies the state-space method to calculate the reliability indices for compensated & uncompensated systems with different success criteria. The importance of using shunt capacitors to improve the level of distribution system reliability is illustrated in addition to their original function as reactive power controllers. Our procedure, based on a Markov process, is applied to a numerical example, and indicates that system reliability is improved when using shunt capacitors.

  11. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  12. HEPATIC IRON STORAGE AND ERYTHROKINETICS AFTER PORTACAVAL SHUNT,

    DTIC Science & Technology

    used in the production of hemoglobin is stored in the liver as hemosiderin. The significance of these findings relative to the reported human cases of hemochromatosis after portal-systemic shunting is discussed. (Author)

  13. Malignant cause of ventriculoperitoneal shunt 'pseudocyst': a case report.

    PubMed

    Awori, Jonathan; Wu, Chris Y; Maher, Cormac O

    2015-01-01

    Abdominal pseudocysts are an uncommon complication of ventriculoperitoneal (VP) shunts. We present the case of a 4-year-old boy with a history of complicated hydrocephalus managed with a VP shunt due to sequelae of prematurity. The patient presented with abdominal distention, and a pseudocyst was diagnosed. Despite shunt externalization and aspiration, the pseudocyst continued to produce up to 1 liter of serosanguineous fluid per day. After MRI revealed malignant features within the pseudocyst, laparotomy was performed and the pseudocyst was partially excised. Pathology reports suggested sarcoma. The cystic mass grew back aggressively, accompanied by distant metastasis. The patient's condition deteriorated and he died from his disease. To our knowledge, this represents the first report of an abdominal malignancy mimicking a pseudocyst and causing VP shunt failure.

  14. Intracardiac migration and knotting of a ventriculoperitoneal shunt.

    PubMed

    Frahm-Jensen, Gert; Newton, Peter R; Drummond, Katharine J; Wagner, Tim P; Mees, Barend M E

    2015-04-01

    We report a patient with delayed migration of the distal ventriculoperitoneal shunt catheter from the peritoneum to the right atrium with associated knotting of the catheter complicating removal. We also review the literature on this topic.

  15. A case of breast cancer involving a ventriculoperitoneal shunt.

    PubMed

    Kamei, Mirei; Kikuchi, Nobuyuki; Ichimura, Homare; Chujo, Masao; Takahashi, Yoshiaki; Sugio, Kenji

    2016-12-01

    An 84-year-old woman was examined for an enlargement of an induration in the left breast. A ventriculoperitoneal shunt had been placed for postoperative normal pressure hydrocephalus of a cerebral hemorrhage, and it had penetrated the mass according to the computed tomography findings. Breast cancer was diagnosed after a close examination; however, close observation was selected because her family rejected treatment. She developed somnolence 7 months after the initial examination, and ventricular dilatation and expansion of the low-density region around the ventricle were noted on computed tomography, suggesting that the enlarged tumor had excluded the shunt and caused obstruction. The growth of breast carcinoma involving a shunt tube can be the cause of obstruction of a ventriculoperitoneal shunt. Our findings suggest that a breast lesion should be evaluated at both pre- and postoperation.

  16. Criteria of cyclic compactness of the sets from Lp - spaces, associated with vector measure

    NASA Astrophysics Data System (ADS)

    Chilin, V.; Rakhimov, B.; Rakhimov, A.

    2013-09-01

    We study the conditional expectations in the Lp-modules associated with a partition of unity of a Boolean algebra. Cyclic compactness criteria of the subsets of Lp found in terms of convergent nets of conditional expectations.

  17. 75 FR 27774 - Eagle Rock Desoto Pipeline, L.P.; Notice of Rate Election

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... Rock Desoto Pipeline, L.P.; Notice of Rate Election May 11, 2010. Take notice that on May 3, 2010, Eagle Rock Desoto Pipeline, L.P., (Desoto) filed a Notice of Rate Election pursuant to section...

  18. 76 FR 35881 - ConocoPhillips Company v. SFPP, L.P.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ...] ConocoPhillips Company v. SFPP, L.P.; Notice of Complaint Take notice that on June 13, 2011, pursuant to...Phillips Company (Complainant) filed a formal complaint against SFPP, L.P. (Respondent), challenging...

  19. 76 FR 35881 - ConocoPhillips Company v. SFPP, L.P.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ...Phillips Company v. SFPP, L.P.; Notice of Complaint Take notice that on June 13, 2011, pursuant to Rule 206...Phillips Company (Complainant) filed a formal complaint against SFPP, L.P. (Respondent), challenging...

  20. 78 FR 11567 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... are adopting a new airworthiness directive (AD) for all Gulfstream Aerospace LP (Type Certificate..., Aerospace Engineer, International Branch, ANM-116, Transport Airplane Directorate, FAA, 1601 Lind Avenue...

  1. 77 FR 44432 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... are adopting a new airworthiness directive (AD) for certain Gulfstream Aerospace LP (Type Certificate...., Washington, DC. FOR FURTHER INFORMATION CONTACT: Tom Groves, Aerospace Engineer, International Branch,...

  2. 75 FR 38514 - Application to Export Electric Energy; Brookfield Energy Marketing LP

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... Application to Export Electric Energy; Brookfield Energy Marketing LP AGENCY: Office of Electricity Delivery and Energy Reliability, DOE. ACTION: Notice of application. SUMMARY: Brookfield Energy Marketing LP... power marketing agencies and other entities within the United States. The existing...

  3. 75 FR 13644 - TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied Natural Gas Deepwater Port License...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-22

    ... Maritime Administration TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied Natural Gas...) for the TORP Terminal LP, Bienville Offshore Energy Terminal (BOET) Liquefied Natural Gas (LNG..., both are identified in FOR FURTHER INFORMATION CONTACT. Summary of the Application TORP Terminal...

  4. 77 FR 38128 - Withdrawal of TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied Natural Gas (LNG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-26

    ... Maritime Administration Withdrawal of TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied... Terminal LP's (TORP) withdrawal of the deepwater port license application for the proposed Bienville Offshore Energy Terminal (BOET). All actions related to the processing and agency coordination...

  5. 75 FR 35017 - Brookfield Energy Marketing LP; Supplemental Notice That Initial Market-Based Rate Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Brookfield Energy Marketing LP; Supplemental Notice That Initial Market... supplemental notice in the above-referenced proceeding of Brookfield Energy Marketing LP's application...

  6. Small bowel perforation: a rare complication of ventriculoperitoneal shunt placement

    PubMed Central

    Bourm, Kelsey; Pfeifer, Cory; Zarchan, Adam

    2016-01-01

    Small bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement. When seen, it most commonly affects the stomach or colon. We describe a case and image findings of an 8-year-old female who presented with sepsis and erosion of the VP shunt into the small bowel. The imaging findings were confirmed surgically. We also provide an overview of the current literature discussing previously reported cases, clinical features, and treatment. PMID:27761183

  7. Hearing Loss in Patients with Shunt-Treated Hydrocephalus.

    PubMed

    Panova, Margarita V; Geneva, Ina E; Madjarova, Kalina I; Bosheva, Miroslava N

    2015-01-01

    Hearing loss is a common manifestation of the long-term complications in patients with shunt treated hydrocephalus along with motor development disturbance, cognitive and visual impairment, epilepsy and endocrine disorders. The aim of the present study was to investigate the alterations of hearing in patients with shunt treated hydrocephalus of non-tumor etiology and at least one year after implantation of ventriculo-peritoneal shunt, as well as their impact on the quality of life of patients. The study included 70 patients (age range 1.25 years - 21.25 years) with shunted non-tumor hydrocephalus and at least one year after placement of the shunt system. Hearing alterations were proved by measuring the brainstem auditory evoked potentials (BAEP) for children up to 5 years of age and children with mental retardation; audiograms was used for children older than 5 years with normal neuro-psychological development (NPD). Of the 70 studied patients 17 (24%) had hearing loss (10 bilateral and 7-unilateral) and all of them had sensorineural hearing loss, which is associated with low weight at birth, posthemorrhagic hydrocephalus and brainstem symptoms at the time of diagnosis of hydrocephalus. Hearing pathology was found more often in shunt-treated patients with NPD retardation, poor functional status and low quality of life. Children with shunt-treated hydrocephalus have hearing loss of sensorineural type. Children with brain stem symptomatology at diagnosing hydrocephalus and children with post-hemorrhagic hydrocephalus show higher risk of hearing loss. Children with shunted hydrocephalus and hearing loss show lower NPD, lower quality of life and lower functional status.

  8. Digital implementation of shunting-inhibitory cellular neural network

    NASA Astrophysics Data System (ADS)

    Hammadou, Tarik; Bouzerdoum, Abdesselam; Bermak, Amine

    2000-05-01

    Shunting inhibition is a model of early visual processing which can provide contrast and edge enhancement, and dynamic range compression. An architecture of digital Shunting Inhibitory Cellular Neural Network for real time image processing is presented. The proposed architecture is intended to be used in a complete vision system for edge detection and image enhancement. The present hardware architecture, is modeled and simulated in VHDL. Simulation results show the functional validity of the proposed architecture.

  9. In vitro flow measurements in ion sputtered hydrocephalus shunts

    NASA Technical Reports Server (NTRS)

    Cho, Y. I.; Back, L. H.

    1989-01-01

    This paper describes an experimental procedure for accurate measurements of the pressure-drop/flow rate relationship in hydrocephalus shunts. Using a fish-hook arrangement, small flow rates in a perforated ion-sputtered Teflon microtubule were measured in vitro in a pressured system and were correlated with pressure in the system. Results indicate that appropriate drainage rates could be obtained in the physiological range for hydrocephalus shunts.

  10. Small bowel perforation: a rare complication of ventriculoperitoneal shunt placement.

    PubMed

    Bourm, Kelsey; Pfeifer, Cory; Zarchan, Adam

    2016-06-01

    Small bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement. When seen, it most commonly affects the stomach or colon. We describe a case and image findings of an 8-year-old female who presented with sepsis and erosion of the VP shunt into the small bowel. The imaging findings were confirmed surgically. We also provide an overview of the current literature discussing previously reported cases, clinical features, and treatment.

  11. Ventriculoperitoneal shunt infection with Mycobacterium fortuitum: a rare offending organism.

    PubMed

    Cadena, Gilbert; Wiedeman, Jean; Boggan, James E

    2014-12-01

    Postsurgical infection is one of the greatest potential morbidities of ventriculoperitoneal shunt surgery. The majority of infections can be linked to contamination with skin flora at the time of surgery, a phenomenon that has been well described. However, there is a paucity of literature regarding infection with nontuberculous mycobacteria. The authors report a case of postoperative ventriculoperitoneal shunt infection with Mycobacterium fortuitum and review the available neurosurgical literature and treatment strategies.

  12. First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii

    PubMed Central

    Baghdadi, Jonathan; Hemarajata, Peera; Humphries, Romney; Kelesidis, Theodoros

    2015-01-01

    Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt. PMID:26618013

  13. Activity of an antimicrobial hydrocephalus shunt catheter against Propionibacterium acnes.

    PubMed

    Bayston, Roger; Vera, Litza; Ashraf, Waheed

    2010-12-01

    Shunt infection is a major complication affecting approximately 10% of procedures. Propionibacterium acnes, an anaerobic skin bacterium, is increasingly recognized as a shunt pathogen, causing up to 14% of infections. Though susceptible to penicillin and cephalosporins, P. acnes shunt infections are not preventable by means of perioperative prophylaxis, due to poor cerebrospinal fluid penetration. Antimicrobial shunts with activity against staphylococci are available, but their activity against P. acnes is unknown, and the study was designed to determine this. Three methods of evaluation were used in order to determine the emergence of resistance when exposure is to high inocula for long periods, the time taken to kill 100% of the bacteria attached to the shunt, and the duration of activity under constant flow conditions with repeated bacterial challenge. Despite repeated exposure to high bacterial inocula over 70 days, no resistance was seen. The time taken to kill all attached bacteria, 96 h, was twice that taken to kill attached staphylococci. Nevertheless, under constant flow conditions with repeated challenges, the antimicrobial catheters resisted colonization by P. acnes for 56 days. Using tests that were designed to be clinically predictive when done together, the results suggest that the antimicrobial catheters will be able to prevent colonization of hydrocephalus shunts by P. acnes.

  14. Intraventricular hemorrhage after ventriculoperitoneal shunt revision: a retrospective review.

    PubMed

    Calayag, Mark; Paul, Alexandra R; Adamo, Matthew A

    2015-07-01

    OBJECT The authors review their ventriculoperitoneal (VP) shunt revisions over a 3-year period to determine the rate of intraventricular hemorrhage (IVH) and subsequent need for re-revision. METHODS Review of medical records identified 35 pediatric patients who underwent 52 VP shunt revisions between 2009 and 2012. The presence and amount of IVH as determined by CT and the time to re-revision were documented. The reason for shunting, catheter position, and time between initial VP shunt placement and subsequent revisions were also recorded. RESULTS After 13 (25%) of the 52 revisions, IVH was evident on postoperative CT scans. The majority of patients had a trace amount of IVH, with only 2% having IVH greater than 5 ml. After 2 (15%) of the 13 revisions associated with IVH, re-revision was required within 1 month. In contrast, the re-revision rate in patients without IVH was 18%. All of the patients who developed IVH had occipital catheters. CONCLUSIONS Some degree of IVH can be expected after approximately one-quarter of all VP shunt revision procedures in pediatric patients, but the rate of significant IVH is low. Furthermore, the presence of IVH does not necessitate an early shunt revision.

  15. Calibration of piezoelectric RL shunts with explicit residual mode correction

    NASA Astrophysics Data System (ADS)

    Høgsberg, Jan; Krenk, Steen

    2017-01-01

    Piezoelectric RL (resistive-inductive) shunts are passive resonant devices used for damping of dominant vibration modes of a flexible structure and their efficiency relies on the precise calibration of the shunt components. In the present paper improved calibration accuracy is attained by an extension of the local piezoelectric transducer displacement by two additional terms, representing the flexibility and inertia contributions from the residual vibration modes not directly addressed by the shunt damping. This results in an augmented dynamic model for the targeted resonant vibration mode, in which the residual contributions, represented by two correction factors, modify both the apparent transducer capacitance and the shunt circuit impedance. Explicit expressions for the correction of the shunt circuit inductance and resistance are presented in a form that is generally applicable to calibration formulae derived on the basis of an assumed single-mode structure, where modal interaction has been neglected. A design procedure is devised and subsequently verified by a numerical example, which demonstrates that effective mitigation can be obtained for an arbitrary vibration mode when the residual mode correction is included in the calibration of the RL shunt.

  16. Quantifying lung shunting during planning for radio-embolization

    NASA Astrophysics Data System (ADS)

    Willowson, Kathy; Bailey, Dale L.; Baldock, Clive

    2011-07-01

    A method is proposed for accurate quantification of lung uptake during shunt studies for liver cancer patients undergoing radio-embolization. The current standard for analysis of [99mTc]-MAA shunt studies is subjective and highly variable. The technique proposed in this work involves a small additional peripheral intravenous injection of macroaggregated albumin (MAA) and two additional static acquisitions (before and after injection) to quantify the absolute activity in the lungs as a result of arterio-venous shunting. Such quantification also allows for estimates of absorbed dose to lung tissue at the time of treatment based on MIRD formalism. The method was used on six radio-embolization patients attending the department for lung shunt analysis. Quantitative values for each were compared to a previously validated technique using fully quantitative SPECT/CT imaging, treated as the gold standard. The average difference between absolute activity shunted to the lungs calculated by the proposed technique compared to the previously validated technique was found to be 2%, with a range of (1-8)%. The proposed method is simple and fast, allowing for accurate quantification of lung shunting and estimates of absorbed dose to lung tissue at treatment, and may one day be used in a one-stop procedure for planning and therapy in a single interventional procedure.

  17. 77 FR 53885 - Jordan Cove Energy Project LP, Pacific Connector Gas Pipeline LP; Notice of Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-04

    ... Extension of Comment Period and Additional Public Scoping Meetings for the Jordan Cove Liquefaction and... comment period for Jordan Cove Energy Project LP's (Jordan Cove) proposed liquefaction project in Coos... Docket No. PF12-17-000. In addition to extending the scoping period, the Commission staff will...

  18. 78 FR 53745 - Gulf South Pipeline Company, LP; Petal Gas Storage, L.L.C.; Gulf South Pipeline Company, LP...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... Federal Energy Regulatory Commission Gulf South Pipeline Company, LP; Petal Gas Storage, L.L.C.; Gulf... (Gulf South) and Petal Gas Storage, L.L.C. (Petal) filed jointly with the Federal Energy Regulatory Commission (Commission) an abbreviated application under section 7(b) and 7(c) of the Natural Gas Act...

  19. 77 FR 29624 - Cheniere Creole Trail Pipeline, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ...] Cheniere Creole Trail Pipeline, L.P.; Notice of Application Take notice that on April 30, 2012, Cheniere Creole Trail Pipeline, L.P. (Cheniere), 700 Milam, Suite 800, Houston, TX 77002, filed an application in..., Cheniere Creole Trail Pipeline, L.P., 700 Milam, Suite 800, Houston, TX 77002, (713) 375-5000...

  20. 78 FR 13663 - Equitrans, L.P. Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Energy Regulatory Commission Equitrans, L.P. Notice of Request Under Blanket Authorization Take notice that on February 12, 2013, Equitrans, L.P. (Equitrans), pursuant to the blanket certificate... open to public inspection. \\1\\ Equitrans, L.P., 85 FERC ] 61,089 (1998). Equitrans proposes to...

  1. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 8 2011-07-01 2011-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system shall... petroleum gases. (b) Welding on LP-Gas containers. Welding is prohibited on containers. (c) Container...

  2. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system shall... petroleum gases. (b) Welding on LP-Gas containers. Welding is prohibited on containers. (c) Container...

  3. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 8 2013-07-01 2013-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system shall... petroleum gases. (b) Welding on LP-Gas containers. Welding is prohibited on containers. (c) Container...

  4. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 8 2012-07-01 2012-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system shall... petroleum gases. (b) Welding on LP-Gas containers. Welding is prohibited on containers. (c) Container...

  5. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 8 2014-07-01 2014-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system shall... petroleum gases. (b) Welding on LP-Gas containers. Welding is prohibited on containers. (c) Container...

  6. Prediction of Susceptibility to Acute Mountain Sickness Using Hypoxia-Induced Intrapulmonary Arteriovenous Shunt and Intracardiac Shunt Fractions

    DTIC Science & Technology

    2013-10-01

    TITLE: Prediction of Susceptibility to Acute Mountain Sickness Using Hypoxia-Induced Intrapulmonary Arteriovenous Shunt and Intracardiac Shunt...01October2012-30September2013 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Prediction of Susceptibility to Acute Mountain Sickness Using...following organizations have approved our protocol: a) Sacred Heart Medical Center IRB, the review board for Oregon Heart and Vascular Institute; b) Oregon

  7. Fever in a child with cerebrospinal fluid access device or shunt: a pragmatic approach to management.

    PubMed

    Cleave, Betsy; Cartmill, Maria; Soo, Shiu Shing; Vyas, Harish

    2016-10-20

    Children with shunts commonly present with fever, and often the focus of infection will be unrelated to their shunt. However, as shunt infections may present with few or even no specific symptoms, evaluation of a child with a shunt presenting with fever should be careful and comprehensive to ensure shunt infections are not missed. Treatment of an infected shunt involves removal of the shunt followed by a long course of antibiotics; missing or partially treating shunt infections can result in significant morbidity and potentially even mortality. Our experience of managing children with shunts presenting with fever is that many non-specialist clinicians have little experience in this area so initial management may not always be appropriate. Those children who are most at risk of shunt infection are those who within the preceding 8 weeks have had insertion, revision or access of their shunt or chemotherapy device, or have had abdominal surgery in the presence of a ventriculoperitoneal shunt. We have chosen 8 weeks as a pragmatic time point, as in our experience the vast majority of children who have had shunt infections have presented within this period. The caveat is that this should not be used as an absolute cut-off where there is strong suspicion of shunt infection or no clear focus at a later time point.

  8. Temporary arterial shunts to maintain limb perfusion after arterial injury: an animal study

    NASA Technical Reports Server (NTRS)

    Dawson, D. L.; Putnam, A. T.; Light, J. T.; Ihnat, D. M.; Kissinger, D. P.; Rasmussen, T. E.; Bradley, D. V. Jr

    1999-01-01

    BACKGROUND: Temporary shunt placement can quickly restore perfusion after extremity arterial injury. This study examined the adequacy of limb blood flow with shunt use, non-heparin-bonded shunt patency over prolonged periods, and the safety of this technique. METHODS: Common iliac arteries were divided and 4.0-mm Silastic Sundt shunts placed in 16 anesthetized pigs. Eight (group I) had shunts placed immediately; eight others (group II) were shunted after an hour of limb ischemia and hemorrhagic shock. Physiologic parameters and femoral artery blood flow in both hindlimbs were continuously monitored. Limb lactic acid generation, oxygen utilization, and hematologic and metabolic effects were serially evaluated for 24 hours. RESULTS: Shunts remained patent in 13 of 16 pigs. Shunts thrombosed in two group I animals because of technical errors, but functioned well after thrombectomy and repositioning. Patency could not be maintained in one animal that died from shock. Flow in group I shunted limbs was 57 (+/-11 SD) % of control. For group II animals in shock, shunted limb flow initially averaged 46 +/- 15% of control, but 4 hours after shunt placement, the mean limb blood flow was the same as in group I. Increased oxygen extraction compensated for the lower flow. Lactic acid production was not increased in comparison to control limbs. CONCLUSION: Shunts provided adequate flow in this model of extremity trauma. Correctly placed shunts stayed patent for 24 hours, without anticoagulation, if shunt placement followed resuscitation.

  9. Reducing CSF shunt placement in patients with spinal myelomeningocele

    PubMed Central

    Sankhla, Suresh; Khan, G. M.

    2009-01-01

    Object: The incidence of hydrocephalus requiring shunts in children with myelomeningocele (MMC) is reported to be very high. Shunt-related complications are a significant cause of morbidity and mortality in this population. In order to minimize shunt placements, we used very rigid clinical selection criteria and followed them in all patients who had myelomeningocele and enlarged ventricles. The follow-up outcome of this retrospective study is reported. Methods: From 2000 to 2007, 23 patients with myelomeningocele and variable degree of hydrocephalus were treated at our institute with primary surgical closure of their myelomeningoceles without a CSF diversion procedure. Patients with severe hydrocephalus who required immediate shunt insertion, and those with no significant associated hydrocephalus were not included in this study. Data regarding the surgical results and complications, postoperative management, and the outcome at follow-up were obtained from their hospital records. Results: Initially increased size of the ventricular system was found to have decreased or stabilized in 17 (81%) patients postoperatively. However, ventriculomegaly continued to progress further in 4 (19%) out of 21 patients. Of 11 patients who presented with enlarged head, eight (73%) patients showed reduction or stabilization in their head circumference. Three (27%) children continued to have progressive head enlargement in the postoperative period and required shunt placement. Signs of raised intracranial pressure observed in six patients on admission, improved in two (33%) and persisted or worsened in four (67%) patients who eventually improved after the insertion of a shunt. Eight (35%) patients experienced wound-related complications following closure of the MMC, including CSF leak in four, wound infection in three, wound breakdown in three, and pseudomeningocele in two patients. Shunt placement was required in the postoperative period in 13 (56.5%) patients to treat raised

  10. Laparoscopic treatment of abdominal complications following ventriculoperitoneal shunt

    PubMed Central

    Grigorean, VT; Onose, G; Popescu, M; Strambu, V; Sandu, AM

    2009-01-01

    The aim of this study is the evaluation of laparoscopic treatment in abdominal complications following ventriculoperitoneal (VP) shunt. Methods: We report a retrospective study including 17 patients with abdominal complications secondary to VP shunt for hydrocephalus, laparoscopically treated in our department, between 2000 and 2007. Results: Patients' age ranged from 1 to 72 years old (mean age 25.8 years old). Male: female ratio was 1.4. Abdominal complications encountered were: shunt disconnection with intraperitoneal distal catheter migration 47.05% (8/17), infections 23.52% (4/17) such as abscesses and peritonitis, pseudocysts 11.76% (2/17), CSF ascites 5.88% (1/17), inguinal hernia 5.88% (1/17), and shunt malfunction due to excessive length of intraperitoneal tube 5.88% (1/17). Free–disease interval varies from 1 day to 21 years, depending on the type of complication, short in peritoneal irritation syndrome and abscesses (days) and long in ascites, pseudocysts(months– years). Laparoscopic treatment was: extraction of the foreign body in shunt disconnection with intraperitoneal distal catheter migration, evacuation, debridement, lavage and drainage for pseudocysts, abscess and peritonitis, shortening of the tube in shunt malfunction due to excessive length of intraperitoneal tube a nd hernioraphy. One diagnostic laparoscopy was performed in a peritoneal irritation syndrome, which found only CSF ascites. There were no conversions to open surgery. The overall mortality was of 5.88% and postoperative morbidity was of 11.76%. In 7 patients operated for abscesses, peritonitis, pseudocysts, and CSF ascites the shunting system was converted in to a ventriculocardiac shunt. Conclusions: Abdominal complication following VP shunt can be successfully performed laparoscopically. Abdominal surgery required, in selected cases, the repositioning of the distal catheter, frequently as a ventriculocardiac shunt. There are abdominal complications with no indication of

  11. Psychosocial adaptations of shunted hydrocephalic children.

    PubMed

    Moilanen, I; Meira, L; Serlo, W; von Wendt, L

    1985-12-01

    The personality, psychosomatic symptoms and family characteristics of 55 shunted hydrocephalic children older than four years were studied. Hydrocephalic childrens' self-concept, measured by the Children's Appereception Test, was found to be very significantly poorer than that of the control children. They also frequently showed behaviour disorders of the MBD-type, e.g. concentration difficulties, aggressiveness, fastidious eating and nervousness. The hydrocephalic childrens' families showed very significantly more cohesion and less rigidity, and significantly less authoritarianism than average Finnish families. When examining the parents' attitudes to their sick child, one third of the children were seen to be in a healthy role, with parental expectations realistically related to the child's abilities. One third of the children were seen as "babies", with unnecessarily over-protective attitudes on the part of their parents, and one third as "scapegoats", with accusatory attitudes from their mother and father. Those in the role of "scapegoats" had the poorest perceptual skills, the highest frequencies of behaviour disorders and the poorest self-concept.

  12. A method for obtaining time-periodic Lp estimates

    NASA Astrophysics Data System (ADS)

    Kyed, Mads; Sauer, Jonas

    2017-01-01

    We introduce a method for showing a prioriLp estimates for time-periodic, linear, partial differential equations set in a variety of domains such as the whole space, the half space and bounded domains. The method is generic and can be applied to a wide range of problems. We demonstrate it on the heat equation. The main idea is to replace the time axis with a torus in order to reformulate the problem on a locally compact abelian group and to employ Fourier analysis on this group. As a by-product, maximal Lp regularity for the corresponding initial-value problem follows without the notion of R-boundedness. Moreover, we introduce the concept of a time-periodic fundamental solution.

  13. Smell of danger: an analysis of LP-gas odorization

    SciTech Connect

    Cain, W.S.; Turk, A.

    1985-03-01

    LP-gas derives warning properties from the odorants ethyl mercaptan or thiophane. Laboratory tests have implied that the average person has the ability to smell the odors before leaking LP-gas reaches one-fifth its lower limit of flammability. Generally, however, laboratory tests ignore or discard persons with a poor sense of smell, especially the elderly and persons with certain types of hyposmia. Some persons who apparently can smell the warning agents when directed may otherwise fail to notice or identify them. Elderly men seem particularly vulnerable to instances of incidental anosmia and olfactory agnosia. Psychophysical testing of the warning agents has been rather unsophisticated. There exists neither a standard protocol for testing nor adequate specification of the perceptual properties that might make one warning agent better than another. Without such developments, improvement in warning agents will fail to occur. Possible improvements include increases in concentration, the use of blends to insure more uniform delivery of agent and, to decrease the perceptual vulnerability of relatively insensitive people, use of agents with favorable psychophysical (stimulus-response) functions and use of agents with favorable adaptation characteristics. Even without a change in existing products, it seems advisable to learn more about the vulnerability of LP-gas users and to employ educational means to reduce risks.

  14. Shunt insufficiency due to knot formation in the peritoneal catheter.

    PubMed

    Fekete, Gábor; Nagy, Andrea; Pataki, István; Bognar, László; Novák, László

    2013-07-30

    The authors report a rare case of the peripheral obstruction of a ventriculoperitoneal shunt. Premature baby was operated on hydrocephalus due to germinal matrix bleeding. After two months of implantation of venticuloperitoneal shunt peripheral insufficiency of the system was emerged. During the shunt revision extensive knot formation became visible. We simply cut the catheter above the knot and the working shunt was replaced into the abdominal cavity. The postoperative course was uneventful and the baby was free of complaints for more than one year. The pathomechanism of knot formation is not clear thus the discovery of the problem during the operation is an unexpected event. In our opinion tight knot cannot be spontaneously formed intraabdominally. Loose knots can be developed and can reduce the capacity of liquor flow. We think that the knot tightens during pulling out. Longer peritoneal catheters can precipitate multiple looping and/or axial torquations and increase the peripheral resistance of the shunt. In such cases when the pulling out is challenged conversion to laparotomy is suggested.

  15. 77 FR 30589 - SteelRiver Infrastructure Partners LP, SteelRiver Infrastructure Associates LLC, SteelRiver...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Surface Transportation Board SteelRiver Infrastructure Partners LP, SteelRiver Infrastructure Associates LLC, SteelRiver Infrastructure Fund North America LP, and Patriot Funding LLC--Control Exemption--Patriot Rail Corp., et al. SteelRiver Infrastructure Partners LP (SRIP LP), SteelRiver...

  16. The Lp_3561 and Lp_3562 Enzymes Support a Functional Divergence Process in the Lipase/Esterase Toolkit from Lactobacillus plantarum.

    PubMed

    Esteban-Torres, María; Reverón, Inés; Santamaría, Laura; Mancheño, José M; de Las Rivas, Blanca; Muñoz, Rosario

    2016-01-01

    Lactobacillus plantarum species is a good source of esterases since both lipolytic and esterase activities have been described for strains of this species. No fundamental biochemical difference exists among esterases and lipases since both share a common catalytic mechanism. L. plantarum WCFS1 possesses a protein, Lp_3561, which is 44% identical to a previously described lipase, Lp_3562. In contrast to Lp_3562, Lp_3561 was unable to degrade esters possessing a chain length higher than C4 and the triglyceride tributyrin. As in other L. plantarum esterases, the electrostatic potential surface around the active site in Lp_3561 is predicted to be basic, whereas it is essentially neutral in the Lp_3562 lipase. The fact that the genes encoding both proteins were located contiguously in the L. plantarum WCFS1 genome, suggests that they originated by tandem duplication, and therefore are paralogs as new functions have arisen during evolution. The presence of the contiguous lp_3561 and lp_3562 genes was studied among L. plantarum strains. They are located in a 8,903 bp DNA fragment that encodes proteins involved in the catabolism of sialic acid and are predicted to increase bacterial adaptability under certain growth conditions.

  17. The Lp_3561 and Lp_3562 Enzymes Support a Functional Divergence Process in the Lipase/Esterase Toolkit from Lactobacillus plantarum

    PubMed Central

    Esteban-Torres, María; Reverón, Inés; Santamaría, Laura; Mancheño, José M.; de las Rivas, Blanca; Muñoz, Rosario

    2016-01-01

    Lactobacillus plantarum species is a good source of esterases since both lipolytic and esterase activities have been described for strains of this species. No fundamental biochemical difference exists among esterases and lipases since both share a common catalytic mechanism. L. plantarum WCFS1 possesses a protein, Lp_3561, which is 44% identical to a previously described lipase, Lp_3562. In contrast to Lp_3562, Lp_3561 was unable to degrade esters possessing a chain length higher than C4 and the triglyceride tributyrin. As in other L. plantarum esterases, the electrostatic potential surface around the active site in Lp_3561 is predicted to be basic, whereas it is essentially neutral in the Lp_3562 lipase. The fact that the genes encoding both proteins were located contiguously in the L. plantarum WCFS1 genome, suggests that they originated by tandem duplication, and therefore are paralogs as new functions have arisen during evolution. The presence of the contiguous lp_3561 and lp_3562 genes was studied among L. plantarum strains. They are located in a 8,903 bp DNA fragment that encodes proteins involved in the catabolism of sialic acid and are predicted to increase bacterial adaptability under certain growth conditions. PMID:27486450

  18. 75 FR 20870 - Montreux Equity Partners II SBIC, L.P.; Montreux Equity Partners III SBIC, L.P.; Notice Seeking...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Montreux Equity Partners II SBIC, L.P.; Montreux Equity Partners III SBIC, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is...

  19. [Intracardiac migration of a ventriculoatrial shunt catheter treated by endovascular transvenous retrieval].

    PubMed

    Matsubara, Noriaki; Miyachi, Shigeru; Tsukamoto, Nobuhiro

    2012-06-01

    The authors report a case of intracardiac migration of a ventriculoatrial (VA) shunt catheter and transvenous retrieval of the migrated shunt catheter. A 67-year-old male, who had previously undergone a VA shunt for hydrocephalus after subarachnoid hemorrhage, presented disorientation, memory disturbance and gait disturbance without any cardiopulmonary symptom. Head CT scan revealed ventriculomegaly that indicated hydrocephalus due to shunt malfunction. Radiogram revealed that the caudal segment of the broken atrial catheter had migrated into the heart (right ventricle). The migrated shunt catheter was retrieved by a transfemoral approach with a pigtail catheter and a snare retriever catheter, although the rostral catheter segment partially remained because of tight adhesion. The VA shunt was then reconstructed. Postoperatively, symptoms due to recurrent hydrocephalus were markedly improved and the VA shunt functioned well. Transvenous catheter retrieval was a less invasive and effective method for VA shunt catheter migration.

  20. Retrieval of a disconnected ventriculoperitoneal shunt catheter by laparoscopy in a newborn child: case report.

    PubMed

    Deinsberger, W; Langhans, M; Winking, M; Böker, D K

    1995-09-01

    In rare cases the peritoneal catheter of a ventriculoperitoneal shunt dislodges from the valve and the peritoneal tube migrates into the peritoneal cavity. For retrieval of the free intraperitoneal shunt, tube laparoscopy is the initial method of choice.

  1. Modified Blalock-Taussig shunt. Use of subclavian artery orifice as flow regulator in prosthetic systemic-pulmonary artery shunts.

    PubMed

    de Leval, M R; McKay, R; Jones, M; Stark, J; Macartney, F J

    1981-01-01

    Between April, 1975, and December, 1979, 99 modified Blalock-Taussig shunts (MBTSs) were carried out at The Hospital for Sick Children, Great Ormond Street. The operation consists of interposing between the subclavian artery and the pulmonary artery a prosthesis of greater diameter than that of the subclavian artery. The first 13 operations were performed with a prosthesis of woven Dacron. Conduits of expanded polytetrafluorethylene (PTFE) were used for 86 MBTSs, and these form the basis of this report. Forty-four (51.1%) shunts were performed in infancy, 25 in patients under the age of 1 month (29.0%). Prostheses of 4 mm were used in 34 cases, 5 mm in 14, and 6 mm in 38. There were five shunt failures (5.8%) documented at postmortem or angiocardiographic investigation. Including two late deaths for which postmortem examinations were not obtained, the overall failure rate was 8.1% (seven patients). All these patients were operated upon in infancy, four of them in the neonatal period. Although a longer follow-up is necessary to assess the validity of these shunts, the early results are encouraging. We believe we can now recommend MBTS as an alternative when the classical Blalock-Taussig shunt is considered unsuitable.

  2. A Subglandular Breast Cerebrospinal Fluid Pseudocyst Following Postsurgical Shunt Migration

    PubMed Central

    Mlynek, Karolina; Frautschi, Russell; Halasa, Brianna; Kwiecien, Grzegorz

    2015-01-01

    Summary: Cerebrospinal fluid (CSF) drainage catheters have been associated with numerous complications in various anatomic locations, because of migration, infection, and obstruction. However, breast-related CSF shunt complications tend to occur infrequently or have seldom been reported in the empirical literature. Therefore, a case is presented detailing a breast pseudocyst caused by migration and subsequent coiling of a ventriculoperitoneal shunt in the right breast pocket. To the best of the authors’ knowledge, this is the first case that has been reported in the peer-reviewed literature of a pseudocyst resulting from a CSF drainage catheter coiling around the breast implant post pancreaticoduodenectomy. Moreover, this case highlights the importance of cross-disciplinary procedural awareness, particularly in regards to breast, ventriculoperitoneal shunt, and pancreatic procedures. PMID:26894004

  3. A Subglandular Breast Cerebrospinal Fluid Pseudocyst Following Postsurgical Shunt Migration.

    PubMed

    Mlynek, Karolina; Frautschi, Russell; Halasa, Brianna; Kwiecien, Grzegorz; Papay, Francis

    2015-12-01

    Cerebrospinal fluid (CSF) drainage catheters have been associated with numerous complications in various anatomic locations, because of migration, infection, and obstruction. However, breast-related CSF shunt complications tend to occur infrequently or have seldom been reported in the empirical literature. Therefore, a case is presented detailing a breast pseudocyst caused by migration and subsequent coiling of a ventriculoperitoneal shunt in the right breast pocket. To the best of the authors' knowledge, this is the first case that has been reported in the peer-reviewed literature of a pseudocyst resulting from a CSF drainage catheter coiling around the breast implant post pancreaticoduodenectomy. Moreover, this case highlights the importance of cross-disciplinary procedural awareness, particularly in regards to breast, ventriculoperitoneal shunt, and pancreatic procedures.

  4. Predicting shunt currents in stacks of bipolar plate cells

    NASA Astrophysics Data System (ADS)

    White, R. E.; Walton, C. W.; Burney, H. S.; Beaver, R. N.

    1986-03-01

    A method is presented for predicting shunt currents in stacks of undivided and divided bipolar plate cells. The method is an efficient way of solving the coupled sets of algebraic equations that arise from using circuit analog models to represent the current paths in stacks of undivided or divided bipolar plate cells. These algebraic equations can be either linear or nonlinear depending upon the current-potential relationships used in the model (i.e., nonlinear circuit elements can be included). The method is used to show the importance of including nonsymmetrical resistances and nonlinear circuit elements in the models. Also, the method is used to predict the shunt currents for a nine cell stack of pilot plant scale bipolar plate, membrane chlor-alkali cells. It is shown that these predictions agree qualitatively with measured values. Finally, the method is used to predict the shunt currents for stacks of 60 and 120 of these cells.

  5. [Usefulness of IPC continuous monitoring in shunt dysfunction].

    PubMed

    Horcajadas, A; Román, A; Olivares, G; Saura, E; Jorques, A; Cordero, N; Ibáñez, B; Sánchez, C; Roldán, M A

    2011-08-01

    Shunt dysfunction is a common situation in neurosurgery. Often symptoms, physical examination and radiology are not enough to set a diagnosis. ICP continuous monitoring is a safe and reliable tool that provides valuable information about CSF dynamics in these patients. Not only quantitative analysis is needed but also a qualitative one that enables pathological waves identification, because high amplitude B waves are strongly related to shunt dysfunction. In this paper experience about ICP continuous monitoring in patients with shunt dysfunction suspect is presented. Quantitative and qualitative data analysis led to a correct diagnosis, improving all the patients treated according to this criterion. An intraparenchymatous Camino® sensor and neuroPICture software (developed by first author) for data collection and graphic representation were used. Complications related to monitoring were absent and graphics obtained useful for qualitative analysis.

  6. Material-induced shunts in multicrystalline silicon solar cells

    SciTech Connect

    Breitenstein, O. Bauer, J.; Rakotoniaina, J. P.

    2007-04-15

    By applying lock-in thermography imaging, light-beam-induced current imaging, electron-beam-induced current imaging at different stages of sample preparation, and infrared light microscopy in transmission mode, the physical nature of the dominant material-induced shunts in multicrystalline solar cells made from p-type silicon material has been investigated. It turns out that these shunts are due to silicon carbide (SiC) filaments, which grow preferentially in grain boundaries and cross the whole cell. These filaments are highly n-type doped, like the emitter layer on the surface of the cells. They are electrically connected both with the emitter and with the back contact, thereby producing internal shunts in the solar cell.

  7. 78 FR 32294 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P., License No. 02/02-0662,02/02...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... ADMINISTRATION DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P., License No. 02/02-0662,02/02... Interest Notice is hereby given that DeltaPoint Capital IV, L.P. and DeltaPoint Capital IV (New York), L.P...). DeltaPoint Capital IV, L.P. provided financing to Switchgear Acquisition, Inc., 1211Stewart...

  8. Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush

    PubMed Central

    Groth, Sylvia L; Greider, Kelsi L

    2015-01-01

    ABSTRACT Objective: To assess the utility of viscoelastic injection to induce bleb expansion and decrease intraocular pressure (IOP) in eyes with encapsulated glaucoma tube shunt blebs. Design: Case series. Subjects and participants: Forty-three glaucomatous eyes, including 13 eyes with congenital, 13 uveitic, 5 neovascular, 5 open angle, 4 narrow angle and 3 traumatic glaucomas. Methods, interventions or testing: All patients underwent viscoelastic flush procedure. A pre-bent 27 or 30-gauge cannula was passed through a 25-gauge paracentesis, advanced over the iris across the anterior chamber, and insinuated into the tube shunt lumen. Once the cannula was firmly lodged in position, 0.45 to 0.85 ml of viscoelastic was injected to hyperinflate the bleb. Main outcome measures: Paired t-tests were performed comparing preoperative IOP and number of medications used preoperatively vs levels measured at 1, 6, 12, 18 and 24 months. Results: Intraocular pressure was reduced from a mean preoperative level of 26.0 ± 1.2 (sem) mm Hg to 15.8 ± 1.0 at 1 month, remaining stable thereafter at each 6-month interval with 15.1 ± 1.1 mm Hg at 24 months (p < 0.0001). Medication use did not vary significantly from baseline. Pressure remained < 21 mm Hg after 2 years in 85% of eyes cannulated within 1 year of primary tube shunt implantation (n = 23), and in 62% of eyes cannulated more than 1 year after tube shunt placement (n = 20). Conclusion: Tube shunt expansion with bolus viscoelastic flush successfully restored encapsulated bleb function, providing a substantial (~10 mm Hg) IOP decrease into the mid-normal pressure range. This persisted in the majority of treated eyes for the entire study period. How to cite this article: Groth SL, Greider KL, Sponsel WE. Utility of Operative Glaucoma Tube Shunt Viscoelastic Bolus Flush. J Curr Glaucoma Pract 2015;9(3):73-76. PMID:26997840

  9. In Vitro and In Vivo Comparison of Two Suprachoroidal Shunts

    PubMed Central

    Oatts, Julius T.; Zhang, Ze; Tseng, Harry; Shields, M. Bruce; Sinard, John H.; Loewen, Nils A.

    2013-01-01

    Purpose. To compare fibrosis, aqueous humor dynamics, and intraocular pressure (IOP) of two suprachoroidal shunts as part of a new class of glaucoma drainage devices. Methods. Following proliferation analysis in vitro, 20 rabbits were implanted with either a gold shunt (GS, GMSplus+, SOLX) or a polypropylene shunt (PS, Aquashunt, OPKO). Ten eyes received mitomycin C (MMC) and triamcinolone. Peak and trough IOP were monitored with a pneumatonometer and tono-pen for 15 weeks. Aqueous humor dynamics were evaluated fluorophotometrically and tonographically. Fibrosis was quantified. Results. In vitro proliferation was similar. In vivo, both shunts were devoid of foreign body reaction but exhibited fibrosis, and GS showed vascularization. There was no significant difference in aqueous or uveoscleral flow. Preoperative morning IOP was 23.7 ± 2 mm Hg, and evening IOP was 26.5 ± 2 mm Hg (P = 0.000). Morning IOP was decreased through 15 weeks and evening IOP through 8 weeks in all groups. The morning IOP decrease was most profound at 15 weeks in PS (41%) compared to GS (18%). Antifibrotics initially enhanced but eventually diminished shunt performance. At 15 weeks, thickness of scleral fibrosis was greater in GS (246 ± 47 μm) and PS (188 ± 47 μm, P = 0.285) compared with GS+MMC (109 ± 26 μm, P = 0.023 to GS) and PS+MMC (48 ± 30 μm, P = 0.028 to PS). Conclusions. In a rabbit model, suprachoroidal polypropylene and gold shunts allow access to a new drainage pathway with different IOP profiles that can be modified with antifibrotics. PMID:23847318

  10. Shunted Piezoelectric Vibration Damping Analysis Including Centrifugal Loading Effects

    NASA Technical Reports Server (NTRS)

    Min, James B.; Duffy, Kirsten P.; Provenza, Andrew J.

    2011-01-01

    Excessive vibration of turbomachinery blades causes high cycle fatigue problems which require damping treatments to mitigate vibration levels. One method is the use of piezoelectric materials as passive or active dampers. Based on the technical challenges and requirements learned from previous turbomachinery rotor blades research, an effort has been made to investigate the effectiveness of a shunted piezoelectric for the turbomachinery rotor blades vibration control, specifically for a condition with centrifugal rotation. While ample research has been performed on the use of a piezoelectric material with electric circuits to attempt to control the structural vibration damping, very little study has been done regarding rotational effects. The present study attempts to fill this void. Specifically, the objectives of this study are: (a) to create and analyze finite element models for harmonic forced response vibration analysis coupled with shunted piezoelectric circuits for engine blade operational conditions, (b) to validate the experimental test approaches with numerical results and vice versa, and (c) to establish a numerical modeling capability for vibration control using shunted piezoelectric circuits under rotation. Study has focused on a resonant damping control using shunted piezoelectric patches on plate specimens. Tests and analyses were performed for both non-spinning and spinning conditions. The finite element (FE) shunted piezoelectric circuit damping simulations were performed using the ANSYS Multiphysics code for the resistive and inductive circuit piezoelectric simulations of both conditions. The FE results showed a good correlation with experimental test results. Tests and analyses of shunted piezoelectric damping control, demonstrating with plate specimens, show a great potential to reduce blade vibrations under centrifugal loading.

  11. Treatment of Portosystemic Shunt Myelopathy with a Stent Graft Deployed through a Transjugular Intrahepatic Route

    SciTech Connect

    Jain, Deepak Arora, Ankur; Deka, Pranjal; Mukund, Amar Bhatnagar, Shorav; Jindal, Deepti Kumar, Niteen Pamecha, Viniyendra

    2013-08-01

    A case of surgically created splenorenal shunt complicated with shunt myelopathy was successfully managed by placement of a stent graft within the splenic vein to close the portosystemic shunt and alleviate myelopathy. To our knowledge, this is the first report of a case of shunt myelopathy in a patient with noncirrhotic portal fibrosis without cirrhosis treated by a novel technique wherein a transjugular intrahepatic route was adopted to deploy the stent graft.

  12. A Retrospective Analysis of Ventriculoperitoneal Shunt Revision Cases of a Single Institute

    PubMed Central

    Park, Man-Kyu; Kim, Myungsoo; Park, Ki-Su; Park, Seong-Hyun; Hwang, Jeong-Hyun

    2015-01-01

    Objective Ventriculoperitoneal (VP) shunt complication is a major obstacle in the management of hydrocephalus. To study the differences of VP shunt complications between children and adults, we analyzed shunt revision surgery performed at our hospital during the past 10 years. Methods Patients who had undergone shunt revision surgery from January 2001 to December 2010 were evaluated retrospectively by chart review about age distribution, etiology of hydrocephalus, and causes of revision. Patients were grouped into below and above 20 years old. Results Among 528 cases of VP shunt surgery performed in our hospital over 10 years, 146 (27.7%) were revision surgery. Infection and obstruction were the most common causes of revision. Fifty-one patients were operated on within 1 month after original VP shunt surgery. Thirty-six of 46 infection cases were operated before 6 months after the initial VP shunt. Incidence of shunt catheter fracture was higher in younger patients compared to older. Two of 8 fractured catheters in the younger group were due to calcification and degradation of shunt catheters with fibrous adhesion to surrounding tissue. Conclusion The complications of VP shunts were different between children and adults. The incidence of shunt catheter fracture was higher in younger patients. Degradation of shunt catheter associated with surrounding tissue calcification could be one of the reasons of the difference in facture rates. PMID:26113963

  13. New and improved ways to treat hydrocephalus: Pursuit of a smart shunt.

    PubMed

    Lutz, Barry R; Venkataraman, Pranav; Browd, Samuel R

    2013-01-01

    The most common treatment for hydrocephalus is placement of a cerebrospinal fluid shunt to supplement or replace lost drainage capacity. Shunts are life-saving devices but are notorious for high failure rates, difficulty of diagnosing failure, and limited control options. Shunt designs have changed little since their introduction in 1950s, and the few changes introduced have had little to no impact on these long-standing problems. For decades, the community has envisioned a "smart shunt" that could provide advanced control, diagnostics, and communication based on implanted sensors, feedback control, and telemetry. The most emphasized contribution of smart shunts is the potential for advanced control algorithms, such as weaning from shunt dependency and personalized control. With sensor-based control comes the opportunity to provide data to the physician on patient condition and shunt function, perhaps even by a smart phone. An often ignored but highly valuable contribution would be designs that correct the high failure rates of existing shunts. Despite the long history and increasing development activity in the past decade, patients are yet to see a commercialized smart shunt. Most smart shunt development focuses on concepts or on isolated technical features, but successful smart shunt designs will be a balance between technical feasibility, economic viability, and acceptable regulatory risk. Here, we present the status of this effort and a framework for understanding the challenges and opportunities that will guide introduction of smart shunts into patient care.

  14. Successful Embolization of a Spontaneous Mesocaval Shunt Using the Amplatzer Vascular Plug II

    SciTech Connect

    Boixadera, Helena; Tomasello, Alejandro; Quiroga, Sergi; Cordoba, Joan; Perez, Mercedes; Segarra, Antoni

    2010-10-15

    A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involving the superior mesenteric vein.

  15. Aerosol Correction for Improving OMPS/LP Ozone Retrieval

    NASA Technical Reports Server (NTRS)

    Chen, Zhong; Bhartia, Pawan K.; Loughman, Robert

    2015-01-01

    The Ozone Mapping and Profiler Suite Limb Profiler (OMPS-LP) on board the Suomi National Polar-orbiting Partnership (SNPP) satellite was launched on Oct. 28, 2011. Limb profilers measures the radiance scattered from the Earth's atmospheric in limb viewing mode from 290 to 1000 nm and infer ozone profiles from tropopause to 60 km. The recently released OMPS-LP Version 2 data product contains the first publicly released ozone profiles retrievals, and these are now available for the entire OMPS mission, which extends from April, 2012. The Version 2 data product retrievals incorporate several important improvements to the algorithm. One of the primary changes is to turn off the aerosol retrieval module. The aerosol profiles retrieved inside the ozone code was not helping the ozone retrieval and was adding noise and other artifacts. Aerosols including polar stratospheric cloud (PSC) and polar mesospheric clouds (PMC) have a detectable effect on OMPS-LP data. Our results show that ignoring the aerosol contribution would produce an ozone density bias of up to 10 percent in the region of maximum aerosol extinction. Therefore, aerosol correction is needed to improve the quality of the retrieved ozone concentration profile. We provide Aerosol Scattering Index (ASI) for detecting aerosols-PMC-PSC, defined as ln(Im-Ic) normalized at 45km, where Im is the measured radiance and Ic is the calculated radiance assuming no aerosols. Since ASI varies with wavelengths, latitude and altitude, we can start by assuming no aerosol profiles in calculating the ASIs and then use the aerosol profile to see if it significantly reduces the residuals. We also discuss the effect of aerosol size distribution on the ozone profile retrieval process. Finally, we present an aerosol-PMC-PSC correction scheme.

  16. High-Flow Arterio-Hepatic Venous Shunt in Hepatocellular Carcinoma: Use of Multi-Electrode Radiofrequency for Shunt Obliteration

    SciTech Connect

    Pua, Uei

    2015-10-15

    Intra-tumoral arterio-hepatic venous shunting (AHVS) poses an impediment to transarterial chemoembolization of liver tumors. Not only does it present a potential hazard for systemic shunting and embolization, but also the altered flow dynamics may also result in poor delivery of drug/embolics to the target tumor bed. Current available techniques to overcome AVHS include arterial embolization (particles, coils, glue, etc.) or temporary venous occlusion using balloons. We hereby illustrate the use of radiofrequency ablation to obliterate a complex AHVS consisting of a varix-like venous aneurysm.

  17. Kinematic analysis following implantation of the PRESTIGE LP

    PubMed Central

    Kowalczyk, Izabela; Chaudhary, Navjot; Duggal, Neil

    2013-01-01

    Background The clinical success of cervical arthroplasty hinges on the ability to preserve or improve the biomechanics of the functional spinal unit. The purpose of this study was to conduct a radiologic assessment of kinematic parameters preimplantation and postimplantation of the PRESTIGE LP Cervical Disc System (Medtronic, Memphis, Tennessee). Methods A total of 120 radiographs of 20 patients following single-level implantation of the PRESTIGE LP were retrospectively reviewed. Static and dynamic radiologic assessments were performed before surgery and at 1 year postoperation. Kinematic parameters including range of motion (ROM), horizontal translation, center of rotation (COR X, Y), anterior disc height and posterior disc height, and disc angle and shell angle were assessed for each spinal level using quantitative motion analysis software. Clinical outcomes were assessed using the short form health survey physical component scores and mental component scores. Results The mean physical component scores and mental component scores of the short form health survey (SF-36) improved significantly following surgery. At 1 year postoperation, ROM, translation, and COR X were preserved. The COR Y shifted superiorly from 3.17 ± 2.08 mm preoperation to 0.98 ± 2.23 mm postoperation (P < .001). The anterior disc height and posterior disc height were significantly increased following surgery (3.97 ± 1.01 to 4.78 ± 1.11 mm and 3.04 ± 0.69 to 3.66 ± 0.61 mm, respectively; P < .01). The preoperative disc angle was 3.32° ± 2.92° and the postoperative shell angle was 1.11° ± 4.29°, with a mean change of −2.22° ± 4.63° (P < .05). Conclusions The PRESTIGE LP maintained preoperative ROM, translation, and COR X values. The postoperative COR Y value changed significantly by shifting superiorly, accompanied by an increase in DH. There was a loss of lordosis at the level of surgery, with the PRESTIGE LP endplates having an almost parallel endplate configuration. PMID

  18. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

    PubMed

    Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

    2016-04-01

    OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure.

  19. 78 FR 44943 - EcoEléctrica, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... Energy Regulatory Commission EcoEl ctrica, L.P.; Notice of Application Take notice that on July 3, 2013, EcoEl ctrica, L.P. (EcoEl ctrica), Road 337, Km. 3.7, Bo. Tallaboa Poniente, Pe uelas, PR 00624, filed... directed to Jaime L. Sanabria, EcoEl ctrica, L.P., Road 337, Km. 3.7, Bo. Tallaboa Poniente, Pe uelas,...

  20. Demonstration of circular shunt in fetal Ebstein anomaly

    PubMed Central

    Sasikumar, Deepa; Sasidharan, Bijulal; Sivasubramanian, Sivasankaran

    2015-01-01

    Ebstein's anomaly was diagnosed in a fetus at 24 weeks of gestation. There was significant cardiomegaly and severe tricuspid regurgitation (TR). There was functional pulmonary atresia with severe pulmonary regurgitation (PR) and this was causing a circular shunt. There was no fetal hydrops. PMID:26556976

  1. Embolization of nonvariceal portosystemic collaterals in transjugular intrahepatic portosystemic shunts

    SciTech Connect

    Bilbao, Jose Ignacio; Arias, Mercedes; Longo, Jesus Maria; Alejandre, Pedro Luis; Betes, Maria Teresa; Elizalde, Arlette Maria

    1997-03-15

    Percutaneous embolization of large portosystemic collaterals was performed in three patients following placement of a transjugular intrahepatic portosystemic shunt in order to improve hepatopetal portal flow. Improved hepatic portal perfusion was achieved in these cases, thereby theoretically reducing the risk of chronic hepatic encephalopathy.

  2. The Evolution of Transjugular Intrahepatic Portosystemic Shunt: Tips

    PubMed Central

    Fanelli, Fabrizio

    2014-01-01

    Since Richter's description in the literature in 1989 of the first procedure on human patients, transjugular intrahepatic portosystemic shunt (TIPS) has been worldwide considered as a noninvasive technique to manage portal hypertension complications. TIPS succeeds in lowering the hepatic sinusoidal pressure and in increasing the circulatory flow, thus reducing sodium retention, ascites recurrence, and variceal bleeding. Required several revisions of the shunt TIPS can be performed in case of different conditions such as hepatorenal syndrome, hepatichydrothorax, portal vein thrombosis, and Budd-Chiari syndrome. Most of the previous studies on TIPS procedure were based on the use of bare stents and most patients chose TIPS 2-3 years after traditional treatment, thus making TIPS appear to be not superior to endoscopy in survival rates. Bare stents were associated with higher incidence of shunt failure and consequently patients required several revisions during the follow-up. With the introduction of a dedicated e-PTFE covered stent-graft, these problems were completely solved, No more reinterventions are required with a tremendous improvement of patient's quality of life. One of the main drawbacks of the use of e-PTFE covered stent-graft is higher incidence of hepatic encephalopathy. In those cases refractory to the conventional medical therapy, a shunt reduction must be performed. PMID:27335841

  3. CONTEXT VIEW ALONG EXISTING PERIMETER TRACKS LOOKING TOWARDS SHUNTS IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    CONTEXT VIEW ALONG EXISTING PERIMETER TRACKS LOOKING TOWARDS SHUNTS IN THEIR PRESENT-DAY POSITIONS, STORAGE SHED, AND MACHINE SHOP. LOOKING NORTHEAST. - Pennsylvania Railway Ore Dock, Lake Erie at Whiskey Island, approximately 1.5 miles west of Public Square, Cleveland, Cuyahoga County, OH

  4. [Small-diameter portosystemic shunts: indications and limitations].

    PubMed

    Angel Mercado, M; Granados-García, J; Barradas, F; Chan, C; Contreras, J L; Orozco, H; Angel-Mercado, M

    1998-01-01

    Low diameter porto-systemic shunts for the treatment of portal hypertension bleeding have emerged as a consequence of the technical development of vascular grafts (PTFE) that allow the use of a narrow lumen. The experience with this kind of operation at the Instituto Nacional de la Nutrición Salvador Zubirán, Mexico City during a 6-year period is reported. There were twenty-seven patients with good liver function (Child-Pugh A-B) were operated or electively, average Age 47.5 years (range 17-71), twenty three patients with liver cirrhosis, one with portal fibrosis and three with idiopathic portal hypertension. Operative mortality: 4%. Rebleeding: 14%. Postoperative encephalopathy was observed in 14 of 27, three of them being grade III-IV (11%). In the remaining 11 cases, it was mild and easily controlled. Postoperative angiography showed shunt patency in 81% of the cases; in 33% of the cases, portal vein diameter reduction was shown, as well as two cases with portal vein thrombosis. In 77% of the cases, adequate postoperative quality of life was observed. Survival (Kaplan-Meier): 86% at 12 months and 56% at 60 months. These kinds of shunts are a good alternate choice for patients considered for surgery, in which other portal blood flow preserving procedures (selective shunts, devascularization with transection) are not feasible.

  5. Focally spared area of fatty liver caused by arterioportal shunt

    SciTech Connect

    Arita, Takeshi; Matsunaga, Naofumi; Honma, Yutaka

    1996-05-01

    We describe a case with a focally spared area in fatty liver caused by arterioportal shunt. Furthermore, we discuss the cause of the focally spared area related to a localized dilution or reduction in portal blood flow. 13 refs., 1 fig.

  6. Demonstration of circular shunt in fetal Ebstein anomaly.

    PubMed

    Sasikumar, Deepa; Sasidharan, Bijulal; Sivasubramanian, Sivasankaran

    2015-01-01

    Ebstein's anomaly was diagnosed in a fetus at 24 weeks of gestation. There was significant cardiomegaly and severe tricuspid regurgitation (TR). There was functional pulmonary atresia with severe pulmonary regurgitation (PR) and this was causing a circular shunt. There was no fetal hydrops.

  7. [Circular shunting of blood: a complication of neonatal Ebstein anomaly].

    PubMed

    Paranon, S; Plat-Wilson, G; Marcoux, M-O; Acar, P

    2010-12-01

    We report a severe neonatal presentation of Ebstein anomaly with homodynamic aggravation at birth attributed to patent ductus arteriosus and circular shunt. Prenatal diagnosis of Ebstein anomaly of the tricuspid valve with functional pulmonary atresia was made at 37 weeks gestation by fetal two- and three-dimensional echocardiography. A cesarean section was performed in view of poor fetal tolerance. The newborn was born with hydrops and multivisceral failure. A post-natal echocardiography demonstrated a left-to-right shunt across the patent ductus arteriosus and functional pulmonary atresia with severe pulmonary insufficiency with absent forward flow. This created a circular shunt, where blood flowed through the ductus to the pulmonary arteries, retrograde through the pulmonary artery and Ebstein valve, across the patent foramen ovale and out the aorta. Prostaglandin E1 infusion was stopped, resulting in clinical and echocardiographic improvement. The management of the phenomenon of a circular shunt across a patent ductus arteriosus with Ebstein malformation involves promoting early ductal closure by stopping prostaglandin therapy.

  8. Pericardial effusion and cardiac tamponade after ventriculoperitoneal shunt placement: a case report.

    PubMed

    Wiwattanadittakul, Natrujee; Katanyuwong, Kamornwan; Jetjumnong, Chumpon; Sittiwangkul, Rekwan; Makonkawkeyoon, Krit

    2016-10-01

    Insertion of a ventriculoperitoneal shunt is a common neurosurgical procedure in both adult and paediatric patients. It is one of the most important treatments in cases of hydrocephalus; however, there is a wide range of complications: the most common complication being a shunt infection, and examples of rare complications are shunt migrations and cardiac tamponade. Several reports of distal ventriculoperitoneal shunt migration in different sites, including chest, right ventricle, pulmonary artery, bowel and scrotum were published. But pericardial effusion with cardiac tamponade and its relationship to distal ventriculoperitoneal shunt migration into the pericardial sac has never been reported.

  9. Pitfalls in the Performance and Interpretation of Scintigraphic Imaging for Pleuroperitoneal Shunt.

    PubMed

    Covington, Matthew F; Choudhary, Gagandeep; Avery, Ryan J; Kuo, Phillip H

    2016-11-01

    Ascites can cause pleural effusions when the peritoneal fluid crosses the diaphragm through a pleuroperitoneal shunt in the setting of hepatic cirrhosis (hepatic hydrothorax) or malignant ascites. Scintigraphic imaging for pleuroperitoneal shunt requires intraperitoneal injection of Tc-SC or Tc-macroaggregated albumin followed by planar imaging of the chest and abdomen. Pleuroperitoneal shunt is confirmed by identifying radiotracer crossing the diaphragm from the peritoneal to pleural space. An atlas of pleuroperitoneal shunt imaging pitfalls is presented to facilitate optimal performance and interpretation of nuclear pleuroperitoneal shunt examinations. Examples include cases of nondiagnostic radiotracer injections, processing errors, and nontarget uptake.

  10. Training Lp norm multiple kernel learning in the primal.

    PubMed

    Liang, Zhizheng; Xia, Shixiong; Zhou, Yong; Zhang, Lei

    2013-10-01

    Some multiple kernel learning (MKL) models are usually solved by utilizing the alternating optimization method where one alternately solves SVMs in the dual and updates kernel weights. Since the dual and primal optimization can achieve the same aim, it is valuable in exploring how to perform Lp norm MKL in the primal. In this paper, we propose an Lp norm multiple kernel learning algorithm in the primal where we resort to the alternating optimization method: one cycle for solving SVMs in the primal by using the preconditioned conjugate gradient method and other cycle for learning the kernel weights. It is interesting to note that the kernel weights in our method can obtain analytical solutions. Most importantly, the proposed method is well suited for the manifold regularization framework in the primal since solving LapSVMs in the primal is much more effective than solving LapSVMs in the dual. In addition, we also carry out theoretical analysis for multiple kernel learning in the primal in terms of the empirical Rademacher complexity. It is found that optimizing the empirical Rademacher complexity may obtain a type of kernel weights. The experiments on some datasets are carried out to demonstrate the feasibility and effectiveness of the proposed method.

  11. Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement.

    PubMed

    Abode-Iyamah, Kingsley O; Khanna, Ryan; Rasmussen, Zachary D; Flouty, Oliver; Dahdaleh, Nader S; Greenlee, Jeremy; Howard, Matthew A

    2016-03-01

    Ventriculoperitoneal (VP) shunt placement is used to treat hydrocephalus. Shunt migration following VP shunt placement has been reported. The risk factors related to this complication have not been previously evaluated to our knowledge. In this retrospective cohort study, we aimed to determine risk factors leading to distal catheter migration and review the literature on the current methods of management and prevention. Adult patients undergoing VP shunt placement from June 2011 to December 2013 at a single institution were identified using electronic health records. The records were reviewed for demographic and procedural information, and subsequent treatment characteristics. The parameters of patients with distal shunt migration were compared to those undergoing new VP shunt placement for the same time period. We identified 137 patients undergoing 157 new VP shunt procedures with an average age of 57.7 ± standard deviation of 18.4 years old. There were 16 distal shunt migrations. Body mass index >30 kg/m(2) and number of previous shunt procedures were found to be independent risk factors for distal catheter migration. Obesity and number of previous shunt procedures were factors for distal catheter migration. Providers and patients should be aware of these possible risk factors prior to VP shunt placement.

  12. Experimental Comparison of Piezoelectric and Magnetostrictive Shunt Dampers

    NASA Technical Reports Server (NTRS)

    Asnani, Vivake M.; Deng, Zhangxian; Scheidler, Justin J.; Dapino, Marcelo J.

    2016-01-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (piezoceramic) and PMN-30%PT (single crystal) stacks, as well as a Tb_0.3 Dy_0.7 Fe_1.92 (Terfenol-D) rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  13. Experimental comparison of piezoelectric and magnetostrictive shunt dampers

    NASA Astrophysics Data System (ADS)

    Asnani, Vivake M.; Deng, Zhangxian; Scheidler, Justin J.; Dapino, Marcelo J.

    2016-04-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (`piezoceramic') and PMN-30%PT (`single crystal') stacks, as well as a Tb0.3Dy0.7Fe1.92 (`Terfenol-D') rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  14. Experimental Comparison of Piezoelectric and Magnetostrictive Shunt Dampers

    NASA Technical Reports Server (NTRS)

    Asnani, Vivake M.; Deng, Zhangxian; Dapino, Marcelo J.; Scheidler, Justin J.

    2016-01-01

    A novel mechanism called the vibration ring is being developed to enable energy conversion elements to be incorporated into the driveline of a helicopter or other rotating machines. Unwanted vibration is transduced into electrical energy, which provides a damping effect on the driveline. The generated electrical energy may also be used to power other devices (e.g., health monitoring sensors). PZT (piezoceramic) and PMN-30PT (single crystal) stacks, as well as a Tb_0.3 Dy_0.7 Fe_1.92 (Terfenol-D) rod with a bias magnet array and a pickup coil, were tested as alternative energy conversion elements to use within the vibration ring. They were tuned for broadband damping using shunt resistors, and dynamic compression testing was conducted in a high-speed load frame. Energy conversion was experimentally optimized at 750Hz by tuning the applied bias stress and resistance values. Dynamic testing was conducted up to 1000Hz to determine the effective compressive modulus, shunt loss factor, internal loss factor, and total loss factor. Some of the trends of modulus and internal loss factor versus frequency were unexplained. The single crystal device exhibited the greatest shunt loss factor whereas the Terfenol-D device had the highest internal and total loss factors. Simulations revealed that internal losses in the Terfenol-D device were elevated by eddy current effects, and an improved magnetic circuit could enhance its shunt damping capabilities. Alternatively, the Terfenol-D device may be simplified to utilize only the eddy current dissipation mechanism (no pickup coil or shunt) to create broadband damping.

  15. Fourth ventricular entrapment caused by rostrocaudal herniation following shunt malfunction.

    PubMed

    Montgomery, C T; Winfield, J A

    1993-01-01

    The subacute development of isolated fourth ventricle (IFV) is a recognized complication following shunting of the lateral ventricles for congenital and acquired hydrocephalus. We present an unusual case of acute IFV in a clinical setting which has not previously been described. Subsequent to rostrocaudal herniation caused by an obstructed frontally placed ventricular catheter, IFV developed in our patient 24 h following shunt revision, necessitating placement of an additional fourth ventricle shunt system. No signs of intraventricular hemorrhage or cerebrospinal fluid (CSF) infection were detected at the time of shunt revision and there was no documentation of similar events in the perinatal history. Dependent upon the actual underlying etiology of this child's hydrocephalus, we hypothesize that two mechanisms may have accounted for this unusual and precipitous development of IFV. Following rostrocaudal herniation and caudal shift of the brainstem, progressive edema in the pons developed. If communicating hydrocephalus was the primary etiology, then midbrain edema occluded the aqueduct of Sylvius, preventing retrograde flow of CSF to the shunt. A distinctly different mechanism for acute IFV must be invoked if aqueductal stenosis was the preexisting cause for congenital hydrocephalus. Following herniation, brainstem displacement and edema resulted in obliteration of the lateral pontine and ambient cisterns, preventing the normal rostral migration of CSF around and over the mesencephalon. Cerebellar tonsillar herniation with impaction of the tonsils into the foramen magnum may have also contributed to obstruction of fourth ventricular outflow in both settings. This unusual case of acute onset IFV is presented in detail. The underlying etiologies and clinical settings in which IFV may develop is reviewed as well.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Magnetic Resonance Imaging–Guided Transcatheter Cavopulmonary Shunt

    PubMed Central

    Ratnayaka, Kanishka; Rogers, Toby; Schenke, William H.; Mazal, Jonathan R.; Chen, Marcus Y.; Sonmez, Merdim; Hansen, Michael S.; Kocaturk, Ozgur; Faranesh, Anthony Z.; Lederman, Robert J.

    2017-01-01

    OBJECTIVES The aim of this study was to test the hypothesis that real-time magnetic resonance imaging (MRI) would enable closed-chest percutaneous cavopulmonary anastomosis and shunt by facilitating needle guidance along a curvilinear trajectory, around critical structures, and between a superior vena cava “donor” vessel and a pulmonary artery “target.” BACKGROUND Children with single-ventricle physiology require multiple open heart operations for palliation, including sternotomies and cardiopulmonary bypass. The reduced morbidity of a catheter-based approach would be attractive. METHODS Fifteen naive swine underwent transcatheter cavopulmonary anastomosis and shunt creation under 1.5-T MRI guidance. An MRI antenna-needle was advanced from the superior vena cava into the target pulmonary artery bifurcation using real-time MRI guidance. In 10 animals, balloon-expanded off-the-shelf endografts secured a proximal end-to-end caval anastomosis and a distal end-to-side pulmonary anastomosis that preserved blood flow to both branch pulmonary arteries. In 5 animals, this was achieved with a novel, purpose-built, self-expanding device. RESULTS Real-time MRI needle access of target vessels (pulmonary artery), endograft delivery, and superior vena cava shunt to pulmonary arteries were successful in all animals. All survived the procedure without complications. Intraprocedural real-time MRI, post-procedural MRI, x-ray angiography, computed tomography, and necropsy showed patent shunts with bidirectional pulmonary artery blood flow. CONCLUSIONS MRI guidance enabled a complex, closed-chest, beating-heart, pediatric, transcatheter structural heart procedure. In this study, MRI guided trajectory planning and reproducible, reliable bidirectional cavopulmonary shunt creation. PMID:27085581

  17. Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques.

    PubMed

    Wang, Mao-Qiang; Liu, Feng-Yong; Duan, Feng

    2012-12-21

    We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms.

  18. Symptomatic vaginal enterocele associated with malfunctioning ventriculoperitoneal shunt and cerebrospinal ascites.

    PubMed

    Karp, Deborah R; Rizvi, Tazeen Z; Davila, G Willy

    2011-09-01

    Abdominal pseudocyst formation is a rare adult complication associated with ventriculoperitoneal (VP) shunts. Presenting symptoms are primarily abdominal and include distention, pain and anorexia, and secondarily neurological with signs and symptoms of shunt malfunction. We describe a case of VP shunt-related pseudocyst formation presenting as symptomatic pelvic organ prolapse with stage 4 enterocele 4 years after VP shunt placement. The patient's vaginal enterocele enlarged and became more symptomatic as intra-abdominal cyst formation expanded. Symptomatic relief of pelvic floor symptomatology including resolution of exteriorized prolapse was established by conservative measures and eventual VP shunt revision and removal. VP shunt malfunction may present as symptomatic pelvic organ prolapse and may require shunt removal or revision for resolution of symptoms.

  19. Sylvian aqueduct syndrome with slit ventricles in shunted hydrocephalus due to adult aqueduct stenosis.

    PubMed

    Maroulis, Helen; Halmagyi, G Michael; Heard, Robert; Cook, Raymond J

    2008-11-01

    The authors report on 3 patients who developed sylvian aqueduct syndrome (SAS) in the context of shunt dysfunction and slit ventricles. All 3 patients had received shunts for adult onset hydrocephalus due to aqueduct stenosis and were stable for years before presenting with loss of upward gaze, convergence-retraction nystagmus, and slit ventricles, all due to shunt overdrainage. All 3 improved after either shunt revision or a third ventriculostomy procedure. Although it is well known that SAS can be caused by shunt blockage producing a transtentorial pressure gradient, these cases emphasize that an identical clinical pattern can occur with a reverse transtentorial pressure gradient and slit ventricles due to shunt overdrainage. The authors propose a simple management plan for patients with shunted hydrocephalus who develop SAS.

  20. Recanalisation of an occluded modified Blalock-Taussig shunt by balloon dilatation.

    PubMed Central

    Sreeram, N; Walsh, K; Peart, I

    1993-01-01

    A four year old boy with pulmonary atresia and ventricular septal defect had an acute cyanotic episode three years after undergoing a right-sided, 6 mm diameter, modified Blalock-Taussig shunt. On admission no continuous murmur could be heard from the shunt and the typical high velocity, continuous flow profile of the shunt could not be identified by Doppler echocardiography. At catheterisation a right subclavian artery angiogram confirmed shunt occlusion. From the subclavian artery, an 0.035 inch wire was used to enter the occluded shunt and then the pulmonary artery. Balloon angioplasty of the entire length of the shunt was performed with 6 mm diameter balloon. After angioplasty the arterial oxygen saturation increased from 63% to 83%. The patient was treated with intravenous heparin followed by warfarin. Repeat catheterisation and angiography eight days later confirmed wide patency of the shunt. Images PMID:8260283

  1. Fuzzy Inference System Approach for Locating Series, Shunt, and Simultaneous Series-Shunt Faults in Double Circuit Transmission Lines.

    PubMed

    Swetapadma, Aleena; Yadav, Anamika

    2015-01-01

    Many schemes are reported for shunt fault location estimation, but fault location estimation of series or open conductor faults has not been dealt with so far. The existing numerical relays only detect the open conductor (series) fault and give the indication of the faulty phase(s), but they are unable to locate the series fault. The repair crew needs to patrol the complete line to find the location of series fault. In this paper fuzzy based fault detection/classification and location schemes in time domain are proposed for both series faults, shunt faults, and simultaneous series and shunt faults. The fault simulation studies and fault location algorithm have been developed using Matlab/Simulink. Synchronized phasors of voltage and current signals of both the ends of the line have been used as input to the proposed fuzzy based fault location scheme. Percentage of error in location of series fault is within 1% and shunt fault is 5% for all the tested fault cases. Validation of percentage of error in location estimation is done using Chi square test with both 1% and 5% level of significance.

  2. The orbital volume measurement in patients with ventriculoperitoneal shunt.

    PubMed

    Kim, Jong-Min; Chang, Moo-Hwan; Kyung, Sungeun E

    2015-01-01

    Enophthalmos occurs from the increased bony volume or decreased soft tissue volume in the orbit and can be caused in patients with long-term ventriculoperitoneal (VP) shunt. This study tried to find out the change of orbital volume by measuring the orbital volume before and after operation in adult patients who underwent VP shunt for hydrocephalus. The 2 evaluators measured orbital volume by using ITK-SNAP 2.4 program with double-blind test for computed tomography images before and after operation targeting 36 patients over the age of 18 who underwent VP shunt with pressure-controlled valve from 2003 to 2011. Wilcoxon matched-pairs signed-rank test of GraphPad software was used to statistically analyze the difference in orbital volume change before and after operation. In case of mean pre-op orbital volume of total 36 patients, the right was measured as 23.72 ± 4.65 cm(3), the left as 23.47 ± 4.61 cm(3), the post-op right as 24.67 ± 4.70 cm(3), and the left as 24.18 ± 4.63 cm(3), showing no statistically significant difference (P = 0.106). The mean pre-op orbital volume of 14 people (28 eyes) followed for more than 11 months was 25.06 ± 4.58 cm(3) in the right and 24.4 ± 5.02 cm(3) in the left and the mean post-op orbital volume was 27.0 ± 4.28 cm(3) in the right and 25.76 ± 3.92 cm(3) in the left, showing statistically significant differences in the change of the volume before and after shunt operation (P = 0.0057). In patients who maintain long-term shunt devices after VP shunt, remodeling of matured orbital bone may be caused due to the change in pressure gradient between cranial cavity and orbit and the possible occurrence of resulting secondary enophthalmos by increased orbital volume should be considered.

  3. 77 FR 7572 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... Energy Regulatory Commission Alliance Pipeline L.P.; Notice of Application Take notice that on January 25, 2012, Alliance Pipeline L.P. filed with the Federal Energy Regulatory Commission an application under... interstate natural gas pipeline lateral designed to connect new natural gas production near Tioga,...

  4. 77 FR 28375 - Eagle Rock Desoto Pipeline, L.P.; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Eagle Rock Desoto Pipeline, L.P.; Notice of Petition for Rate Approval Take notice that on May 1, 2012, Eagle Rock Desoto Pipeline, L.P. (Desoto) filed a Rate Election pursuant...

  5. 76 FR 20971 - Eagle Rock Desoto Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Eagle Rock Desoto Pipeline, L.P.; Notice of Filing Take notice that on April 7, 2011, Eagle Rock Desoto Pipeline, L.P. filed a revised Statement of Operating Conditions...

  6. 75 FR 3723 - Longhorn Partners Pipeline L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ... Federal Energy Regulatory Commission Longhorn Partners Pipeline L.P.; Notice of Filing January 14, 2010. Take notice that on January 6, 2010, Longhorn Partners Pipeline L.P. submitted a request for the waiver...: February 3, 2010. Kimberly Bose, Secretary. BILLING CODE 6717-01-P...

  7. 78 FR 62349 - Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-18

    ... Energy Regulatory Commission Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order Take notice... Procedure, 18 CFR 385.207(a)(2)(2013), Sunoco Pipeline L.P. (SPLP) filed a petition requesting a declaratory... and Procedure (18 CFR 385.211 and 385.214) on or before 5:00 p.m. Eastern Time on the...

  8. 76 FR 35880 - Chevron Products Company v. SFPP, L.P.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ...] Chevron Products Company v. SFPP, L.P.; Notice of Complaint Take notice that on June 13, 2011, pursuant to... system of SFPP, L.P. (Respondent). This complaint is directed at the existing base rates contained in the...Support@ferc.gov , or call (866) 208-3676 (toll free). For TTY, call (202) 502-8659. Comment Date: 5...

  9. 78 FR 66354 - Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... Energy Regulatory Commission Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order Take notice... Procedure, 18 CFR 385.207(a)(2)(2013), Sunoco Pipeline L.P. (SPLP) filed a petition requesting a declaratory... (18 CFR 385.211 and 385.214) on or before 5:00 p.m. Eastern time on the specified comment...

  10. 75 FR 63452 - Lobo Pipeline Company L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... Energy Regulatory Commission Lobo Pipeline Company L.P.; Notice of Baseline Filing October 7, 2010. Take notice that on October 1, 2010, Lobo Pipeline Company L.P. submitted a revised baseline filing of its...Support@ferc.gov , or call (866) 208-3676 (toll free). For TTY, call (202) 502-8659. Comment Date: 5...

  11. 78 FR 36182 - Calpine Texas Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... Energy Regulatory Commission Calpine Texas Pipeline, L.P.; Notice of Filing Take notice that on June 7, 2013, Calpine Texas Pipeline, L.P. filed to cancel its Statement of Operating Conditions and rates for...-8659. Comment Date: 5:00 p.m. Eastern Time on Friday, June 21, 2013. Dated: June 10, 2013. Kimberly...

  12. 75 FR 3723 - Longhorn Partners Pipeline L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ... Energy Regulatory Commission Longhorn Partners Pipeline L.P.; Notice of Filing January 14, 2010. Take notice that on January 6, 2010, Longhorn Partners Pipeline L.P. submitted a request for the waiver of the.... BILLING CODE 6717-01-P...

  13. 75 FR 37785 - Crosstex North Texas Pipeline, L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... Energy Regulatory Commission Crosstex North Texas Pipeline, L.P.; Notice of Baseline Filing June 23, 2010. Take notice that on June 21, 2010, Crosstex North Texas Pipeline, L.P. submitted a baseline filing of...Support@ferc.gov , or call (866) 208-3676 (toll free). For TTY, call (202) 502-8659. Comment Date: 5...

  14. 78 FR 18973 - Bridgeline Holdings, L.P.; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Energy Regulatory Commission Bridgeline Holdings, L.P.; Notice of Petition for Rate Approval Take notice that on February 28, 2013, as supplemented on March 12, 2013, Bridgeline Holdings, L.P. filed for... free). For TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Monday, April 1,...

  15. 77 FR 70432 - Magic Valley Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... Energy Regulatory Commission Magic Valley Pipeline, L.P.; Notice of Filing Take notice that on November 15, 2012, Magic Valley Pipeline, L.P. (Magic Valley) filed to revise its Statement of Operating... free). For TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Tuesday, November 27,...

  16. 77 FR 13593 - PowerSmith Cogeneration Project, LP; Notice of Request for Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... Energy Regulatory Commission PowerSmith Cogeneration Project, LP; Notice of Request for Waiver Take... Act of 1978 (PURPA), as amended, 18 CFR 292.205(c), PowerSmith Cogeneration Project, LP (PowerSmith... operated by PowerSmith located in Oklahoma. PowerSmith makes such a request because of a delay in...

  17. 76 FR 4648 - PowerSmith Cogeneration Project, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Energy Regulatory Commission PowerSmith Cogeneration Project, LP; Notice of Filing January 19, 2011. Take notice that on January 13, 2011, PowerSmith Cogeneration Project, LP (PowerSmith), pursuant to section... Regulations for the topping-cycle cogeneration facility owned and operated by PowerSmith located in...

  18. 75 FR 69428 - Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-12

    ... Energy Regulatory Commission Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing November 4, 2010. Take notice that on November 3, 2010, Enbridge Pipelines (North Texas) L.P. submitted a revised...-8659. Comment Date: 5 p.m. Eastern Time on Monday, November 15, 2010. Kimberly D. Bose,...

  19. 77 FR 63813 - Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-17

    ... Energy Regulatory Commission Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order Take notice... Procedure, 18 CFR 385.207(a)(2)(2012), Sunoco Pipeline L.P. (``SPLP''), filed a petition seeking a... the Commission's Rules of Practice and Procedure (18 CFR 385.211 and 385.214) on or before 5:00...

  20. 75 FR 49917 - Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ... Energy Regulatory Commission Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing August 6, 2010. Take notice that on July 29, 2010, Enbridge Pipelines (North Texas) L.P. submitted a revised...-8659. Comment Date: 5 p.m. Eastern Time on Monday, August 16, 2010. Nathaniel J. Davis, Sr.,...

  1. 75 FR 22125 - Trans-Union Interstate Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... Energy Regulatory Commission Trans-Union Interstate Pipeline, L.P.; Notice of Filing April 20, 2010. Take notice that on April 9, 2010 Trans-Union Interstate Pipeline, L.P. submitted a request for waiver of the.... BILLING CODE 6717-01-P...

  2. 76 FR 12103 - Erie Boulevard Hydropower, L.P; Notice of Settlement Agreement and Soliciting Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... Energy Regulatory Commission Erie Boulevard Hydropower, L.P; Notice of Settlement Agreement and.... Date Filed: February 18, 2011. d. Applicant: Erie Boulevard Hydropower, L.P. e. Location: The existing... Daoust, Erie Boulevard Hydropower, 33 West 1st Street, South, Fulton, NY, 13069; (315) 598-6131. i....

  3. 75 FR 60840 - Highland Capital Management, L.P. and Highland Funds I; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... delegate portfolio management responsibilities of all or a portion of the Series to one or more subadvisers... COMMISSION Highland Capital Management, L.P. and Highland Funds I; Notice of Application September 27, 2010.... Applicants: Highland Capital Management, L.P. (the ``Adviser'') and Highland Funds I (the ``Trust''...

  4. 77 FR 36123 - Special Conditions: Gulfstream Aerospace LP (GALP), Model Gulfstream G280 Airplane; Aircraft...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-18

    ... Federal Aviation Administration 14 CFR Part 25 Special Conditions: Gulfstream Aerospace LP (GALP), Model... comments. SUMMARY: These special conditions are issued for the Gulfstream Aerospace LP, Model Gulfstream... architecture and connectivity capabilities of the airplane's computer systems and networks, which may...

  5. 76 FR 28026 - TransCanada Keystone Pipeline, LP; Notice of Request for Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... Energy Regulatory Commission TransCanada Keystone Pipeline, LP; Notice of Request for Waiver Take notice that on May 2, 2011, TransCanada Keystone Pipeline, LP (TransCanada Keystone) filed a request for... changes to its committed rates. TransCanada Keystone states that good cause exists to grant such a...

  6. 78 FR 26358 - TransCanada Keystone Pipeline, LP; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TransCanada Keystone Pipeline, LP; Notice of Petition for Declaratory Order... and Procedure, 18 CFR 385.207(a)(2)(2012), TransCanada Keystone Pipeline, LP filed a petition...

  7. 76 FR 35070 - Canexus Chemicals Canada L.P. v. BNSF Railway Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Canexus Chemicals Canada L.P. v. BNSF Railway Company AGENCY: Surface... (FIRS) at: (800) 877-8339. SUPPLEMENTARY INFORMATION: Canexus Chemicals Canada L.P. (Canexus) has...

  8. 76 FR 25229 - Special Conditions: Gulfstream Aerospace LP (GALP) Model G250 Airplane, Dynamic Test Requirements...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 25 Special Conditions: Gulfstream Aerospace LP (GALP) Model... special conditions are issued for the Gulfstream Aerospace LP (GALP) model G250 airplane. This...

  9. 77 FR 58323 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... propose to adopt a new airworthiness directive (AD) for all Gulfstream Aerospace LP (Type Certificate... information identified in this proposed AD, contact Gulfstream Aerospace Corporation, P.O. Box 2206,...

  10. 77 FR 71585 - Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of... of the Federal Power Act, 16 U.S.C. 824(e) and 825(e), Brookfield Energy Marketing LP...

  11. 78 FR 30911 - Texas Eastern Transmission, LP; Prior Notice Activity Under Blanket Certificate

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Texas Eastern Transmission, LP; Prior Notice Activity Under Blanket Certificate On May 8, 2013, Texas Eastern Transmission, LP (Texas Eastern), filed a prior notice request pursuant to Sections 157.205, 157.213,...

  12. 78 FR 69078 - Houston Pipe Line Company LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... October 28, 2013, Houston Pipe Line Company LP (HPL), 1300 Main Street, Houston, Texas 77002, filed an... directed to Mr. Jim Wright, Deputy General Counsel, Houston Pipe Line Company LP, 1300 Main Street, Houston... either: Complete its environmental assessment (EA) and place it into the Commission's public record...

  13. 77 FR 68118 - TexStar Transmission, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; Notice of Petition for Rate Approval Take notice that on November 2, 2012, TexStar Transmission, LP (TexStar) filed a Petition for Rate...

  14. 78 FR 21929 - TexStar Crude Oil Pipeline, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Crude Oil Pipeline, LP; Notice of Filing Take notice that on March 26, 2013, TexStar Crude Oil Pipeline, LP (TexStar) submitted to the Federal Energy...

  15. 78 FR 14778 - Application to Export Electric Energy; Shell Energy North America (US), L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... Application to Export Electric Energy; Shell Energy North America (US), L.P. AGENCY: Office of Electricity... (US), L.P. (Shell Energy) has applied to renew its authority to transmit electric energy from the..., which authorized Shell Energy to transmit electric energy from the United States to Mexico as a...

  16. 78 FR 14779 - Application to Export Electric Energy; Shell Energy North America (US), L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... Application to Export Electric Energy; Shell Energy North America (US), L.P. AGENCY: Office of Electricity... (US), L.P. (Shell Energy) has applied to renew its authority to transmit electric energy from the..., which authorized Shell Energy to transmit electric energy from the United States to Canada as a...

  17. 76 FR 71014 - Idaho Power Company, IDACORP Energy, L.P., IDACORP, Inc.; Notice of Petition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Idaho Power Company, IDACORP Energy, L.P., IDACORP, Inc.; Notice of Petition Take notice that on September 9, 2011, Idaho Power Company, IDACORP Energy, L.P., and IDACORP,...

  18. 77 FR 74182 - Magic Valley Pipeline, L.P.; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Magic Valley Pipeline, L.P.; Notice of Petition for Rate Approval Take notice that on November 30, 2012, Magic Valley Pipeline, L.P. (Magic Valley) filed a petition for...

  19. 77 FR 26585 - Steel Partners Holdings L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... COMMISSION Steel Partners Holdings L.P.; Notice of Application April 27, 2012. AGENCY: Securities and... Investment Company Act of 1940 (``Act''). Summary of Application: Steel Partners Holdings L.P. (``SPH... its acquisition of WebBank in 1998 until July 14, 2009. 2. Prior to December 2008, Steel Partners...

  20. 78 FR 13661 - Energy Transfer Fuel, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Energy Transfer Fuel, LP; Notice of Petition for Rate Approval Take notice that on February 15, 2013, Energy Transfer Fuel, LP filed for approval of rates for...

  1. Automated Test Assembly Using lp_Solve Version 5.5 in R

    ERIC Educational Resources Information Center

    Diao, Qi; van der Linden, Wim J.

    2011-01-01

    This article reviews the use of the software program lp_solve version 5.5 for solving mixed-integer automated test assembly (ATA) problems. The program is freely available under Lesser General Public License 2 (LGPL2). It can be called from the statistical language R using the lpSolveAPI interface. Three empirical problems are presented to…

  2. 78 FR 16845 - Equitrans, L.P.; Equitable Gas Company, LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... Energy Regulatory Commission Equitrans, L.P.; Equitable Gas Company, LLC; Notice of Application Take notice that on March 1, 2013, Equitrans, L.P. (Equitrans), 625 Liberty Avenue, Suite 1700, Pittsburgh...: 5:00 p.m. Eastern Time on April 2, 2013. Dated: March 12, 2013. Kimberly D. Bose, Secretary....

  3. 76 FR 28221 - Trans-Union Interstate Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-16

    ... Energy Regulatory Commission Trans-Union Interstate Pipeline, L.P.; Notice of Filing Take notice that on April 7, 2011 Trans-Union Interstate Pipeline, L.P. submitted a request for a waiver of the reporting...-8659. Comment Date: June 9, 2011. Dated: May 10, 2011. Kimberly Bose, Secretary. BILLING CODE 6717-01-P...

  4. 77 FR 44610 - Enbridge Pipelines (North Texas) L.P.; Notice of Compliance Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... Federal Energy Regulatory Commission Enbridge Pipelines (North Texas) L.P.; Notice of Compliance Filing Take notice that on July 13, 2012, Enbridge Pipelines (North Texas) L.P. filed a revised Statement of... TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Monday, July 30, 2012. Dated:...

  5. 77 FR 278 - Southcross Mississippi Pipeline, L.P. Notice of Extension of Time

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Southcross Mississippi Pipeline, L.P. Notice of Extension of Time On December 13, 2011, Southcross Mississippi Pipeline, L.P. (Southcross) filed a request to extend the date for filing its next rate case pursuant...

  6. 76 FR 81925 - Freeport LNG Development, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... Energy Regulatory Commission Freeport LNG Development, L.P.; Notice of Application Take notice that on December 9, 2011, Freeport LNG Development, L.P. (Freeport LNG), filed an application pursuant to Section 3... authorization to modify the certificated LNG facilities located on Quintana Island, Texas. The filing may...

  7. 78 FR 35263 - Freeport LNG Development, L.P.; Application for Blanket Authorization To Export Previously...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... Freeport LNG Development, L.P.; Application for Blanket Authorization To Export Previously Imported... receipt of an application (Application), filed on April 19, 2013, by Freeport LNG Development, L.P. (Freeport LNG), requesting blanket authorization to export liquefied natural gas (LNG) that previously...

  8. 75 FR 74029 - Sabine Pass LNG, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... Energy Regulatory Commission Sabine Pass LNG, L.P.; Notice of Application November 22, 2010. Take notice that on November 12, 2010, Sabine Pass LNG, L.P. (Sabine Pass), 700 Milam Street, Suite 800, Houston... a redundant high pressure boil off gas compressor at its existing Sabine Pass LNG Terminal,...

  9. 78 FR 23552 - Dominion Cove Point LNG, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-19

    ... Energy Regulatory Commission Dominion Cove Point LNG, LP; Notice of Application Take notice that on April 1, 2013, Dominion Cove Point LNG, LP (Dominion Cove Point), 120 Tredegar Street, Richmond, Virginia... for the export at its existing Cove Point LNG terminal in Calvert County, Maryland....

  10. 76 FR 40723 - Dominion Cove Point LNG, LP; Notice of Technical Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Dominion Cove Point LNG, LP; Notice of Technical Conference On May 27, 2011, pursuant to section 4 of the Natural Gas Act (NGA), Dominion Cove Point LNG, LP (Cove Point) filed...

  11. 76 FR 58488 - Dominion Cove Point LNG, LP; Application for Blanket Authorization to Export Previously Imported...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... Dominion Cove Point LNG, LP; Application for Blanket Authorization to Export Previously Imported Liquefied... (Application), filed on August 8, 2011, by Dominion Cove Point LNG, LP (DCP), requesting blanket authorization to export liquefied natural gas (LNG) that previously had been imported into the United States...

  12. 77 FR 68116 - TEAK Texana Transmission Company, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... Energy Regulatory Commission TEAK Texana Transmission Company, LP; Notice of Petition for Rate Approval Take notice that on November 2, 2012, TEAK Texana Transmission Company, LP (TEAK) filed a Petition for Rate Approval pursuant to 284.123(b)(2) of the Commissions regulations for firm and...

  13. Morphological studies of pulmonary arteriovenous shunting in a lamb model of superior cavopulmonary anastomosis.

    PubMed

    McMullan, David Michael; Reddy, Vadiyala Mohan; Gottliebson, William M; Silverman, Norman H; Perry, Stanton B; Chan, Frandics; Hanley, Frank Louis; Riemer, Robert Kirk

    2008-07-01

    We sought to identify and characterize the abnormal vascular structures responsible for pulmonary arteriovenous shunting following the Glenn cavopulmonary shunt. Superior cavopulmonary shunt is commonly performed as part of the staged pathway to total cavopulmonary shunt to treat univentricular forms of congenital heart disease, however, clinically significant pulmonary arteriovenous malformations develop in some patients after the procedure. The causes of pulmonary arteriovenous malformations and other pulmonary vascular changes that occur after cavopulmonary shunt are not known. Using a juvenile lamb model of superior cavopulmonary anastomosis that reliably produces pulmonary arteriovenous malformations, we performed echocardiography and morphological analyses to determine the anatomic site of shunting and to identify the vascular structures involved. Pulmonary arteriovenous shunting was identified by contrast echocardiography in all surviving animals (n = 40) following superior cavopulmonary anastomosis. Pulmonary vascular corrosion casts revealed abnormal tortuous vessels joining pulmonary arteries and veins in cavopulmonary shunt animals but not control animals. In conclusion, unusual channels that bridged pulmonary arteries and veins were identified. These may represent the vascular structures responsible for arteriovenous shunting following the classic Glenn cavopulmonary shunt. Detailed analysis of these structures may elucidate factors responsible for their development.

  14. Hepatic encephalomyelopathy in a calf with congenital portosystemic shunt (CPSS).

    PubMed

    Marçal, Valéria Café; Oevermann, Anna; Bley, Tim; Pfister, Patrizia; Miclard, Julien

    2008-03-01

    A 4-month-old female Holstein Friesian calf was referred to the Veterinary Teaching Hospital, University of Berne, Switzerland for evaluation of ataxia, weakness, apathy and stunted growth. Clinical examination revealed generalized ataxia, propioceptive deficits, decreased menace response and sensibility. Postmortem examination did not reveal macroscopic changes of major organs. Histologically, the brain and the spinal cord lesions were characterized by polymicrocavitation, preferentially affecting the white matter fibers at the junction of grey and white matter and by the presence of Alzheimer type II cells. The liver revealed lesions consistent with a congenital portosystemic shunt, characterized by increased numbers of arteriolar profiles and hypoplasia to absence of portal veins. The pathological investigations along with the animal history and clinical signs indicated a hepatic encephalomyelopathy due to a congenital portosystemic shunt.

  15. Ateriovenous subclavia-shunt for head and neck reconstruction.

    PubMed

    Depprich, Rita A; Naujoks, Christian D; Meyer, Ulrich; Kübler, Norbert R; Handschel, Jörg G

    2008-11-24

    Reconstruction of the facial hard- and soft tissues is of special concern for the rehabilitation of patients especially after ablative tumor surgery has been performed. Impaired soft and hard tissue conditions as a sequelae of extensive surgical resection and/or radiotherapy may impede common reconstruction methods. Even free flaps may not be used without interposition of a vein graft as recipient vessels are not available as a consequence of radical neck dissection. We describe the reconstruction of the facial hard- and soft tissues with a free parasacpular flap in a patient who had received ablative tumor surgery and radical cervical lymphadenectomy as a treatment regimen for squamous cell carcinoma (SCC). To replace the missing cervical blood vessels an arteriovenous subclavia-shunt using a saphena magna graft was created. Microvascular free flap transfer was performed as a 2-stage procedure two weeks after the shunt operation. The microvascular reconstructive technique is described in detail.

  16. Pericardio-Amniotic Shunting for Incomplete Pentalogy of Cantrell.

    PubMed

    Engels, Alexander C; Debeer, Anne; Russo, Francesca M; Aertsen, Michael; Aerts, Katleen; Miserez, Marc; Deprest, Jan; Lewi, Liesbeth; Devlieger, Roland

    2017-01-01

    A 27-year-old woman, gravida 2, para 0, presented with an incomplete Pentalogy of Cantrell with an omphalocele, diaphragmatic hernia, and a pericardial defect at 32 weeks' gestation. A large pericardial effusion compressed the lungs and had led to a reduced lung growth with an observed-to-expected total lung volume of 28% as measured by MRI. The effusion disappeared completely after the insertion of a pericardio-amniotic shunt at 33 weeks. After birth, the newborn showed no signs of pulmonary hypoplasia and underwent a surgical correction of the defect. Protracted wound healing and a difficult withdrawal from opioids complicated the neonatal period. The child was discharged on postnatal day 105 in good condition. This case demonstrates that in case of Pentalogy of Cantrell with large pericardial effusion, the perinatal outcome might be improved by pericardio-amniotic shunting.

  17. Could there be light at the end of the tunnel? Mesocaval shunting for refractory esophageal varices in patients with contraindications to transjugular intrahepatic portosystemic shunt

    PubMed Central

    Davis, Jessica; Chun, Albert K; Borum, Marie L

    2016-01-01

    Cirrhotic patients with recurrent variceal bleeds who have failed prior medical and endoscopic therapies and are not transjugular intrahepatic portosystemic shunt candidates face a grim prognosis with limited options. We propose that mesocaval shunting be offered to this group of patients as it has the potential to decrease portal pressures and thus decrease the risk of recurrent variceal bleeding. Mesocaval shunts are stent grafts placed by interventional radiologists between the mesenteric system, most often the superior mesenteric vein, and the inferior vena cava. This allows flow to bypass the congested hepatic system, reducing portal pressures. This technique avoids the general anesthesia and morbidity associated with surgical shunt placement and has been successful in several case reports. In this paper we review the technique, candidate selection, potential pitfalls and benefits of mesocaval shunt placement. PMID:27429715

  18. Results of Trabectome Surgery Following Failed Glaucoma Tube Shunt Implantation

    PubMed Central

    Mosaed, Sameh; Chak, Garrick; Haider, Asghar; Lin, Ken Y.; Minckler, Don S.

    2015-01-01

    Abstract To evaluate the safety and efficacy of Trabectome after failed tube shunt surgery. Twenty patients with prior failed tube shunt surgery who underwent Trabectome alone were included. All patients had at least 3 months of follow-up. Outcomes measured included intraocular pressure (IOP), glaucoma medications, and secondary glaucoma surgeries. The success for Kaplan–Meier survival analysis is defined as IOP ≤21 mm Hg, IOP reduced by at least 20% from preoperative IOP, and no secondary glaucoma surgery. Mean preoperative IOP was 23.7 ± 6.4 mm Hg and mean number of glaucoma medications was 3.2 ± 1.5. At 12 months, IOP was reduced to 15.5 ± 3.2 mm Hg (P = 0.05) and number of medications was reduced to 2.4 ± 1.5 (P = 0.44). Survival rate at 12 months was 84% and 3 patients required additional glaucoma surgery with 15 patients reaching 12 months follow-up. Other than failure of IOP control and transient hypotony (IOP < 3 mm Hg) day 1 in 2 cases, there were no adverse events. Trabecular bypass procedures have traditionally been considered an approach appropriate for early-to-moderate glaucoma; however, our study indicates benefit in refractory glaucoma as well. Eyes that are prone to conjunctival scarring and hypertrophic wound healing, such as those who have failed tube shunt surgery, may benefit from procedures that avoid conjunctival incision such as Trabectome. This study indicates potential benefits in this patient population. Trabectome was safe and effective in reducing IOP at 1-year follow-up in patients with prior failed tube shunt surgery, but not effective in reducing medication reliance in these patients. PMID:26222842

  19. [Work condition of electricians servicing railway shunting and maneuvering yards].

    PubMed

    Talivanova, R V; Elizarov, B B; Kudrin, V A; Ovechkina, Zh V

    1995-01-01

    The article represents main occupational hazards and work conditions of such railway occupation as electromechanic and electromounter of shunting yards of railway stations. Complete hygienic evaluation of the occupational activities is given for individuals working at Moskovskaya, Oktjabrskaya and Sevemaya railroads. Health state of the workers was studied according to transitory disablement materials, the morbidity and its structure were analyzed. The authors outline some suggestions to improve the work conditions and decrease the morbidity.

  20. [The congenital portosystemic shunt in dogs and cats. I].

    PubMed

    Grevel, V; Schmidt, S; Lettow, E; Suter, P F; Schmidt, G U

    1987-01-01

    An overview of the circulation of the liver and of the pathogenesis of hepatic encephalopathy as a result of portal vascular anomalies is given. Clinical signs associated with portal systemic shunts are described on the basis of 16 cases, 14 dogs and 2 cats. These animals ranged in age at the time of presentation from 4 months to 7 years. The predominant abnormality observed were central nervous signs, which differed in severity. 15 animals showed a reduction in liver size. The different techniques of contrast angiography allowing demonstration of a portal systemic shunt are presented along with a discussion of the pros and cons of each. Additionally the significance of making portal venous pressure measurements prior to each angiography is also explained. In most cases mesenteric portography was chosen. Based on their location the anomalies could be categorized as intrahepatic (4 dogs) or extrahepatic (10 dogs, 2 cats). In both groups breeds of various size are represented. The extrahepatic shunts could be further described as portal-caval (n = 5), portal-phrenic (n = 4) and portal-azygos (n = 3). In five of the older animals angiography showed in addition some hepatic perfusion by the portal vein. Laboratory evaluation revealed increased resting blood ammonia concentrations (greater than 200-912 micrograms/100 ml) in all animals. Seven dogs had definitely subnormal BUN concentrations (less than 10 mg%) and ten dogs low total plasmaprotein levels (less than 5.4 g%). Free amino acids (24) were determined in four dogs and a lowered hepatic encephalopathy index (less than 1.64) was found. Medical palliative therapy to control the clinical signs is discussed. The only effective long term therapy is, however, surgery. The shunt vessel is narrowed so that a greater volume of portal blood reaches the liver. Experience gained from the surgical therapy of 14 animals is presented. Ten of these survived well without requiring further therapy at a later time. Finally the

  1. Genetic invalidation of Lp-PLA2 as a therapeutic target: Large-scale study of five functional Lp-PLA2-lowering alleles.

    PubMed

    Gregson, John M; Freitag, Daniel F; Surendran, Praveen; Stitziel, Nathan O; Chowdhury, Rajiv; Burgess, Stephen; Kaptoge, Stephen; Gao, Pei; Staley, James R; Willeit, Peter; Nielsen, Sune F; Caslake, Muriel; Trompet, Stella; Polfus, Linda M; Kuulasmaa, Kari; Kontto, Jukka; Perola, Markus; Blankenberg, Stefan; Veronesi, Giovanni; Gianfagna, Francesco; Männistö, Satu; Kimura, Akinori; Lin, Honghuang; Reilly, Dermot F; Gorski, Mathias; Mijatovic, Vladan; Munroe, Patricia B; Ehret, Georg B; Thompson, Alex; Uria-Nickelsen, Maria; Malarstig, Anders; Dehghan, Abbas; Vogt, Thomas F; Sasaoka, Taishi; Takeuchi, Fumihiko; Kato, Norihiro; Yamada, Yoshiji; Kee, Frank; Müller-Nurasyid, Martina; Ferrières, Jean; Arveiler, Dominique; Amouyel, Philippe; Salomaa, Veikko; Boerwinkle, Eric; Thompson, Simon G; Ford, Ian; Wouter Jukema, J; Sattar, Naveed; Packard, Chris J; Shafi Majumder, Abdulla Al; Alam, Dewan S; Deloukas, Panos; Schunkert, Heribert; Samani, Nilesh J; Kathiresan, Sekar; Nordestgaard, Børge G; Saleheen, Danish; Howson, Joanna Mm; Di Angelantonio, Emanuele; Butterworth, Adam S; Danesh, John

    2017-03-01

    Aims Darapladib, a potent inhibitor of lipoprotein-associated phospholipase A2 (Lp-PLA2), has not reduced risk of cardiovascular disease outcomes in recent randomized trials. We aimed to test whether Lp-PLA2 enzyme activity is causally relevant to coronary heart disease. Methods In 72,657 patients with coronary heart disease and 110,218 controls in 23 epidemiological studies, we genotyped five functional variants: four rare loss-of-function mutations (c.109+2T > C (rs142974898), Arg82His (rs144983904), Val279Phe (rs76863441), Gln287Ter (rs140020965)) and one common modest-impact variant (Val379Ala (rs1051931)) in PLA2G7, the gene encoding Lp-PLA2. We supplemented de-novo genotyping with information on a further 45,823 coronary heart disease patients and 88,680 controls in publicly available databases and other previous studies. We conducted a systematic review of randomized trials to compare effects of darapladib treatment on soluble Lp-PLA2 activity, conventional cardiovascular risk factors, and coronary heart disease risk with corresponding effects of Lp-PLA2-lowering alleles. Results Lp-PLA2 activity was decreased by 64% ( p = 2.4 × 10(-25)) with carriage of any of the four loss-of-function variants, by 45% ( p < 10(-300)) for every allele inherited at Val279Phe, and by 2.7% ( p = 1.9 × 10(-12)) for every allele inherited at Val379Ala. Darapladib 160 mg once-daily reduced Lp-PLA2 activity by 65% ( p < 10(-300)). Causal risk ratios for coronary heart disease per 65% lower Lp-PLA2 activity were: 0.95 (0.88-1.03) with Val279Phe; 0.92 (0.74-1.16) with carriage of any loss-of-function variant; 1.01 (0.68-1.51) with Val379Ala; and 0.95 (0.89-1.02) with darapladib treatment. Conclusions In a large-scale human genetic study, none of a series of Lp-PLA2-lowering alleles was related to coronary heart disease risk, suggesting that Lp-PLA2 is unlikely to be a causal risk factor.

  2. 78 FR 4842 - Linden VFT, LLC v. Brookfield Energy Marketing, LP, Cargill Power Markets, LLC; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Linden VFT, LLC v. Brookfield Energy Marketing, LP, Cargill Power Markets... a formal complaint against Brookfield Energy Marketing, LP and Cargill Power Markets,...

  3. 78 FR 48177 - Purdue Pharma L.P.; Withdrawal of Approval of a New Drug Application for Oxycontin

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    .... FDA-2013-N-0883] Purdue Pharma L.P.; Withdrawal of Approval of a New Drug Application for Oxycontin...) Extended-Release Tablets, held by Purdue Pharma L.P. (Purdue), One Stamford Forum, Stamford, CT...

  4. 75 FR 19643 - West Oaks Energy LP; Supplemental Notice That Initial Market-Based Rate Filing Includes Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ...-000] West Oaks Energy LP; Supplemental Notice That Initial Market- Based Rate Filing Includes Request...-referenced proceeding of West Oaks Energy LP's application for market-based rate authority, with...

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    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ...] West Oaks Energy NY/NE, LP; Supplemental Notice That Initial Market-Based Rate Filing Includes Request...-referenced proceeding of West Oaks Energy NY/NE LP's application for market-based rate authority, with...

  6. 77 FR 25133 - Foreign-Trade Zone 126, Temporary/Interim Manufacturing Authority, Brightpoint North America L.P...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... North America L.P. (Cell Phone Kitting and Distribution); Notice of Approval On March 2, 2012, the...) authority, on behalf of Brightpoint North America L.P., to produce cell phone kits under FTZ...

  7. Extremely rare complications in cerebrospinal fluid shunt operations.

    PubMed

    Surchev, J; Georgiev, K; Enchev, Y; Avramov, R

    2002-06-01

    The cerebrospinal fluid shunt operation, from its first realization in 1908 by Kausch till our days, is still of a significant importance for the long-term treatment of the internal hydrocephalus. Well known are many complications connected with the use of the valve systems (malfunction, infectious, overdrainage, secondary craniosynostosis and etc.). For a period of 17 years (1984-2000) at the Clinic of Pediatric Neurosurgery, Department of Neurosurgery, Sofia Medical University, 414 cerebrospinal fluid shunt operations were performed on children. 216 were drained to the right atrium of the heart, 198 to the peritoneal cavity. They were followed up by catamnesis until the year 2001. The authors describe 2 extremely rare cases with post-shunt complication as a result of a malfunction of the valve system, owing to a migration of the distal catheter: 1) in the anus; 2) in the urethra. In the first case the distal catheter perforated the colon transversum and by the way of the intestines went out through the anus. In the second case the distal catheter protruded out of the body through the bladder and the urethra. Their clinical appearance, the diagnostic examinations and the operative treatment are shown.

  8. Modified Blalock-Taussig Shunt with an Umbilical Vein Graft

    PubMed Central

    Leão, Luiz Eduardo V.; Andrade, José Carlos S.; Succi, José Ernesto; Cueva, Clotario C.; Ribeiro, Expedito E.; Carvalho, Antonio Carlos C.; Buffolo, Enio

    1985-01-01

    We describe a modification of the Blalock Taussig anastomosis, with the interposition of a glutaraldehyde-tanned umbilical vein graft between the subclavian and pulmonary arteries. This operation was performed in 64 children: 11 were less than 1 month of age (17.2%), and 23 were between 1 and 6 months of age (34.9%). Hospital deaths occurred in six patients—all less than 6 months of age (9.4%). There was no instance of shunt occlusion noted. The clinical course was uneventful among survivors, except for one patient who died of endocarditis in the late postoperative follow-up. The shunt procedure may be performed very rapidly, with minimal dissection, allowing the use of a graft larger than the diameter of the subclavian artery. This modification of the Blalock Taussig operation compares favorably with our previous experience with other shunt procedures and may be considered a valuable alternative in the palliative surgical treatment of several malformations with severe pulmonary oligemia. Images PMID:15227043

  9. Sodium Accumulation at Potential-Induced Degradation Shunted Areas in Polycrystalline Silicon Modules

    SciTech Connect

    Harvey, Steven P.; Aguiar, Jeffery A.; Hacke, Peter; Guthrey, Harvey; Johnston, Steve; Al-Jassim, Mowafak

    2016-11-01

    We investigated potential-induced degradation (PID) in silicon mini-modules that were subjected to accelerated stressing to induce PID conditions. Shunted areas on the cells were identified with photoluminescence and dark lock-in thermography (DLIT) imaging. The identical shunted areas were then analyzed via time-of-flight secondary-ion mass spectrometry (TOFSIMS) imaging, 3-D tomography, and high-resolution transmission electron microscopy. The TOF-SIMS imaging indicates a high concentration of sodium in the shunted areas, and 3-D tomography reveals that the sodium extends more than 2 um from the surface below shunted regions. Transmission electron microscopy investigation reveals that a stacking fault is present at an area identified as shunted by DLIT imaging. After the removal of surface sodium, tomography reveals persistent sodium present around the junction depth of 300 nm and a drastic difference in sodium content at the junction when comparing shunted and nonshunted regions.

  10. Causative role of infection in chronic non-thromboembolic pulmonary hypertension following ventriculo-atrial shunt.

    PubMed

    Amelot, Aymeric; Bouazza, Schaharazad; George, Bernard; Bresson, Damien

    2014-08-01

    A severe complication of ventriculo-atrial (VA) shunt placement for treatment of hydrocephalus is chronic thromboembolic pulmonary hypertension (CTEPH). We report here a patient with a VA shunt for treatment of hydrocephalus who presented two consecutive episodes of VA shunt-induced infection by Staphylococcus epidermidis and who rapidly developed chronic PH. Extensive radiological investigations and normal ventilation/perfusion lung scan allowed us to rule out CTEPH. To our knowledge, no other case of chronic pulmonary hypertension (PH) related to VA shunt insertion has been reported so far. PH in this patient with VA shunt is clinically distinct from CTEPH and has been caused by VA shunt-induced S. epidermidis infection per se.

  11. Chemoembolic Hepatopulmonary Shunt Reduction to Allow Safe Yttrium-90 Radioembolization Lobectomy of Hepatocellular Carcinoma

    SciTech Connect

    Gaba, Ron C.; VanMiddlesworth, Kyle A.

    2012-12-15

    Yttrium-90 ({sup 90}Y) radioembolization represents an emerging transcatheter treatment option for the management of hepatocellular carcinoma (HCC). Elevation of the hepatopulmonary shunt fraction risks nontarget radiation to the lungs and may limit the use of {sup 90}Y therapy in patients with locally advanced disease with vascular invasion, who often demonstrate increased shunting. We present two cases in which patients with HCC and portal vein invasion resulting in elevated hepatopulmonary shunt fractions underwent chemoembolic shunt closure to allow safe {sup 90}Y radioembolization. Both patients demonstrated excellent tumor response and patient survival. On this basis, we propose a role for chemoembolic reduction of the lung shunt fraction before {sup 90}Y radioembolization in patients with extensive tumor-related hepatopulmonary shunting.

  12. Post Blalock-Taussig shunt mediastinal mass - a single shadow with two different destinies.

    PubMed

    Rohit, Manoj Kumar; Vadivelu, Ramalingam; Khandelwal, Niranjan; Krishna, Satheesh

    2014-01-01

    The modified Blalock-Taussig shunt is a synthetic shunt between the subclavian and pulmonary artery, used in the treatment of congenital cyanotic heart diseases with pulmonary hypoperfusion. Delayed complications include progressive failure of the shunt, serous fluid leak, and pseudoaneurysm formation. We report two different and rare mediastinal vascular complications following modified BT shunt surgery in this case report. The first one is a seroma, due to serous fluid leakage through the shunt graft, which is a relatively benign complication. The second one is a pseudoaneurysm, arising from the shunt, a frequently fatal complication. Generally, X-ray chest is used for screening in these patients. CT angiography plays a vital role in the diagnosis of both these conditions. Management in pseudoaneurysm should be aggressive, as timely intervention may be life saving, while in seroma the management is most often conservative occasionally requiring surgical intervention.

  13. Chemoembolic hepatopulmonary shunt reduction to allow safe yttrium-90 radioembolization lobectomy of hepatocellular carcinoma.

    PubMed

    Gaba, Ron C; Vanmiddlesworth, Kyle A

    2012-12-01

    Yttrium-90 ((90)Y) radioembolization represents an emerging transcatheter treatment option for the management of hepatocellular carcinoma (HCC). Elevation of the hepatopulmonary shunt fraction risks nontarget radiation to the lungs and may limit the use of (90)Y therapy in patients with locally advanced disease with vascular invasion, who often demonstrate increased shunting. We present two cases in which patients with HCC and portal vein invasion resulting in elevated hepatopulmonary shunt fractions underwent chemoembolic shunt closure to allow safe (90)Y radioembolization. Both patients demonstrated excellent tumor response and patient survival. On this basis, we propose a role for chemoembolic reduction of the lung shunt fraction before (90)Y radioembolization in patients with extensive tumor-related hepatopulmonary shunting.

  14. Transjugular intrahepatic portosystemic shunt combined with esophagogastric variceal embolization in the treatment of a large gastrorenal shunt

    PubMed Central

    Jiang, Qin; Wang, Ming-Quan; Zhang, Guo-Bing; Wu, Qiong; Xu, Jian-Ming; Kong, De-Run

    2016-01-01

    AIM: To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with stomach and esophageal variceal embolization (SEVE) in cirrhotic patients with a large gastrorenal vessel shunt (GRVS). METHODS: Eighty-one cirrhotic patients with gastric variceal bleeding (GVB) associated with a GRVS were enrolled in the study and accepted TIPS combined with SEVE (TIPS + SEVE), by which portosystemic pressure gradient (PPG), biochemical, TIPS-related complications, shunt dysfunction, rebleeding, and death were evaluated. RESULTS: The PPGs before TIPS were greater than 12 mmHg in 81 patients. TIPS + SEVE treatment caused a significant decrease in PPG (from 37.97 ± 6.36 mmHg to 28.15 ± 6.52 mmHg, t = 19.22, P < 0.001). The percentage of reduction in PPG was greater than 20% from baseline. There were no significant differences in albumin, alanine aminotransferase, aspartate aminotransferase, bilirubin, prothrombin time, or Child-Pugh score before and after operation. In all patients, rebleeding rates were 3%, 6%, 12%, 18%, and 18% at 1, 3, 6, 12, and 18 mo, respectively. Five patients (6.2%) were diagnosed as having hepatic encephalopathy. The rates of shunt dysfunction were 0%, 4%, 9%, 26%, and 26%, at 1, 3, 6, 12, and 18 mo, respectively. The cumulative survival rates in 1, 3, 6, 12, and 18 mo were 100%, 100%, 95%, 90%, and 90%, respectively. CONCLUSION: Our preliminary results indicated that the efficacy and safety of TIPS + SEVE were satisfactory in cirrhotic patients with GVB associated with a GRVS (GVB + GRVS). PMID:27458505

  15. 75 FR 51451 - Erie Boulevard Hydropower, L.P.; Notice of Intent To File License Application, Filing of Pre...

    Federal Register 2010, 2011, 2012, 2013, 2014

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    ... Energy Regulatory Commission Erie Boulevard Hydropower, L.P.; Notice of Intent To File License..., 2010. d. Submitted By: Erie Boulevard Hydropower, L.P. e. Name of Project: Chasm Hydroelectric Project....gov . j. Erie Boulevard Hydropower, L.P. (Erie) filed its request to use the Traditional...

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    Federal Register 2010, 2011, 2012, 2013, 2014

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    ... Energy Regulatory Commission Erie Boulevard Hydropower, L.P.; Notice of Application Tendered for Filing... Hydropower, L.P. e. Name of Project: Oswegatchie River Hydroelectric Project. f. Location: The existing multi... Contact: Jon Elmer, Erie Boulevard Hydropower, L.P, 800 Starbuck Ave., Suite 802, Watertown, New...

  17. 78 FR 62344 - Sabine Pass Liquefaction Expansion, LLC, Sabine Pass Liquefaction, LLC, and Sabine Pass LNG, L.P...

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    2013-10-18

    ... Sabine Pass LNG, L.P., Cheniere Creole Trail Pipeline, L.P.; Notice of Application Take notice that on... LNG, L.P. (collectively referred to as Sabine Pass) filed with the Federal Energy Regulatory..., construct, and operate additional liquefied natural gas (LNG) export facilities at the Sabine Pass...

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    ..., LLC; Sabine Pass LNG, L.P.; Cheniere Creole Trail Pipeline, L.P.: Notice of Intent To Prepare an... Sabine Pass Liquefaction Expansion, LLC; Sabine Pass Liquefaction, LLC; and Sabine Pass LNG, L.P... metric tonnes of liquefied natural gas (LNG) per annum (mtpa) via LNG carriers. Trains 5 and 6...

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    ... ADMINISTRATION Cardinal Growth, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that Cardinal Growth, L.P., 311 South Wacker Driver... Business Administration (``SBA'') Rules and Regulations (13 CFR 107.730). Cardinal Growth, L.P....

  20. Evaluation of Magnetostrictive Shunt Damper Performance Using Iron (Fe)-Gallium (Ga) Alloy

    DTIC Science & Technology

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    Evaluation of Magnetostrictive Shunt Damper Performance Using Iron (Fe)-Gallium (Ga) Alloy by Andrew James Murray and Dr. JinHyeong Yoo...Aberdeen Proving Ground, MD 21005 ARL-TN-0566 September 2013 Evaluation of Magnetostrictive Shunt Damper Performance Using Iron (Fe... Magnetostrictive Shunt Damper Performance Using Iron (Fe)- Gallium (Ga) Alloy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  1. Breast Capsular Cerebrospinal Fluid Collection from Migration of a Ventriculoperitoneal Shunt Catheter

    PubMed Central

    Knaus, William J.; Kamali, Parisa; Chun, Yoon

    2016-01-01

    Summary: In this case report we have described an unusual complication of ventriculoperitoneal shunt migration into a breast implant capsule. The patient was appropriately diagnosed with computed tomographic imaging and successfully managed with shunt revision and cerebrospinal fluid aspiration. Given the high complication profile of ventriculoperitoneal shunt catheters, this case suggests an opportunity for improved perioperative communication between plastic surgeons and neurosurgeons in patients with breast implants. Coordination regarding the subcutaneous catheter tunneling may hopefully minimize the risk of this complication. PMID:27257570

  2. A Case of Discontinued Proximal Limb of a Ventriculoperitoneal Shunt With Patent Fibrous Tract.

    PubMed

    Bermo, Mohammed; Leung, Alan S; Matesan, Manuela

    2016-06-01

    Radionuclide shuntogram is important in the evaluation of cerebrospinal fluid (CSF) shunts complications such as mechanical failure, malpositioning, pseudocyst, or overdrainage. We present here a case of congenital hydrocephalus and posterior fossa cyst with multiple shunt procedures and revisions with breakage of the proximal tube of the ventriculoperitoneal shunt but preserved CSF drainage through the patent fibrous tract. Careful correlation with SPECT/CT images helped confirm the breakage and exclude CSF leak outside of the tract, which was suspected on planar images.

  3. Spontaneous peritoneal catheter knot formation: A rare cause of ventriculoperitoneal shunt malfunction.

    PubMed

    Sher, Idrees; Gambhir, Shanu; Pinto, Sarah; Mujic, Asim; Peters-Willke, Jens; Hunn, Andrew

    2017-04-01

    Ventriculoperitoneal (VP) shunting remains invaluable in the management of hydrocephalus. It is a common procedure that can be complicated by shunt malfunction due to infection, blockage and disconnection. Spontaneous peritoneal catheter knot formation causing CSF flow obstruction is a rare phenomenon. We present a case of a 12years old boy with spontaneous knot formation in the peritoneal catheter causing VP shunt obstruction and hydrocephalus.

  4. Reversibility of intrapulmonary arteriovenous shunts in liver cirrhosis documented by serial radionuclide perfusion lung scans

    SciTech Connect

    Chen, N.S.; Barnett, C.A.; Farrer, P.A.

    1984-05-01

    Using serial perfusion lung scans, the opening up and closure of right-to-left intrapulmonary arteriovenous shunts has been documented over a period of several weeks in a patient with chronic alcoholic liver disease. The presence of the shunts correlates well with the severity of hypoxemia and the presence of nodular mottling on chest radiographs. The time course of these changes with clinical status suggests lability and the functional nature of these shunts.

  5. Robert H. Pudenz (1911-1998) and Ventriculoatrial Shunt: Historical Perspective.

    PubMed

    Konar, Subhas K; Maiti, Tanmoy K; Bir, Shyamal C; Kalakoti, Piyush; Nanda, Anil

    2015-11-01

    Robert H. Pudenz was a renowned neurosurgeon in North America in the 20th century, famous for his contributions in the evolution of the shunt valve and ventriculoatrial shunt surgery. With his innovative idea and help from Heyer, in 1955, he demonstrated that a venous catheter worked best when in the right atrium and that the slit valve should be located at the most distal portion of the shunt system to prevent retrograde filling and thrombosis. He also contributed to various experimental studies on the brain, especially the electrical response of different neural structures. This historical vignette focuses on the work of Robert Pudenz and the evolution of the ventriculoatrial shunt.

  6. A rare but life-threatening complication of ventriculo-atrial shunt.

    PubMed

    Tonn, P; Gilsbach, J M; Kreitschmann-Andermahr, I; Franke, A; Blindt, R

    2005-12-01

    Insertion of ventriculoperitoneal and ventriculoatrial shunts is routinely performed. Infarction pneumonia and atrial thrombus formation are described as very rare complications of ventriculoatrial shunts. We present the case of a female patient with ventriculoatrial shunt insertion as long term treatment for aequeductal stenosis who presented with recurrent episodes of dyspnoea, chest pain, and unilateral pleural effusion. Diagnostic evaluation revealed a positive D-dimer test, bilateral basal infiltrates and pleural effusion. Transesophageal echocardiography established the diagnosis of a thrombus in the right atrium. Laboratory testing for thrombophilia revealed a homozygous factor V Leiden mutation. In the following, a shunt revision was performed.

  7. [Peritoneal pseudocysts: complications of ventriculo-peritoneal shunts. Apropos of 3 cases].

    PubMed

    Badiane, S B; Sakho, Y; Kabre, A; Ba, M C; Fall, B; Ndoye, N; Badiane, M; Gueye, E M; Gueye, M

    1997-01-01

    From 1975 to 1995, 335 patients were operated for hydrocephalus in neurosurgical clinic of CHU Fann, and got ventriculo-peritoneal shunt. 3 cases of patients presenting an uncommon complication of ventriculo-peritoneal shunt: abdominal pseudo cyst, are reported and discussed. The digestive symptoms are the first to manifest themselves for a period of time, then confusing with other forms of abdominal cysts. The suggested treatment is to remove the shunt from the peritoneal cavity and perform a ventriculo-atrial shunt, then to proceed to a laparotomy, drain the fluid and resect the cyst wall. The results are excellent.

  8. Optimization of shunt placement for the Norwood surgery using multi-domain modeling.

    PubMed

    Moghadam, Mahdi Esmaily; Migliavacca, Francesco; Vignon-Clementel, Irene E; Hsia, Tain-Yen; Marsden, Alison L

    2012-05-01

    An idealized systemic-to-pulmonary shunt anatomy is parameterized and coupled to a closed loop, lumped parameter network (LPN) in a multidomain model of the Norwood surgical anatomy. The LPN approach is essential for obtaining information on global changes in cardiac output and oxygen delivery resulting from changes in local geometry and physiology. The LPN is fully coupled to a custom 3D finite element solver using a semi-implicit approach to model the heart and downstream circulation. This closed loop multidomain model is then integrated with a fully automated derivative-free optimization algorithm to obtain optimal shunt geometries with variable parameters of shunt diameter, anastomosis location, and angles. Three objective functions: (1) systemic; (2) coronary; and (3) combined systemic and coronary oxygen deliveries are maximized. Results show that a smaller shunt diameter with a distal shunt-brachiocephalic anastomosis is optimal for systemic oxygen delivery, whereas a more proximal anastomosis is optimal for coronary oxygen delivery and a shunt between these two anatomies is optimal for both systemic and coronary oxygen deliveries. Results are used to quantify the origin of blood flow going through the shunt and its relationship with shunt geometry. Results show that coronary artery flow is directly related to shunt position.

  9. Biofilm-associated infection: the hidden face of cerebrospinal fluid shunt malfunction.

    PubMed

    Mounier, Roman; Kapandji, Natacha; Birnbaum, Ron; Cook, Fabrice; Rodriguez, Cristophe; Nebbad, Bibba; Lobo, David; Dhonneur, Gilles

    2016-12-01

    Diagnosis of cerebrospinal fluid (CSF) shunt infection is difficult. Growing evidence links this pattern to biofilm-associated infections (BAI). Biofilm may explain the indolent development of the infection, and the poor efficiency of traditional microbiologic methods. We report the case of a patient admitted for hydrocephalus associated to CSF shunt malfunction. None of the clinical, serum, or CSF laboratory findings were in favor of an infectious process. Only scanning electron microscopy (SEM) revealed the presence of biofilm. Hence, despite a broad CSF shunt infection definition, some infections could remain undiagnosed by the traditional approach. This study is the first to provide some direct evidence for bacterial biofilm-associated CSF shunt infection.

  10. Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy

    SciTech Connect

    Sakurabayashi, Shin; Sezai, Shuichi; Yamamoto, Yoshihiro; Hirano, Masanori; Oka, Hiroshi

    1997-03-15

    Purpose. To evaluate the efficacy of embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy (CRHE). Methods. Seven cirrhotic patients with CRHE refractory to medical treatment (3 men and 4 women, mean age 66 years) were studied. Five patients had splenorenal shunts, 1 had a gastrorenal shunt, and 1 had an intrahepatic portal vein-hepatic vein shunt. Shunt embolization was performed using stainless steel coils, with a percutaneous transhepatic portal vein approach in 4 patients and a transrenal vein approach in 3 patients. Results. After embolization, the shunt disappeared in 4 patients on either ultrasound pulsed Doppler monitoring or portography. Complications observed in the 7 patients were fever, transient pleural effusion, ascites, and mild esophageal varices. For 3-6 months after embolization, the 4 patients whose shunts disappeared showed minimal or no reappearance of a shunt, and had no recurrence of encephalopathy. The serum ammonia levels decreased and electroencephalograms also improved. One of the 4 patients, who developed mild esophageal varices, required no treatment. Treatment was effective in 3 of the 4 patients (75%) who underwent embolization via a transhepatic portal vein. Conclusion. Transvascular embolization of shunts improved the outcome in 4 of 7 patients. The most effective embolization was achieved via the percutaneous transhepatic portal vein approach.

  11. Ventriculo-peritoneal shunt malfunction due to complete migration and subgaleal coiling of the proximal and distal catheters.

    PubMed

    Pikis, Stylianos; Cohen, José E; Shoshan, Yigal; Benifla, Mony

    2015-01-01

    Ventriculo-peritoneal (VP) shunt malfunction due to proximal and distal catheter migration has been rarely reported in the literature. Shunt migration has been proposed to occur as a result of a combination of various mechanisms, including the windlass effect, retained memory of the shunt tubing, inadequate shunt fixation, and increased intra-abdominal pressures. We describe a rare case of a 6-week-old child who presented in our department with VP shunt malfunction due to complete proximal migration and coiling of the peritoneal and ventricular VP shunt catheters within a subgaleal pocket at the left occipital area.

  12. Neural Network Based Modeling and Analysis of LP Control Surface Allocation

    NASA Technical Reports Server (NTRS)

    Langari, Reza; Krishnakumar, Kalmanje; Gundy-Burlet, Karen

    2003-01-01

    This paper presents an approach to interpretive modeling of LP based control allocation in intelligent flight control. The emphasis is placed on a nonlinear interpretation of the LP allocation process as a static map to support analytical study of the resulting closed loop system, albeit in approximate form. The approach makes use of a bi-layer neural network to capture the essential functioning of the LP allocation process. It is further shown via Lyapunov based analysis that under certain relatively mild conditions the resulting closed loop system is stable. Some preliminary conclusions from a study at Ames are stated and directions for further research are given at the conclusion of the paper.

  13. A New Algorithm for Detecting Cloud Height using OMPS/LP Measurements

    NASA Technical Reports Server (NTRS)

    Chen, Zhong; DeLand, Matthew; Bhartia, Pawan K.

    2016-01-01

    The Ozone Mapping and Profiler Suite Limb Profiler (OMPS/LP) ozone product requires the determination of cloud height for each event to establish the lower boundary of the profile for the retrieval algorithm. We have created a revised cloud detection algorithm for LP measurements that uses the spectral dependence of the vertical gradient in radiance between two wavelengths in the visible and near-IR spectral regions. This approach provides better discrimination between clouds and aerosols than results obtained using a single wavelength. Observed LP cloud height values show good agreement with coincident Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) measurements.

  14. Optical manipulation of biological particles using LP21 mode in fiber

    NASA Astrophysics Data System (ADS)

    Chen, Shijie; Huang, He; Zou, Hongmei; Li, Qing; Fu, Jian; Lin, Feng; Wu, X.

    2014-12-01

    We demonstrate the optical manipulation of biological particles using a low-order LP21 fiber mode. The focused four-lobed LP21 mode distribution was theoretically and experimentally found to be effective in optical tweezer applications, including selective cellular pick-up, pairing, grouping or separation, as well as rotation of cell dimers and clusters. Our proposed theoretical model estimates both the translational dragging force and rotational torque in good accordance with experimental data. With a simple all-fiber configuration, and low peak irradiation to target bioparticles, the proposed LP21 ‘optical chuck’ system has great application potential in biological test systems.

  15. Validated linear dynamic model of electrically-shunted magnetostrictive transducers with application to structural vibration control

    NASA Astrophysics Data System (ADS)

    Scheidler, Justin J.; Asnani, Vivake M.

    2017-03-01

    This paper presents a linear model of the fully-coupled electromechanical behavior of a generally-shunted magnetostrictive transducer. The impedance and admittance representations of the model are reported. The model is used to derive the effect of the shunt’s electrical impedance on the storage modulus and loss factor of the transducer without neglecting the inherent resistance of the transducer’s coil. The expressions are normalized and then shown to also represent generally-shunted piezoelectric materials that have a finite leakage resistance. The generalized expressions are simplified for three shunts: resistive, series resistive-capacitive, and inductive, which are considered for shunt damping, resonant shunt damping, and stiffness tuning, respectively. For each shunt, the storage modulus and loss factor are plotted for a wide range of the normalized parameters. Then, important trends and their impact on different applications are discussed. An experimental validation of the transducer model is presented for the case of resistive and resonant shunts. The model closely predicts the measured response for a variety of operating conditions. This paper also introduces a model for the dynamic compliance of a vibrating structure that is coupled to a magnetostrictive transducer for shunt damping and resonant shunt damping applications. This compliance is normalized and then shown to be analogous to that of a structure that is coupled to a piezoelectric material. The derived analogies allow for the observations and equations in the existing literature on structural vibration control using shunted piezoelectric materials to be directly applied to the case of shunted magnetostrictive transducers.

  16. Persistent hydrocephalus due to postural activation of a ventricular shunt anti-gravity device.

    PubMed

    Craven, Claudia L; Toma, Ahmed K; Watkins, Laurence D

    2017-03-01

    The ever present need to balance over drainage with under drainage in hydrocephalus has required innovations including adjustable valves with antigravity devices. These are activated in the vertical position to prevent siphoning. We describe a group of bedridden patients who presented with unexplained under drainage caused by activation of antigravity shunt components produced by peculiar head/body position. Retrospective single centre case series of hydrocephalus patients, treated with ventriculo-peritoneal (VP) shunt insertion between April 2014 - February 2016. These patients presented with clinical and radiological under drainage syndrome. Medical notes were reviewed for clinical picture and outcome. Radiological studies were reviewed assessing shunt placement and ventricular size. Seven patients presented with clinical and radiological under drainage syndrome. A consistent posturing of long term hyper-flexion of the neck whilst lying supine was observed. All patients had similar shunt construct (adjustable Miethke ProGAV valve and shunt assistant anti-gravity component). In each of those patients a hypothesis was formulated that neck flexion was activating the shunt assistance anti-gravity component in supine position. Five patients underwent shunt revision surgery removing the shunt assistant device from the cranium and adding an anti-gravity component to the shunt system at the chest. One had the shunt assistant completely removed and one patient was managed conservatively with mobilisation. All patients had clinical and radiological improvement. Antigravity shunt components implanted cranially in bedridden hydrocephalus patients will produce underdrainage due to head flexion induced anti-gravity device activation. In these patients, anti-gravity devices should be placed at the chest. Alternatively, special nursing attention should be paid to head-trunk angle.

  17. Bacterial contamination of surgeons gloves during shunt insertion: a pilot study.

    PubMed

    Sørensen, P; Ejlertsen, T; Aaen, D; Poulsen, K

    2008-10-01

    Bacterial infection is a major cause of shunt dysfunction. It is well-known that the majority of pathogenic micro-organisms are low-virulent bacteria normally found on intact skin. Probably shunts become contaminated during surgery either by contact to the patient skin, or contact from contaminated gloves or instruments. This study was performed to find out to what extent gloves become contaminated during shunt surgery. Gloves used during shunt implantation were examined in 10 operations. Shunt implantation was done using recommended precautions to avoid infection, including prophylactic antibiotics and double gloving, by surgeons experienced in shunt surgery. Surgical incision, dissection and tunnelling were done. Then the surgeon, the scrub-nurse and, in three cases, the assistant made an imprint of their outer gloves on agar plates. Hereafter, they changed the outer pair of gloves before handling the shunt and completing the operation. The plates were cultured for 6 days in both aerobic and anaerobic environment. In all cases the surgeons gloves were contaminated, and in six cases also the nurses' gloves were contaminated, as well as all three assistants. Propionebacterium acnes were cultured from gloves in all 10 operations and coagulase-negative Staphylococci were found in eight operations. These results are preliminary, but nevertheless they are alarming. Despite the use of recommended precautions to avoid infections we found that a substantial numbers of gloves from surgeon, scrub nurse and assistant were contaminated with micro-organisms less than 15 min after surgery has been commenced and before the shunts were handled. This study offers a feasible, simple and logical explanation of how shunts may become contaminated and infected. A simple measure would be to change the outer pairs of gloves before handling of the shunt material during surgery, as was done in this study, where non-shunt infections were observed.

  18. Evaluation of Ventriculoperitoneal Shunt-Related Complications in Intracranial Meningioma with Hydrocephalus.

    PubMed

    Bir, Shyamal C; Sapkota, Shabal; Maiti, Tanmoy K; Konar, Subhas; Bollam, Papireddy; Nanda, Anil

    2017-02-01

    Objective Meningioma is a common intracranial tumor that predisposes patients to hydrocephalus which may require a permanent cerebrospinal fluid (CSF) diversion procedure such as ventriculoperitoneal (VP) shunts. We reviewed our long-term experience with VP shunts for the management of hydrocephalus in patients with meningioma. Methods and Materials A total of 48 Patients with meningioma who underwent VP shunt insertion for hydrocephalus from 1990 to 2013 was included in our case series. The study population was evaluated clinically and radiographically after VP shunt placement. Results Overall shunt failure was seen in 13 (27%) patients. Single and multiple shunt revisions were required in eight (16.7%) and five (10.4%) patients, respectively. The overall shunt revision within 6 months, 1 , and 5 years was 19, 23, and 27%, respectively. Male patient was significantly associated with the longer survival after shunt placement. Revisions free survival after 3, 5, 10, and 15 years of VP shunt placement were 70, 46, 30, and 20%, respectively. Finally, in regression analysis, age greater than 65 years (p = 0.02, 95% confidence interval (CI) = 0.1-0.13), tumor in posterior fossa (p < 0.0001, 95% CI = 0.1-0.23), tumor size (> 5 cm) (p = 0.3, 95% CI = 0.01-0.19), and Simpson resection grades II to IV (p = 0.04, 95% CI = 0.07-0.2) were identified as positive predictors of requirement of CSF flow diversion Conclusion The findings of the present study reveal that VP shunting is an important treatment option for the management of hydrocephalus in patients with meningioma. Further studies using less invasive techniques are warranted to compare the benefits of VP shunt for the management of hydrocephalus.

  19. Neuropsychological Assessment of Adult Patients with Shunted Hydrocephalus

    PubMed Central

    Bakar, Emel Erdogan

    2010-01-01

    Objective This study is planned to determine the neurocognitive difficulties of hydrocephalic adults. Methods The research group contained healthy adults (control group, n : 15), and hydrocephalic adults (n : 15). Hydrocephalic group consisted of patients with idiopathic aquaduct stenosis and post-meningitis hydrocephalus. All patients were followed with shunted hydrocephalus and not gone to shunt revision during last two years. They were chosen from either asymptomatic or had only minor symptoms without motor and sensorineural deficit. A neuropsychological test battery (Raven Standart Progressive Matrices, Bender-Gestalt Test, Cancellation Test, Clock Drawing Test, Facial Recognition Test, Line Orientation Test, Serial Digit Learning Test, Stroop Color Word Interference Test-TBAG Form, Verbal Fluency Test, Verbal Fluency Test, Visual-Aural Digit Span Test-B) was applied to all groups. Results Neuropsychological assessment of hydrocephalic patients demonstrated that they had poor performance on visual, semantic and working memory, visuoconstructive and frontal functions, reading, attention, motor coordination and executive function of parietal lobe which related with complex and perseverative behaviour. Eventually, these patients had significant impairment on the neurocognitive functions of their frontal, parietal and temporal lobes. On the other hand, the statistical analyses performed on demographic data showed that the aetiology of the hydrocephalus, age, sex and localization of the shunt (frontal or posterior parietal) did not affect the test results. Conclusion This prospective study showed that adult patients with hydrocephalus have serious neuropsychological problems which might be directly caused by the hydrocephalus; and these problems may cause serious adaptive difficulties in their social, cultural, behavioral and academic life. PMID:20379471

  20. 75 FR 73069 - Enstor Grama Ridge Storage and Transportation, LLC, Enstor Katy Storage and Transportation, LP...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ...; Docket No. PR10-83-001] Enstor Grama Ridge Storage and Transportation, LLC, Enstor Katy Storage and Transportation, LP, et al.; Notice of Baseline Filings November 18, 2010. Enstor Grama Ridge Storage Docket...

  1. Characterization of LpGPAT Gene in Lilium pensylvanicum and Response to Cold Stress

    PubMed Central

    Sun, Shao-kun; Yang, Ni-na; Chen, Li-jing; Irfan, Muhammad; Zhao, Xing-hua; Li, Tian-lai

    2015-01-01

    LpGPAT was obtained from L. pensylvanicum using RT-PCR and rapid amplification of cDNA ends. The cloned full-length cDNA was 1544 bp; it encoded 410 amino acids and had a molecular size of 46 KDa. The nucleic acid sequence analysis showed that it shared high homology with other known GPATs. SMAT result suggests that there is a PlsC that exists in 176-322 amino acid sequence of LpGAPT; it means LpGPAT protein is a member of the family of acyltransferase and has acyltransferase enzymatic activity. Result of real-time quantitative PCR and semiquantitative PCR support LpGPAT gene is definitely induced by low temperature stress. PMID:25710023

  2. Incomplete deployment of the Vena Tech LP filter--case series and concerns.

    PubMed

    Contractor, Sohail; Esmaeili, Azadeh; Reina, Diego; Deitch, Edwin

    2011-05-01

    The Vena Tech LP vena cava filter (B Braun, Evanston, Illinois) has been FDA approved since 2001 and is a permanent vena cava filtration device. It replaced the previous Vena tech LGM filter also manufactured by B Braun. The LGM filter had 2 case series reporting a high incidence of incomplete deployment of the filter, especially when placed from a jugular approach. Design changes were made to this device and the LP filter introduced. The LP filter has also been reported to have incompletely deployed both in peer reviewed literature as well as the FDA MAUDE website. We present here 3 cases of incomplete deployment of the Vena Tech LP filter and review the cases previously described as well as attempt to present possible etiologies for incomplete deployment.

  3. Valproic acid-induced hyperammonaemic coma and unrecognised portosystemic shunt.

    PubMed

    Nzwalo, Hipólito; Carrapatoso, Leonor; Ferreira, Fátima; Basilio, Carlos

    2013-06-01

    Hyperammonaemic encephalopathy is a rare and potentially fatal complication of valproic acid treatment. The clinical presentation of hyperammonaemic encephalopathy is wide and includes seizures and coma. We present a case of hyperammonaemic coma precipitated by sodium valproate use for symptomatic epilepsy in a patient with unrecognised portosystemic shunt, secondary to earlier alcoholism. The absence of any stigmata of chronic liver disease and laboratory markers of liver dysfunction delayed the recognition of this alcohol-related complication. The portal vein bypass led to a refractory, valproic acid-induced hyperammonaemic coma. The patient fully recovered after dialysis treatment.

  4. Shunting arc plasma source for pure carbon ion beama)

    NASA Astrophysics Data System (ADS)

    Koguchi, H.; Sakakita, H.; Kiyama, S.; Shimada, T.; Sato, Y.; Hirano, Y.

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA/mm2 at the peak of the pulse.

  5. A theoretical and experimental study of coplanar waveguide shunt stubs

    NASA Technical Reports Server (NTRS)

    Dib, Nihad I.; Ponchak, George E.; Katehi, Linda P. B.

    1993-01-01

    A comprehensive theoretical and experimental study of straight and bent coplanar waveguide (CPW) shunt stubs is presented. In the theoretical analysis, the CPW is assumed to be inside a cavity while, the experiments are performed on open structures. For the analysis of CPW discontinuities with air-bridges, a hybrid technique was developed which was validated through extensive theoretical and experimental comparisons. The effect of the cavity resonances on the behavior of the stubs with and without air-bridges is investigated. In addition, the encountered radiation loss due to the discontinuities is evaluated experimentally.

  6. Piezoelectric vibration damping using resonant shunt circuits: an exact solution

    NASA Astrophysics Data System (ADS)

    Soltani, P.; Kerschen, G.; Tondreau, G.; Deraemaeker, A.

    2014-12-01

    The objective of this paper is to propose an exact closed-form solution to the {{H}∞ } optimization of piezoelectric materials shunted with inductive-resistive passive electrical circuits. Realizing that Den Hartog's method which imposes fixed points of equal height in the receptance transfer function is approximate, the parameters of the piezoelectric tuned vibration absorber are calculated through the direct minimization of the maxima of the receptance. The method is applied to a one-degree-of-freedom primary oscillator considering various values of the electromechanical coupling coefficients.

  7. Shunting arc plasma source for pure carbon ion beam.

    PubMed

    Koguchi, H; Sakakita, H; Kiyama, S; Shimada, T; Sato, Y; Hirano, Y

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA∕mm(2) at the peak of the pulse.

  8. RHIC INSERTION REGION, SHUNT POWER SUPPLY CURRENT ERRORS.

    SciTech Connect

    BRUNO,D.; GANETIS,G.; LAMBIASE,R.F.; SANDBERG,J.

    2001-06-18

    The Relativistic Heavy Ion Collider (RHIC) was commissioned in 1999 and 2000. RHIC requires power supplies to supply currents to highly inductive superconducting magnets. The RHIC Insertion Region contain's many shunt power supplies to trim the current of different magnet elements in a large superconducting magnet circuit. Power Supply current error measurements were performed during the commissioning of RHIC. Models of these power supply systems were produced to predict and improve these power supply current errors using the circuit analysis program MicroCap V by Spectrum Software (TM). Results of the power supply current errors are presented from the models and from the measurements performed during the commissioning of RHIC.

  9. Oxidized phospholipids and lipoprotein-associated phospholipase A2 as important determinants of Lp(a) functionality and pathophysiological role.

    PubMed

    Tselepis, Alexandros D

    2016-04-02

    Lipoprotein(a) [Lp(a)] is composed of a low density lipoprotein (LDL)-like particle to which apolipoprotein (a) [apo(a)] is linked by a single disulfide bridge. Lp(a) is considered a causal risk factor for ischemic cardiovascular disease (CVD) and calcific aortic valve stenosis (CAVS). The evidence for a causal role of Lp(a) in CVD and CAVS is based on data from large epidemiological databases, mendelian randomization studies, and genomewide association studies. Despite the well-established role of Lp(a) as a causal risk factor for CVD and CAVS, the underlying mechanisms are not well understood. A key role in the Lp(a) functionality may be played by its oxidized phospholipids (OxPL) content. Importantly, most of circulating OxPL are associated with Lp(a); however, the underlying mechanisms leading to this preferential sequestration of OxPL on Lp(a) over the other lipoproteins, are mostly unknown. Several studies support the hypothesis that the risk of Lp(a) is primarily driven by its OxPL content. An important role in Lp(a) functionality may be played by the lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that catalyzes the degradation of OxPL and is bound to plasma lipoproteins including Lp(a). The present review article discusses new data on the pathophysiological role of Lp(a) and particularly focuses on the functional role of OxPL and Lp-PLA2 associated with Lp(a).

  10. Time to First Shunt Failure in Pediatric Patients over 1 Year Old: A 10-Year Retrospective Study.

    PubMed

    Shannon, Chevis N; Carr, Kevin R; Tomycz, Luke; Wellons, John C; Tulipan, Noel

    2013-01-01

    Studies comparing alternatives to ventriculoperitoneal (VP) shunting for treatment of hydrocephalus have often relied upon data from an earlier era that may not be representative of contemporary shunt survival outcomes. We sought to determine the shunt survival rate of our cohort and compare our results to previously published shunt survival and endoscopic third ventriculostomy (ETV) success rates. We identified 95 patients between 1 and 18 years of age, who underwent initial VP shunt placement between January 2001 and December 2010. Our study shows a shunt survival rate of 85% at 6 months and 79% at 2 years, for initial shunts in pediatric patients over 1 year of age in this cohort. The overall infection rate was 3%. This compares favorably with published success rates of ETV at similar time points as well as with the rate of infection. This suggests that ventricular shunting remains a viable alternative to ETV in the older child.

  11. Analysis of the Suitability of OMPS LP Ozone Profile Dataset for Extending the Aura MLS Record

    NASA Astrophysics Data System (ADS)

    Kramarova, N. A.; Bhartia, P. K.; Stolarski, R. S.; DeLand, M. T.

    2014-12-01

    The new Ozone Mapping and Profiler Suite (OMPS), launched on 28 October 2011 on the Suomi National Polar-orbiting Partnership satellite, represents the next generation of the US ozone monitoring system. The OMPS Limb Profiler (LP) sensor measures solar radiances scattered from the atmospheric limb in the UV and visible spectral ranges and reconstruct the vertical ozone profiles from the cloud top up to 60 km. The regular LP observations started in early 2012, and now the LP data record exceeds 2.5 years. In this presentation we will demonstrate capability of the new LP sensor to characterize the vertical ozone distribution in different atmospheric regions that are most sensitive to the changes in the stratospheric composition and dynamics. We will consider: a) the seasonal ozone patterns in the lower stratosphere - upper troposphere; b) the vertical ozone distribution inside the Antarctic ozone hole; c) the ozone patterns forced by the Quasi-Biennial Oscillations in the lower tropical stratosphere. The main focus of this study is to perform a comprehensive analysis of ozone patterns obtained from OMPS LP with those observed by Aura MLS to isolate similarities and differences between two sensors in characterizing these processes. We will examine how well LP reproduces the named above natural signals in comparison with MLS in terms of amplitude, phase and vertical structure. One of the key issues is that two instruments measure ozone in different coordinate systems: the LP measures ozone profiles as number density on a regular altitude scale, while Aura MLS retrieves ozone profiles as mixing ratios on pressure vertical grids. The comparison of two measurements requires unit conversion that in turn involves temperature profiles. Thus, the uncertainties related to the unit conversion should be accounted during the analysis. This scientific validation is critical for the further LP algorithm improvement and continuation of the Aura MLS ozone record in the future.

  12. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  13. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  14. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  15. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  16. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  17. Superior vena cava syndrome with retropharyngeal edema as a complication of ventriculoatrial shunt

    PubMed Central

    Al-Natour, Mohammed S; Entezami, Pouya; Nazzal, Munier M S; Casabianca, Andrew B; Assaly, Ragheb; Riley, Kalen; Gaudin, Daniel

    2015-01-01

    Key Clinical Message Thirty-seven-year old female with hydrocephalus managed by a ventriculoatrial (VA) shunt presented with upper body edema, dysphagia, and headache. Imaging demonstrated thrombosis of the superior vena cava (SVC). Direct catheter thrombolysis led to resolution of thrombus burden. Superior vena cava thrombosis is a rare consequence of VA shunting and must be managed emergently. PMID:26509004

  18. Recurrent pleural effusion without intrathoracic migration of ventriculoperitoneal shunt catheter: a case report.

    PubMed

    Chuen-im, Piyaporn; Smyth, Matthew D; Segura, Bradley; Ferkol, Thomas; Rivera-Spoljaric, Katherine

    2012-01-01

    Pleural effusion is a rare complication of ventriculoperitoneal (VP) shunting, usually due to the migration of the VP shunt catheter into the thorax. Herein we report a neurologically disadvantaged child with a lobar holoprosencephaly and hydrocephalus, initially treated with a VP shunt, who years later developed recurrent right-sided pleural effusion ultimately confirmed to be a cerebrospinal fluid (CSF) hydrothorax without intra-thoracic migration of the distal shunt catheter. Thoracentesis was compatible with a transudative effusion. Given the presence of a persistent pleural effusion, beta-2 transferrin concentrations were measured, which yielded a positive result. Plain radiographs and head computed tomography (CT) showed a normally positioned, functional VP shunt. A spine CT myelogram to look for a spinal dural-thoracic CSF fistula was negative. A radionuclide CSF shunt study demonstrated normal functioning VP shunt with radiotracer accumulation within the peritoneum, with subsequent tracer rapidly accumulating in the right hemithorax. Video-assisted thoracoscopic (VATS) exploration with drainage of the pleural effusion and pleurodesis was then performed. No diaphragmatic defect or shunt tubing within the thorax was found and the procedure failed to resolve the effusion. The patient's recurrent effusion was ultimately resolved with intracranial endoscopic choroid plexus coagulation to decrease CSF output.

  19. Management of cardiac migration of a distal shunt catheter: the radiological pitfalls.

    PubMed

    Aboukais, R; Zairi, F; Marinho, P; Lejeune, J-P

    2015-02-01

    Cardiac migration is a rare complication of the ventriculoperitoneal shunt. We report a case of a late migration of the distal shunt into the pulmonary arteries. The authors underline the radiological features that suggested the presence of a knot. Preoperative planning and the assistance of a vascular surgeon were required due to the presence of a knot.

  20. Chronic Leptomeningitis and Spinal Intradural Mass Secondary to Alternaria Infection in a Patient with Ventriculoperitoneal Shunt

    PubMed Central

    Thompson, Russell; Jandial, Rahul; Tegtmeier, Bernard; Chen, Mike Yue

    2016-01-01

    Fungal infection following placement of ventriculostomy or ventriculoperitoneal (VP) shunt is uncommon. We report the first case of Alternaria related central nervous system (CNS) shunt infection in a patient with CNS ependymoma manifesting as leptomeningitis and a spinal intradural mass. This case illustrates the diagnostic and management challenges. PMID:27840750

  1. Ventriculoperitoneal shunt for treatment of hydrocephalus in a French bulldog puppy

    PubMed Central

    Giacinti, Jolene A.

    2016-01-01

    A 6.5-week-old bulldog was presented with lethargy, anorexia, and stunted growth. A domed skull, ventrolateral strabismus, hypermetria, and delayed hopping were observed. Congenital hydrocephalus was diagnosed and a ventriculoperitoneal shunt was placed. After surgery, a shunt obstruction occurred but resolved with treatment. The puppy responded well and neurological deficits continued to improve after surgery. PMID:26933271

  2. Creation of transcatheter aortopulmonary and cavopulmonary shunts using magnetic catheters: feasibility study in swine.

    PubMed

    Levi, Daniel S; Danon, Saar; Gordon, Brent; Virdone, Nicky; Vinuela, Fernando; Shah, Sanjay; Carman, Greg; Moore, John W

    2009-05-01

    Surgical shunts are the basic form of palliation for many types of congenital heart disease. The Glenn shunt (superior cavopulmonary connection) and central shunt (aortopulmonary connection) represent surgical interventions that could potentially be accomplished by transcatheter techniques. We sought to investigate the efficacy of using neodymium iron boron (NdFeB) magnetic catheters to create transcatheter cavopulmonary and aortopulmonary shunts. NdFeB magnets were machined and integrated into catheters. "Target" catheters were placed in the pulmonary arteries (PAs), and radiofrequency "perforation" catheters were placed in either the descending aorta (DAo) for central shunts or the superior vena cava (SVC) for Glenn shunts. The magnet technique or "balloon target" method was used to pass wires from the DAo or the SVC into the PA. Aortopulmonary and cavopulmonary connections were then created using Atrium iCAST covered stents. Magnet catheters were used to perforate the left pulmonary artery from the DAo, thereby establishing a transcatheter central shunt. Given the orientation of the vasculature, magnetic catheters could not be used for SVC-to-PA connections; however, perforation from the SVC to the right pulmonary artery was accomplished with a trans-septal needle and balloon target. Transcatheter Glenn or central shunts were successfully created in four swine.

  3. Normal-pressure hydrocephalus: current understanding of diagnostic tests and shunting

    SciTech Connect

    Black, P.M.

    1982-02-01

    Normal-pressure hydrocephalus is no longer difficult to diagnose or treat-cranial computed tomographic scanning has made the diagnosis of ventricular enlargement straightforward, and shunt placement often helps the patient whose condition can be traced to a specific cause. Predicting accurately whether a patient will benefit from a shunt, however, is still problematic.

  4. Shunt currents in vanadium flow batteries: Measurement, modelling and implications for efficiency

    NASA Astrophysics Data System (ADS)

    Fink, H.; Remy, M.

    2015-06-01

    Shunt currents are an important factor which must be considered when designing a stack for flow batteries. They lead to a reduction of the coulombic efficiency and can cause furthermore a critical warming of the electrolyte. Shunt currents inevitably appear at bypass connections of the hydraulic system between the single cells of a stack. In this work the shunt currents of a five-celled mini stack of a vanadium flow battery with external hydraulic system and their effects are investigated directly. The external hydraulic system allows the implementation of current sensors for direct measurement of the shunt currents; moreover, the single bypass channels can be interrupted by clamping the tube couplings and with it the shunt currents between the cells when the pumps are off. Thus the shares of losses by cross contamination and by shunt currents are quantified separately by charge conservation measurements. The experimentally gained data are compared to a shunt current model based on a equivalent circuit diagram and the linear equation system derived from it. Experiments and model data are in good agreement. The effects of shunt currents for different flow frame geometries and number of cells in a stack are simulated and presented in this work.

  5. Acute modified Blalock-Taussing shunt obstruction successfully treated with urokinase and heparin.

    PubMed

    Mizzi, J; Grech, V

    2005-07-01

    Acute modified Blalock-Tuassig shunt obstruction due to thrombosis may be life-threatening. We report non-invasive relief of shunt obstruction with thrombolysis and heparinisation, a potentially life-saving intervention that is applicable in all settings, including outside tertiary paediatric cardiology centres.

  6. Acute modified Blalock-Taussing shunt obstruction successfully treated with urokinase and heparin

    PubMed Central

    Mizzi, J; Grech, V

    2005-01-01

    Acute modified Blalock-Tuassig shunt obstruction due to thrombosis may be life-threatening. We report non-invasive relief of shunt obstruction with thrombolysis and heparinisation, a potentially life-saving intervention that is applicable in all settings, including outside tertiary paediatric cardiology centres. PMID:22368653

  7. Advantages of Selective Use of Intraluminal Shunt in Carotid Endarterectomy: A Study of 122 Cases

    PubMed Central

    Usman, Rashid; Ghaffar, Salma

    2016-01-01

    Objectives: To assess the advantage of selective use of shunt in carotid endarterectomy (CEA) under local anesthesia. Materials and Methods: A total of 122 consecutive patients fulfilling international guidelines were included. Shunt was used selectively only in cases of bilateral severe carotid artery occlusive disease or in those patients who developed neurological symptoms on clamping of carotid artery. Follow up was done weekly for one month; then every month for 3 months; and then every 3 months for a year. Results: Shunt was used only in 5% (n = 6) patients. Of these, 2.5% (n = 3) patients were those who developed neurological symptoms on clamping the internal carotid and deployment of shunt resulted in complete resolution of symptoms. 2.5% (n = 3) had severe bilateral carotid stenosis and shunt was deployed. One of these patients developed stroke which was permanent. There was no mortality. The mean procedure time was 170 min in patients in whom shunt was used, when compared with 100 min in patients without shunt (P = 0.003). Conclusion: Use of shunt in carotid endarterectomy under local anesthesia as selective policy has an advantage in terms of cost effectiveness, operation time and prevention of potential complications. PMID:28018499

  8. LpMab-23: A Cancer-Specific Monoclonal Antibody Against Human Podoplanin.

    PubMed

    Yamada, Shinji; Ogasawara, Satoshi; Kaneko, Mika K; Kato, Yukinari

    2017-04-07

    Human podoplanin (hPDPN), the ligand of C-type lectin-like receptor-2, is involved in cancer metastasis. Until now, many monoclonal antibodies (mAbs) have been established against hPDPN. However, it is still difficult to develop a cancer-specific mAb (CasMab) against hPDPN because the protein sequence of hPDPN expressed in cancer cells is the same as that in normal cells. Herein, we report LpMab-23 of the mouse IgG1 subclass, a novel CasMab against hPDPN. In an immunohistochemical analysis, LpMab-23 reacted with tumor cells of human oral cancer, but did not react with normal cells such as lymphatic endothelial cells (LECs). In contrast, LpMab-17, another anti-hPDPN mAb, reacted with both tumor cells and LECs. Furthermore, flow cytometric analysis revealed that LpMab-23 reacted with hPDPN-expressing cancer cell lines (LN319, RERF-LC-AI/hPDPN, Y-MESO-14/hPDPN, and HSC3/hPDPN) but showed little reaction with normal cells (LECs and HEK-293T), although another anti-hPDPN mAb, LpMab-7, reacted with both hPDPN-expressing cancer cells and normal cells, indicating that LpMab-23 is a CasMab against hPDPN.

  9. Amplitude and recurrence time analysis of LP activity at Mount Etna, Italy

    NASA Astrophysics Data System (ADS)

    Cauchie, Léna; Saccorotti, Gilberto; Bean, Christopher J.

    2015-09-01

    The aim of this work is to improve our understanding of the long-period (LP) source mechanism at Mount Etna (Italy) through a statistical analysis of detailed LP catalogues. The behavior of LP activity is compared with the empirical laws governing earthquake recurrence, in order to investigate whether any relationships exist between these two apparently different earthquake classes. We analyzed a family of 8894 events detected during a temporary experiment in August 2005. For that time interval, the LP activity is sustained in time and the volcano did not exhibit any evident sign of unrest. The completeness threshold of the catalogue is established through a detection test based on synthetic waveforms. The retrieved amplitude distribution differs significantly from the Gutenberg-Richter law, and the interevent times distribution does not follow the typical γ law, expected for tectonic activity. In order to compare these results with a catalogue for which the source mechanism is well established, we applied the same procedure to a data set from Stromboli Volcano, where recurrent LP activity is closely related to very-long-period pulses, in turn associated with the summit explosions. Our results indicate that the two catalogues exhibit similar behavior in terms of amplitude and interevent time distributions. This suggests that the Etna's LP signals are most likely driven by stress changes caused by an intermittent degassing process occurring at depth, similar to that which drives the summit explosions at Stromboli Volcano.

  10. The shunt-LDO regulator to power the upgraded ATLAS pixel detector

    NASA Astrophysics Data System (ADS)

    Gonella, L.; Barbero, M.; Hügging, F.; Krüger, H.; Wermes, N.

    2012-01-01

    The shunt-LDO regulator is a new regulator concept which combines a shunt and a Low Drop-Out (LDO) regulator. Designed as an improved shunt regulator to match the needs of serially powered detector systems, it can also be used as a pure LDO regulator for general application in powering schemes requiring linear regulation. The flexibility of the design makes the shunt-LDO regulator a good candidate for use in the powering schemes envisaged for the upgrades of the ATLAS pixel detector. Two shunt-LDO regulators integrated in the prototype of the next ATLAS pixel front-end chip, the FE-I4A, are used to demonstrate the feasibility of the proposed powering solutions.

  11. Sound absorption of a finite micro-perforated panel backed by a shunted loudspeaker.

    PubMed

    Tao, Jiancheng; Jing, Ruixiang; Qiu, Xiaojun

    2014-01-01

    Deep back cavities are usually required for micro-perforated panel (MPP) constructions to achieve good low frequency absorption. To overcome the problem, a close-box loudspeaker with a shunted circuit is proposed to substitute the back wall of the cavity of the MPP constructions to constitute a composite absorber. Based on the equivalent circuit model, the acoustic impedance of the shunted loudspeaker is formulated first, then a prediction model of the sound absorption of the MPP backed by shunted loudspeaker is developed by employing the mode solution of a finite size MPP coupled by an air cavity with an impendence back wall. The MPP absorbs mid to high frequency sound, and with properly adjusted electrical parameters of its shunted circuit, the shunted loudspeaker absorbs low frequency sound, so the composite absorber provides a compact solution to broadband sound control. Numerical simulations and experiments are carried out to validate the model.

  12. Fetal surgery for hydrocephalus: successful in utero ventriculoamniotic shunt for Dandy-Walker syndrome.

    PubMed

    Depp, R; Sabbagha, R E; Brown, J T; Tamura, R K; Reedy, N J

    1983-06-01

    The diagnosis of fetal hydrocephalus based on dilation of the ventricular system presents a broad range of management decisions. The options are presented and a case of Dandy-Walker syndrome managed by fetal ventriculoamniotic shunt placement is presented as an example. Under ultrasonic guidance, a shunt was placed at 30 weeks' gestation by later newborn Dubowitz examination. Delivery was delayed for five weeks, one to two weeks following probable shunt malfunction, after achieving fetal lung maturation. Follow-up six months after definitive neonatal ventricular shunting and three weeks after shunt revision revealed a socially active male infant with a motor development index of 87 and a psychomotor development index of 95. Potential advantages of fetal surgery including achievement of term gestation are presented. Proposed guidelines for determining the benefit of such procedures are also presented.

  13. Pleural effusion in a child with a ventriculoperitoneal shunt and congenital heart disease.

    PubMed

    Henningfeld, Jennifer; Loomba, Rohit S; Encalada, Santiago; Magner, Kristin; Pfister, Jennifer; Matthews, Anne; Foy, Andrew; Mikhailov, Theresa

    2016-01-01

    We present the unique case of an 8 month old infant who required extracorporeal membrane oxygenation (ECMO) after neonatal repair of tetralogy of Fallot. While on ECMO, he developed grade 3 intraventricular hemorrhage resulting in hydrocephalus requiring ventriculoperitoneal (VP) shunt placement at 5 months of life. He presented to cardiology clinic with a 2-month history of poor weight gain, tachypnea, and grunting and was found to have a large right sided pleural effusion. This was proven to be cerebrospinal fluid (CSF) accumulation secondary to poor peritoneal absorption with subsequent extravasation of CSF into the thoracic cavity via a diaphragmatic defect. After diaphragm repair, worsening ascites from peritoneal malabsorption led to shunt externalization and ultimate conversion to a ventriculoatrial (VA) shunt. This is the second reported case of VA shunt placement in a child with congenital heart disease and highlights the need to consider CSF extravasation as the cause of pleural effusions in children with VP shunts.

  14. CSF hydrothorax after ventriculoperitoneal shunt without catheter migration: a case report.

    PubMed

    Kocaogullar, Yalcin; Güney, Onder; Kaya, Bülent; Erdi, Fatih

    2011-10-01

    Ventriculoperitoneal (VP) shunting is the most common procedure performed for the management of hydrocephalus. VP shunt related complications remain a persistent problem in current clinical practice. Five-year-old female patient was admitted to our hospital with persistent dyspnea complaint. The patient was operated at the age of 3 months and a VP shunt established in a different clinic due to hydrocephalus associated with Dandy-Walker malformation. The patient's chest X-ray revealed right sided pleural effusion. Thorasentesis was performed and the effusion was drained with a chest tube. The discharged liquid was consistent with CSF. Scintigraphic radionuclide shunt analyses were performed and CSF passage from abdomen to chest and lower mediastinal region was determined in the late static images. The patient was operated and the incorporated ventriculoperitoneal shunt was removed. Hydrothorax was completely resolved after early postoperative stage. CSF hydrothorax especially without catheter migration is an unusual but potentially serious-clinical complication.

  15. Multiple Liver Abscesses Associated with Ventriculoperitoneal Shunt Infection: Case Report and Review of the Literature

    PubMed Central

    Yang, Tae Ki

    2013-01-01

    Liver abscess following ventriculoperitoneal (VP) shunting occurs very rarely. We report an unusual case of multiple liver abscesses caused by Staphylococcus capitis in a 50-year-old compromised woman due to a complicating VP shunt infection. We reviewed the nine cases of VP shunt complications reported in the English literature, and speculated that the most likely pathogenetic mechanism in our case is an infected peritoneal tip that migrated to and penetrated the liver, which subsequently caused the formation of multiple liver abscesses. The patient was successfully treated with percutaneous aspiration, drainage of the abscesses, intravenous antibiotics, and shunt revision. Awareness and vigilance of the possibility of liver abscess formation caused by VP shunt infection will help establish an early accurate diagnosis and therapeutic strategy. PMID:24379956

  16. A noninvasive approach to quantitative measurement of flow through CSF shunts. Technical note.

    PubMed

    Stein, S C; Apfel, S

    1981-04-01

    A method of measuring flow rate through cerebrospinal fluid (CSF) shunts is reported. It consists of two thermistors in series applied to the skin over the shunt tubing. The thermistors respond by a drop in measured temperature following application of an ice cube placed on the skin overlying the proximal shunt tube. The time required for the thermal response to travel between the two thermistors is related to the velocity of flow through the shunt tubing. Flow rate can then be calculated using the internal diameter of the tubing. A series of animal experiments employing a constant infusion of mock CSF through subcutaneously implanted shunt tubing showed excellent correlation between calculated flow rates and actual infusion rates. The device is noninvasive and easily adapted to use in patients. The measurements are readily repeatable.

  17. Hepatic Arterial Infusion Chemotherapy Combined with Venous Embolization in a Patient with Hepatic Metastases with an Arteriovenous Shunt

    SciTech Connect

    Nishiofuku, Hideyuki; Tanaka, Toshihiro; Sakaguchi, Hiroshi; Yamamoto, Kiyosei; Inoue, Masayoshi; Sueyoshi, Satoru; Shinnkai, Takayuki; Hasegawa, Masatoshi; Kichikawa, Kimihiko

    2009-07-15

    We describe herein a patient who had hepatic metastases with an arteriovenous shunt and was treated by hepatic arterial infusion chemotherapy. The arteriovenous shunt was diagnosed by {sup 99m}Tc-macroaggregated albumin scintigraphy and hepatic venous embolization was performed to reduce shunt flow.

  18. Laparoscopic Cholecystectomy for Acute Calcular Cholecystitis in a Patient with Ventriculoperitoneal Shunt: A Case Report and Literature Review.

    PubMed

    Albarrak, Abdullah A; Khairy, Sami; Ahmed, Alzahrani Mohammed

    2015-01-01

    Management of patients who have ventriculoperitoneal shunt presenting with acute calcular cholecystitis has remained a clinical challenge. In this paper, the hospital course and the follow-up of a patient presenting with acute calcular cholecystitis and ventriculoperitoneal shunt managed with laparoscopic cholecystectomy are presented followed by literature review on the management of acute calcular cholecystitis in patients who have ventriculoperitoneal shunts.

  19. Tc-99m MAA total-body imaging to detect intrapulmonary right-to-left shunts and to evaluate the therapeutic effect in pulmonary arteriovenous shunts.

    PubMed

    Lu, G; Shih, W J; Chou, C; Xu, J Y

    1996-03-01

    The appearance of radiotracer in the systemic circulation to document the visualization of the brain, kidneys, and spleen after intravenous administration of Tc-99m MAA indicates right-to-left shunts because MAA particles (20-60 microns) are supposedly trapped in the pulmonary bed (less than 15 microns). Six hypoxemia patients (1 male, 5 females; age range, 12-52 years) with intrapulmonary right-to-left shunts were evaluated by Tc-99m MAA dynamic perfusion imaging and total-body scans. Tc-99m MAA total-body imaging of the six patients with intrapulmonary right-to-left shunts (3 patients with chronic liver disease/cirrhosis of the liver and 3 patients with pulmonary arteriovenous fistulae) revealed significant radiotracer uptake in extrapulmonary organs such as the brain, kidneys, and spleen; a shunt ratio, estimated by a semiquantitative method, ranged from 17.8% to 52%. All dynamic pulmonary perfusion scans showed a normal sequence of cardiopulmonary flow without intracardiac shunts. Three patients with pulmonary arteriovenous fistulae underwent a second Tc-99m MAA total-body imaging after embolization therapy (2 patients) or lobectomy (1 patient). The result in lobectomized patients were negative for uptake in extrapulmonary organs; the two patients who underwent embolization therapy demonstrated only mild improvement. As a consequence of these findings, the authors conclude that Tc-99m MAA total-body imaging can be used for the diagnosis of intrapulmonary right-to-left shunts, as well as for the evaluation of postshunt therapy.

  20. Transjugular Intrahepatic Portosystemic Shunt (TIPS): Current Status and Future Possibilities

    SciTech Connect

    Bilbao, Jose Ignacio; Quiroga, Jorge; Herrero, Jose Ignacio; Benito, Alberto

    2002-08-15

    Since the insertion of the first TIPS in 1989 much has been learned about this therapeutic procedure. It has an established role for the treatment of some complications of portal hypertension: prevention of recurrent variceal bleeding and rescue of patients with acute uncontrollable variceal bleeding. In addition TIPS is useful for Budd-Chiari syndrome, refractory ascites and hepatorenal syndrome, although its specific role in these indications remains to be definitively established. However, the decrease in sinusoidal blood flow induced by TIPS can lead to the patient developing hepatic encephalopathy and liver failure in some cases. Therefore, TIPS should be used with caution in patients with very poor liver function. From a technical point of view, successful placement of TIPS is achieved in more than 98% of cases by experienced groups. At present, evaluation of TIPS dysfunction based on morphology probably leads to an overdiagnosis of this complication since most of these cases are not associated with clinical manifestations (recurrent bleeding or refractory ascites). The major disadvantage of TIPS remains its poor long-term patency requiring a mandatory surveillance program. The indicator for shunt function/malfunction should be the portosystemic pressure gradient, which is best assessed by intravascular measurements. Shunt obstructions may be prevented or reduced by the use of stent-grafts in the future.

  1. Fabrication and characterization of shunted μ-SQUID

    SciTech Connect

    Kumar, Nikhil; Fournier, T.; Courtois, H.; Gupta, Anjan K.

    2014-04-24

    In order to eliminate hysteresis, we have fabricated and characterized niobium based shunted micron size superconducting quantum interference devices (μ-SQUIDs). We find a wide temperature range where these μ-SQUIDs are non-hysteretic in nature and show a very good I{sub c} vs. B oscillations in hysteretic regime and V vs. B oscillations in non-hysteretic regime. Here we report the characteristics of a shunted- μ-SQUID (Wf38LS72D5). In this device we have achieved a large voltage modulation, in non-hysteretic regime, at various temperatures including such as 1.1 mV at 6.62 K with a transfer function V{sub Φ} = 7.2mV/Φ{sub 0}. The figures within the original article PDF file, as supplied to AIP Publishing, were affected by a PDF-processing error. Consequently, the article re-flowed and pagination increased from 3 to 4 pages. This article was updated on 14 May 2014 to correct the PDF-processing error, with the scientific content remaining unchanged. Readers are advised that the replacement article PDF file contains an additional blank page to preserve the original pagination.

  2. A High Isolation Series-Shunt RF MEMS Switch

    PubMed Central

    Yu, Yuan-Wei; Zhu, Jian; Jia, Shi-Xing; Shi, Yi

    2009-01-01

    This paper presents a wide band compact high isolation microelectromechanical systems (MEMS) switch implemented on a coplanar waveguide (CPW) with three ohmic switch cells, which is based on the series-shunt switch design. The ohmic switch shows a low intrinsic loss of 0.1 dB and an isolation of 24.8 dB at 6 GHz. The measured average pull-in voltage is 28 V and switching time is 47 μs. In order to shorten design period of the high isolation switch, a structure-based small-signal model for the 3-port ohmic MEMS switch is developed and parameters are extracted from the measured results. Then a high isolation switch has been developed where each 3-port ohmic MEMS switch is closely located. The agreement of the measured and modeled radio frequency (RF) performance demonstrates the validity of the electrical equivalent model. Measurements of the series-shunt switch indicate an outstanding isolation of more than 40 dB and a low insertion loss of 0.35 dB from DC to 12 GHz with total chip size of 1 mm × 1.2 mm. PMID:22408535

  3. [Arteriovenous shunting in obesity, its relation to lung volume].

    PubMed

    Martínez Guerra, M L; Fernández Bonetti, P; Sandoval Zárate, J; Lupi Herrera, E

    1981-01-01

    Thirty-five patients with an average overweight of 67.1% were studied. Pulmonary restriction of a variable degree was found in 68.6/; in 60% due to reduction of respiratory reserve volume. Bronchial obstruction was detected in 57% as measured by forced midexpiratory flow (25-75%). In addition, 14% showed a decrease of 75-85% in forced expiratory flow, which suggested that the pathology was located in the small respiratory airways. The PaO2 while breathing room air and in a resting state was of 52.6 +/- 9.42 mmHg, and after breathing it increased to 69.07 +/- 11.01 mmHg. The PaO2 breathing inspiratory fractions of 99.6% O2 in a resting condition was 309.34 +/- 70.07 mmHg, and after deep breathing it rose to 354.0 +/- 64.27 mmHg. The mechanisms which produce hypoxemia in the obese were analysed and it was concluded that they were due fundamentally to alterations of the ventilation perfusion ratio and to an increase of the venous-arterial shunt. In some cases, alveolar hypoventilation contributed (Pickwick syndrome). By increasing the pulmonary volume with deep breathing, the ventilation perfusion ratio improves or becomes normal, likewise, the venous-arterial shunt can improve or persist as the only cause of hypoxemia.

  4. Design and measurement of improved capacitively-shunted flux qubits

    NASA Astrophysics Data System (ADS)

    Sears, Adam; Birenbaum, Jeffrey; Hover, David; Gudmundsen, Theodore; Kerman, Andrew; Welander, Paul; Yoder, Jonilyn L.; Gustavsson, Simon; Jin, Xiaoyue; Kamal, Archana; Clarke, John; Oliver, William

    2014-03-01

    The addition of a capacitive or inductive shunt across one of the junctions can alter the coherence properties of a classic flux or RF-SQUID qubit. We have studied the performance of capacitively shunted flux qubits fabricated with MBE aluminum, starting from a 2D coplanar waveguide geometry used in similar high-performance transmon qubits, and measured dispersively. We will detail the importance of design parameters that preserve the flux qubit's anharmonicity and discuss conclusions about materials quality based on calculations of the participation of junction, dielectric, and superconductor components. This research was funded in part by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA); and by the Assistant Secretary of Defense for Research & Engineering under Air Force Contract number FA8721-05-C-0002. All statements of fact, opinion or conclusions contained herein are those of the authors and should not be construed as representing the official views or policies of IARPA, the ODNI, or the U.S. Government Present address: SLAC National Accelerator Laboratory, Menlo Park, CA.

  5. Choice of valve type and poor ventricular catheter placement: Modifiable factors associated with ventriculoperitoneal shunt failure.

    PubMed

    Jeremiah, Kealeboga Josephine; Cherry, Catherine Louise; Wan, Kai Rui; Toy, Jennifer Ah; Wolfe, Rory; Danks, Robert Andrew

    2016-05-01

    Ventriculoperitoneal (VP) shunt insertion is a common neurosurgical procedure, essentially unchanged in recent years, with high revision rates. We aimed to identify potentially modifiable associations with shunt failure. One hundred and forty patients who underwent insertion of a VP shunt from 2005-2009 were followed for 5-9years. Age at shunt insertion ranged from 0 to 91years (median 44, 26% <18years). The main causes of hydrocephalus were congenital (26%), tumour-related (25%), post-haemorrhagic (24%) or normal pressure hydrocephalus (19%). Fifty-eight (42%) patients required ⩾1 shunt revision. Of these, 50 (88%) were for proximal catheter blockage. The median time to first revision was 108days. Early post-operative CT scans were available in 105 patients. Using a formal grading system, catheter placement was considered excellent in 49 (47%) but poor (extraventricular) in 13 (12%). On univariate analysis, younger age, poor ventricular catheter placement and use of a non-programmable valve were associated with shunt failure. On logistic regression modelling, the independent associations with VP shunt failure were poor catheter placement (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.3-18.9, p=0.02) and use of a non-programmable valve (OR 0.4, 95% CI 0.2-1.0, p=0.04). In conclusion, poor catheter placement (revision rate 77%) was found to be the strongest predictor of shunt failure, with no difference in revisions between excellent (43%) and moderate (43%) catheter placement. Avoiding poor placement in those with mild or moderate ventriculomegaly may best reduce VP shunt failures. There may also be an influence of valve choice on VP shunt survival.

  6. Relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt.

    PubMed

    Yamada, Shoko Merrit; Kitagawa, Ryo; Teramoto, Akira

    2013-01-01

    The long-term maintenance of ventriculoperitoneal (VP) shunt function depends on the correct placement of the catheter tip in the lateral ventricle. The relationship between the location of the ventricular catheter tip and VP shunt function was analyzed in 52 patients. The location of the ventricular catheter tip was classified into one of the following five groups: (i) Group A--superior to the foramen of Monro; (ii) Group B--in the center of the lateral ventricle body; (iii) Group C--in the third ventricle; (iv) Group D--contacting the ventricle wall; and (v) Group E--in the septum pellucidum. VP shunt function was defined as well controlled hydrocephalus when the Evan's ratio of the ventricular size was < 0.3. The VP shunt functioned well in 14 of 52 patients (26.9%), the shunt valve pressure was incorrectly set in 21 (40.4%), and irreversible shunt malfunction was identified in 17 (32.7%). Among the 14 patients with a well-functioning shunt, 13 were in Groups A or B with an odds ratio (OR) of 17.875 (p<0.05). In the 17 irreversible shunt malfunctions, 13 were identified in Groups C, D, or E with an OR of 0.123 (p<0.05). Long term VP shunt function or failure due to irreversible malfunction is directly influenced by the position of the ventricular catheter tip. Ideal points for positioning the ventricular catheter tip are superior to the foramen of Monro and in the center of the lateral ventricle body. Early shunt revision may be required for patients in whom the catheter tip contacts the ventricle wall or is located in the septum pellucidum.

  7. Left ventricular to right atrial shunt (Gerbode defect): congenital versus acquired

    PubMed Central

    2014-01-01

    Introduction Congenital left ventricular to right atrial (LV-RA) shunt (Gerbode defect) is rare, while acquired LV-RA shunt has been increasingly reported. As yet, systematically incorporated data of the LV-RA shunt have not been presented. Aim To present the clinical features, diagnostic challenge and management strategies of congenital and acquired LV-RA shunts. Material and methods The data source was based on a comprehensive literature retrieval of the LV-RA shunt in the period 1990–2013. Results In comparison with the acquired Gerbode defect, the congenital Gerbode defect group of patients were younger and were associated more often with additional congenital disorders. Previous cardiac surgery and infective endocarditis were the two major aetiologies of the occurrence of the acquired shunts. Paravalvular abscess was associated in 10.2% and atrioventricular block in 13.6% of the acquired group patients. Transoesophageal echocardiography showed a higher diagnostic accuracy, lower missed diagnosis and lower inclusive diagnosis rates, in comparison to transthoracic echocardiography, but the misdiagnosis rates of the two modalities did not differ from each other. Four (4.5%) of the acquired group patients were complicated by atrioventricular block following surgical or interventional closure of the shunt. Eight (9.1%) patients died in the acquired group, but no patient died in the congenital group. Conclusions The diagnosis of an LV-RA shunt is quite challenging, especially in the context of coexisting abnormalities including an additional intracardiac shunt, tricuspid regurgitation, pulmonary artery hypertension and infective endocarditis, which have to be carefully differentiated from the shunt by further investigations. A better control of infective complications and careful manoeuvres during surgery may help to keep the LV-RA-sensitive septum intact. PMID:25489305

  8. Selective 5-HT7 receptor agonists LP 44 and LP 211 elicit an analgesic effect on formalin-induced orofacial pain in mice

    PubMed Central

    DEMİRKAYA, Kadriye; AKGÜN, Özlem Martı; ŞENEL, Buğra; ÖNCEL TORUN, Zeynep; SEYREK, Melik; LACİVİTA, Enza; LEOPOLDO, Marcello; DOĞRUL, Ahmet

    2016-01-01

    ABSTRACT The most recently identified serotonin (5-HT) receptor is the 5-HT7 receptor. The antinociceptive effects of a 5-HT7 receptor agonist have been shown in neuropathic and inflammatory animal models of pain. A recent study demonstrated the functional expression of 5-HT7 receptors in the substantia gelatinosa (SG) of the trigeminal subnucleus caudalis, which receives and processes orofacial nociceptive inputs. Objective To investigate the antinociceptive effects of pharmacological activation of 5-HT7 receptors on orofacial pain in mice. Material and Methods Nociception was evaluated by using an orofacial formalin test in male Balb-C mice. Selective 5-HT7 receptor agonists, LP 44 and LP 211 (1, 5, and 10 mg/kg), were given intraperitoneally 30 min prior to a formalin injection. A bolus of 10 µl of 4% subcutaneous formalin was injected into the upper lip of mice and facial grooming behaviors were monitored. The behavioral responses consisted of two distinct periods, the early phase corresponding to acute pain (Phase I: 0–12 min) and the late phase (Phase II: 12–30 min). Results LP 44 and LP 211 (1, 5, and 10 mg/kg) produced an analgesic effect with reductions in face rubbing time in both Phase I and Phase II of the formalin test. Conclusion Our results suggest that 5-HT7 receptor agonists may be promising analgesic drugs in the treatment of orofacial pain. PMID:27383702

  9. Infection rates following initial cerebrospinal fluid shunt placement across pediatric hospitals in the United States

    PubMed Central

    Simon, Tamara D.; Hall, Matthew; Riva-Cambrin, Jay; Albert, J. Elaine; Jeffries, Howard E.; LaFleur, Bonnie; Dean, J. Michael; Kestle, John R. W.

    2010-01-01

    Object Reported rates of CSF shunt infection vary widely across studies. The study objective was to determine the CSF shunt infection rates after initial shunt placement at multiple US pediatric hospitals. The authors hypothesized that infection rates between hospitals would vary widely even after adjustment for patient, hospital, and surgeon factors. Methods This retrospective cohort study included children 0–18 years of age with uncomplicated initial CSF shunt placement performed between January 1, 2001, and December 31, 2005, and recorded in the Pediatric Health Information System (PHIS) longitudinal administrative database from 41 children's hospitals. For each child with 24 months of follow-up, subsequent CSF shunt infections and procedures were determined. Results The PHIS database included 7071 children with uncomplicated initial CSF shunt placement during this time period. During the 24 months of follow-up, these patients had a total of 825 shunt infections and 4434 subsequent shunt procedures. Overall unadjusted 24-month CSF shunt infection rates were 11.7% per patient and 7.2% per procedure. Unadjusted 24-month cumulative incidence rates for each hospital ranged from 4.1 to 20.5% per patient and 2.5–12.3% per procedure. Factors significantly associated with infection (p < 0.05) included young age, female sex, African-American race, public insurance, etiology of intraventricular hemorrhage, respiratory complex chronic condition, subsequent revision procedures, hospital volume, and surgeon case volume. Malignant lesions and trauma as etiologies were protective. Infection rates for each hospital adjusted for these factors decreased to 8.8–12.8% per patient and 1.4–5.3% per procedure. Conclusions Infections developed in > 11% of children who underwent uncomplicated initial CSF shunt placements within 24 months. Patient, hospital, and surgeon factors contributed somewhat to the wide variation in CSF shunt infection rates across hospitals. Additional

  10. Bilateral abducens and facial nerve palsies as a localizing sign due to reduction in intracranial pressure after fourth ventriculoperitoneal shunting

    PubMed Central

    Maramattom, Boby Varkey; Panikar, Dilip

    2016-01-01

    A trapped fourth ventricle often requires fourth ventriculoperitoneal shunting (4VP). Complications of this procedure include shunt blockage, infection, shunt migration, and overdrainage. Cranial nerve palsies are very rare after 4VP shunting and have been described with over drainage and brainstem distortion. We present an unusual case of bilateral abducens and facial nerve palsies after 4VP shunting after normalization of 4th ventricular parameters. Measurement of various brainstem angles presented us with a plausible hypothesis to explain the cranial nerve dysfunction. PMID:27994363

  11. Ventriculoperitoneal Shunt Tip as a Rare Cause for Recurrent Pain Episodes in a Child: Think Irritable Peritoneum.

    PubMed

    Poryo, Martin; Eymann, Regina; Meyer, Sascha

    2015-01-01

    Ventriculoperitoneal (VP) shunting is an established treatment to regulate the drainage of cerebrospinal fluid (CSF) in posthaemorrhagic hydrocephalus. Several complications (e.g. blockage of CSF shunting, overdrainage, but also catheter-related perforation of abdominal organs, etc.) may occur and may lead to painful episodes, mostly headache, in these children. Here, we report on a 7-year-old child with recurrent painful episodes after revision of a VP shunt that subsided only after repositioning of the abdominal tip of the VP shunt. Visceral irritation by a malpositioned VP shunt should be considered as a cause for recurrent pain in non-verbal children without other relevant clinical findings.

  12. Laparoscopic distal splenoadrenal shunt for the treatment of portal hypertension in children with congenital hepatic fibrosis

    PubMed Central

    Zhang, Jin-Shan; Cheng, Wei; Li, Long

    2017-01-01

    Abstract Background: The distal splenorenal shunt is an effective procedure for the treatment of portal hypertension in children. However, there has been no report about laparoscopic distal splenorenal shunt in the treatment of portal hypertension in children. Methods: From December 2015 to August 2016, 4 children with upper gastrointestinal bleeding underwent laparoscopic distal splenoadrenal shunt. Portal hypertension and splenomegaly were demonstrated on the preoperative computed tomography (CT) and sonography. The distal splenic vein was mobilized and anastomosed to the left adrenal vein laparoscopically. All patients were followed-up postoperatively. Results: The laparoscopic distal splenoadrenal shunt was successfully performed in all patients. The liver fibrosis was diagnosed by postoperative liver pathology. The operative time ranged from 180 to 360 minutes. The blood loss was minimal. The length of hospital stay was 6 to 13 days. The duration of following-up was 1 to 9 months (median: 3 months). The portal pressure and splenic size were decreased postoperatively. The complete blood count normalized and the biochemistry tests were within normal range after surgery. Postoperative ultrasound and CT confirmed shunt patency and satisfactory flow in the splenoadrenal shunt in all patients. No patient developed recurrence of variceal bleeding. Conclusions: The laparoscopic splenoadrenal shunt is a feasible treatment of portal hypertension in children. PMID:28099341

  13. Syringo-Subarachnoid-Peritoneal Shunt Using T-Tube for Treatment of Post-Traumatic Syringomyelia

    PubMed Central

    Kim, Seon-Hwan; Youm, Jin-Young; Kwon, Hyon-Jo

    2012-01-01

    Various surgical procedures for the treatment of post-traumatic syringomyelia have been introduced recently, but most surgical strategies have been unreliable. We introduce the concept and technique of a new shunting procedure, syringo-subarachnoid-peritoneal shunt. A 54-year-old patient presented to our hospital with a progressive impairment of motion and position sense on the right side. Sixteen years before this admission, he had been treated by decompressive laminectomy for a burst fracture of L1. On his recent admission, magnetic resonance (MR) imaging studies of the whole spine revealed the presence of a huge syrinx extending from the medulla to the L1 vertebral level. We performed a syringo-subarachnoid-peritoneal shunt, including insertion of a T-tube into the syrinx, subarachnoid space and peritoneal cavity. Clinical manifestations and radiological findings improved after the operation. The syringo-subarachnoid-peritoneal shunt has several advantages. First, fluid can communicate freely between the syrinx, the subarachnoid space, and the peritoneal cavity. Secondly, we can prevent shunt catheter from migrating because dural anchoring of the T-tube is easy. Finally, we can perform shunt revision easily, because only one arm of the T-tube is inserted into the intraspinal syringx cavity. We think that this procedure is the most beneficial method among the various shunting procedures. PMID:22993681

  14. Shunting normal pressure hydrocephalus: the predictive value of combined clinical and CT data.

    PubMed Central

    Vanneste, J; Augustijn, P; Tan, W F; Dirven, C

    1993-01-01

    The value of an ordinal global scale derived from combined clinical and CT data (clin/CT scale) to predict the clinical outcome in 112 patients shunted for presumed normal pressure hydrocephalus (NPH) was analysed. The clinical data were retrospectively collected, all CT scans were re-evaluated, and the clin/CT scale was determined blind to the results of further ancillary tests and to the post-surgical outcome. The scale ranked three classes of prediction: on the basis of clinical and CT characteristics, improvement after shunting was probable, possible, or improbable. The predictive value of the clin/CT scale for the subgroup of communicating NPH was established for two different strategies, depending on the strictness of selection criteria for shunting. In the subgroup of patients with presumed communicating NPH, the prevalence of shunt responsiveness was 29%; the best strategy was to shunt only patients with probable shunt-responsive NPH: the sensitivity was 0.54, the specificity 0.84, and the predictive accuracy 0.75, with a limited number of ineffective shunts (11%) and missed improvements (13%). The study illustrates its need to assess the pre-test probability of NPH based on combined clinical and CT data, before establishing the clinical usefulness of an ancillary test. PMID:8459240

  15. Are Shunt Revisions Associated with IQ in Congenital Hydrocephalus? A Meta -Analysis.

    PubMed

    Arrington, C Nikki; Ware, Ashley L; Ahmed, Yusra; Kulesz, Paulina A; Dennis, Maureen; Fletcher, Jack M

    2016-12-01

    Although it is generally acknowledged that shunt revisions are associated with reductions in cognitive functions in individuals with congenital hydrocephalus, the literature yields mixed results and is inconclusive. The current study used meta-analytic methods to empirically synthesize studies addressing the association of shunt revisions and IQ in individuals with congenital hydrocephalus. Six studies and three in-house datasets yielded 11 independent samples for meta-analysis. Groups representing lower and higher numbers of shunt revisions were coded to generate effect sizes for differences in IQ scores. Mean effect size across studies was statistically significant, but small (Hedges' g = 0.25, p < 0.001, 95 % CI [0.08, 0.43]) with more shunt revisions associated with lower IQ scores. Results show an association of lower IQ and more shunt revisions of about 3 IQ points, a small effect, but within the error of measurement associated with IQ tests. Although clinical significance of this effect is not clear, results suggest that repeated shunt revisions because of shunt failure is associated with a reduction in cognitive functions.

  16. Diagnosis of ventriculoperitoneal shunt infection using [F-18]-FDG PET: a case report.

    PubMed

    Rehman, T; Chohan, M O; Yonas, H

    2011-06-01

    Infection of cerebrospinal fluid (CSF) shunts is a common occurrence and can often be difficult to diagnose using standard analysis of shunt fluid. This article presents the first case report on the diagnosis of a CSF shunt infection on FDG PET scan. A 26-year-old female underwent ventriculoperitoneal shunt placement after developing a pseudomeningocele subsequent to a suboccipital craniectomy for Chiari malformation. Two months later, the patient presented with abdominal pain and non-specific symptoms and was found to have a perisplenic abscess for which she was adequately treated. Failure of her symptoms to solve and an initial negative shunt CSF analysis prompted the search for other sources of infection. An FDG PET scan performed a week later found evidence of increase tracer uptake around the distal tip of the catheter and a repeat shunt CSF analysis showed evidence of CSF infection. FDG PET may be useful in diagnosing shunt related infections in case of high clinical suspicion when standard diagnostic modalities fail to diagnose hardware infection.

  17. The Bohr Effect Is Not a Likely Promoter of Renal Preglomerular Oxygen Shunting

    PubMed Central

    Olgac, Ufuk; Kurtcuoglu, Vartan

    2016-01-01

    The aim of this study was to evaluate whether possible preglomerular arterial-to-venous oxygen shunting is affected by the interaction between renal preglomerular carbon dioxide and oxygen transport. We hypothesized that a reverse (venous-to-arterial) shunting of carbon dioxide will increase partial pressure of carbon dioxide and decrease pH in the arteries and thereby lead to increased oxygen offloading and consequent oxygen shunting. To test this hypothesis, we employed a segment-wise three-dimensional computational model of coupled renal oxygen and carbon dioxide transport, wherein coupling is achieved by shifting the oxygen-hemoglobin dissociation curve in dependence of local changes in partial pressure of carbon dioxide and pH. The model suggests that primarily due to the high buffering capacity of blood, there is only marginally increased acidity in the preglomerular vasculature compared to systemic arterial blood caused by carbon dioxide shunting. Furthermore, effects of carbon dioxide transport do not promote but rather impair preglomerular oxygen shunting, as the increase in acidity is higher in the veins compared to that in the arteries. We conclude that while substantial arterial-to-venous oxygen shunting might take place in the postglomerular vasculature, the net amount of oxygen shunted at the preglomerular vasculature appears to be marginal. PMID:27833564

  18. Effect of cerebrospinal fluid shunts on intracranial pressure and on cerebrospinal fluid dynamics

    PubMed Central

    Fox, John L.; McCullough, David C.; Green, Robert C.

    1973-01-01

    Part 2 describes measurements of intracranial cerebrospinal fluid (CSF) pressure in 18 adult patients with CSF shunts, all pressure measurements being referred to a horizontal plane close to the foramina of Monro. All 18 patients had normal CSF pressure by lumbar puncture; however, in one patient an intracranial pressure of +280 mm was subsequently measured after pneumoencephalography. Twelve patients had pre-shunt CSF pressures measured intracranially: 11 ranged from +20 to +180 mm H2O and one was +280 mm H2O in the supine position. In the upright posture nine patients had values of −10 to −140 mm H2O, while three others were +60, +70, and +280 mm H2O. After CSF shunting in these 18 patients the pressures were −30 to +30 mm H2O in the supine position and −210 to −370 mm in the upright position. The effect of posture on the siphoning action of these longer shunts in the erect, adult patient is a major uncontrollable variable in maintenance of intracranial pressure after shunting. Other significant variables are reviewed. In Part 3 a concept of the hydrocephalus phenomenon is described. Emphasis is placed on the pressure differential (Pd) and force differential (Fd) causing pre-shunt ventricular enlargement and post-shunt ventricular size reduction. The site of Pd, which must be very small and not to be confused with measured ventricular pressure, P, must be at the ventricular wall. Images PMID:4541079

  19. Pediatric hydrocephalus: Does the shunt device pressure selection affect the outcome?

    PubMed Central

    Sinha, Arvind; Sharma, Anuj; Gupta, Charitesh

    2012-01-01

    Aim: To compare the efficacy of low- versus medium-pressure shunts in pediatric hydrocephalus in a randomized controlled trial. Materials and Methods: Forty patients of pediatric hydrocephalus were randomized into two groups. The Chhabra differential pressure VP shunt (low or medium) was inserted in every patient. Postoperative follow-up was performed for symptomatic improvement and radiological evaluation (by sonography or computed tomography scan) for ventricle hemispheric ratio (VHR). Comparative analysis of pre- and postoperative VHR and need of redo surgery for shunt malformation were carried out to establish outcomes. Results: Nineteen patients had a low-pressure and 21 patients had a medium-pressure shunt inserted. The age of the patients ranged from 1 day to 10 years. The average preoperative VHR in group A was 55.37%, which reduced to 40% postoperatively (P = 0.00005); likewise, the pre- and postoperative VHR in group B were 61.57% and 42%, respectively, which was statistically significant (P = 0.0006). The complications of shunts and incidence of redo shunt surgery in both groups were not found to be statistically significant (P = 0.5614). Conclusions: The study found no significant difference in the outcome of patients with low- or medium-pressure shunt placement in pediatric hydrocephalus. PMID:22529548

  20. Pathophysiological role and clinical significance of lipoprotein-associated phospholipase A₂ (Lp-PLA₂) bound to LDL and HDL.

    PubMed

    Tellis, Constantinos C; Tselepis, Alexandros D

    2014-01-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2), also named as platelet-activating factor (PAF)-acetylhydrolase, exhibits a Ca2+-independent phospholipase A2 activity and catalyzes the hydrolysis of the ester bond at the sn-2 position of PAF and oxidized phospholipids (oxPL). These phospholipids are formed under oxidative and inflammatory conditions, and may play important roles in atherogenesis. The vast majority of plasma Lp-PLA2 mass binds to low-density lipoprotein (LDL) while a smaller amount is associated with high-density lipoprotein (HDL). Lp-PLA2 is also bound to lipoprotein (a) [Lp(a)], very low-density lipoprotein (VLDL) and remnant lipoproteins. Several lines of evidence suggest that the role of plasma Lp-PLA2 in atherosclerosis may depend on the type of lipoprotein particle with which this enzyme is associated. Data from large Caucasian population studies have supported plasma Lp-PLA2 (primarily LDL-associated Lp-PLA2) as a cardiovascular risk marker independent of, and additive to, traditional risk factors. On the contrary, the HDL-associated Lp-PLA2 may express antiatherogenic activities and is also independently associated with lower risk for cardiac death. The present review presents data on the biochemical and enzymatic properties of Lp-PLA2 as well as its structural characteristics that determine the association with LDL and HDL. We also critically discuss the possible pathophysiological and clinical significance of the Lp- PLA2 distribution between LDL and HDL in human plasma, in view of the results of prospective epidemiologic studies on the association of Lp-PLA2 with future cardiovascular events as well the recent studies that evaluate the possible effectiveness of specific Lp-PLA2 inhibitors in reducing residual cardiovascular risk.

  1. Management of pregnancy and delivery of a patient with malfunctioning ventriculoperitoneal shunt.

    PubMed

    Schiza, S; Stamatakis, E; Panagopoulou, A; Valsamidis, D

    2012-01-01

    The use of ventriculoperitoneal shunts increased the life expectancy of many women with hydrocephalus who are able to reach childbearing age. It is believed that pregnancy may be associated with shunt malfunction and the management of pregnant women with a malfunctioning ventriculoperitoneal shunt is a challenging medical condition for the anaesthetist, the obstetrician and the neurosurgeon. We report on a case of a 35-year-old primiparous woman who underwent a scheduled caesarean delivery at 30 weeks' gestation due to deteriorating neurological condition during pregnancy. The patient had a history of astrocytoma resection in the past and placement of a ventriculoperitoneal shunt due to obstructive hydrocephalus. She had a normal life without neurological deficits until the 18th week of gestation, when the first neurological symptoms appeared. An MRI was done that showed significant dilatation of the fourth ventricle and it was believed that the shunt was not functioning properly so the patient's symptoms were present because of raised intracranial pressure. In the 30th week of gestation, she had a caesarean delivery under epidural anaesthesia and she gave birth to a live female infant. Her neurological condition started improving 48 h after delivery and the symptoms gradually regressed. At 20 days after surgery she was discharged from hospital. The presence of a ventriculoperitoneal shunt is not a contraindication for pregnancy. Maternal shunt dependency carries a relatively high incidence of complications for some patients, e.g. shunt malfunction due to raised intraabdominal pressure caused by the gravid uterus. The results of pregnancies and deliveries in women with pre-existing ventriculoperitoneal shunts are favourable if there is proper management.

  2. Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

    SciTech Connect

    Bruckheimer, Elchanan Dagan, Tamir; Atar, Eli; Schwartz, Michael; Kachko, Ludmila; Superina, Riccardo; Amir, Gabriel; Shapiro, Rivka; Birk, Einat

    2013-12-15

    Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by {approx}50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5-13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2-8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 {+-} 11.3 to 10.8 {+-} 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 {+-} 0.5 to 4.0 {+-} 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 {+-} 53.6 to 65.7 {+-} 9.6 {mu}mol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia.

  3. Identification of differentiation-inducing activity produced by human bone marrow stromal cell line LP101.

    PubMed

    Hiramoto, Masaki; Kawakami, Yutaka; Nabeshima, Ryusuke; Shima, Daisuke; Handa, Hiroshi; Aizawa, Shin

    2004-11-01

    We have previously reported that human promyelocytic leukemia HL-60 cells can be induced to differentiate into mature granulocytes when HL-60 co-cultivated with human bone marrow stromal LP101 cells. In the present study, we investigated which factors produced by LP101 cells induce HL-60 cells to differentiate into mature granulocytes. The expression of the cell surface antigen CD11b on HL-60 cells was increased after a 72-h culture with the conditioned medium (CM) obtained from LP101 cells. LP101 cells were observed to produce various cytokines, including TNF-alpha, GM-CSF and IL-6. The neutralizing antibodies against these cytokines partially suppressed the CM-induced differentiation of HL-60 cells. Recombinant TNF-alpha induced the differentiation of HL-60 cells, and GM-CSF and IL-6 additionally enhanced the effect of TNF-alpha. When the CM was divided into a low molecular weight (LMW) fraction and a high molecular weight (HMW) fraction by ultrafiltration, the LMW fraction synergistically enhanced the differentiation inducible activity of TNF-alpha. These results demonstrate that LP101 cells induce the differentiation of HL-60 cells by producing various cytokines including TNF-alpha, IL-6, and GM-CSF, and that unknown low molecular weight factors also participate.

  4. Analysis of error floor of LDPC codes under LP decoding over the BSC

    SciTech Connect

    Chertkov, Michael; Chilappagari, Shashi; Vasic, Bane; Stepanov, Mikhail

    2009-01-01

    We consider linear programming (LP) decoding of a fixed low-density parity-check (LDPC) code over the binary symmetric channel (BSC). The LP decoder fails when it outputs a pseudo-codeword which is not a codeword. We propose an efficient algorithm termed the instanton search algorithm (ISA) which, given a random input, generates a set of flips called the BSC-instanton and prove that: (a) the LP decoder fails for any set of flips with support vector including an instanton; (b) for any input, the algorithm outputs an instanton in the number of steps upper-bounded by twice the number of flips in the input. We obtain the number of unique instantons of different sizes by running the ISA sufficient number of times. We then use the instanton statistics to predict the performance of the LP decoding over the BSC in the error floor region. We also propose an efficient semi-analytical method to predict the performance of LP decoding over a large range of transition probabilities of the BSC.

  5. Immunomodulatory Effects of Lactobacillus plantarum Lp62 on Intestinal Epithelial and Mononuclear Cells.

    PubMed

    Ferreira Dos Santos, Thalis; Alves Melo, Tauá; Almeida, Milena Evangelista; Passos Rezende, Rachel; Romano, Carla Cristina

    2016-01-01

    Probiotic lactic acid bacteria are known for their ability to modulate the immune system. They have been shown to inhibit inflammation in experiments with animal models, cell culture, and clinical trials. The objective of this study was to elucidate the anti-inflammatory potential of Lactobacillus plantarum Lp62, isolated from cocoa fermentation, in a cell culture model. Lp62 inhibited IL-8 production by Salmonella Typhi-stimulated HT-29 cells and prevented the adhesion of pathogens to these epithelial cells. The probiotic strain was able to modulate TNF-α, IL1-β, and IL-17 secretion by J774 macrophages. J774 activation was reduced by coincubation with Lp62. PBMC culture showed significantly higher levels of CD4(+)CD25(+) T lymphocytes following treatment with Lp62. Probiotics also induced increased IL-10 secretion by mononuclear cells. L. plantarum Lp62 was able to inhibit inflammatory stimulation in epithelial cells and macrophages and activated a tolerogenic profile in mononuclear cells of healthy donors. These results indicate this strain for a possible application in the treatment or prevention of inflammatory diseases.

  6. Passively minimizing structural sound radiation using shunted piezoelectric materials

    NASA Astrophysics Data System (ADS)

    Bulent Ozer, M.; Royston, Thomas J.

    2003-10-01

    Two methods are presented to determine optimal inductance and resistance values of the shunt circuit across a piezoceramic material, which is bonded to a simply supported plate in order to minimize sound radiation from the plate. The first method (DH) makes use of den Hartog's damped vibration absorber principle. The second method (SM) uses the Sherman Morrison matrix inversion theorem. The effectiveness of each method is compared with regard to minimizing total acoustic sound-power radiation and acoustic pressure at a point. Optimization algorithms and case studies are presented using a linearized model for the piezoceramic and using a nonlinear model for the piezoceramic that accounts for the inherent dielectric hysteresis. Case studies demonstrate that the second method (SM) results in superior performance, under both linear and nonlinear system assumptions. Studies also illustrate that, if the nonlinearity in the system is significant, it must be incorporated in the optimization process.

  7. Cross-limb vascular shunting for major limb replantation.

    PubMed

    Lee, Yao-Chou; Lee, Jing-Wei

    2009-02-01

    In the management of traumatic major limb amputation, rapid re-establishment of circulation to the amputated part is imperative so as to prevent complications related to reperfusion injury, especially for those already suffering from prolonged ischemia. A temporary, extra-anatomic cross limb shunting with infusion lines can be used to perfuse the amputated part almost instantaneously. This allows the surgeon to carry out skeletal fixation and other reparative works in an unhurried manner. The cannulation site is targeted at intact vessels far away from the injury zone, obviating the need to explore and handle traumatized vessels at the mangled stump ends, thus greatly simplifying and expediting the revascularization process. Such a method had been successfully applied in 2 young people suffering traumatic arm amputation and thigh amputation, respectively. We suggested that such a procedure could be a useful adjunct in the field of major limb replantation.

  8. Emphysematous pyonephrosis associated with extrahepatic portosystemic shunt in a dog

    PubMed Central

    LIM, Jongsu; YOON, Youngmin; JUNG, Dongin; YEON, Seongchan; LEE, Heechun

    2015-01-01

    A 16-month-old intact female Maltese dog was referred for examination of depression and vomiting. Ultrasonography revealed dilated right renal pelvis containing echogenic fluid with free gas. A hyperechoic material suspected of urolith was identified in the right ureter. Computed tomography revealed emphysematous change of the right kidney associated with ureteral obstruction and extrahepatic portosystemic shunt (EHPSS). Ureteronephrectomy and surgical correction were performed for the EHPSS. Escherichia coli was isolated from pus from the right kidney. Quantitative analysis revealed that the urolith was an ammonium urate stone. After 5 months follow-up, no complication was observed. This is the first report of emphysematous pyonephrosis associated with EHPSS in a dog. PMID:26668166

  9. Transient Hemolytic Anemia after Transjugular Intrahepatic Portosystemic Stent Shunt

    PubMed Central

    Garcia-Rebollo, Sagrario; Santolaria-Fernández, Francisco; Diaz-Romero, Francisco; Rodriguez-Moreno, Fermin; Martinez-Riera, Antonio

    1996-01-01

    Management of variceal bleeding secondary to portal hypertension constitutes a challenging issue, particularly in child's C cirrhotic patients. Recently, transjugular placement of self-expanding metallic stents in the liver (TIPS), creating a shunt between the portal and hepatic branches has provided a safe and promising therapeutic approach in this clinical situation. We report here the case of a 66-year-old male cirrhotic patient who developed a moderately severe clinical picture of a Coombsnegative hemolytic anemia (serum hemoglobin, 93 g/l, serum bilirubin 160.74 umol/L (9.4 mg/dl), indirect 6.3 mg/dl (107.73 umol/L); serum LDH 1220 u/l, reticulocytes, 5.1%. serum ferritin, 1221 ug/1, schistocytes in peripheral blood smear) the week after undergoing a TIPS, suggesting the development ofa microangiopathic hemolytic anaemia secondary to red blood cell disruption by passing through the metallic network of the stent. PMID:8809588

  10. Shunt Diode Designs in Li/cf Shuttle Batteries

    NASA Technical Reports Server (NTRS)

    Miller, D.; Higgins, R.

    1984-01-01

    Although Li/CF cells and batteries have an excellent safety record, they are included with other battery systems that require additional safety precautions. One precaution suggested is the inclusion of shunt diodes into these batteries. The benefits of this addition are examined. All cells tested at elevated temperatures vent regardless of length of time between being fully discharged and reversed or inclusion of the diode in the system. Cells discharged at ambient temperatures all show a relatively quick reversal, but stabilize at voltages that are high enough that the diodes are not functioning. Cells tested at depressed temperatures reverse the deepest of all cells tested, with the deepest reversal occurring very early in the test and voltages recovering to above -0.60 volts near the end of the tests. Anode limited cells will eliminate the venting during hot reversal.

  11. Statistics of voltage fluctuations in resistively shunted Josephson junctions

    NASA Astrophysics Data System (ADS)

    Marthaler, Michael; Golubev, Dmitry; Utsumi, Yasuhiro; Schön, Gerd

    2011-03-01

    The intrinsic nonlinearity of Josephson junctions converts Gaussian current noise in the input into non-Gaussian voltage noise in the output. For a resistively shunted Josephson junction with white input noise we determine numerically exactly the properties of the few lowest cumulants of the voltage fluctuations, and we derive analytical expressions for these cumulants in several important limits. The statistics of the voltage fluctuations is found to be Gaussian at bias currents well above the Josephson critical current, but Poissonian at currents below the critical value. In the transition region close to the critical current the higher-order cumulants oscillate and the voltage noise is strongly non-Gaussian. For coloured input noise we determine the third cumulant of the voltage.

  12. Statistics of voltage fluctuations in resistively shunted Josephson junctions

    NASA Astrophysics Data System (ADS)

    Golubev, D. S.; Marthaler, M.; Utsumi, Y.; Schön, Gerd

    2010-05-01

    The intrinsic nonlinearity of Josephson junctions converts Gaussian current noise in the input into non-Gaussian voltage noise in the output. For a resistively shunted Josephson junction with white input noise we determine numerically exactly the properties of the few lowest cumulants of the voltage fluctuations, and we derive analytical expressions for these cumulants in several important limits. The statistics of the voltage fluctuations is found to be Gaussian at bias currents well above the Josephson critical current but Poissonian at currents below the critical value. In the transition region close to the critical current the higher-order cumulants oscillate and the voltage noise is strongly non-Gaussian. For colored input noise we determine the third cumulant of the voltage.

  13. A SQUID gradiometer module with large junction shunt resistors

    NASA Astrophysics Data System (ADS)

    Qiu, Yang; Liu, Chao; Zhang, Shu-Lin; Zhang, Guo-Feng; Wang, Yong-Liang; Li, Hua; Zeng, Jia; Kong, Xiang-Yan; Xie, Xiao-Ming

    2014-08-01

    A dual-washer superconducting quantum interference device (SQUID) with a loop inductance of 350 pH and two on-washer integrated input coils is designed according to conventional niobium technology. In order to obtain a large SQUID flux-to-voltage transfer coefficient, the junction shunt resistance is selected to be 33 Ω. A vertical SQUID gradiometer module with a baseline of 100 mm is constructed by utilizing such a SQUID and a first-order niobium wire-wound antenna. The sensitivity of this module reaches about 0.2 fT/(cm·Hz1/2) in the white noise range using a direct readout scheme, i.e., the SQUID is directly connected to an operational amplifier, in a magnetically shielded room. Some magnetocardiography (MCG) measurements with a sufficiently high signal-to-noise ratio (SNR) are demonstrated.

  14. Portosplenic blood flow separation in a patient with portosystemic encephalopathy and a spontaneous splenorenal shunt.

    PubMed

    Zamora, Carlos Armando; Sugimoto, Koji; Tsurusaki, Masakatsu; Yamaguchi, Masato; Izaki, Kenta; Taniguchi, Takanori; Iwama, Yuki; Mimura, Fumitoshi; Sugimura, Kazuro

    2004-08-01

    A patient with portosystemic encephalopathy, hyperammonemia, and a spontaneous splenorenal shunt was admitted to the authors' institution after a failed attempt at transvenous retrograde shunt obliteration. As an alternative approach, the authors separated splenic and portal flows by embolizing only the proximal splenic vein while leaving the shunt intact. Thus, the splenic flow could escape into the systemic circulation and an extreme increase in portal pressure was avoided. The procedure could provide rapid decreases in blood ammonia levels and a fast resolution of symptoms, but repeated interventions were required.

  15. Lack of shunt response in suspected idiopathic normal pressure hydrocephalus with Alzheimer disease pathology.

    PubMed

    Hamilton, Roy; Patel, Sunil; Lee, Edward B; Jackson, Eric M; Lopinto, Joanna; Arnold, Steven E; Clark, Christopher M; Basil, Anuj; Shaw, Leslie M; Xie, Sharon X; Grady, M Sean; Trojanowski, John Q

    2010-10-01

    To determine the impact of cortical Alzheimer disease pathology on shunt responsiveness in individuals treated for idiopathic normal pressure hydrocephalus (iNPH), 37 patients clinically diagnosed with iNPH participated in a prospective study in which performance on neurologic, psychometric, and gait measures before and 4 months after shunting was correlated with amyloid β plaques, neuritic plaques, and neurofibrillary tangles observed in cortical biopsies obtained during shunt insertion. No complications resulted from biopsy acquisition. Moderate to severe pathology was associated with worse baseline cognitive performance and diminished postoperative improvement on NPH symptom severity scales, gait measures, and cognitive instruments compared to patients lacking pathology.

  16. Tunable acoustic waveguide based on vibro-acoustic metamaterials with shunted piezoelectric unit cells

    NASA Astrophysics Data System (ADS)

    Kwon, Byung-Jin; Jung, Jin-Young; Lee, Dooho; Park, Kwang-Chun; Oh, Il-Kwon

    2015-10-01

    We propose a new class of acoustic waveguides with tunable bandgaps (TBs) by using vibro-acoustic metamaterials with shunted periodic piezoelectric unit cells. The unit metamaterial cells that consist of a single crystal piezoelectric transducer and an electrical shunt circuit are designed to induce a strong vibro-acousto-electrical coupling, resulting in a tunable acoustic bandgap as well as local structural resonance and Bragg scattering bandgaps. The present results show that the TB frequency can be actively controlled and the transmission loss of the acoustic wave can be greatly improved by simply changing the inductance values in the shunt circuit.

  17. An interesting case of screen-detected breast cancer encasing a ventriculoperitoneal shunt.

    PubMed

    Jain, Yogesh Kumar; Kokan, Jalal S

    2013-01-23

    A 67-year-old woman was diagnosed with a breast cancer via screening encasing the ventriculoperitoneal shunt. Triple assessment including MRI scan of the breast confirmed the presence of a breast mass and the tubing of the ventriculoperitoneal shunt was running directly through the mass. She underwent wide local excision of the breast cancer as well as rerouting of VP shunt as a joint procedure with the neurosurgery team and recovered uneventfully. This is a very rare and an interesting case and required management involving a different specialty.

  18. Brain abscesses associated with right-to-left shunts in adults.

    PubMed

    Memon, Kashif A; Cleveland, Kerry O; Gelfand, Michael S

    2012-04-01

    Although brain abscesses are frequently cryptogenic in origin, bacteria must reach the brain either by direct or hematogenous spread. Right-to-left shunts, caused either by intrapulmonary vascular malformations or congenital heart defects, may allow microorganisms to evade the normal host defenses in the lungs and lead to development of brain abscesses. Two patients recently presented with brain abscesses and were found to have conditions associated with right-to-left shunts. The diagnosis of brain abscess should prompt the clinician to consider right-to-left shunts as a possible predisposing condition for brain abscess.

  19. Testing of cerebrospinal compensatory reserve in shunted and non-shunted patients: a guide to interpretation based on an observational study.

    PubMed Central

    Czosnyka, M; Whitehouse, H; Smielewski, P; Simac, S; Pickard, J D

    1996-01-01

    OBJECTIVE--To design a computerised infusion test to compensate for the disadvantages of Katzman's lumbar infusion method: inadequate accuracy of estimation of the resistance to cerebrospinal fluid outflow and poor predictive value in normal pressure hydrocephalus. METHODS--Accuracy was improved by intracranial pressure signal processing and model analysis for measurement of cerebrospinal compensatory variable. These include the CSF outflow resistance, brain compliance, pressure-volume index, estimated sagittal sinus pressure, CSF formation rate, and other variables. Infusion may be made into the lumbar space, ventricles, or, when assessing shunt function in vivo, the shunt chamber. RESULTS AND CONCLUSIONS--The computerised test has been used for five years in a multicentre study in 350 hydrocephalic patients of various ages, aetiologies, and states of cerebrospinal compensation. The principles of using the test to characterise different types of CSF circulatory disorders in patients presenting with ventricular dilatation, including brain atrophy and normal and high pressure hydrocephalus, are presented and illustrated. Previous studies showed a positive correlation between cerebrospinal compensatory variables and the results of shunting, but such a prediction remains difficult in idiopathic normal pressure hydrocephalus, particularly in elderly patients. The technique is helpful in the assessment of shunt malfunction, including posture-related overdrainage, over-drainage related to the nocturnal B wave activity, and proximal or distal shunt obstruction. The appendix presents an introduction of the mathematical modelling of CSF pressure volume-compensation included in computerised infusion test software. Images PMID:8778261

  20. Lp stability for entropy solutions of scalar conservation laws with strict convex flux

    NASA Astrophysics Data System (ADS)

    Adimurthi; Ghoshal, Shyam Sundar; Veerappa Gowda, G. D.

    Here we consider the scalar convex conservation laws in one space dimension with strictly convex flux which is in C1. Existence, uniqueness and L1 contractivity were proved by Kružkov [14]. Using the relative entropy method, Leger showed that for a uniformly convex flux and for the shock wave solutions, the L2 norm of a perturbed solution relative to the shock wave is bounded by the L2 norm of the initial perturbation. Here we generalize the result to Lp norm for all 1⩽p<∞. Also we show that for the non-shock wave solution, Lp norm of the perturbed solution relative to the modified N-wave is bounded by the Lp norm of the initial perturbation for all 1⩽p<∞.

  1. Effects of topography and crustal heterogeneities on the source estimation of LP event at Kilauea volcano

    USGS Publications Warehouse

    Cesca, S.; Battaglia, J.; Dahm, T.; Tessmer, E.; Heimann, S.; Okubo, P.

    2008-01-01

    The main goal of this study is to improve the modelling of the source mechanism associated with the generation of long period (LP) signals in volcanic areas. Our intent is to evaluate the effects that detailed structural features of the volcanic models play in the generation of LP signal and the consequent retrieval of LP source characteristics. In particular, effects associated with the presence of topography and crustal heterogeneities are here studied in detail. We focus our study on a LP event observed at Kilauea volcano, Hawaii, in 2001 May. A detailed analysis of this event and its source modelling is accompanied by a set of synthetic tests, which aim to evaluate the effects of topography and the presence of low velocity shallow layers in the source region. The forward problem of Green's function generation is solved numerically following a pseudo-spectral approach, assuming different 3-D models. The inversion is done in the frequency domain and the resulting source mechanism is represented by the sum of two time-dependent terms: a full moment tensor and a single force. Synthetic tests show how characteristic velocity structures, associated with shallow sources, may be partially responsible for the generation of the observed long-lasting ringing waveforms. When applying the inversion technique to Kilauea LP data set, inversions carried out for different crustal models led to very similar source geometries, indicating a subhorizontal cracks. On the other hand, the source time function and its duration are significantly different for different models. These results support the indication of a strong influence of crustal layering on the generation of the LP signal, while the assumption of homogeneous velocity model may bring to misleading results. ?? 2008 The Authors Journal compilation ?? 2008 RAS.

  2. Capillary tone: cyclooxygenase, shear stress, luminal glycocalyx, and hydraulic conductivity (Lp)

    PubMed Central

    Williams, Donna A; Flood, Mary H

    2015-01-01

    Control of capillary hydraulic conductivity (Lp) is the physiological mechanism that underpins systemic hydration. Capillaries form the largest surface of endothelial cells in any species with a cardiovascular system and all capillaries are exposed to the flow-induced force, shear stress (τ). Vasoactive molecules such as prostacyclin (cyclooxygenase product, COX) are released from endothelial cells in response to τ. Little is known about how COX activity impacts capillary Lp. The purpose here was to assess Lp in situ following an acute Δτ stimulus and during COX1/COX2 inhibition. Mesenteric true capillaries (TC) of Rana pipiens (pithed) were cannulated for Lp assessment using the modified Landis technique. Rana were randomized into Control and Test groups. Two capillaries per animal were used (perfusate, 10 mg·mL−1 BSA/frog Ringer's; superfusate, frog Ringer's or indomethacin (10−5 mol·L−1) mixed in frog Ringer's solution). Three distinct responses of Lp to indomethacin (TC2) were demonstrated (TC1 and TC2 medians: Test Subgroup 1, 3.0 vs. 1.8; Test Subgroup 2, 18.2 vs. 2.2; Test Subgroup 3, 4.2 vs. 10.2 × 10−7 cm·sec−1·cm H2O−1). Multiple regression analysis revealed a relationship between capillary Lp and systemic red blood cell concentration or hematocrit, plasma protein concentration, and Δτ (Test Subgroup 1, R2 = 0.59, P < 0.0001; Test Subgroup 2, R2 = 0.96, P = 0.002), but only during COX inhibition. Maintaining red blood cell and plasma protein levels within a normal range may control barrier function in a healthy state. Recovering barrier function may be an unrecognized benefit of transfusions during blood loss or edema formation. PMID:25896981

  3. Capillary tone: cyclooxygenase, shear stress, luminal glycocalyx, and hydraulic conductivity (Lp).

    PubMed

    Williams, Donna A; Flood, Mary H

    2015-04-01

    Control of capillary hydraulic conductivity (Lp) is the physiological mechanism that underpins systemic hydration. Capillaries form the largest surface of endothelial cells in any species with a cardiovascular system and all capillaries are exposed to the flow-induced force, shear stress (τ). Vasoactive molecules such as prostacyclin (cyclooxygenase product, COX) are released from endothelial cells in response to τ. Little is known about how COX activity impacts capillary Lp. The purpose here was to assess Lp in situ following an acute Δτ stimulus and during COX1/COX2 inhibition. Mesenteric true capillaries (TC) of Rana pipiens (pithed) were cannulated for Lp assessment using the modified Landis technique. Rana were randomized into Control and Test groups. Two capillaries per animal were used (perfusate, 10 mg·mL(-1) BSA/frog Ringer's; superfusate, frog Ringer's or indomethacin (10(-5) mol·L(-1)) mixed in frog Ringer's solution). Three distinct responses of Lp to indomethacin (TC2) were demonstrated (TC1 and TC2 medians: Test Subgroup 1, 3.0 vs. 1.8; Test Subgroup 2, 18.2 vs. 2.2; Test Subgroup 3, 4.2 vs. 10.2 × 10(-7) cm·sec(-1)·cm H2O(-1)). Multiple regression analysis revealed a relationship between capillary Lp and systemic red blood cell concentration or hematocrit, plasma protein concentration, and Δτ (Test Subgroup 1, R(2) = 0.59, P < 0.0001; Test Subgroup 2, R(2) = 0.96, P = 0.002), but only during COX inhibition. Maintaining red blood cell and plasma protein levels within a normal range may control barrier function in a healthy state. Recovering barrier function may be an unrecognized benefit of transfusions during blood loss or edema formation.

  4. Long Period (LP) volcanic earthquake source location at Merapi volcano by using dense array technics

    NASA Astrophysics Data System (ADS)

    Metaxian, Jean Philippe; Budi Santoso, Agus; Laurin, Antoine; Subandriyo, Subandriyo; Widyoyudo, Wiku; Arshab, Ghofar

    2015-04-01

    Since 2010, Merapi shows unusual activity compared to last decades. Powerful phreatic explosions are observed; some of them are preceded by LP signals. In the literature, LP seismicity is thought to be originated within the fluid, and therefore to be representative of the pressurization state of the volcano plumbing system. Another model suggests that LP events are caused by slow, quasi-brittle, low stress-drop failure driven by transient upper-edifice deformations. Knowledge of the spatial distribution of LP events is fundamental for better understanding the physical processes occurring in the conduit, as well as for the monitoring and the improvement of eruption forecasting. LP events recorded at Merapi have a spectral content dominated by frequencies between 0.8 and 3 Hz. To locate the source of these events, we installed a seismic antenna composed of 4 broadband CMG-6TD Güralp stations. This network has an aperture of 300 m. It is located on the site of Pasarbubar, between 500 and 800 m from the crater rim. Two multi-parameter stations (seismic, tiltmeter, S-P) located in the same area, equipped with broadband CMG-40T Güralp sensors may also be used to complete the data of the antenna. The source of LP events is located by using different approaches. In the first one, we used a method based on the measurement of the time delays between the early beginnings of LP events for each array receiver. The observed differences of time delays obtained for each pair of receivers are compared to theoretical values calculated from the travel times computed between grid nodes, which are positioned in the structure, and each receiver. In a second approach, we estimate the slowness vector by using MUSIC algorithm applied to 3-components data. From the slowness vector, we deduce the back-azimuth and the incident angle, which give an estimation of LP source depth in the conduit. This work is part of the Domerapi project funded by French Agence Nationale de la Recherche (https

  5. Broadband electric-field-induced LP01 and LP02 second harmonic generation in Xe-filled hollow-core PCF.

    PubMed

    Ménard, Jean-Michel; Köttig, Felix; St J Russell, Philip

    2016-08-15

    Second harmonic (SH) generation with 300 fs pump pulses is reported in a xenon-filled hollow-core photonic crystal fiber (PCF) across which an external bias voltage is applied. Phase-matched intermodal conversion from a pump light in the LP01 mode to SH light in the LP02 mode is achieved at a particular gas pressure. Using periodic electrodes, quasi-phase-matched SH generation into the low-loss LP01 mode is achieved at a different pressure. The low linear dispersion of the gas enables phase-matching over a broad spectral window, resulting in a measured bandwidth of ∼10  nm at high pump energies. A conversion efficiency of ∼18%/mJ is obtained. Gas-filled anti-resonant-reflecting hollow-core PCF uniquely offers pressure-tunable phase-matching, ultra-broadband guidance, and a very high optical damage threshold, which hold great promise for efficient three-wave mixing, especially in difficult-to-access regions of the electromagnetic spectrum.

  6. Use of acetazolamide to decrease cerebrospinal fluid production in chronically ventilated patients with ventriculopleural shunts

    PubMed Central

    Carrion, E; Hertzog, J; Medlock, M; Hauser, G; Dalton, H

    2001-01-01

    Acetazolamide (ACTZ), a carbonic anhydrase inhibitor, has been shown to decrease cerebrospinal fluid (CSF) production in both in vivo and in vitro animal models. We report two children with hydrocephalus who experienced multiple shunt failures, and who had externalised ventriculostomy drains (EVD) prior to ventriculopleural shunt placement. The effects of increasing doses of ACTZ on CSF production and subsequent tolerance to ventriculopleural shunts were evaluated. The patients had a 48% and a 39% decrease in their EVD CSF output when compared to baseline with maximum ACTZ dose of 75 mg/kg/day and 50 mg/kg/day, respectively (p < 0.05). This is the first report of change in CSF volume in children after extended treatment with ACTZ. ACTZ treatment in mechanically ventilated paediatric patients with hydrocephalus may improve tolerance of ventriculopleural shunts and minimise respiratory compromise. Potassium and bicarbonate supplements are required to correct metabolic disturbances.

 PMID:11124792

  7. Optimizing the Shunting Schedule of Electric Multiple Units Depot Using an Enhanced Particle Swarm Optimization Algorithm

    PubMed Central

    Jin, Junchen

    2016-01-01

    The shunting schedule of electric multiple units depot (SSED) is one of the essential plans for high-speed train maintenance activities. This paper presents a 0-1 programming model to address the problem of determining an optimal SSED through automatic computing. The objective of the model is to minimize the number of shunting movements and the constraints include track occupation conflicts, shunting routes conflicts, time durations of maintenance processes, and shunting running time. An enhanced particle swarm optimization (EPSO) algorithm is proposed to solve the optimization problem. Finally, an empirical study from Shanghai South EMU Depot is carried out to illustrate the model and EPSO algorithm. The optimization results indicate that the proposed method is valid for the SSED problem and that the EPSO algorithm outperforms the traditional PSO algorithm on the aspect of optimality. PMID:27436998

  8. Optimizing the Shunting Schedule of Electric Multiple Units Depot Using an Enhanced Particle Swarm Optimization Algorithm.

    PubMed

    Wang, Jiaxi; Lin, Boliang; Jin, Junchen

    2016-01-01

    The shunting schedule of electric multiple units depot (SSED) is one of the essential plans for high-speed train maintenance activities. This paper presents a 0-1 programming model to address the problem of determining an optimal SSED through automatic computing. The objective of the model is to minimize the number of shunting movements and the constraints include track occupation conflicts, shunting routes conflicts, time durations of maintenance processes, and shunting running time. An enhanced particle swarm optimization (EPSO) algorithm is proposed to solve the optimization problem. Finally, an empirical study from Shanghai South EMU Depot is carried out to illustrate the model and EPSO algorithm. The optimization results indicate that the proposed method is valid for the SSED problem and that the EPSO algorithm outperforms the traditional PSO algorithm on the aspect of optimality.

  9. Surgical attenuation of spontaneous congenital portosystemic shunts in dogs resolves hepatic encephalopathy but not hypermanganesemia.

    PubMed

    Gow, Adam G; Frowde, Polly E; Elwood, Clive M; Burton, Carolyn A; Powell, Roger M; Tappin, Simon W; Foale, Rob D; Duncan, Andrew; Mellanby, Richard J

    2015-10-01

    Hypermanganesemia is commonly recognized in human patients with hepatic insufficiency and portosystemic shunting. Since manganese is neurotoxic, increases in brain manganese concentrations have been implicated in the development of hepatic encephalopathy although a direct causative role has yet to be demonstrated. Evaluate manganese concentrations in dogs with a naturally occurring congenital shunt before and after attenuation as well as longitudinally following the changes in hepatic encephalopathy grade. Our study demonstrated that attenuation of the shunt resolved encephalopathy, significantly reduced postprandial bile acids, yet a hypermanganasemic state persisted. This study demonstrates that resolution of hepatic encephalopathy can occur without the correction of hypermanganesemia, indicating that increased manganese concentrations alone do not play a causative role in encephalopathy. Our study further demonstrates the value of the canine congenital portosystemic shunt as a naturally occurring spontaneous model of human hepatic encephalopathy.

  10. [Hydrothorax as a complication of a ventricle peritoneal shunt. A case report].

    PubMed

    Yéboles, Raúl M; Vázquez, Lorena; Seoane, Marta; Castro, Susana; Ruiz, Beatriz

    2017-02-24

    The ventricle peritoneal (VP) shunt is commonly used in the treatment of hydrocephalus. It is a relatively simple and effective technique, but around 70% of the patients with a VP shunt have a complication in their lifetime. Most of these complications are due to infection or mechanical dysfunction. The thoracic complications are rare. The present case is one of the small number of them found in the literature, describing hydrothorax as a complication of a VP shunt without catheter migration and without ascites. The case is presented of a 2 year-old girl with VP shunt. The patient was diagnosed with pleural effusion compatible with hydrothorax. After finding beta-2-transferrin in the pleural fluid, it was it was shown to be from cerebrospinal fluid. Cranial CT showed the catheter in a proper position, and the Xray and ultrasound showed the catheter correctly positioned in the peritoneum.

  11. Ultrasound characterization of interface oscillation as a proxy for ventriculoperitoneal shunt function.

    PubMed

    Aralar, April Joy C; Bird, Matthew D; Graham, Robert D; Beomseo Koo; Shenai, Mahesh B; Chitnis, Parag V; Sikdar, Siddhartha

    2016-08-01

    Hydrocephalus, where cerebrospinal fluid (CSF) production rate is greater than reabsorption rate, leads to impaired neurological function if left untreated. Ventriculoperitoneal shunts (VPS) are implanted in the brain ventricles to route CSF. VPS systems have a high failure rate, and failure symptoms resemble symptoms of common maladies. The current gold standard for shunt diagnosis, surgical intervention, poses high risk and requires an expensive procedure for patients. Current non-invasive methods lack proper insight to assist physicians. We propose a noninvasive method of characterizing the oscillation of the shunt's pressure-relief valve to assist physicians in shunt diagnosis. Brightness-mode and motion-mode ultrasound images can be used to determine fluid flow. Blockage in the system could be detected by observing the phase change of the ultrasound signal in different flow cases with or without perturbation. Future testing and implementation can allow for the use of this method in localizing and identifying the modality of failure.

  12. Urethral protrusion of the abdominal catheter of ventriculoperitoneal shunt: Case report of extremely rare complication.

    PubMed

    Yazar, Ugur; Kanat, Ayhan; Akca, Nezih; Gazioglu, Gurkan; Arda, Irfan S; Kazdal, Hizir

    2012-05-01

    Hydrocephalus in its various forms constitutes one of the major problems in pediatric neurosurgical practice. The placement of a ventriculoperitoneal (VP) shunt is the most common form of treatment for hydrocephalus, so that all neurosurgeons struggle with shunt malfunctions and their complications. Well-known complications are connected with the use of the valve systems (malfunction, infectious, overdrainage, secondary craniosynostosis, etc.). We report an unusual case of protruding abdominal catheter from the urethra. This girl had received a VP shunt for hydrocephalus following surgery of posterior fossa medulloblastoma 4 years ago. After admission, the entire system was removed, antibiotic treatment was administered for 2 weeks, and a new VP shunt was placed. The postoperative course was uneventful. This complication is extremely rare.

  13. Three-dimensional multislice helical computed tomography techniques for canine extra-hepatic portosystemic shunt assessment.

    PubMed

    Bertolini, Giovanna; Rolla, Edoardo C; Zotti, Alessandro; Caldin, Marco

    2006-01-01

    The purpose of the present study was to investigate the feasibility and usefulness of three-dimensional (3D) multislice computed tomography (CT) angiography with maximum intensity projection (MIP) and volume rendering (VR) in six dogs with clinical and sonographic findings suggestive of portosystemic shunt. Furthermore, we aimed to estimate the diameter of the portal vein and shunt vessels. MIP and VR reconstructions were performed for each patient and the origin and insertion of all shunt vessels were detected. In addition, 3D reconstructions allowed excellent depiction of vascular morphology and topography. All diagnoses and vessel measurements were confirmed by surgery. 3D multidetector CT angiography is a promising, noninvasive, and accurate method of evaluating dogs with suspected portosystemic shunts.

  14. Assessment of FGPM shunt damping for vibration reduction of laminated composite beams

    NASA Astrophysics Data System (ADS)

    Lezgy-Nazargah, M.; Divandar, S. M.; Vidal, P.; Polit, O.

    2017-02-01

    This work addresses theoretical and finite element investigations of functionally graded piezoelectric materials (FGPMs) for shunted passive vibration damping of laminated composite beams. The properties of piezoelectric patches are assumed to vary through the thickness direction following the exponent or power law distribution in terms of the volume fractions of the constituent materials. By employing Hamilton's principle, the governing differential equations of motion are derived. The resulting system of equations of vibration is solved by employing an efficient three-nodded beam element which is based on a refined sinus piezoelectric model. The effects of effective electromechanical coupling coefficients (EEMCCs), different electric shunt circuits and different material compositions on the shunted damping performance are investigated. The optimal values of the electric components belonging to each shunt circuit are numerically determined.

  15. [The development of extrahepatic portacaval shunt device based on magnetic compression technique through the interventional procedure].

    PubMed

    Yan, Xiaopeng; Lv, Yi; Ma, Jia; Liu, Wenyan; Li, Jianhui; Ma, Feng; Wang, Haohua

    2013-11-01

    A device of extrahepatic portacaval shunt is introduced. This device is composed of the daughter and parent magnets and the vascular interventional operation equipment. It is based on the principle of magnetic compression technology, through the intervention approach the daughter and mother magnet are moved to the portal vein and inferior vena cava, respectively. Then the two magnets attract and compress the vessel walls of portal vein and inferior vena cava. Two weeks later, the magnets are detached from the vessel wall with a RUPS-set and the portacaval shunt is established. It is mainly used for the treatment of portal hypertension. It belongs to the interventional operation, there is no any foreign body remaining after the portacaval shunt is established, which can maintain long-term patency. Futhermore the portacaval shunt will not be expanded, therefore it can significantly reduce the incidence of hepatic encephalopathy.

  16. Vibration and wave propagation attenuation for metamaterials by periodic piezoelectric arrays with high-order resonant circuit shunts

    NASA Astrophysics Data System (ADS)

    Zhou, Wanlu; Wu, You; Zuo, Lei

    2015-06-01

    Beam or plate metamaterials with periodic piezoelectric arrays have attracted more and more attention in recent years for wave propagation attenuation and the corresponding vibration reduction. Conventional designs use resistive shunt (R-shunt) and resistor-inductor shunt (RL-shunt). An innovative metamaterial with a high-order resonant shunt circuit is proposed and investigated for vibration and wave propagation attenuation in this paper. The proposed high-order resonant shunt circuit can introduce two local resonances in series around the tuning frequency to broaden the attenuation bandwidth, or can create two separate resonances to achieve two separate bandgaps. Finite element modeling of the beam metamaterial with wave propagation and vibration in the transverse direction is established. Simulations have been conducted to compare the vibration attenuation performances among R-shunt, RL-shunt, and the proposed high-order shunt. An impedance-based method has been presented for the parameter design of electrical components in the proposed high-order shunt for bandgaps at two desired frequencies.

  17. Evaluation of Microbial Bacterial and Fungal Diversity in Cerebrospinal Fluid Shunt Infection

    PubMed Central

    Simon, Tamara D.; Pope, Christopher E.; Browd, Samuel R.; Ojemann, Jeffrey G.; Riva-Cambrin, Jay; Mayer-Hamblett, Nicole; Rosenfeld, Margaret; Zerr, Danielle M.; Hoffman, Lucas

    2014-01-01

    Background Cerebrospinal fluid shunt infection can be recalcitrant. Recurrence is common despite appropriate therapy for the pathogens identified by culture. Improved diagnostic and therapeutic approaches are required, and culture-independent molecular approaches to cerebrospinal fluid shunt infections have not been described. Objectives To identify the bacteria and fungi present in cerebrospinal fluid from children with cerebrospinal fluid shunt infection using a high-throughput sequencing approach, and to compare those results to those from negative controls and conventional culture. Methods This descriptive study included eight children ≤18 years old undergoing treatment for culture-identified cerebrospinal fluid shunt infection. After routine aerobic culture of each cerebrospinal fluid sample, deoxyribonucleic acid (DNA) extraction was followed by amplification of the bacterial 16S rRNA gene and the fungal ITS DNA region tag-encoded FLX-Titanium amplicon pyrosequencing and microbial phylogenetic analysis. Results The microbiota analyses for the initial cerebrospinal fluid samples from all eight infections identified a variety of bacteria and fungi, many of which did not grow in conventional culture. Detection by conventional culture did not predict the relative abundance of an organism by pyrosequencing, but in all cases, at least one bacterial taxon was detected by both conventional culture and pyrosequencing. Individual bacterial species fluctuated in relative abundance but remained above the limits of detection during infection treatment. Conclusions Numerous bacterial and fungal organisms were detected in these cerebrospinal fluid shunt infections, even during and after treatment, indicating diverse and recalcitrant shunt microbiota. In evaluating cerebrospinal fluid shunt infection, fungal and anaerobic bacterial cultures should be considered in addition to aerobic bacterial cultures, and culture-independent approaches offer a promising alternative

  18. [Syringomyelia secondary to adhesive arachnoiditis: clinical profiles and efficacy of shunt operations].

    PubMed

    Kamada, K; Iwasaki, Y; Hida, K; Abe, H; Isu, T

    1993-02-01

    The authors report nine cases of syringomyelia secondary to adhesive arachnoiditis treated in our institute from 1982 to 1991. Neurological signs, radiological features, and results of surgical treatment were reviewed. Common initial manifestations in association with syringomyelia were spastic paraparesis in 8 patients (88.9%), regional sensory loss in 4 (44.4%), neurogenic bladder in 4 (44.4%), and somatic pain in 2 (22.2%). All the neurological symptoms or signs progressed gradually for years. All the patients were treated with various modes of shunt operations, including syringo-peritoneal shunt in seven patients, syringo-subarachnoid shunt in one, and ventriculo-peritoneal shunt in one, respectively. Three patients who failed to resolve their major complaints after the first surgery further received syringo-peritoneal shunts. Postsurgical follow-up periods ranged from 18 months to 10 years. Serial MR imaging revealed a significant reduction of the size of syringomyelia in 8 of 9 patients. However only 6 patients showed certain improvement of neurological deficits. Three patients who failed to improve clearly had a long (beyond 15 years) history of syringomyelia before the first surgical treatment. A total of 11 syringo-peritoneal shunts were done in 8 patients of whom 5 patients improved neurologically. It was noticed that 4 of 5 successful syringo-peritoneal shunts were placed in the caudal level of the syrinx. In conclusion, syringo-peritoneal shunt may be at present an optimal mode of surgical management for syringomyelia secondary to adhesive arachnoiditis. In addition, we would like to recommend that follow-up serial MR imaging be done for patients having adhesive arachnoiditis in order to detect syringomyelia as early as possible.

  19. Superconducting FCL using a combined inducted magnetic field trigger and shunt coil

    DOEpatents

    Tekletsadik, Kasegn D.

    2007-10-16

    A single trigger/shunt coil is utilized for combined induced magnetic field triggering and shunt impedance. The single coil connected in parallel with the high temperature superconducting element, is designed to generate a circulating current in the parallel circuit during normal operation to aid triggering the high temperature superconducting element to quench in the event of a fault. The circulating current is generated by an induced voltage in the coil, when the system current flows through the high temperature superconducting element.

  20. Functional magnetic resonance imaging before and after ventriculoperitoneal shunting for hydrocephalus--case report.

    PubMed

    Fukuhara, T; Luciano, M G; Liu, J Z; Yue, G H

    2001-12-01

    A 70-year-old man with hydrocephalus was examined with functional magnetic resonance (fMR) imaging before and after ventriculoperitoneal shunting. Preoperatively, activation by right hand exercise revealed only a slight signal increase in the peri-rolandic area. However, 3 months after ventriculoperitoneal shunting, a significant signal increase was observed. fMR imaging may detect activity-related improvement of cerebral blood flow responses in patients with hydrocephalus after surgical treatment.