Nuclear reactor flow control method and apparatus
Church, J.P.
1993-03-30
Method and apparatus for improving coolant flow in a nuclear reactor during accident as well as nominal conditions. The reactor has a plurality of fuel elements in sleeves and a plenum above the fuel and through which the sleeves penetrate. Holes are provided in the sleeve so that coolant from the plenum can enter the sleeve and cool the fuel. The number and size of the holes are varied from sleeve to sleeve with the number and size of holes being greater for sleeves toward the center of the core and less for sleeves toward the periphery of the core. Preferably the holes are all the same diameter and arranged in rows and columns, the rows starting from the bottom of every sleeve and fewer rows in peripheral sleeves and more rows in the central sleeves.
Nuclear reactor flow control method and apparatus
Church, John P.
1993-01-01
Method and apparatus for improving coolant flow in a nuclear reactor during accident as well as nominal conditions. The reactor has a plurality of fuel elements in sleeves and a plenum above the fuel and through which the sleeves penetrate. Holes are provided in the sleeve so that coolant from the plenum can enter the sleeve and cool the fuel. The number and size of the holes are varied from sleeve to sleeve with the number and size of holes being greater for sleeves toward the center of the core and less for sleeves toward the periphery of the core. Preferably the holes are all the same diameter and arranged in rows and columns, the rows starting from the bottom of every sleeve and fewer rows in peripheral sleeves and more rows in the central sleeves.
Sleeve gastrectomy with anti-reflux procedures
Santoro, Sergio; Lacombe, Arnaldo; de Aquino, Caio Gustavo Gaspar; Malzoni, Carlos Eduardo
2014-01-01
Objective Sleeve gastrectomy is the fastest growing surgical procedure to treat obesity in the world but it may cause or worsen gastroesophageal reflux disease. This article originally aimed to describe the addition of anti-reflux procedures (removal of periesophageal fats pads, hiatoplasty, a small plication and fixation of the gastric remnant in position) to the usual sleeve gastrectomy and to report early and late results. Methods Eighty-eight obese patients that also presented symptoms of gastroesophageal reflux disease were submitted to sleeve gastrectomy with anti-reflux procedures. Fifty of them were also submitted to a transit bipartition. The weight loss of these patients was compared to consecutive 360 patients previously submitted to the usual sleeve gastrectomy and to 1,140 submitted to sleeve gastrectomy + transit bipartition. Gastroesophageal reflux disease symptoms were specifically inquired in all anti-reflux sleeve gastrectomy patients and compared to the results of the same questionnaire applied to 50 sleeve gastrectomy patients and 60 sleeve gastrectomy + transit bipartition patients that also presented preoperative symptoms of gastroesophageal reflux disease. Results In terms of weight loss, excess of body mass index loss percentage after anti-reflux sleeve gastrectomy is not inferior to the usual sleeve gastrectomy and anti-reflux sleeve gastrectomy + transit bipartition is not inferior to sleeve gastrectomy + transit bipartition. Anti-reflux sleeve gastrectomy did not add morbidity but significantly diminished gastroesophageal reflux disease symptoms and the use of proton pump inhibitors to treat this condition. Conclusion The addition of anti-reflux procedures, such as hiatoplasty and cardioplication, to the usual sleeve gastrectomy did not add morbidity neither worsened the weight loss but significantly reduced the occurrence of gastroesophageal reflux disease symptoms as well as the use of proton pump inhibitors. PMID:25295447
Gorscak, Donald A.; Maringo, John J.; Nilsen, Roy J.
1988-01-01
A stuck fuel rod capping sleeve to be used during derodding of spent fuel assemblies if a fuel rod becomes stuck in a partially withdrawn position and, thus, has to be severed. The capping sleeve has an inner sleeve made of a lower work hardening highly ductile material (e.g., Inconel 600) and an outer sleeve made of a moderately ductile material (e.g., 304 stainless steel). The inner sleeve may be made of an epoxy filler. The capping sleeve is placed on a fuel rod which is then severed by using a bolt cutter device. Upon cutting, the capping sleeve deforms in such a manner as to prevent the gross release of radioactive fuel material
Development and evaluation of gas-pressurized elastic sleeves for extravehicular activity.
Tanaka, Kunihiko; Tohnan, Momoka; Abe, Chikara; Iwata, Chihiro; Yamagata, Kenji; Tanaka, Masao; Tanaka, Nobuyuki; Morita, Hironobu
2010-07-01
In space, mobility of the current extravehicular activity space suit is limited due to the pressure differential between the inside and outside of the suit. We have previously demonstrated that an elastic glove increased mobility when compared with a non-elastic glove such as that found in the current suit. Extending this work, we hypothesized that an elastic sleeve would also have more mobility compared to a non-elastic sleeve, but a partially elastic sleeve, consisting of elastic joints sewn to non-elastic parts in low mobility areas, might generate similar mobility to a wholly elastic sleeve. The right arms of 10 volunteers were studied with wholly elastic, partially elastic, and non-elastic sleeves in a chamber pressure of -220 mmHg. Range of motion (ROM) of the wrist and electromyography (EMG) of the flexor carpi radialis muscle and the biceps brachii muscle during wrist and elbow flexion were measured. ROM of the wrist was similar among all the sleeves. However, EMG amplitudes during wrist flexion with both elastic sleeves were significantly smaller than that with the non-elastic sleeve. EMG amplitudes during 90 degrees of elbow flexion were also significantly smaller in both elastic sleeves. However, no significant difference in EMG amplitudes was observed between the two elastic sleeves (0.53 +/- 0.06, 0.56 +/- 0.07, 1.14 +/- 0.10 V for wholly elastic, partially elastic, and non-elastic sleeves, respectively). The mobility of elastic sleeves is better than that of a non-elastic sleeve. Elasticity over the joints is important; however the elasticity of the other parts does not appear to affect mobility.
Harris, William G.
1985-01-01
A heat limiting tubular sleeve extending over only a portion of a tube having a generally uniform outside diameter, the sleeve being open on both ends, having one end thereof larger in diameter than the other end thereof and having a wall thickness which decreases in the same direction as the diameter of the sleeve decreases so that the heat transfer through the sleeve and tube is less adjacent the large diameter end of the sleeve than adjacent the other end thereof.
Xiao, Yong Jie; Chen, Fu Quan; Dong, Yi Zhi
2016-01-01
During driving sleeve of cast-in-place piles by vibratory hammers, soils were squeezed into sleeve and then soil plugging was formed. The physic-mechanical properties of the soil plug have direct influence on the load transmission between the sleeve wall and soil plug. Nevertheless, the researches on this issue are insufficient. In this study, finite element and infinite element coupling model was introduced, through the commercial code ABAQUS, to simulate the full penetration process of the sleeve driven from the ground surface to the desired depth by applying vibratory hammers. The research results indicated that the cyclic shearing action decreases both in soil shear strength and in granular cementation force when the sleeve is driven by vibratory hammers, which leads to a partially plugged mode of the soil plug inside the sleeve. Accordingly, the penetration resistance of sleeve driven by vibratory hammers is the smallest compared to those by other installation methods. When driving the sleeve, the annular soil arches forming in the soil plug at sleeve end induce a significant rise in the internal shaft resistance. Moreover, the influence of vibration frequencies, sleeve diameters, and soil layer properties on the soil plug was investigated in detail, and at the same time improved formulas were brought forward to describe the soil plug resistance inside vibratory driven sleeve.
Summary report, Flexible VSR`s and VSR channel sleeve development programs
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kempf, F.J.
1963-11-15
(VSR = vertical safety rod.) This report summarizes results of development programs which have evaluated vertical rod channel sleeving materials and provided flexible vertical rods, acceptable for both interim use before rod channel sleeving, and for subsequent use in sleeved channels. B{sub 4}C is the rod material; graphite and Al oxide are among the sleeve materials.
Apparatus and method for measuring the expansion properties of a cement composition
Spangle, Lloyd B.
1983-01-01
An apparatus is disclosed which is useful for measuring the expansion properties of semi-solid materials which expand to a solid phase, upon curing, such as cement compositions. The apparatus includes a sleeve, preferably cylindrical, which has a vertical slit on one side, to allow the sleeve to expand. Mounted on the outside of the sleeve are several sets of pins, consisting of two pins each. The two pins in each set are located on opposite sides of the slit. In the test procedure, the sleeve is filled with wet cement, which is then cured to a solid. As the cement cures it causes the sleeve to expand. The actual expansion of the sleeve represents an expansion factor for the cement. This factor is calculated by measuring the distance across the pins of each set, when the sleeve is empty, and again after the cured cement expands the sleeve.
Pressurizer with a mechanically attached surge nozzle thermal sleeve
Wepfer, Robert M
2014-03-25
A thermal sleeve is mechanically attached to the bore of a surge nozzle of a pressurizer for the primary circuit of a pressurized water reactor steam generating system. The thermal sleeve is attached with a series of keys and slots which maintain the thermal sleeve centered in the nozzle while permitting thermal growth and restricting flow between the sleeve and the interior wall of the nozzle.
Finite element Analysis of Semi-Grouting Sleeve Connection Member Based on ABAQUS
NASA Astrophysics Data System (ADS)
Bao, Longsheng; Fan, Qianyu; Wang, Ling
2018-05-01
This paper use investigates the force transfer mechanism and failure form of semi-grouting sleeve members under axial load, analyze the weak points of structural bearing capacity and verify the reliability of the connection of steel bars through finite element analysis software. The results show that adding the axial load to semi-grouting sleeve forms a 45°oblique compression zone, which help to transfer stress between reinforcement, grouting material and sleeve. Because the maximum stress of sleeve doesn’t reach its tensile resistance and the deformation of the sleeve is located at the junction of the grouting and the threaded section when the stress value of steel bars at each end of the semi-grouting sleeve reach its ultimate tensile strength, we conclude that the semi-grouting sleeve members can meet the construction quality requirements and be used to connect the steel bars at the joints of the assembled structures. It is necessary to avoid breaking down, since the deformation section will accumulate large plastic deformation during the processing of the sleeve.
Benett, William J.; Richards, James B.
2003-01-01
A sleeve-type silicon polymerase chain reaction (PCR) chamber or thermocycler having improved thermal performance. The silicon sleeve reaction chamber is improved in thermal performance by etched features therein that reduce thermal mass and increase the surface area of the sleeve for cooling. This improved thermal performance of the thermocycler enables an increase in speed and efficiency of the reaction chamber. The improvement is accomplished by providing grooves in the faces of the sleeve and a series of grooves on the interior surfaces that connect with grooves on the faces of the sleeve. The grooves can be anisotropically etched in the silicon sleeve simultaneously with formation of the chamber.
Benett, William J.; Richards, James B.
2005-05-17
A sleeve-type silicon polymerase chain reaction (PCR) chamber or thermocycler having improved thermal performance. The silicon sleeve reaction chamber is improved in thermal performance by etched features therein that reduce thermal mass and increase the surface area of the sleeve for cooling. This improved thermal performance of the thermocycler enables an increase in speed and efficiency of the reaction chamber. The improvement is accomplished by providing grooves in the faces of the sleeve and a series of grooves on the interior surfaces that connect with grooves on the faces of the sleeve. The grooves can be anisotropically etched in the silicon sleeve simultaneously with formation of the chamber.
Nath, Anand; Yewale, Sayali; Tran, Tung; Brebbia, John S; Shope, Timothy R; Koch, Timothy R
2016-12-21
To evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy (VSG). VSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage. Of 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients (9.3%) have narrowing of the sleeve with 25 (7.1%) having sharp angulation or a spiral while 8 (2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients (39%); 10 patients (30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids. Narrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients.
Nath, Anand; Yewale, Sayali; Tran, Tung; Brebbia, John S; Shope, Timothy R; Koch, Timothy R
2016-01-01
AIM To evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy (VSG). METHODS VSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage. RESULTS Of 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients (9.3%) have narrowing of the sleeve with 25 (7.1%) having sharp angulation or a spiral while 8 (2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients (39%); 10 patients (30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids. CONCLUSION Narrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients. PMID:28058017
Babelay, E.F.
1962-02-13
A flexible shaft coupling for operation at speeds in excess of 14,000 rpm is designed which requires no lubrication. A driving sleeve member and a driven sleeve member are placed in concentric spaced relationship. A torque force is transmitted to the driven member from the driving member through a plurality of nylon balls symmetrically disposed between the spaced sleeves. The balls extend into races and recesses within the respective sleeve members. The sleeve members have a suitable clearance therebetween and the balls have a suitable radial clearance during operation of the coupling to provide a relatively loose coupling. These clearances accommodate for both parallel and/or angular misalignments and avoid metal-tometal contact between the sleeve members during operation. Thus, no lubrication is needed, and a minimum of vibrations is transmitted between the sleeve members. (AEC)
Motorized wellbore fishing tool
DOE Office of Scientific and Technical Information (OSTI.GOV)
Smith, L.E.; Schasteen, T.
1989-08-15
This patent describes a fishing tool for retrieving an article located in a wellbore, wherein the fishing tool may be lowered into the wellbore by means connected to one end of the fishing tool. The fishing tool comprising: an elongated tubular body; an inner sleeve member secured to the body and extending axially within the body; a ball key disposed within each of the openings and movable at least partially into the bore in locking registration with a fishing head connected to the article; an outer sleeve member disposed in sleeved relationship around the inner sleeve member and movable axiallymore » between first and second positions with respect to the inner sleeve member. The outer sleeve member being operable to prevent, in the first position, radial outward movement of the ball keys out of the bore. The outer sleeve member including recess means formed thereon such that in the second position of the outer sleeve member the recess means is adjacent to the circumferentially spaced openings to allow limited radial outward movement of the ball keys; and means for axially moving the outer sleeve member between the first and second positions for engaging and releasing the fishing head with respect to the tool.« less
Sinclair, Jonathan; Taylor, Paul John
2017-07-17
Prophylactic knee bracing is extensively utilized in athletic populations, to reduce the high risk from knee injuries, but their role in the attenuation of anterior cruciate ligament (ACL) pathologies is not well understood. The aim of the current investigation was to investigate the effects of a prophylactic knee sleeve on ACL loading parameters linked to the aetiology of injury in recreational athletes. Laboratory. Repeated measures. Thirteen healthy male recreational athletes. Intervention Participants performed run, cut and single leg hop movements under two conditions; prophylactic knee sleeve and no-sleeve. Biomechanical data was captured using an eight-camera 3D motion capture system and a force platform. Peak ACL force, average ACL load rate and instantaneous ACL load rate were quantified using a musculoskeletal modelling approach. The results showed that both average and instantaneous ACL load rates were significantly reduced when wearing the knee sleeve in the hop (sleeve = 612.45/ 1286.39N/kg/s & no-sleeve = 743.91/ 1471.42 N/kg/s) and cut (sleeve = 222.55/ 1058.02 N/kg/s & no-sleeve = 377.38/ 1183.01 N/kg/s) movements. Given the biomechanical association between ACL loading and the aetiology of ACL injuries, it is proposed that athletes may be able to attenuate their risk from injury during cut and hop movements through utilization of a prophylactic knee sleeve.
Mechanism Research on Melting Loss of Coppery Tuyere Small Sleeve in Blast Furnace
NASA Astrophysics Data System (ADS)
Chai, Yi-Fan; Zhang, Jian-Liang; Ning, Xiao-Jun; Wei, Guang-Yun; Chen, Yu-Ting
2016-01-01
The tuyere small sleeve in blast furnace works under poor conditions. The abnormal damage of it will severely affect the performance of the blast furnace, thus it should be replaced during the damping down period. So it is of great significance that we study and reduce the burnout of tuyere small sleeve. Melting loss is one case of its burnout. This paper studied the reasons of tuyere small sleeve's melting loss, through computational simulation and microscopic analysis of the melting section. The research shows that the temperature of coppery tuyere small sleeve is well distributed when there is no limescale in the lumen, and the temperature increases with the thickness of limescale. In addition, the interruption of circulating water does great harm to the tuyere small sleeve. The melting loss of tuyere small sleeve is caused by iron-slag erosion, with the occurrence of the melt metallurgical bonding and diffusion metallurgical combination.
Comparison of stiffness and interface pressure during rest and exercise among various arm sleeves.
Hirai, M; Niimi, K; Iwata, H; Sugimoto, I; Ishibashi, H; Ota, T; Nakamura, H
2010-08-01
To compare the interface pressure during rest and exercise among various kinds of arm sleeves. The interface pressure underneath nine different arm sleeves was measured during 10 maximal opening and closing movements of fingers using a pressure transducer (Air Pack Type Analyser) in 16 healthy volunteers. Furthermore, in order to evaluate the characteristics of each arm sleeve, the extensibility, stiffness and thickness were determined in vitro by several apparatuses. There was a significant correlation between stiffness and extensibility. The stiffness was significantly correlated with the pressure difference between muscle contraction and relaxation during exercise. The higher the value of stiffness, the greater the pressure amplitude during exercise. Short-stretch arm sleeves characterized with a high level stiffness, including thick round- and flat-knitted arm sleeves, are more beneficial for the augmentation of muscle pumping than long-stretch arm sleeves, in the same way as short-stretch bandages or stockings applied to the leg.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lane, W.L.; Lewis, D.L.
1987-04-07
A rockbolt is described for installation in a bore in the roof of an underground excavation to support the roof, the rockbolt comprising: a sleeve insertable into the bore and having an upper and a lower end; at least one port in the sleeve near the upper end; means inside the sleeve near the upper end for engaging a device for supplying hardenable binder material inserted into the sleeve, the engaging means having at least one passage therein communicating with the port to allow binder material to pass from the device through the engaging means and out the port, tomore » encase the sleeve in binder material; means for engaging the sleeve, near the lower end, to the roof face; means for engaging the sleeve near the upper end to the rock surrounding the bore and means for tensioning the rockbolt to compress the rock between the upper and lower ends.« less
Swell Sleeves for Testing Explosive Devices
NASA Technical Reports Server (NTRS)
Hinkel, Todd J.; Dean, Richard J.; Hohmann, Carl W.; Hacker, Scott C.; Harrington, Douglas W.; Bacak, James W.
2003-01-01
A method of testing explosive and pyrotechnic devices involves exploding the devices inside swell sleeves. Swell sleeves have been used previously for measuring forces. In the present method, they are used to obtain quantitative indications of the energy released in explosions of the devices under test. A swell sleeve is basically a thick-walled, hollow metal cylinder threaded at one end to accept a threaded surface on a device to be tested (see Figure 1). Once the device has been tightly threaded in place in the swell sleeve, the device-and-swell-sleeve assembly is placed in a test fixture, then the device is detonated. After the explosion, the assembly is removed from the test fixture and placed in a coordinate-measuring machine for measurement of the diameter of the swell sleeve as a function of axial position. For each axial position, the original diameter of the sleeve is subtracted from the diameter of the sleeve as swollen by the explosion to obtain the diametral swelling as a function of axial position (see Figure 2). The amount of swelling is taken as a measure of the energy released in the explosion. The amount of swelling can be compared to a standard amount of swelling to determine whether the pyrotechnic device functioned as specified.
Fretting and Corrosion Damage in Taper Adapter Sleeves for Ceramic Heads: A Retrieval Study.
MacDonald, Daniel W; Chen, Antonia F; Lee, Gwo-Chin; Klein, Gregg R; Mont, Michael A; Kurtz, Steven M; Cates, Harold E; Kraay, Matthew J; Rimnac, Clare M
2017-09-01
During revision surgery with a well-fixed stem, a titanium sleeve can be used in conjunction with a ceramic head to achieve better stress distribution across the taper surface. In vitro testing suggests that corrosion is not a concern in sleeved ceramic heads; however, little is known about the in vivo fretting corrosion of the sleeves. The purpose of this study was to investigate fretting corrosion in sleeved ceramic heads in retrieved total hip arthroplasties. Thirty-seven sleeved ceramic heads were collected during revision. The femoral heads and sleeves were implanted 0.0-3.3 years. The implants were revised predominantly for instability, infection, and loosening. Fifty percent of the retrievals were implanted during a primary surgery. Fretting corrosion was assessed using the Goldberg-Higgs semiquantitative scoring system. Mild-to-moderate fretting corrosion scores (score = 2-3) were observed in 92% of internal tapers, 19% of external tapers, and 78% of the stems. Severe fretting corrosion was observed in 1 stem trunnion that was previously retained during revision surgery and none of the retrieved sleeves. There was no difference in corrosion damage of sleeves used in primary or revision surgery. The fretting corrosion scores in this study were predominantly mild and lower than reported fretting scores of cobalt-chrome heads in metal-on-polyethylene bearings. Although intended for use in revisions, we found that the short-term in vivo corrosion behavior of the sleeves was similar in both primary and revision surgery applications. From an in vivo corrosion perspective, sleeves are a reasonable solution for restoring the stem taper during revision surgery. Copyright © 2017. Published by Elsevier Inc.
A Wideband Corner-Reflector Antenna for 240 to 400 MHz.
1983-09-19
8217 .; ,:,:. .-.:.,.;.. - -... - .- . -.. .-- v...- ..... .-. .-.- 1,.:..- FIGURES 1. Corner Reflector with Open-Sleeve Dipole Feed ............ ...... 7 2...Open-Sleeve Dipole Feed for Corner Reflector, 240-400 MHz........ 8 3. Closeup Photo of Open-Sleeve Dpole ..................... ...... 8 4. VSWR of...4-ft Corner Reflector, Open-Sleeve Dipole Feed .......... 9 5. Gain of Corner Reflector............ .............. . ....... 9 6. Measured E- and H
System and method for manufacture of airfoil components
Moors, Thomas Michael
2016-11-29
Embodiments of the present disclosure relate generally to systems and methods for manufacturing an airfoil component. The system can include: a geometrical mold; an elongated flexible sleeve having a closed-off interior and positioned within the geometrical mold, wherein the elongated flexible sleeve is further positioned to have a desired geometry; an infusing channel in fluid communication with the closed-off interior of the elongated flexible sleeve and configured to communicate a resinous material thereto; a vacuum channel in fluid communication with the closed-off interior of the elongated flexible sleeve and configured to vacuum seal the closed-off interior of the elongated flexible sleeve; and a glass fiber layer positioned within the closed-off interior of the elongated flexible sleeve.
Remotely Adjustable Hydraulic Pump
NASA Technical Reports Server (NTRS)
Kouns, H. H.; Gardner, L. D.
1987-01-01
Outlet pressure adjusted to match varying loads. Electrohydraulic servo has positioned sleeve in leftmost position, adjusting outlet pressure to maximum value. Sleeve in equilibrium position, with control land covering control port. For lowest pressure setting, sleeve shifted toward right by increased pressure on sleeve shoulder from servovalve. Pump used in aircraft and robots, where hydraulic actuators repeatedly turned on and off, changing pump load frequently and over wide range.
Coring device with a improved core sleeve and anti-gripping collar with a collective core catcher
DOE Office of Scientific and Technical Information (OSTI.GOV)
Story, A.L.; Filshtinsky, M.
1986-01-28
This patent describes an improved coring apparatus used in combination with a coring bit and drill string. This device consists of: an outer driving structure adapted to be connected at one end to the coring bit for cutting a core in a borehole, and at the other end to the lower end of the drill string in telescoping and co-rotatable manner therewith; an inner barrel disposed within the outer driving structure and including a lower end portion adjacent to the bit; first means supporting the inner barrel in spaced relationship to the outer driving structure while permitting rotation of themore » driving structure with respect to the inner barrel; a woven metal mesh sleeve mounted in surrounding relation on at least a portion of the exterior surface of the inner barrel; second means, connected to a free end of the sleeve opposite the leading portion of the sleeve, for maintaining the portion of the sleeve which surrounds the inner barrel in compression and to maintain an inside diameter greater than the outside diameter of the inner barrel of the portion of the sleeve surrounding the inner barrel while the portion of the sleeve positioned inside the inner barrel being in tension to grip and compress a core received within the sleeve and having an outside diameter less than the inside diameter of the inner barrel when in tension, wherein the second means is also for engaging the core when the means is drawn into the inner barrel, and third means positioned within the inner barrel and connected to the leading portion of the sleeve to draw the sleeve within the inner barrel and to apply tension to the portion of the sleeve within the barrel to encase and grip the core as it is cut.« less
Bronchovascular versus bronchial sleeve resection for central lung tumors.
Lausberg, Henning F; Graeter, Thomas P; Tscholl, Dietmar; Wendler, Olaf; Schäfers, Hans-Joachim
2005-04-01
Pneumonectomy has traditionally been the treatment of choice for central lung tumors. Bronchial sleeve resections are increasingly considered as a reasonable alternative. For tumor involvement of both central airways and pulmonary artery, bronchovascular sleeve resections are possible, but considered to be technically demanding and associated with a higher perioperative risk. In addition, their role as adequate oncologic treatment for lung cancer is unclear. We have compared the early and long-term results of bronchovascular sleeve resection with those of bronchial sleeve resection and pneumonectomy. We retrospectively analyzed all patients who underwent bronchial sleeve resection (group I, n = 104), bronchovascular sleeve resection (group II, n = 67), and pneumonectomy (group III, n = 63) for central lung cancer in our institution. The groups were comparable regarding demographics and tumor, node, and metastasis (TNM) stage. Early mortality was 1.9% in group I, 1.5% in group II, and 6.3% in group III (p = 0.19). The rate of bronchial complications was 0.96% in group I, 0% in group II, and 7.9% in group III (p = 0.006). Five-year survival was 46.1% in group I, 42.9% in group II, and 30.4% in group III (p = 0.16). Freedom from local recurrence of disease (5 years) was 83.8% in group I, 84.2% in group II, and 88.7% in group III (p = 0.56). Bronchovascular sleeve resections are as safe as bronchial sleeve resections for the treatment of central lung cancer. Both procedures have comparable early and long-term results, which are similar to those of pneumonectomy. It appears reasonable to apply bronchovascular sleeve resections more liberally.
Installation and assembly device and method of using
Kolsun, George J.
1997-01-01
An installation and assembly device for aligning a first member such as a pump impeller with a second member such as an inlet nozzle of an impeller pump. The installation and assembly device includes a sleeve slideable within the inlet nozzle and a vertical positioning assembly which has a contact member that is extendable out away from the sleeve so as to vertically position the sleeve on a shoulder of the inlet nozzle and to present an upper contact surface spaced a certain distance from the shoulder to provide the desired vertical spacing with respect to the impeller contacting the upper contact surface. The vertical positioning assembly is retractable so as to allow for removal of the sleeve through the nozzle when installation and assembly are completed. The alignment device also includes a radial alignment assembly supported by the sleeve and adjustable to an expanded state for contacting and spacing the interior surface of the impeller a certain distance from the sleeve and hence a certain distance from the inlet nozzle. The radial alignment device being adjustable from a retracted removal state to an expanded state and also being adjustable to fine tune the spacing of the impeller from the sleeve. The radial alignment device also preferably includes members that can be used to releasably secure the sleeve to the impeller.
Combination drilling and skiving tool
Stone, William J.
1989-01-01
A combination drilling and skiving tool including a longitudinally extending hollow skiving sleeve slidably and concentrically mounted on a right-handed twist drill. Dogs or pawls provided on the internal periphery of the skiving sleeve engage with the helical grooves of the drill. During a clockwise rotation of the tool, the drill moves downwardly and the sleeve translates upwardly, so that the drill performs a drilling operation on a workpiece. On the other hand, the drill moves upwardly and the sleeve translates downwardly, when the tool is rotated in a counter-clockwise direction, and the sleeve performs a skiving operation. The drilling and skiving operations are separate, independent and exclusive of each other.
NASA Technical Reports Server (NTRS)
Giandomenico, A.; Dame, J. M.; Behimer, H. (Inventor)
1978-01-01
A wrench is described that is usable where limited access normally requires an open-end wrench, but which has substantially the high-torque capacity and small radial clearance characteristics of a closed-end wrench. The wrench includes a sleeve forming a nut-engageable socket with a gap in its side, and an adaptor forming a socket with a gap in its side, the adaptor closely surrounding the sleeve and extending across the gap in the sleeve. The sleeve and adaptor have surfaces that become fully engaged when a wrench handle is applied to the adaptor to turn it so as to tighten a nut engaged by the sleeve.
Insert sleeve prevents tube soldering contamination
NASA Technical Reports Server (NTRS)
Stein, J.
1966-01-01
Teflon sleeve insert prevents contamination of internal tube surfaces by solder compound during soldering operations that connect and seal the tube ends. The sleeve insert is pressed into the mating tube ends with a slight interference fit.
External combustor for gas turbine engine
Santanam, Chandran B.; Thomas, William H.; DeJulio, Emil R.
1991-01-01
An external combustor for a gas turbine engine has a cyclonic combustion chamber into which combustible gas with entrained solids is introduced through an inlet port in a primary spiral swirl. A metal draft sleeve for conducting a hot gas discharge stream from the cyclonic combustion chamber is mounted on a circular end wall of the latter adjacent the combustible gas inlet. The draft sleeve is mounted concentrically in a cylindrical passage and cooperates with the passage in defining an annulus around the draft sleeve which is open to the cyclonic combustion chamber and which is connected to a source of secondary air. Secondary air issues from the annulus into the cyclonic combustion chamber at a velocity of three to five times the velocity of the combustible gas at the inlet port. The secondary air defines a hollow cylindrical extension of the draft sleeve and persists in the cyclonic combustion chamber a distance of about three to five times the diameter of the draft sleeve. The hollow cylindrical extension shields the drive sleeve from the inlet port to prevent discharge of combustible gas through the draft sleeve.
ELECTROMAGNETIC APPARATUS FOR MOVING A ROD
Young, J.N.
1957-08-20
An electromagnetic device for moving an object in a linear path by increments is described. The device is specifically adapted for moving a neutron absorbing control rod into and out of the core of a reactor and consists essentially of an extension member made of magnetic material connected to one end of the control rod and mechanically flexible to grip the walls of a sleeve member when flexed, a magnetic sleeve member coaxial with and slidable between limit stops along the flexible extension, electromagnetic coils substantially centrally located with respect to the flexible extension to flex the extension member into gripping engagement with the sleeve member when ener gized, moving electromagnets at each end of the sleeve to attract the sleeve when energized, and a second gripping electromagnet positioned along the flexible extension at a distance from the previously mentioned electromagnets for gripping the extension member when energized. In use, the second gripping electromagnet is deenergized, the first gripping electromagnet is energized to fix the extension member in the sleeve, and one of the moving electromagnets is energized to attract the sleeve member toward it, thereby moving the control rod.
Modeling and testing of a knitted-sleeve fluidic artificial muscle
NASA Astrophysics Data System (ADS)
Ball, Erick J.; Meller, Michael A.; Chipka, Jordan B.; Garcia, Ephrahim
2016-11-01
The knitted-sleeve fluidic muscle is similar in design to a traditional McKibben muscle, with a separate bladder and sleeve. However, in place of a braided sleeve, it uses a tubular-knit sleeve made from a thin strand of flexible but inextensible yarn. When the bladder is pressurized, the sleeve expands by letting the loops of fiber slide past each other, changing the dimensions of the rectangular cells in the stitch pattern. Ideally, the internal volume of the sleeve would reach a maximum when its length has contracted by 2/3 from its maximum length, and although this is not reachable in practice, preliminary tests show that free contraction greater than 50% is achievable. The motion relies on using a fiber with a low coefficient of friction in order to reduce hysteresis to an acceptable level. In addition to increased stroke length, potential advantages of this technique include slower force drop-off during the stroke, more useable energy in certain applications, and greater similarity to the force-length relationship of skeletal muscle. Its main limitation is its potentially greater effect from friction compared to other fluidic muscle designs.
Godsil, E.C.; Robinson, E.Y.
1963-07-16
A variable-throw cam comprising inner and outer eccentric sleeves which are adjustably locked together is described. The cam throw is varied by unlocking the inner and outer sleeves, rotating the outer sleeve relative to the inner one until the desired throw is obtained, and locking the sleeves together again. The cam is useful in applications wherein a continuously-variable throw is required, e.g., ram-and-die pressing operations, cyclic fatigue testing of materials, etc. (AEC)
Safety System for Controlling Fluid Flow into a Suction Line
NASA Technical Reports Server (NTRS)
England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)
2018-01-01
A safety system includes a sleeve fitted within a pool's suction line at its inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith. A first sensor is coupled to the sleeve to sense pressure therein, and a second pressure sensor is coupled to the plate to sense pressure in one of the plates' holes.
Regeneratively cooled transition duct with transversely buffered impingement nozzles
DOE Office of Scientific and Technical Information (OSTI.GOV)
Morrison, Jay A; Lee, Ching-Pang; Crawford, Michael E
2015-04-21
A cooling arrangement (56) having: a duct (30) configured to receive hot gases (16) from a combustor; and a flow sleeve (50) surrounding the duct and defining a cooling plenum (52) there between, wherein the flow sleeve is configured to form impingement cooling jets (70) emanating from dimples (82) in the flow sleeve effective to predominately cool the duct in an impingement cooling zone (60), and wherein the flow sleeve defines a convection cooling zone (64) effective to cool the duct solely via a cross-flow (76), the cross-flow comprising cooling fluid (72) exhausting from the impingement cooling zone. In themore » impingement cooling zone an undimpled portion (84) of the flow sleeve tapers away from the duct as the undimpled portion nears the convection cooling zone. The flow sleeve is configured to effect a greater velocity of the cross-flow in the convection cooling zone than in the impingement cooling zone.« less
NASA Technical Reports Server (NTRS)
Burgess, Kevin (Inventor); Yakos, David (Inventor); Walthall, Bryan (Inventor)
2011-01-01
A stemless ball valve comprising two flanges and a ball with a channel, two axis pins and two travel pins. One end of each axis and travel pin is fixedly attached to the ball, and the other end of each axis pin is lodged into a notch in the first or second flange such that the axis pin is allowed to rotate in the notch. The guide sleeve comprises two channels, and one end of each travel pin is situated within one of the two channels in the guide sleeve. An outer magnetic cartridge causes the inner magnetic cartridge and guide sleeve to rotate, and when the guide sleeve rotates, the travel pins move up and down within the channels in the guide sleeve. The movement of the travel pins within the channels in the guide sleeve causes the ball to rotate, thereby opening and closing the ball valve.
Safety System for Controlling Fluid Flow into a Suction Line
NASA Technical Reports Server (NTRS)
England, John Dwight (Inventor); Kelley, Anthony R. (Inventor); Cronise, Raymond J. (Inventor)
2015-01-01
A safety system includes a sleeve fitted within a pool's suction line at the inlet thereof. An open end of the sleeve is approximately aligned with the suction line's inlet. The sleeve terminates with a plate that resides within the suction line. The plate has holes formed therethrough. A housing defining a plurality of distinct channels is fitted in the sleeve so that the distinct channels lie within the sleeve. Each of the distinct channels has a first opening on one end thereof and a second opening on another end thereof. The second openings reside in the sleeve. Each of the distinct channels is at least approximately three feet in length. The first openings are in fluid communication with the water in the pool, and are distributed around a periphery of an area of the housing that prevents coverage of all the first openings when a human interacts therewith.
Wearing long sleeves while prepping a patient in the operating room decreases airborne contaminants.
Markel, Troy A; Gormley, Thomas; Greeley, Damon; Ostojic, John; Wagner, Jennifer
2018-04-01
The use of long sleeves by nonscrubbed personnel in the operating room has been called into question. We hypothesized that wearing long sleeves and gloves, compared with having bare arms without gloves, while applying the skin preparation solution would decrease particulate and microbial contamination. A mock patient skin prep was performed in 3 different operating rooms. A long-sleeved gown and gloves, or bare arms, were used to perform the procedure. Particle counters were used to assess airborne particulate contamination, and active and passive microbial assessment was achieved through air samplers and settle plate analysis. Data were compared with Student's t-test or Mann-Whitney U, and P < .05 was considered to be significant. Operating room B demonstrated decreased 5.0- µm particle sizes with the use of sleeves, while operating rooms A and C showed decreased total microbes only with the use of sleeves. Despite there being no difference in the average number of total microbes for all operating rooms assessed, the use of sleeves specifically appeared to decrease the shed of Micrococcus. The use of long sleeves and gloves while applying the skin preparation solution decreased particulate and microbial shedding in several of the operating rooms tested. Although long sleeves may not be necessary for all operating room personnel, they may decrease airborne contamination while the skin prep is applied, which may lead to decreased surgical site infections. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Apparatus for a compact adjustable passive compliant mechanism
Salisbury, Curt Michael
2015-03-17
Various technologies described herein pertain to an adjustable compliance apparatus. The adjustable compliance apparatus includes a shaft, a sleeve element, and a torsion spring. The sleeve element includes a bore there through, where the shaft is positioned through the bore of the sleeve element. Further, the torsion spring includes a plurality of coils, where the shaft is positioned through the plurality of coils. Moreover, the sleeve element is slidable in an axial direction along the shaft between the torsion spring and the shaft. Accordingly, compliance of the adjustable compliance apparatus is adjustable based on a number of the plurality of coils in contact with the sleeve element as positioned along the shaft within the torsion spring.
[Effect of Radii barrier sleeves on cure depth of composite resin].
Wang, Binping; DU, Yongxiu
2009-01-01
To explore the effect of Radii barrier sleeves on the cure depth of composite resin. Cylinder mold was prepared, and the resin was filled strictly into the mold. The surface was flattened and then cured with plastic engraver's knife.The depth of composite resin which was cured by QHL75TM with or without Radii barrier sleeves was compared. The cure depth of composite resin which were cured by QHL75TM with or without Radii barrier sleeves of photo-curing machine was 4.38 mm and 4.27 mm respectively,with no statistical difference. The cure depth of composite resin is not influenced by Radii barrier sleeves under the same light condition.
Ro, Kyung-Han; Park, Jong-Hoon; Kim, Myo-Jong; Lee, Dae-Hee
2014-03-01
Sleeve fractures are generally restricted to children or adolescents, and usually occur at the lower patella pole. Here we report on a superior pole sleeve fracture in an adult that occurred following forceful passive physiotherapy after cast immobilization. To our knowledge, this is the first report of a superior pole sleeve fracture in an otherwise healthy adult. The case highlighted that a diagnosis of a superior patella pole sleeve fracture in an adult can easily be missed because it is a rare injury, and hence is unlikely to be suspected by physicians. Copyright © 2013 Elsevier B.V. All rights reserved.
Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system.
Zhao, Yandong; Jiao, Wenjie; Ren, Xiaoyang; Zhang, Liangdong; Qiu, Tong; Fu, Bo; Wang, Lei
2016-04-12
Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.
Jendrzejczyk, Joseph A.
1982-01-01
An electrical fluid force transducer for measuring the magnitude and direction of fluid forces caused by lateral fluid flow, includes a movable sleeve which is deflectable in response to the movement of fluid, and a rod fixed to the sleeve to translate forces applied to the sleeve to strain gauges attached to the rod, the strain gauges being connected in a bridge circuit arrangement enabling generation of a signal output indicative of the magnitude and direction of the force applied to the sleeve.
NASA Astrophysics Data System (ADS)
Liu, Yong Jun; Li, Chao; Zhou, When Jun
2018-06-01
This paper presents some numerical simulation results of tensile properties of reinforcing bars spliced by grout-filled coupling sleeves under fire conditions to identify the effect of load ratio on fire resistance time of spliced reinforcing bars, which provide a useful base for predicting structural behaviors of pre-cast reinforced concrete buildings in fires. A spliced rebar system investigated in this paper consists of two equal-diameter steel reinforcing bars with 25mm diameter and a straight coupling sleeve with 50mm outer and 45mm inner diameters. As a result, the thickness of grout between steel bars and sleeves are 20mm. Firstly, the temperature distributions in steel bars connected by grout- filled coupling sleeves exposed to ISO 834 standard fire were calculated utilizing finite element analysis software ANSYS. Secondly, the stress changes in heated steel bars connected by grout-filled coupling sleeves under different constant tensile loads were calculated step by step until the rebar system failed due to fire. Thus, the fire resistant time of rebar spliced by grout-filled coupling sleeves under different axial tensile loads can be determined, further, the relationship between fire resistance time and axial tensile loads ratio can could be obtained. Finally, the fire resistant times versus axial tensile load ratios curve of grout-filled splice sleeve rebars exposed to ISO 834 standard fire is presented.
Madhok, B M; Carr, W R J; McCormack, C; Boyle, M; Jennings, N; Schroeder, N; Balupuri, S; Small, P K
2016-08-01
Laparoscopic sleeve gastrectomy is a safe and effective bariatric operation, but postoperative reflux symptoms can sometimes necessitate revisional surgery. Roux-en-Y gastric bypass is the preferred operation in morbidly obese patients with gastro-oesophageal reflux disease. In 2011, we introduced preoperative endoscopy to assess for hiatus hernia or evidence of oesophagitis in conjunction with an assessment of gastro-oesophageal reflux symptoms for all patients undergoing bariatric surgery with a view to avoid sleeve gastrectomy for these patients. A prospectively maintained database was used to identify patients who underwent sleeve gastrectomy before and after we changed the unit policy. The need for revisional surgery in patients with troublesome gastro-oesophageal reflux disease was examined. Prior to 2011, 130 patients underwent sleeve gastrectomy, and 11 (8.5%) of them required conversion to Roux-en-Y gastric bypass for symptomatic reflux disease. Following the policy change, 284 patients underwent sleeve gastrectomy, and to date, only five (1.8%) have required revisional surgery (p = 0.001). Baseline demographics were comparable between the groups, and average follow-up period was 47 and 33 months, respectively, for each group. Preoperative endoscopy and a detailed clinical history regarding gastro-oesophageal reflux symptoms may improve patient selection for sleeve gastrectomy. Avoiding sleeve gastrectomy in patients with reflux disease and/or hiatus hernia may reduce the incidence of revisional surgery. © 2016 World Obesity.
Peterli, Ralph; Wölnerhanssen, Bettina Karin; Peters, Thomas; Vetter, Diana; Kröll, Dino; Borbély, Yves; Schultes, Bernd; Beglinger, Christoph; Drewe, Jürgen; Schiesser, Marc; Nett, Philipp; Bueter, Marco
2018-01-16
Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs the standard Roux-en-Y gastric bypass procedure is unknown. To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss, changes in comorbidities, increase in quality of life, and adverse events. The Swiss Multicenter Bypass or Sleeve Study (SM-BOSS), a 2-group randomized trial, was conducted from January 2007 until November 2011 (last follow-up in March 2017). Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 Swiss bariatric centers, 217 patients were enrolled and randomly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass with a 5-year follow-up period. Patients were randomly assigned to undergo laparoscopic sleeve gastrectomy (n = 107) or laparoscopic Roux-en-Y gastric bypass (n = 110). The primary end point was weight loss, expressed as percentage excess body mass index (BMI) loss. Exploratory end points were changes in comorbidities and adverse events. Among the 217 patients (mean age, 45.5 years; 72% women; mean BMI, 43.9) 205 (94.5%) completed the trial. Excess BMI loss was not significantly different at 5 years: for sleeve gastrectomy, 61.1%, vs Roux-en-Y gastric bypass, 68.3% (absolute difference, -7.18%; 95% CI, -14.30% to -0.06%; P = .22 after adjustment for multiple comparisons). Gastric reflux remission was observed more frequently after Roux-en-Y gastric bypass (60.4%) than after sleeve gastrectomy (25.0%). Gastric reflux worsened (more symptoms or increase in therapy) more often after sleeve gastrectomy (31.8%) than after Roux-en-Y gastric bypass (6.3%). The number of patients with reoperations or interventions was 16/101 (15.8%) after sleeve gastrectomy and 23/104 (22.1%) after Roux-en-Y gastric bypass. Among patients with morbid obesity, there was no significant difference in excess BMI loss between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass at 5 years of follow-up after surgery. clinicaltrials.gov Identifier: NCT00356213.
Improved design and durability of aluminum die casting horizontal shot sleeves
NASA Astrophysics Data System (ADS)
Birceanu, Sebastian
The design and performance of shot sleeves is critical in meeting the engineering requirements of aluminum die cast parts. Improvement in shot sleeve materials have a major impact on dimensional stability, reproducibility and quality of the product. This investigation was undertaken in order to improve the life of aluminum die casting horizontal shot sleeves. Preliminary pin tests were run to evaluate the soldering, wash-out and thermal fatigue behavior of commercially available materials and coatings. An experimental rig was designed and constructed for shot sleeve configuration evaluation. Fabrication and testing of experimental shot sleeves was based upon preliminary results and manufacturing costs. Three shot sleeve designs and materials were compared to a reference nitrided H13 sleeve. Nitrided H13 is the preferred material for aluminum die casting shot sleeves because of wear resistance, strength and relative good soldering and wash-out resistance. The study was directed towards damage evaluation on the area under the pouring hole. This area is the most susceptible to damage because of high temperatures and impingement of molten aluminum. The results of this study showed that tungsten and molybdenum had the least amount of soldering and wash-out damage, and the best thermal fatigue resistance. Low solubility in molten aluminum and stability of intermetallic layers are main factors that determine the soldering and wash-out behavior. Thermal conductivity and thermal expansion coefficient directly influence thermal fatigue behavior. TiAlN nanolayered coating was chosen as the material with the best damage resistance among several commercial PVD coatings, because of relatively large thickness and simple deposition conditions. The results show that molybdenum thermal sprayed coating provided the best protection against damage under the pouring hole. Improved bonding is however required for life extension of the coating. TiAlN PVD coating applied on H13 nitrided substrate performed very well as long as the coating was maintained. Nitrided H13 sleeve showed extensive damage that occurred as early as 200 cycles. The nitrided layer only slowed down the diffusion process and dissolution took place at a higher rate as soon as the layer wore off. Stellite 6 sleeve also showed considerable wear under the action of molten aluminum.
Biomechanical and functional efficacy of knee sleeves: A literature review.
Mohd Sharif, Nahdatul Aishah; Goh, Siew-Li; Usman, Juliana; Wan Safwani, Wan Kamarul Zaman
2017-11-01
Knee sleeves are widely used for the symptomatic relief and subjective improvements of knee problems. To date, however, their biomechanical effects have not been well understood. To determine whether knee sleeves can significantly improve the biomechanical variables for knee problems. Systematic literature search was conducted on four online databases - PubMed, Web of Science, ScienceDirect and Springer Link - to find peer-reviewed and relevant scientific papers on knee sleeves published from January 2005 to January 2015. Study quality was assessed using the Structured Effectiveness Quality Evaluation Scale (SEQES). Twenty studies on knee sleeves usage identified from the search were included in the review because of their heterogeneous scope of coverage. Twelve studies found significant improvement in gait parameters (3) and functional parameters (9), while eight studies did not find any significant effects of knee sleeves usage. Most improvements were observed in: proprioception for healthy knees, gait and balance for osteoarthritic knees, and functional improvement of injured knees. This review suggests that knee sleeves can effect functional improvements to knee problems. However, further work is needed to confirm this hypothesis, due to the lack of homogeneity and rigor of existing studies. Copyright © 2017 Elsevier Ltd. All rights reserved.
Compressible sleeve provides automatic centering for grinding or turning of cylinders
NASA Technical Reports Server (NTRS)
Rohrer, J. A.
1968-01-01
Elastomeric sleeve supported on a threaded mandrel automatically centers cylindrical castings for grinding or turning. By expanding the diameter of the sleeve with pressure against the ends, the casting becomes rigidly supported and the surfacing operation can be completed.
Power control for heat engines
Dineen, John J.
1984-01-01
A power control arrangement for a Stirling engine includes a sleeve mounted in each cylinder for axial movement and a port in the sleeve leading to a dead space. The port is covered by the piston at a position that is determined by the piston position and the axial adjustment of the sleeve. The compression phase of the Stirling cycle for that piston begins when the port is covered, so the position of the sleeve is used to set the Stirling engine power level.
Nguyen, Ninh T; Smith, Brian R; Reavis, Kevin M; Nguyen, Xuan-Mai T; Nguyen, Brian; Stamos, Michael J
2012-05-01
Strategic laparoscopic surgery for improved cosmesis (SLIC) is a less invasive surgical approach than conventional laparoscopic surgery. The aim of this study was to examine the feasibility and safety of SLIC for general and bariatric surgical operations. Additionally, we compared the outcomes of laparoscopic sleeve gastrectomy with those performed by the SLIC technique. In an academic medical center, from April 2008 to December 2010, 127 patients underwent SLIC procedures: 38 SLIC cholecystectomy, 56 SLIC gastric banding, 26 SLIC sleeve gastrectomy, 1 SLIC gastrojejunostomy, and 6 SLIC appendectomy. SLIC sleeve gastrectomy was initially performed through a single 4.0-cm supraumbilical incision with extraction of the gastric specimen through the same incision. The technique evolved to laparoscopic incisions that were all placed within the umbilicus and suprapubic region. There were no 30-day or in-hospital mortalities or 30-day re-admissions or re-operations. For SLIC cholecystectomy, gastric banding, appendectomy, and gastrojejunostomy, conversion to conventional laparoscopy occurred in 5.3%, 5.4%, 0%, and 0%, respectively; there were no major or minor postoperative complications. For SLIC sleeve gastrectomy, there were no significant differences in mean operative time and length of hospital stay compared with laparoscopic sleeve gastrectomy; 1 (3.8%) of 26 SLIC patients required conversion to five-port laparoscopy. There were no major complications. Minor complications occurred in 7.7% in the SLIC sleeve group versus 8.3% in the laparoscopic sleeve group. SLIC in general and bariatric operations is technically feasible, safe, and associated with a low rate of conversion to conventional laparoscopy. Compared with laparoscopic sleeve gastrectomy, SLIC sleeve gastrectomy can be performed without a prolonged operative time with comparable perioperative outcomes.
Sleeve gastrectomy and anti-reflux procedures.
Crawford, Christopher; Gibbens, Kyle; Lomelin, Daniel; Krause, Crystal; Simorov, Anton; Oleynikov, Dmitry
2017-03-01
Obesity is an epidemic in the USA that continues to grow, becoming a leading cause of premature avoidable death. Bariatric surgery has become an effective solution for obesity and its comorbidities, and one of the most commonly utilized procedures, the sleeve gastrectomy, can lead to an increase in gastroesophageal reflux following the operation. While these data are controversial, sometimes operative intervention can be necessary to provide durable relief for this problem. We performed an extensive literature review examining the different methods of anti-reflux procedures that are available both before and after a sleeve gastrectomy. We reviewed several different types of anti-reflux procedures, including those that supplement the lower esophageal sphincter anatomy, such as magnetic sphincter augmentation and radiofrequency ablation procedures. Re-operation was also discussed as a possible treatment of reflux in sleeve gastrectomy, especially if the original sleeve becomes dilated or if a conversion to a Roux-en-Y gastric bypass or biliopancreatic diversion is deemed necessary. Sleeve gastrectomy with concomitant anti-reflux procedure was also reviewed, including the anti-reflux gastroplasty, hiatal hernia repair, and limited fundoplication. A number of techniques can be used to mitigate the severity of reflux, either by maintaining the normal anatomic structures that limit reflux or by supplementing these structures with a plication or gastroplasty. Individuals with existing severe reflux should not be considered for a sleeve gastrectomy. New techniques that incorporate plication at the time of the index sleeve gastrectomy show some improvement, but these are in small series that will need to be further evaluated. The only proven method of treating intractable reflux after sleeve gastrectomy is conversion to a Roux-en-Y gastric bypass.
High temperature control rod assembly
Vollman, Russell E.
1991-01-01
A high temperature nuclear control rod assembly comprises a plurality of substantially cylindrical segments flexibly joined together in succession by ball joints. The segments are made of a high temperature graphite or carbon-carbon composite. The segment includes a hollow cylindrical sleeve which has an opening for receiving neutron-absorbing material in the form of pellets or compacted rings. The sleeve has a threaded sleeve bore and outer threaded surface. A cylindrical support post has a threaded shaft at one end which is threadably engaged with the sleeve bore to rigidly couple the support post to the sleeve. The other end of the post is formed with a ball portion. A hollow cylindrical collar has an inner threaded surface engageable with the outer threaded surface of the sleeve to rigidly couple the collar to the sleeve. the collar also has a socket portion which cooperates with the ball portion to flexibly connect segments together to form a ball and socket-type joint. In another embodiment, the segment comprises a support member which has a threaded shaft portion and a ball surface portion. The threaded shaft portion is engageable with an inner threaded surface of a ring for rigidly coupling the support member to the ring. The ring in turn has an outer surface at one end which is threadably engageably with a hollow cylindrical sleeve. The other end of the sleeve is formed with a socket portion for engagement with a ball portion of the support member. In yet another embodiment, a secondary rod is slidably inserted in a hollow channel through the center of the segment to provide additional strength. A method for controlling a nuclear reactor utilizing the control rod assembly is also included.
Device for use in loading tension members. [characterized by elongated elastic body
NASA Technical Reports Server (NTRS)
Appleberry, W. T. (Inventor)
1975-01-01
The indicator is characterized by an elongated elastic body having extended from the opposite ends of threaded shanks adapted to selected tension members. A pair of external shoulders, one of which is axially displaceable relative to the other, and a rigid tubular sleeve interposed between said shoulders are included. Tension is applied to the elastic body for imparting strain. The movable shoulder can be advanced into abutting engagement with the sleeve, whereby the sleeve is placed in compression once the tensile forces are removed from the shanks. A reapplication of tensile forces equal to the initially applied tensile forces removes the sleeve from compression, whereby the sleeve is freed for rotation for thus indicating the magnitude of the applied tensile forces.
Shrinkable sleeve eliminates shielding gap in RF cable
NASA Technical Reports Server (NTRS)
1965-01-01
RF shielding gap between an RF cable and a multipin connector is eliminated by a sleeve assembly installed between the connector and the terminated portion of the shielding. The assembly is enclosed in a heat-shrinkable plastic sleeve which completes the continuous RF shield.
NASA Technical Reports Server (NTRS)
Bluck, Raymond M. (Inventor); Bush, Harold G. (Inventor); Johnson, Robert R. (Inventor)
1991-01-01
A process for producing seamless metal-clad composite structures includes providing a hollow, metallic inner member and an outer sleeve to surround the inner member and define an inner space therebetween. A plurality of continuous reinforcing fibers is attached to the distal end of the outside diameter of the inner member, and the inner member is then introduced, distal end first, into one end of the outer sleeve. The inner member is then moved, distal end first, into the outer sleeve until the inner member is completely enveloped by the outer sleeve. A liquid matrix material is then injected into the space containing the reinforcing fibers between the inner member and the outer sleeve. Next a pressurized heat transfer medium is passed through the inner member to cure the liquid matrix material. Finally, the wall thickness of both the inner member and the outer sleeve are reduced to desired dimensions by chemical etching, which adjusts the thermal expansion coefficient of the metal-clad composite structure to a desired value.
Quartararo, N; Barry, P H
1987-12-01
A technical problem associated with the patch clamp technique has been the changing of solutions bathing the membrane patch. The simple technique described here solves this problem by means of a movable polythene sleeve placed on the shaft of the patch clamp pipette. The sleeve is initially placed so that the tip of the pipette is exposed. A gigaohm seal is formed using standard techniques. The patch is then excised and the sleeve is slipped down a few mm past the end of the tip of the pipette. When the pipette and sleeve is now removed from the solution, a small drop of solution covering the membrane patch is held in place at the end of the sleeve by surface tension. The pipette is then easily transferred to a different solution without passing the membrane patch through the air-water interface. The sleeve is then simply pulled back up the pipette shaft to expose the membrane patch to the new solution.
McKay, M.D.; Sweeney, C.E.; Spangler, B.S. Jr.
1993-11-30
A flow meter and temperature measuring device are described comprising a tube with a body centered therein for restricting flow and a sleeve at the upper end of the tube to carry several channels formed longitudinally in the sleeve to the appropriate axial location where they penetrate the tube to allow pressure measurements and temperature measurements with thermocouples. The high pressure measurement is made using a channel penetrating the tube away from the body and the low pressure measurement is made at a location at the widest part of the body. An end plug seals the end of the device and holes at its upper end allow fluid to pass from the interior of the tube into a plenum. The channels are made by cutting grooves in the sleeve, the grooves widened at the surface of the sleeve and then a strip of sleeve material is welded to the grooves closing the channels. Preferably the sleeve is packed with powdered graphite before cutting the grooves and welding the strips. 7 figures.
High precision high flow range control valve
McCray, J.A.
1999-07-13
A fluid control valve is described having a valve housing having first and second valve housing openings for the ingress and egress of fluid through the control valve. Disposed within a void formed by the control valve is a sleeve having at least one sleeve opening to permit the flow of fluid therethrough. A flow restricter travels within the sleeve to progressively block off the sleeve opening and thereby control flow. A fluid passageway is formed between the first valve housing opening and the outer surface of the sleeve. A second fluid passageway is formed between the inside of the sleeve and the second valve housing opening. Neither fluid passageway contains more than one 90 [degree] turn. In the preferred embodiment only one of the two fluid passageways contains a 90[degree] turn. In another embodiment, the control valve housing is bifurcated by a control surface having control surface opening disposed therethrough. A flow restricter is in slidable contact with the control surface to restrict flow of fluid through the control surface openings. 12 figs.
High precision high flow range control valve
McCray, John A.
1999-01-01
A fluid control valve is described having a valve housing having first and second valve housing openings for the ingress and egress of fluid through the control valve. Disposed within a void formed by the control valve is a sleeve having at least one sleeve opening to permit the flow of fluid therethrough. A flow restricter travels within the sleeve to progressively block off the sleeve opening and thereby control flow. A fluid passageway is formed between the first valve housing opening and the outer surface of the sleeve. A second fluid passageway is formed between the inside of the sleeve and the second valve housing opening. Neither fluid passageway contains more than one 90.degree. turn. In the preferred embodiment only one of the two fluid passageways contains a 90.degree. turn. In another embodiment, the control valve housing is bifurcated by a control surface having control surface opening disposed therethrough. A flow restricter is in slidable contact with the control surface to restrict flow of fluid through the control surface openings.
Model of radiation transmittance by inorganic fouling on UV reactor lamp sleeves.
Wait, Isaac W; Blatchley, Ernest R
2010-11-01
The efficacy of UV disinfection of water depends on the ability of radiation to pass from UV lamps through the quartz sleeves that encase them; the accumulation of metal-containing foulants on sleeve surfaces inhibits disinfection by absorbing radiation that would otherwise be available for inactivation. In a series of experiments, the composition and quantity of sleeve foulants were studied relative to water chemistry and sleeve transmittance. Findings indicate that iron and calcium dominate fouling, with elevated fouling activity by iron, aluminum, manganese, and zinc. A regression-based modeling approach was used to characterize and quantify the effects of foulant metals on UV absorbance. The molar extinction coefficient for iron was found to be more than 3 times greater than that of calcium. Iron's relatively high activity in fouling reactions, elevated capacity to absorb UV, and reduced solubility under oxidizing conditions makes it a fouling precursor of particular concern, with respect to potential for sleeve fouling in UV reactors.
Mechanical counter pressure on the arm counteracts adverse effects of hypobaric exposures
NASA Technical Reports Server (NTRS)
Tanaka, Kunihiko; Limberg, Ryan; Webb, Paul; Reddig, Mike; Jarvis, Christine W.; Hargens, Alan R.
2003-01-01
INTRODUCTION: Current space suits have limited movement due to gas pressurization during exposure to the vacuum of space. Alternatively, if pressure is applied by an elastic garment vs. pneumatic garment to produce mechanical counter pressure (MCP), several advantages are possible. In this study, we investigate local microcirculatory and other effects produced with and without a prototype MCP glove and sleeve during exposure to varying levels of vacuum. METHODS: The entire arms of eight male volunteers were studied at normal ambient pressure and during 5 min exposures to -50, -100, and -150 mm Hg with and without the MCP glove and sleeve. Pressure distribution, skin microvascular flow, and temperature were measured. RESULTS: The MCP glove and sleeve generated over 200 mm Hg on the middle finger, dorsum of the hand, and the wrist. However, pressure was significantly lower on the forearm and the upper arm. Without the glove and sleeve, only two of eight subjects tolerated -100 mm Hg. Also, no subject tolerated -150 mm Hg. However, subjects tolerated all vacuum pressures wearing the glove and sleeve. Skin microvascular flow and temperature remained within control values with the glove and sleeve at a chamber pressure of -150 mm Hg. DISCUSSION: The MCP glove and sleeve counteracts adverse effects of vacuum exposures due to lower pressure differentials. Pressure levels over the hand and wrist are similar to those of the current U.S. space suit glove and sleeve, but additional development is required to increase MCP over the forearm and upper arm.
76 FR 59116 - Procurement List; Additions
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-23
... NSN: AF110--Shirt, Class A/Primary Duty, USAF, Men's, Long Sleeve, Dark Navy Blue, Numerous Sizes. NSN: AF111--Shirt, Class A/Primary Duty, USAF, Women's, Long Sleeve, Dark Navy Blue, Numerous Sizes. NSN: AF120--Shirt, Class A/Primary Duty, USAF, Men's, Short Sleeve, Dark Navy Blue, Numerous Sizes. NSN...
Use of color-coded sleeve shutters accelerates oscillograph channel selection
NASA Technical Reports Server (NTRS)
Bouchlas, T.; Bowden, F. W.
1967-01-01
Sleeve-type shutters mechanically adjust individual galvanometer light beams onto or away from selected channels on oscillograph papers. In complex test setups, the sleeve-type shutters are color coded to separately identify each oscillograph channel. This technique could be used on any equipment using tubular galvanometer light sources.
Dynamic, High-Temperature, Flexible Seal
NASA Technical Reports Server (NTRS)
Steinetz, Bruce M.; Sirocky, Paul J.
1989-01-01
New seal consists of multiple plies of braided ceramic sleeves filled with small ceramic balls. Innermost braided sleeve supported by high-temperature-wire-mesh sleeve that provides both springback and preload capabilities. Ceramic balls reduce effect of relatively high porosity of braided ceramic sleeves by acting as labyrinth flow path for gases and thereby greatly increasing pressure gradient seal can sustain. Dynamic, high-temperature, flexible seal employed in hypersonic engines, two-dimensional convergent/divergent and vectorized-thrust exhaust nozzles, reentry vehicle airframes, rocket-motor casings, high-temperature furnaces, and any application requiring non-asbestos high-temperature gaskets.
Inductively coupled plasma torch with laminar flow cooling
Rayson, Gary D.; Shen, Yang
1991-04-30
An improved inductively coupled gas plasma torch. The torch includes inner and outer quartz sleeves and tubular insert snugly fitted between the sleeves. The insert includes outwardly opening longitudinal channels. Gas flowing through the channels of the insert emerges in a laminar flow along the inside surface of the outer sleeve, in the zone of plasma heating. The laminar flow cools the outer sleeve and enables the torch to operate at lower electrical power and gas consumption levels additionally, the laminar flow reduces noise levels in spectroscopic measurements of the gaseous plasma.
Vasilikostas, Georgios; Sanmugalingam, Nimalan; Khan, Omar; Reddy, Marcus; Groves, Chris; Wan, Andrew
2014-03-01
Endoscopic stenting is a relatively new technique for the treatment of post sleeve gastrectomy complications. Partially covered stents are used in this method to minimise the risk of migration but they are associated with difficulties with removal. Patients requiring emergency stenting following sleeve gastrectomy underwent insertion of a partially covered metallic stent. One month later, if the stent was not easily removable, a fully covered overlapping stent was inserted and the patient was readmitted 2 weeks later for removal of both stents. Four patients required stenting following sleeve gastrectomy leaks, and one patient required stenting for a stricture. In these cases, a 'stent in a stent' technique was used for removal. This technique allows the safe removal of partially covered stents inserted following sleeve gastrectomy complications.
NASA Technical Reports Server (NTRS)
Tucker, Dennis Stephen (Inventor); Capo-Lugo, Pedro A. (Inventor)
2016-01-01
A single-axis accelerometer includes a housing defining a sleeve. An object/mass is disposed in the sleeve for sliding movement therein in a direction aligned with the sleeve's longitudinal axis. A first piezoelectric strip, attached to a first side of the object and to the housing, is longitudinally aligned with the sleeve's longitudinal axis. The first piezoelectric strip includes a first strip of a piezoelectric material with carbon nanotubes substantially aligned along a length thereof. A second piezoelectric strip, attached to a second side of the object and to the housing, is longitudinally aligned with the sleeve's longitudinal axis. The second piezoelectric strip includes a second strip of the piezoelectric material with carbon nanotubes substantially aligned along a length thereof. A voltage sensor is electrically coupled to at least one of the first and second piezoelectric strips.
Sleeve gastrectomy and gastro-oesophageal reflux disease: a complex relationship.
Mahawar, Kamal K; Jennings, Neil; Balupuri, Shlok; Small, Peter K
2013-07-01
Sleeve gastrectomy is rapidly becoming popular as a standalone bariatric operation. At the same time, there are valid concerns regarding its long-term durability and postoperative gastro-oesophageal reflux disease. Though gastric bypass remains the gold standard bariatric operation, it is not suitable for all patients. Sleeve gastrectomy is sometimes the only viable option. Patients with inflammatory bowel disease, liver cirrhosis, significant intra-abdominal adhesions involving small bowel and those reluctant to undergo gastric bypass could fall in this category. It is widely recognised that some patients report worsening of their gastro-oesophageal reflux disease after sleeve gastrectomy. Still, others develop de novo reflux. This review examines if it is possible to identify these patients prior to surgery and thus prevent postoperative gastro-oesophageal reflux disease after sleeve gastrectomy.
Downhole steam generator with improved preheating/cooling features
Donaldson, A. Burl; Hoke, Donald E.; Mulac, Anthony J.
1983-01-01
An apparatus for downhole steam generation employing dual-stage preheaters for liquid fuel and for the water. A first heat exchange jacket for the fuel surrounds the fuel/oxidant mixing section of the combustor assembly downstream of the fuel nozzle and contacts the top of the combustor unit of the combustor assembly, thereby receiving heat directly from the combustion of the fuel/oxidant. A second stage heat exchange jacket surrounds an upper portion of the oxidant supply line adjacent the fuel nozzle receiving further heat from the compression heat which results from pressurization of the oxidant. The combustor unit includes an inner combustor sleeve whose inner wall defines the combustion zone. The inner combustor sleeve is surrounded by two concentric water channels, one defined by the space between the inner combustor sleeve and an intermediate sleeve, and the second defined by the space between the intermediate sleeve and an outer cylindrical housing. The channels are connected by an annular passage adjacent the top of the combustor assembly and the countercurrent nature of the water flow provides efficient cooling of the inner combustor sleeve. An annular water ejector with a plurality of nozzles is provided to direct water downwardly into the combustor unit at the boundary of the combustion zone and along the lower section of the intermediate sleeve.
Downhole steam generator with improved preheating/cooling features. [Patent application
Donaldson, A.B.; Hoke, D.E.; Mulac, A.J.
1980-10-10
An apparatus is described for downhole steam generation employing dual-stage preheaters for liquid fuel and for the water. A first heat exchange jacket for the fuel surrounds the fuel/oxidant mixing section of the combustor assembly downstream of the fuel nozzle and contacts the top of the combustor unit of the combustor assembly, thereby receiving heat directly from the combustion of the fuel/oxidant. A second stage heat exchange jacket surrounds an upper portion of the oxidant supply line adjacent the fuel nozzle receiving further heat from the compression heat which results from pressurization of the oxidant. The combustor unit includes an inner combustor sleeve whose inner wall defines the combustion zone. The inner combustor sleeve is surrounded by two concentric water channels, one defined by the space between the inner combustor sleeve and an intermediate sleeve, and the second defined by the space between the intermediate sleeve and an outer cylindrical housing. The channels are connected by an annular passage adjacent the top of the combustor assembly and the countercurrent nature of the water flow provides efficient cooling of the inner combustor sleeve. An annular water ejector with a plurality of nozzles is provided to direct water downwardly into the combustor unit at the boundary of the combustion zone and along the lower section of the intermediate sleeve.
NASA Astrophysics Data System (ADS)
Karrenberg, Gregor; Wortberg, Johannes
2015-05-01
The High-Speed-S-Truder with floating screw sleeve is an alternative extrusion concept with solid-melt-separation. A fairly conventional 35 mm screw with a length of 21 D, which is accelerated by a 75 kW gearless, water cooled synchronous drive, conveys the resin into a 60 mm screw sleeve with a length of 10 D. Inside the sleeve the material is plasticizied and discharged into the outer screw channel of the sleeve through radial bores. Only the solid bed remains inside. The development of a melt pool - and thus a decrease of the plasticizing capacity - is avoided. The sleeve is rotated by drag forces only (approximately 10 - 15 % of the screw speed). Due to the low speed of the screw sleeve molten material is conveyed to a 4 D Dynamic Mixing Ring in a gentle manner. The DMRs floating ring and the screw sleeve are directly coupled. The granules in the screw channel are stopped by a barrier on the screw in front of the mixing device. So nearly no unmelted material can pass the system. For temperature management in the plastification and mixing zone a 3-zone heating/air-cooling system is used. Various kinds of experiments with the High-Speed S-Truder were conducted. Reachable throughputs with different types of material (LDPE, LLDPE, PP, PS) have been tested. Also three screw geometries, which are mainly varying in the channel depth, were compared. Experimental results and theoretical background will be described in this paper.
Salminen, Paulina; Helmiö, Mika; Ovaska, Jari; Juuti, Anne; Leivonen, Marja; Peromaa-Haavisto, Pipsa; Hurme, Saija; Soinio, Minna; Nuutila, Pirjo; Victorzon, Mikael
2018-01-16
Laparoscopic sleeve gastrectomy for treatment of morbid obesity has increased substantially despite the lack of long-term results compared with laparoscopic Roux-en-Y gastric bypass. To determine whether laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass are equivalent for weight loss at 5 years in patients with morbid obesity. The Sleeve vs Bypass (SLEEVEPASS) multicenter, multisurgeon, open-label, randomized clinical equivalence trial was conducted from March 2008 until June 2010 in Finland. The trial enrolled 240 morbidly obese patients aged 18 to 60 years, who were randomly assigned to sleeve gastrectomy or gastric bypass with a 5-year follow-up period (last follow-up, October 14, 2015). Laparoscopic sleeve gastrectomy (n = 121) or laparoscopic Roux-en-Y gastric bypass (n = 119). The primary end point was weight loss evaluated by percentage excess weight loss. Prespecified equivalence margins for the clinical significance of weight loss differences between gastric bypass and sleeve gastrectomy were -9% to +9% excess weight loss. Secondary end points included resolution of comorbidities, improvement of quality of life (QOL), all adverse events (overall morbidity), and mortality. Among 240 patients randomized (mean age, 48 [SD, 9] years; mean baseline body mass index, 45.9, [SD, 6.0]; 69.6% women), 80.4% completed the 5-year follow-up. At baseline, 42.1% had type 2 diabetes, 34.6% dyslipidemia, and 70.8% hypertension. The estimated mean percentage excess weight loss at 5 years was 49% (95% CI, 45%-52%) after sleeve gastrectomy and 57% (95% CI, 53%-61%) after gastric bypass (difference, 8.2 percentage units [95% CI, 3.2%-13.2%], higher in the gastric bypass group) and did not meet criteria for equivalence. Complete or partial remission of type 2 diabetes was seen in 37% (n = 15/41) after sleeve gastrectomy and in 45% (n = 18/40) after gastric bypass (P > .99). Medication for dyslipidemia was discontinued in 47% (n = 14/30) after sleeve gastrectomy and 60% (n = 24/40) after gastric bypass (P = .15) and for hypertension in 29% (n = 20/68) and 51% (n = 37/73) (P = .02), respectively. There was no statistically significant difference in QOL between groups (P = .85) and no treatment-related mortality. At 5 years the overall morbidity rate was 19% (n = 23) for sleeve gastrectomy and 26% (n = 31) for gastric bypass (P = .19). Among patients with morbid obesity, use of laparoscopic sleeve gastrectomy compared with use of laparoscopic Roux-en-Y gastric bypass did not meet criteria for equivalence in terms of percentage excess weight loss at 5 years. Although gastric bypass compared with sleeve gastrectomy was associated with greater percentage excess weight loss at 5 years, the difference was not statistically significant, based on the prespecified equivalence margins. clinicaltrials.gov Identifier: NCT00793143.
NASA Technical Reports Server (NTRS)
Burley, R. K.
1983-01-01
Electrochemical deburring removes burrs from assembled injector tubes. Since process uses liquid anodic dissolution in liquid electrolyte to proide deburring action, smoothes surfaces and edges in otherwise inaccessible areas. Tool consists of sleeve that contains metallic ring cathode. Sleeve is placed over tube, and electrolytic solution is forced to flow between tube and sleeve. The workpiece serves an anode.
78 FR 14934 - Airworthiness Directives; The Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-08
... discrepancies of the wiring and surrounding Teflon sleeves of the fuel tank boost pumps and override/jettison... the wiring and sleeves with new parts, as necessary. The first SNPRM proposed to reduce the initial... inspections to detect discrepancies of the wiring and surrounding Teflon sleeves of the fuel tank boost pumps...
NASA Technical Reports Server (NTRS)
Bluck, Raymond M. (Inventor); Bush, Harold G. (Inventor); Johnson, Robert R. (Inventor)
1990-01-01
A metallic outer sleeve is provided which is capable of enveloping a hollow metallic inner member having continuous reinforcing fibers attached to the distal end thereof. The inner member is then introduced into outer sleeve until inner member is completely enveloped by outer sleeve. A liquid matrix member is then injected into space between inner member and outer sleeve. A pressurized heat transfer medium is flowed through the inside of inner member, thereby forming a fiber reinforced matrix composite material. The wall thicknesses of both inner member and outer sleeve are then reduced to the appropriate size by chemical etching, to adjust the thermal expansion coefficient of the metal-clad composite structure to the desired value. thereby forming a fiber reinforced matrix composite material. The wall thicknesses of both inner member and outer sleeve are then reduced to the appropriate size by chemical etching, to adjust the thermal expansion coefficient of the metal-clad composite structure to the desired value. The novelty of this invention resides in the development of a efficient method of producing seamless metal clad fiber reinforced organic matrix composite structures.
Method and apparatus for extracting tritium and preparing radioactive waste for disposal
Heung, Leung K.
1994-01-01
Apparatus for heating an object such as a nuclear target bundle to release and recover hydrogen and contain the disposable residue for disposal. The apparatus comprises an inverted furnace, a sleeve/crucible assembly for holding and enclosing the bundle, conveying equipment for placing the sleeve onto the crucible and loading the bundle into the sleeve/crucible, a lift for raising the enclosed bundle into the furnace, and hydrogen recovery equipment including a trap and strippers, all housed in a containment having negative internal pressure. The crucible/sleeve assembly has an internal volume that is sufficient to enclose and hold the bundle before heating; the crucible's internal volume is sufficient by itself to hold and enclose the bundle's volume after heating. The crucible can then be covered and disposed of; the sleeve, on the other hand, can be reused.
Apparatus and method for sealing perforated well casing
Blount, Curtis G.; Benham, Robert A.; Brock, Jerry L.; Emerson, John A.; Ferguson, Keith R.; Scheve, Donald F.; Schmidt, Joseph H.; Schuler, Karl W.; Stanton, Philip L.
1997-01-01
Perforations and other openings in well casings, liners and other conduits may be substantially blocked or sealed to prevent fluid flow between the casing or liner interior and an earth formation by placing a radially expansible sleeve adjacent the perforations or openings and urging the sleeve into forcible engagement with the casing or inner wall using an explosive charge. An apparatus including a radially contracted sleeve formed by a coiled plate member or a tubular member having flutes defined by external and internal folds, may be deployed into a well casing or liner through a production or injection tubing string and on the end of a flexible cable or coilable tubing. An explosive charge disposed on the apparatus and within the sleeve may be detonated to urge the sleeve into forcible engagement with the casing inner wall.
Apparatus and method for sealing perforated well casing
Blount, C.G.; Benham, R.A.; Brock, J.L.; Emerson, J.A.; Ferguson, K.R.; Scheve, D.F.; Schmidt, J.H.; Schuler, K.W.; Stanton, P.L.
1997-03-25
Perforations and other openings in well casings, liners and other conduits may be substantially blocked or sealed to prevent fluid flow between the casing or liner interior and an earth formation by placing a radially expansible sleeve adjacent the perforations or openings and urging the sleeve into forcible engagement with the casing or inner wall using an explosive charge. An apparatus including a radially contracted sleeve formed by a coiled plate member or a tubular member having flutes defined by external and internal folds, may be deployed into a well casing or liner through a production or injection tubing string and on the end of a flexible cable or coilable tubing. An explosive charge disposed on the apparatus and within the sleeve may be detonated to urge the sleeve into forcible engagement with the casing inner wall. 17 figs.
Intraoperative fracture of phacoemulsification sleeve
2010-01-01
Background We describe a case of intraoperative fracture of phacoemulsification sleeve during phacoemulsification surgery. Case presentation Phacoemulsification surgery was performed in the left eye of a 58-year-old lady with grade II nuclear sclerosis & grade I cortical cataract. Towards the end of quadrant removal, there was anterior chamber instability with impaired followability of nuclear fragments. The distal part of the fractured sleeve remained inside the anterior chamber upon removal of the phacoemulsification probe. The retained sleeve was retrieved with a pair of forceps through the corneal incision site, which did not require widening. There was no missing fragments retained intraocularly and the patient had an uneventful recovery with vision of 20/25 at three months post-operatively. Conclusion Phacoemulsification sleeve fracture is an uncommon complication. With early identification of this condition and proper management, major complications can be avoided. PMID:21118542
Mans, Esther; Serra-Prat, Mateu; Palomera, Elisabet; Suñol, Xavier; Clavé, Pere
2015-09-01
The relation between hunger, satiation, and integrated gastrointestinal motility and hormonal responses in morbidly obese patients after sleeve gastrectomy has not been determined. The objective was to assess the effects of sleeve gastrectomy on hunger, satiation, gastric and gallbladder motility, and gastrointestinal hormone response after a liquid meal test. Three groups were studied: morbidly obese patients (n = 16), morbidly obese patients who had had sleeve gastrectomy (n = 8), and nonobese patients (n = 16). The participants fasted for 10 h and then consumed a 200-mL liquid meal (400 kcal + 1.5 g paracetamol). Fasting and postprandial hunger, satiation, hormone concentrations, and gastric and gallbladder emptying were measured several times over 4 h. No differences were observed in hunger and satiation curves between morbidly obese and nonobese groups; however, sleeve gastrectomy patients were less hungry and more satiated than the other groups. Antrum area during fasting in morbidly obese patients was statistically significant larger than in the nonobese and sleeve gastrectomy groups. Gastric emptying was accelerated in the sleeve gastrectomy group compared with the other 2 groups (which had very similar results). Gallbladder emptying was similar in the 3 groups. Sleeve gastrectomy patients showed the lowest ghrelin concentrations and higher early postprandial cholecystokinin and glucagon-like peptide 1 peaks than did the other participants. This group also showed an improved insulin resistance pattern compared with morbidly obese patients. Sleeve gastrectomy seems to be associated with profound changes in gastrointestinal physiology that contribute to reducing hunger and increasing sensations of satiation. These changes include accelerated gastric emptying, enhanced postprandial cholecystokinin and glucagon-like peptide 1 concentrations, and reduced ghrelin release, which together may help patients lose weight and improve their glucose metabolism after surgery. This trial was registered at clinicaltrials.gov as NCT02414893. © 2015 American Society for Nutrition.
Design of a Soft Robotic Elbow Sleeve with Passive and Intent-Controlled Actuation
Koh, Tze Hui; Cheng, Nicholas; Yap, Hong Kai; Yeow, Chen-Hua
2017-01-01
The provision of continuous passive, and intent-based assisted movements for neuromuscular training can be incorporated into a robotic elbow sleeve. The objective of this study is to propose the design and test the functionality of a soft robotic elbow sleeve in assisting flexion and extension of the elbow, both passively and using intent-based motion reinforcement. First, the elbow sleeve was developed, using elastomeric and fabric-based pneumatic actuators, which are soft and lightweight, in order to address issues of non-portability and poor alignment with joints that conventional robotic rehabilitation devices are faced with. Second, the control system was developed to allow for: (i) continuous passive actuation, in which the actuators will be activated in cycles, alternating between flexion and extension; and (ii) an intent-based actuation, in which user intent is detected by surface electromyography (sEMG) sensors attached to the biceps and triceps, and passed through a logic sequence to allow for flexion or extension of the elbow. Using this setup, the elbow sleeve was tested on six healthy subjects to assess the functionality of the device, in terms of the range of motion afforded by the device while in the continuous passive actuation. The results showed that the elbow sleeve is capable of achieving approximately 50% of the full range of motion of the elbow joint among all subjects. Next, further experiments were conducted to test the efficacy of the intent-based actuation on these healthy subjects. The results showed that all subjects were capable of achieving electromyography (EMG) control of the elbow sleeve. These preliminary results show that the elbow sleeve is capable of carrying out continuous passive and intent-based assisted movements. Further investigation of the clinical implementation of the elbow sleeve for the neuromuscular training of neurologically-impaired persons, such as stroke survivors, is needed. PMID:29118693
What matters after sleeve gastrectomy: patient characteristics or surgical technique?
Dhar, Vikrom K; Hanseman, Dennis J; Watkins, Brad M; Paquette, Ian M; Shah, Shimul A; Thompson, Jonathan R
2018-03-01
The impact of operative technique on outcomes in laparoscopic sleeve gastrectomy has been explored previously; however, the relative importance of patient characteristics remains unknown. Our aim was to characterize national variability in operative technique for laparoscopic sleeve gastrectomy and determine whether patient-specific factors are more critical to predicting outcomes. We queried the database of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for laparoscopic sleeve gastrostomies performed in 2015 (n = 88,845). Logistic regression models were used to determine predictors of postoperative outcomes. In 2015, >460 variations of laparoscopic sleeve gastrectomy were performed based on combinations of bougie size, distance from the pylorus, use of staple line reinforcement, and oversewing of the staple line. Despite such substantial variability, technique variants were not predictive of outcomes, including perioperative morbidity, leak, or bleeding (all P ≥ .05). Instead, preoperative patient characteristics were found to be more predictive of these outcomes after laparoscopic sleeve gastrectomy. Only history of gastroesophageal disease (odds ratio 1.44, 95% confidence interval 1.08-1.91, P < .01) was associated with leak. Considerable variability exists in technique among surgeons nationally, but patient characteristics are more predictive of adverse outcomes after laparoscopic sleeve gastrectomy. Bundled payments and reimbursement policies should account for patient-specific factors in addition to current accreditation and volume thresholds when deciding risk-adjustment strategies. Copyright © 2018 Elsevier Inc. All rights reserved.
Homopolar machine for reversible energy storage and transfer systems
Stillwagon, Roy E.
1978-01-01
A homopolar machine designed to operate as a generator and motor in reversibly storing and transferring energy between the machine and a magnetic load coil for a thermo-nuclear reactor. The machine rotor comprises hollow thin-walled cylinders or sleeves which form the basis of the system by utilizing substantially all of the rotor mass as a conductor thus making it possible to transfer substantially all the rotor kinetic energy electrically to the load coil in a highly economical and efficient manner. The rotor is divided into multiple separate cylinders or sleeves of modular design, connected in series and arranged to rotate in opposite directions but maintain the supply of current in a single direction to the machine terminals. A stator concentrically disposed around the sleeves consists of a hollow cylinder having a number of excitation coils each located radially outward from the ends of adjacent sleeves. Current collected at an end of each sleeve by sleeve slip rings and brushes is transferred through terminals to the magnetic load coil. Thereafter, electrical energy returned from the coil then flows through the machine which causes the sleeves to motor up to the desired speed in preparation for repetition of the cycle. To eliminate drag on the rotor between current pulses, the brush rigging is designed to lift brushes from all slip rings in the machine.
Homopolar machine for reversible energy storage and transfer systems
Stillwagon, Roy E.
1981-01-01
A homopolar machine designed to operate as a generator and motor in reversibly storing and transferring energy between the machine and a magnetic load coil for a thermo-nuclear reactor. The machine rotor comprises hollow thin-walled cylinders or sleeves which form the basis of the system by utilizing substantially all of the rotor mass as a conductor thus making it possible to transfer substantially all the rotor kinetic energy electrically to the load coil in a highly economical and efficient manner. The rotor is divided into multiple separate cylinders or sleeves of modular design, connected in series and arranged to rotate in opposite directions but maintain the supply of current in a single direction to the machine terminals. A stator concentrically disposed around the sleeves consists of a hollow cylinder having a number of excitation coils each located radially outward from the ends of adjacent sleeves. Current collected at an end of each sleeve by sleeve slip rings and brushes is transferred through terminals to the magnetic load coil. Thereafter, electrical energy returned from the coil then flows through the machine which causes the sleeves to motor up to the desired speed in preparation for repetition of the cycle. To eliminate drag on the rotor between current pulses, the brush rigging is designed to lift brushes from all slip rings in the machine.
78 FR 17082 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbojet Engines
Federal Register 2010, 2011, 2012, 2013, 2014
2013-03-20
... flight. (5) If you find any broken bolt in the HPT shaft air seal sleeve, visually inspect the HPT stage... assembly, high pressure turbine (HPT) bearing support assembly and HPT air seal sleeve bolts identified... turbine (HPT) bearing support assembly, and HPT air seal sleeve within 100 engine cycles-in-service. (2...
77 FR 66769 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbojet Engines
Federal Register 2010, 2011, 2012, 2013, 2014
2012-11-07
.... (5) If any bolt is found broken in the HPT shaft air seal sleeve, inspect the HPT stage 1 disc for...) bearing support assembly and HPT air seal sleeve bolts identified that, before installation, those bolts... assembly, high-pressure turbine (HPT) bearing support assembly, and HPT air seal sleeve. (2) If engine...
Bergman, Ulf C.
1984-01-01
The safety valve contains a resilient gland to be held between a valve seat and a valve member and is secured to the valve member by a sleeve surrounding the end of the valve member adjacent to the valve seat. The sleeve is movable relative to the valve member through a limited axial distance and a gap exists between said valve member and said sleeve.
Staple line reinforcement during sleeve gastrectomy with a new type of reinforced stapler.
El Moussaoui, Imad; Limbga, Augustin; Mehdi, Abdelilah
2018-04-01
Bleeding and staple-line leak, are the most common complications of laparoscopic sleeve gastrectomy. To decrease the incidence of this complications, a variety of intraoperative reinforcement of staple line is used. Reinforced GIA™ is a new automatic suture device with pre-attached synthetic tissue reinforcement, but no study has evaluated its use in sleeve gastrectomy. The objective of this study is to evaluate the efficacy and safety of this new staple line reinforcement technique in laparoscopic sleeve gastrectomy. We conducted a retrospective review of 290 patients who underwent laparoscopic sleeve gastrectomy between January 2013 and January 2016 in which reinforced GIA™ or standard GIA™ was used. Patients preoperative characteristics, Operative time, staple line leaks, staple line bleeds, stenosis, and complications requiring reoperation were collected. A total of 187 laparoscopic sleeve gastrectomy were performed with standard GIA and 103 with reinforced GIA™. Patient characteristics were not significantly different between the groups. The average operating time in the standard GIA group is 57.41±16.44 min against 50.9±14.12 min in the reinforced GIA group (P=0.006). Two staple line leaks developed in the standard GIA group and reoperated against no patients in the reinforced GIA group, without significant difference between the both groups (P=0.66). Staple line bleeds are less in the reinforced GIA group, only 23 (22.3%) against 78 (41.7%) cases in the standard GIA group (P=0.001). No patients of both groups developed gastric sleeve stenosis. During laparoscopic sleeve gastrectomy, the use of a reinforced stapler significantly reduces the operative time and staple line bleeding. No significant difference is evidenced in terms of reduction of staple line leaks with this reinforced stapler.
Method and apparatus for extracting tritium and preparing radioactive waste for disposal
Heung, L.K.
1994-03-29
Apparatus is described for heating an object such as a nuclear target bundle to release and recover hydrogen and contain the disposable residue for disposal. The apparatus comprises an inverted furnace, a sleeve/crucible assembly for holding and enclosing the bundle, conveying equipment for placing the sleeve onto the crucible and loading the bundle into the sleeve/crucible, a lift for raising the enclosed bundle into the furnace, and hydrogen recovery equipment including a trap and strippers, all housed in a containment having negative internal pressure. The crucible/sleeve assembly has an internal volume that is sufficient to enclose and hold the bundle before heating; the crucible's internal volume is sufficient by itself to hold and enclose the bundle's volume after heating. The crucible can then be covered and disposed of; the sleeve, on the other hand, can be reused. 4 figures.
Development of on line automatic separation device for apple and sleeve
NASA Astrophysics Data System (ADS)
Xin, Dengke; Ning, Duo; Wang, Kangle; Han, Yuhang
2018-04-01
Based on STM32F407 single chip microcomputer as control core, automatic separation device of fruit sleeve is designed. This design consists of hardware and software. In hardware, it includes mechanical tooth separator and three degree of freedom manipulator, as well as industrial control computer, image data acquisition card, end effector and other structures. The software system is based on Visual C++ development environment, to achieve localization and recognition of fruit sleeve with the technology of image processing and machine vision, drive manipulator of foam net sets of capture, transfer, the designated position task. Test shows: The automatic separation device of the fruit sleeve has the advantages of quick response speed and high separation success rate, and can realize separation of the apple and plastic foam sleeve, and lays the foundation for further studying and realizing the application of the enterprise production line.
Iatrogenic injury of the intrathoracic oesophagus with bougie during sleeve gastrectomy
Signorini, Franco José; Verónica, Gorodner; Marcos, Marani; German, Viscido; Federico, Moser
2018-01-01
One of the most popular procedures amongst obesity surgery is the sleeve gastrectomy. There is international consensus regarding the usage of bougie for sleeve gastrectomy calibration. Nevertheless, there is a dissociation between the number of oesophageal perforations reported for any other oesophageal/gastric operation that requires bougie (e.g., anti-reflux surgery, incidence 1.2%) and bariatric surgery, where this complication seems to be almost a myth. Interestingly enough, the number of bariatric procedures is much higher than any other oesophageal/gastric surgery. This suggests that oesophageal perforations in obesity surgery are underreported. We report a case of injury of the intrathoracic oesophagus with bougie that occurred during a sleeve gastrectomy. In the infrequent case that the perforation is diagnosed during surgery, primary repair during the same intervention is highly recommended. Videothoracoscopy might be an effective option in case of necessity. We were able to complete the sleeve gastrectomy without increasing morbidity. PMID:28695879
NASA Technical Reports Server (NTRS)
Burgess, Kevin (Inventor); Yakos, David (Inventor); Walthall, Bryan (Inventor)
2012-01-01
A stemless ball valve comprising: a right flange; left flange; ball with an axis pin and two travel pins; ball seal on either side of the ball; guide sleeve with inner walls comprising two channels; cartridge guide holder; inner magnetic cartridge; and outer magnetic cartridge. The ball is situated inside of the guide sleeve, and a travel pin is located in each of the two channels. The guide sleeve is situated inside of the cartridge guide holder, which is located adjacent to and outside of the inner magnetic cartridge and secured to the inner magnetic cartridge such that when the inner magnetic cartridge rotates, the cartridge guide holder also rotates. The cartridge guide holder is secured to the guide sleeve such that when the cartridge guide holder rotates, the travel pins move within the channels in the inner walls of the guide sleeve, thereby causing the ball to rotate.
QUICK DISCONNECT ELECTRICAL CONNECTOR
None
1962-08-14
A remotely actuated quick-dlsconnect electrical connector which comprises a pair of mating portrons releasably retained together by a bayonet- type joint with a rotatable sleeve on one of the mating portions providing for engagement and disengagement of the joint is described. A lanyard with ends passed through fulcrums and affixed to the sleeve erfects rotation of the sleeve and disengages the joint. (AEC)
Correy, T.B.
1961-10-01
A welding torch into which water and inert gas are piped separately for cooling and for providing a suitable gaseous atmosphere is described. A welding electrode is clamped in the torch by a removable collet sleeve and a removable collet head. Replacement of the sleeve and head with larger or smaller sleeve and head permits a larger or smaller welding electrode to be substituted on the torch. (AEC)
Directly susceptible, noncarbon metal ceramic composite crucible
Holcombe, Jr., Cressie E.; Kiggans, Jr., James O.; Morrow, S. Marvin; Rexford, Donald
1999-01-01
A sintered metal ceramic crucible suitable for high temperature induction melting of reactive metals without appreciable carbon or silicon contamination of the melt. The crucible comprises a cast matrix of a thermally conductive ceramic material; a perforated metal sleeve, which serves as a susceptor for induction heating of the crucible, embedded within the ceramic cast matrix; and a thermal-shock-absorber barrier interposed between the metal sleeve and the ceramic cast matrix to allow for differential thermal expansions between the matrix and the metal sleeve and to act as a thermal-shock-absorber which moderates the effects of rapid changes of sleeve temperature on the matrix.
Hutto, E.L.
1961-08-15
A manipulator is described for performing, within an entirely enclosed cell containling radioactive materials, various mechanical operations. A rod with flexible fingers is encompassed by a tubular sleeve shorter than the rod. Relative movement between the rod and sleeve causes the fingers to open and close. This relative movement is effected by relative movement of permanent magnets in magnetic coupling relation to magnetic followers affixed to the ends of the rod and sleeve. The rod and its sleeve may be moved as a unit axially or may be rotated by means of the magnetic couplings. The manipulator is enclosed within a tubular member which is flexibly sealed to an opening in the cell. (AEC)
Li, Shuben; Chai, Huiping; Huang, Jun; Zeng, Guangqiao; Shao, Wenlong; He, Jianxing
2014-04-01
The purpose of the current study is to present the clinical and surgical results in patients who underwent hybrid video-assisted thoracic surgery with segmental-main bronchial sleeve resection. Thirty-one patients, 27 men and 4 women, underwent segmental-main bronchial sleeve anastomoses for non-small cell lung cancer between May 2004 and May 2011. Twenty-six (83.9%) patients had squamous cell carcinoma, and 5 patients had adenocarcinoma. Six patients were at stage IIB, 24 patients at stage IIIA, and 1 patient at stage IIIB. Secondary sleeve anastomosis was performed in 18 patients, and Y-shaped multiple sleeve anastomosis was performed in 8 patients. Single segmental bronchiole anastomosis was performed in 5 cases. The average time for chest tube removal was 5.6 days. The average length of hospital stay was 11.8 days. No anastomosis fistula developed in any of the patients. The 1-, 2-, and 3-year survival rates were 83.9%, 71.0%, and 41.9%, respectively. Hybrid video-assisted thoracic surgery with segmental-main bronchial sleeve resection is a complex technique that requires training and experience, but it is an effective and safe operation for selected patients.
Gesture-Based Robot Control with Variable Autonomy from the JPL Biosleeve
NASA Technical Reports Server (NTRS)
Wolf, Michael T.; Assad, Christopher; Vernacchia, Matthew T.; Fromm, Joshua; Jethani, Henna L.
2013-01-01
This paper presents a new gesture-based human interface for natural robot control. Detailed activity of the user's hand and arm is acquired via a novel device, called the BioSleeve, which packages dry-contact surface electromyography (EMG) and an inertial measurement unit (IMU) into a sleeve worn on the forearm. The BioSleeve's accompanying algorithms can reliably decode as many as sixteen discrete hand gestures and estimate the continuous orientation of the forearm. These gestures and positions are mapped to robot commands that, to varying degrees, integrate with the robot's perception of its environment and its ability to complete tasks autonomously. This flexible approach enables, for example, supervisory point-to-goal commands, virtual joystick for guarded teleoperation, and high degree of freedom mimicked manipulation, all from a single device. The BioSleeve is meant for portable field use; unlike other gesture recognition systems, use of the BioSleeve for robot control is invariant to lighting conditions, occlusions, and the human-robot spatial relationship and does not encumber the user's hands. The BioSleeve control approach has been implemented on three robot types, and we present proof-of-principle demonstrations with mobile ground robots, manipulation robots, and prosthetic hands.
Kaijser, Mirjam A; van Ramshorst, Gabrielle H; Emous, Marloes; Veeger, Nic J G M; van Wagensveld, Bart A; Pierie, Jean-Pierre E N
2018-04-09
Bariatric procedures are technically complex and skill demanding. In order to standardize the procedures for research and training, a Delphi analysis was performed to reach consensus on the practice of the laparoscopic gastric bypass and sleeve gastrectomy in the Netherlands. After a pre-round identifying all possible steps from literature and expert opinion within our study group, questionnaires were send to 68 registered Dutch bariatric surgeons, with 73 steps for bypass surgery and 51 steps for sleeve gastrectomy. Statistical analysis was performed to identify steps with and without consensus. This process was repeated to reach consensus of all necessary steps. Thirty-eight participants (56%) responded in the first round and 32 participants (47%) in the second round. After the first Delphi round, 19 steps for gastric bypass (26%) and 14 for sleeve gastrectomy (27%) gained full consensus. After the second round, an additional amount of 10 and 12 sub-steps was confirmed as key steps, respectively. Thirteen steps in the gastric bypass and seven in the gastric sleeve were deemed advisable. Our expert panel showed a high level of consensus expressed in a Cronbach's alpha of 0.82 for the gastric bypass and 0.87 for the sleeve gastrectomy. The Delphi consensus defined 29 steps for gastric bypass and 26 for sleeve gastrectomy as being crucial for correct performance of these procedures to the standards of our expert panel. These results offer a clear framework for the technical execution of these procedures.
Does Sleeve Shape Make a Difference in Outcomes?
Alhaj Saleh, Adel; Janik, Michal R; Mustafa, Rami R; Alshehri, Mohammed; Khan, Adil H; Kalantar Motamedi, Seyed Mohammad; Rahim, Shiraz; Patel, Indravadan; Aryaie, Amir; Abbas, Mujjahid; Rogula, Tomasz; Khaitan, Leena
2018-06-01
Sleeve gastrectomy (SG) is one of the most common procedures performed for weight loss. Many seek the "perfect sleeve" with the notion that the type of calibrating device affects sleeve shape, and this in turn will affect outcomes and complications. Two major concerns after SG are amount of weight loss and acid reflux. Our aim was to determine if the various calibration methods could impact sleeve shape and thereby allow for better outcomes of weight loss and reflux. A retrospective chart review was performed of 210 patients who underwent SG and had postoperative upper gastrointestinal (UGI) study from 2011 to 2015 in a single center by a single (fellowship-trained) bariatric surgeon. Data regarding demographics, calibrating devices and clinical outcomes at 1 year (weight loss and de novo acid reflux) were collected. UGIs were reviewed by two radiologists blinded to the clinical outcomes. Sleeve shape was classified according to a previously described classification as tubular, dumbbell, upper pouch, or lower pouch. The types of calibrating devices used to guide the sleeve size intraoperatively were endoscopy, large-bore orogastric tube, and fenestrated suction tube. One hundred ninety-nine patients met inclusion criteria (11 had no esophagram). Demographics revealed age 45.76 ± 10.6 years, BMI 47 ± 8.6 kg/m 2 , and 82% female. Calibration devices used were endoscopic guidance (7.6%), large bore orogastric tube (41.4%), and fenestrated suction tube (50.5%). Sleeve shape was reported as 32.6% tubular, 20.6% dumbbell, 39.2% lower pouch, and 7.5% upper pouch (100% interrater reliability). No correlation was seen with type of calibration used. Of patients, 62.0% had > 50% excess weight loss at 1 year. Twenty-three percent of patients remained on PPI at 1 year (of which 43.3% did not have reflux preoperatively). The lower pouch shape showed a trend toward less reflux and more weight loss. This study showed no clear association between uniformity of sleeve shape and the type of calibration device used. The study showed a trend toward decreased reflux and improved weight loss with the lower pouch shape, regardless of calibration device.
Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions.
Huh, Jeannie; Easley, Mark E; Nunley, James A
2016-06-01
An Achilles sleeve avulsion occurs when the tendon ruptures distally from its calcaneal insertion as a continuous "sleeve." This relatively rare injury pattern may not be appreciated until the time of surgery and can be challenging to treat because, unlike a midsubstance rupture, insufficient tendon remains on the calcaneus to allow for end-to-end repair, and unlike a tuberosity avulsion fracture, any bony element avulsed with the tendon is inadequate for internal fixation. This study aimed to highlight the characteristics of Achilles sleeve avulsions and present the outcomes of operative repair using suture anchor fixation. A retrospective analysis was conducted on 11 consecutive Achilles tendon sleeve avulsions (10 males, 1 female; mean age 44 years) that underwent operative repair between 2008 and 2014. Patient demographics, injury presentation, and operative details were reviewed. Postoperative outcomes were collected at a mean follow-up of 38.4 (range, 12-83.5) months, including the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, visual analog scale (VAS) for pain, plantarflexion strength, patient satisfaction, and complications. Eight patients (72.7%) had preexisting symptoms of insertional Achilles disease. Ten of 11 (90.9%) injuries were sustained during recreational athletic activity. An Achilles sleeve avulsion was recognized preoperatively in 7 of 11 (64%) cases, where lateral ankle radiographs demonstrated a small radiodensity several centimeters proximal to the calcaneal insertion. Intraoperatively, 90.9% of sleeve avulsions had a concomitant Haglund deformity and macroscopic evidence of insertional tendinopathy. All patients healed after suture anchor repair. The average AOFAS score was 92.8 and VAS score was 0.9. Ten patients (90.9%) were completely satisfied. One complication occurred, consisting of delayed wound healing. Achilles tendon sleeve avulsions predominantly occurred in middle-aged men with preexisting insertional disease, while engaged in athletic activity. Suture anchor fixation, combined with addressing concomitant insertional pathology, was a reliable and safe technique for the operative management of Achilles tendon sleeve avulsions. The majority of patients returned to their preinjury levels of work and recreational activity. Level IV, retrospective case series. © The Author(s) 2016.
Negative pressures during swing phase in below-knee prostheses with rubber sleeve suspension.
Chino, N; Pearson, J R; Cockrell, J L; Mikishko, H A; Koepke, G H
1975-01-01
Negative pressures in the small space between the distal stump and the below-knee prosthetic socket were measured during swing phase for a series of nine subjects. A molded rubber sleeve connecting the prosthesis and the thigh was found to enhance this effect so that suction suspension occurred during the entire swing phase. Deterioration of the suction occurred when the sleeve was intentionally pierced, and when other suspensions such as a suprapatellar cuff or thigh band were tested. The findings indicate that the total-contact socket, gel liner and elastic sleeve combine to create suction in the below-knee socket which improves overall comfort and function for the patient in using the prosthesis.
Imai, Kazuhiro; Minamiya, Yoshihiro; Saito, Hajime; Miyakoshi, Naohisa; Hongo, Michio; Kasukawa, Yuji; Ishikawa, Yoshinori; Motoyama, Satoru; Sato, Yusuke; Shimada, Yoichi; Ogawa, Jun-ichi
2013-07-01
We describe a novel technique of using halo-vest-enforced immobilization to relieve anastomotic tension after tracheal sleeve resection. Immediately after the tracheal sleeve resection, four halo titanium pins were inserted in the skulls of the patients to secure the halo-vest. All patients fitted with halo-vests were able to eat and drink and their clinical course was good. Bronchoscopy confirmed the absence of anastomotic leaks and stenoses, and there were no complications associated with the halo-vest. We believe that ensuring neck flexion using a halo-vest after tracheal sleeve resection is an excellent way of relieving anastomotic tension that would predispose the wound to dehiscence.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1980-10-09
Following the ignition of crude oil that leaked from a fractured 22 in. oil pipeline at a levee crossing at Berwick, Louisiana, on 1/2/80, NTSB has recommended that Texaco Pipeline Co., the line owner, review the practice of using fillet-welded reinforcement sleeves for tie-in welds to determine if these sleeves have caused any pipeline failures in its system; notify the pipeline patrol of the location of such existing sleeves and instruct it to examine the areas around these sleeves for signs of leakage; and evaluate existing procdures for leak detection to make these procedures more effective. The American Petroleum Institutemore » has also been urged to notify its member companies of the Berwick accident and the aforementioned recommendations. These pipeline and other safety recommendation letters and reports of accidents, including the determination of the cause of the explosion, burning, and sinking of the Liberian tanker Seatige.« less
NASA Technical Reports Server (NTRS)
Rothrock, A M; Marsh, E T
1935-01-01
Test data and analysis show that the rate of fuel leakage between a lapped plunger and sleeve varies directly with the density of the fuel, the diameter of the plunger, the pressure producing the leakage, and the cube of the mean clearance between the plunger and sleeve. The rate varies inversely as the length of the lapped fit and the viscosity of the fuel. With a mean clearance between the plunger and sleeve of 0.0001 inch the leakage amounts to approximately 0.2 percent of the fuel injected with gasoline and as low as 0.01 percent with diesel fuel oils. With this mean clearance an effective seal is obtained when the length of the lap is three times the diameter of the lap. The deformation of the sleeve and plunger under pressure is sufficient to change the rate of leakage appreciably from that which would be obtained if the clearance was constant under pressure.
Retractor Tool for Brain Surgery
NASA Technical Reports Server (NTRS)
Helms, R.; Hayes, T.
1982-01-01
Proposed brain-surgery tool has an octogonal fixture for positioning latex tube over incision. Eight stainless-steel wires embedded in latex extend to hold positioning fixture. Another eight are also embedded in the latex. Concentric sleeves are successively inserted into expandable latex tube. The first sleeve is placed over a solid rod. Last sleeve is a stainless-steel tube 1 inch in diameter. It is overcoated with Teflon (or equivalent) material.
Sleeve fracture of the adult patella: Case report and review of the literature.
Xie, Linjun; Xu, Hong; Zhang, Lizhi; Xu, Rong; Guo, Yingkun
2017-08-01
The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group. Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella. Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury. Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon. Six months after the operation, she could fully use her left knee without any pain and disability. Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity.
Crimped braided sleeves for soft, actuating arm in robotic abdominal surgery.
Elsayed, Yahya; Lekakou, Constantina; Ranzani, Tommaso; Cianchetti, Matteo; Morino, Mario; Arezzo, Alberto; Menciassi, Arianna; Geng, Tao; Saaj, Chakravarthini M
2015-01-01
This paper investigates different types of crimped, braided sleeve used for a soft arm for robotic abdominal surgery, with the sleeve required to contain balloon expansion in the pneumatically actuating arm while it follows the required bending, elongation and diameter reduction of the arm. Three types of crimped, braided sleeves from PET (BraidPET) or nylon (BraidGreyNylon and BraidNylon, with different monofilament diameters) were fabricated and tested including geometrical and microstructural characterisation of the crimp and braid, mechanical tests and medical scratching tests for organ damage of domestic pigs. BraidPET caused some organ damage, sliding under normal force of 2-5 N; this was attributed to the high roughness of the braid pattern, the higher friction coefficient of polyethylene terephthalate (PET) compared to nylon, and the high frequency of the crimp peaks for this sleeve. No organ damage was observed for the BraidNylon, attributed to both the lower roughness of the braid pattern and the low friction coefficient of nylon. BraidNylon also required the lowest tensile force during its elongation to similar maximum strain as that of BraidPET, translating to low power requirements. BraidNylon is recommended for the crimped sleeve of the arm designed for robotic abdominal surgery.
Alamdari, Nasser Malekpour; Bakhtiyari, Mahmood; Gholizadeh, Barmak; Shariati, Catrine
2018-03-01
The indications for sleeve gastrectomy as a primary procedure for the surgical treatment of morbid obesity have increased worldwide. Pain is the most common complaint for patients on the first day after laparoscopic sleeve gastrectomy. There are various methods for decreasing pain after laparoscopic sleeve gastrectomy such as the use of intraperitoneal bupivacaine hydrochloride. This clinical trial was an attempt to discover the effects of intraperitoneal bupivacaine hydrochloride on alleviating postoperative pain after laparoscopic sleeve gastrectomy. In general, 120 patients meeting the inclusion criteria were enrolled. Patients were randomly allocated into two interventions and control groups using a balanced block randomization technique. One group received intraperitoneal bupivacaine hydrochloride (30 cm 3 ), and the other group served as the control one and did not receive bupivacaine hydrochloride. Diclofenac suppository and paracetamol injection were administered to both groups for postoperative pain management. The mean subjective postoperative pain score was significantly decreased in patients who received intraperitoneal bupivacaine hydrochloride within the first 24 h after the surgery; thus, the instillation of bupivacaine hydrochloride was beneficial in managing postoperative pain. The intraoperative peritoneal irrigation of bupivacaine hydrochloride (30 cm 3 , 0.25%) in sleeve gastrectomy patients was safe and effective in reducing postoperative pain, nausea, and vomiting (IRCT2016120329181N4).
Aortic Root Biomechanics After Sleeve and David Sparing Techniques: A Finite Element Analysis.
Tasca, Giordano; Selmi, Matteo; Votta, Emiliano; Redaelli, Paola; Sturla, Francesco; Redaelli, Alberto; Gamba, Amando
2017-05-01
Aortic root aneurysm can be treated with valve-sparing procedures. The David and Yacoub techniques have shown excellent long-term results but are technically demanding. Recently, a new and simpler procedure, the Sleeve technique, was proposed with encouraging results. We aimed to quantify the biomechanics of the initially aneurysmal aortic root (AR) after the Sleeve procedure to assess whether it induces abnormal stresses, potentially undermining its durability. Two finite element (FE) models of the physiologic and aneurysmal AR were built, accounting for the anatomical asymmetry and the nonlinear and anisotropic mechanical properties of human AR tissues. On the aneurysmal model, the Sleeve and David techniques were simulated based on the corresponding published technical features. Aortic root biomechanics throughout 2 consecutive cardiac cycles were computed in each simulated configuration. Both sparing techniques restored physiologic-like kinematics of aortic valve (AV) leaflets but induced different leaflets stresses. The time course averaged over the leaflets' bellies was 35% higher in the David model than in the Sleeve model. Commissural stresses, which were equal to 153 and 318 kPa in the physiologic and aneurysmal models, respectively, became 369 and 208 kPa in the David and Sleeve models, respectively. No intrinsic structural problems were detected in the Sleeve model that might jeopardize the durability of the procedure. If corroborated by long-term clinical outcomes, the results obtained suggest that using this new technique could successfully simplify the surgical repair of AR aneurysms and reduce intraoperative complications. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Ibitoye, Ayo Zaccheaus; Nwoye, Ephraim Okeke; Aweda, Adebayo Moses; Oremosu, Ademola A; Anunobi, Chidozie Charles; Akanmu, Nurudeen Olanrewaju
2016-12-01
To study the efficiency of a dual slot antenna with a floating metallic sleeve on the ablation of different ex vivo bovine tissues. COMSOL Multiphysics® version 4.4 (Stockholm, Sweden), which is based on finite element methods (FEM), was used to design and simulate monopole and dual slot with sleeve antennas. Power, specific absorption rate (SAR), temperature and necrosis distributions in the selected tissues were determined using these antennas. Monopole and dual slot with sleeve antennas were designed, simulated, constructed and applied in this study based on a semi-rigid coaxial cable. Ex vivo experiments were performed on liver, lung, muscle and heart of bovine obtained from a public animal slaughter house. The microwave energy was delivered using a 2.45 GHz solid-state microwave generator at 40 W for 3, 5 and 10 min. Aspect ratio, ablation length and ablation diameter were also determined on ablated tissues and compared with simulated results. Student's t-test was used to compare the statistically significant difference between the performance of the two antennas. The dual slot antenna with sleeve produces localised microwave energy better than the monopole antenna in all ablated tissues using simulation and experimental validation methods. There were significant differences in ablation diameter and aspect ratio between the sleeve antenna and monopole antenna. Additionally, there were no significant differences between the simulation and experimental results. This study demonstrated that the dual slot antenna with sleeve produced larger ablation zones and higher sphericity index in ex vivo bovine tissues with minimal backward heating when compared with the monopole antenna.
Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients.
Aurora, Alexander R; Khaitan, Leena; Saber, Alan A
2012-06-01
Sleeve gastrectomy has become a popular stand-alone bariatric procedure with comparable weight loss and resolution of comorbidities to that of laparoscopic gastric bypass. The simplicity of the procedure and the decreased long-term risk profile make this surgery more appealing. Nonetheless, the ever present risk of a staple-line leak is still of great concern and needs further investigation. An electronic literature search of MEDLINE database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications was completed. Keywords used in the search were "sleeve gastrectomy" OR "gastric sleeve" AND "leak." We analyzed 29 publications, including 4,888 patients. We analyzed the frequency of leak after sleeve gastrectomy and its associated risks of causation. The risk of leak after sleeve gastrectomy in all comers was 2.4%. This risk was 2.9% in the super-obese [body mass index (BMI) > 50 kg/m(2)] and 2.2% for BMI < 50 kg/m(2). Staple height and use of buttressing material did not affect leak rate. The use of a size 40-Fr or greater bougie was associated with a leak rate of 0.6% compared with those who used smaller sizes whose leak rate was 2.8%. Leaks were found at the proximal third of the stomach in 89% of cases. Most leaks were diagnosed after discharge. Endoscopic management is a viable option for leaks and was documented in 11% of cases as successful. Sleeve gastrectomy has become an important surgical option for the treatment of the ever growing morbidly obese population. The risk of leak is low at 2.4%. Attention to detail specifically at the esophagogastric junction cannot be stressed enough. Careful patient selection (BMI < 50 kg/m(2)) and adopting the use of a 40-Fr or larger bougie may decrease the risk of leak. Vigilant follow-up during the first 30 days is critical to avoid catastrophe, because most leaks will happen after patient discharge.
Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?
Rebecchi, Fabrizio; Allaix, Marco E; Patti, Marco G; Schlottmann, Francisco; Morino, Mario
2017-01-01
Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only. A few studies objectively investigated gastroesophageal function and the reflux profile by esophageal manometry and 24-h pH monitoring, reporting postoperative normalization of esophageal acid exposure in up to 85% of patients with preoperative GERD, and occurrence of de novo GERD in about 5% of cases. There is increasing evidence showing the key role of the surgical technique on the incidence of postoperative GERD. Main technical issues are a relative narrowing of the mid portion of the gastric sleeve, a redundant upper part of the sleeve (both depending on the angle under which the sleeve is stapled), and the presence of a hiatal hernia. Concomitant hiatal hernia repair is recommended. To date, either medical therapy with proton pump inhibitors or conversion of LSG to laparoscopic Roux-en-Y gastric bypass are the available options for the management of GERD after LSG. Recently, new minimally invasive approaches have been proposed in patients with GERD and hypotensive LES: the LINX® Reflux Management System procedure and the Stretta® procedure. Large studies are needed to assess the safety and long-term efficacy of these new approaches. In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5th International Consensus Conference on sleeve gastrectomy. PMID:28428706
Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?
Rebecchi, Fabrizio; Allaix, Marco E; Patti, Marco G; Schlottmann, Francisco; Morino, Mario
2017-04-07
Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only. A few studies objectively investigated gastroesophageal function and the reflux profile by esophageal manometry and 24-h pH monitoring, reporting postoperative normalization of esophageal acid exposure in up to 85% of patients with preoperative GERD, and occurrence of de novo GERD in about 5% of cases. There is increasing evidence showing the key role of the surgical technique on the incidence of postoperative GERD. Main technical issues are a relative narrowing of the mid portion of the gastric sleeve, a redundant upper part of the sleeve (both depending on the angle under which the sleeve is stapled), and the presence of a hiatal hernia. Concomitant hiatal hernia repair is recommended. To date, either medical therapy with proton pump inhibitors or conversion of LSG to laparoscopic Roux-en-Y gastric bypass are the available options for the management of GERD after LSG. Recently, new minimally invasive approaches have been proposed in patients with GERD and hypotensive LES: the LINX ® Reflux Management System procedure and the Stretta ® procedure. Large studies are needed to assess the safety and long-term efficacy of these new approaches. In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5 th International Consensus Conference on sleeve gastrectomy.
Wlaszczuk, Adam; Marcol, Wiesław; Kucharska, Magdalena; Wawro, Dariusz; Palen, Piotr; Lewin-Kowalik, Joanna
2016-11-01
The influence of different kinds of nerve guidance conduits on regeneration of totally transected rat sciatic nerves through a 7-mm gap was examined. Five different types of conduits made of chitosan and poly(D,L-lactide-co-glycolide) (PLGA) were constructed and tested in vivo. We divided 50 animals into equal groups of 10, with a different type of conduit implanted in each group: chitosan sponge core with an average molecular mass of polymer (Mv) of 287 kDa with 7 channels in a PLGA sleeve, chitosan sponge core with an Mv of 423 kDa with 7 channels in a PLGA sleeve, chitosan sponge core (Mv, 423 kDa) with 13 channels in a PLGA sleeve, chitosan multifilament yarn in a PLGA sleeve, and a PLGA sleeve only. Seven weeks after the operation, we examined the distance covered by regenerating nerve fibers, growing of nerves into the conduit's core, and intensity and type of inflammatory reaction in the conduit, as well as autotomy behavior (reflecting neuropathic pain intensity) in the animals. Two types of conduits were allowing nerve outgrowth through the gap with minor autotomy and minor inflammatory reactions. These were the conduits with chitosan multifilament yarn in a PLGA sleeve and the conduits with 13-channel microcrystalline chitosan sponge in a PLGA sleeve. The type of chitosan used to build the nerve guidance conduit influences the intensity and character of inflammatory reaction present during nerve regeneration, which in turn affects the distance crossed by regenerating nerve fibers, growing of the nerve fibers into the conduit's core, and the intensity of autotomy in the animals. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Sleeve fracture of the adult patella
Xie, Linjun; Xu, Hong; Zhang, Lizhi; Xu, Rong; Guo, Yingkun
2017-01-01
Abstract Rationale: The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group. Patient concerns: Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella. Diagnoses: Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury. Interventions: Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon. Outcomes: Six months after the operation, she could fully use her left knee without any pain and disability. Lessons: Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity. PMID:28796028
Bickel, Amitai; Shturman, Alexander; Sergeiev, Michael; Ivry, Shimon; Eitan, Arieh; Atar, Shaul
2014-10-01
Pneumatic leg sleeves are widely used after prolonged operations for prevention of venous stasis. In healthy volunteers they increase cardiac function. We evaluated the hemodynamic effects and safety of intermittent sequential pneumatic compression (ISPC) leg sleeves in patients with chronic congestive heart failure (CHF). We studied 19 patients with systolic left ventricular dysfunction and CHF. ISPC leg sleeves, each with 10 air cells, were operated by a computerized compressor, exerting 2 cycles/min. Hemodynamic and echocardiographic parameters were measured before, during, and after ISPC activation. The baseline mean left ventricular ejection fraction was 29 ± 9.2%, median 32%, range 10%-40%. Cardiac output (from 4.26 to 4.83 L/min; P = .008) and stroke volume (from 56.1 to 63.5 mL; P = .029) increased significantly after ISPC activation, without a reciprocal increase in heart rate, and declined after sleeve deactivation. Systemic vascular resistance (SVR) decreased significantly (from 1,520 to 1,216 dyne-s/cm5; P = .0005), and remained lower than the baseline level throughout the study. There was no detrimental effect on diastolic function and no adverse clinical events, despite increased pulmonary venous return. ISPC leg sleeves in patients with chronic CHF do not exacerbate symptoms and transiently improve cardiac output through an increase in stroke volume and a reduction in SVR. Copyright © 2014 Elsevier Inc. All rights reserved.
Kabukoba, J J; Pearce, J M
1993-08-01
1. To design a device that would reduce contamination of staff during obstetric procedures. 2. To undertake clinical trials to assess the effectiveness and acceptability of such a device. A prospective study. The arm sleeve is made of a nonwoven material laminated on polyethylene film making it waterproof. It has an elastomeric cuff with adhesive that ensures a watertight seal between it and the glove. Delivery suite in a teaching hospital. Doctors and midwives were requested to wear the sleeve on top of the standard gown and gloves. Each user was assessed for blood contamination at the end of the procedure and a questionnaire detailing the extent of contamination and the views of the user was completed. Eighty questionnaires were completed. The contamination of arms and hands was 3.8% and 5%, respectively. Eighty-nine percent thought the sleeve had served its purpose and 76% said they would use it regularly. The sleeve is an effective protective device which complements the glove and gown. We recommend that it should be used during all obstetric procedures.
Airborne asbestos exposures associated with work on asbestos fire sleeve materials.
Blake, Charles L; Harbison, Stephen C; Johnson, Giffe T; Harbison, Raymond D
2011-11-01
Asbestos-containing fire sleeves have been used as a fire protection measure for aircraft fluid hoses. This investigation was conducted to determine the level of airborne asbestos fiber exposure experienced by mechanics who work with fire sleeve protected hoses. Duplicate testing was performed inside a small, enclosed workroom during the fabrication of hose assemblies. Personal air samples taken during this work showed detectable, but low airborne asbestos fiber exposures. Analysis of personal samples (n=9) using phrase contract microscopy (PCM) indicated task duration airborne fiber concentrations ranging from 0.017 to 0.063 fibers per milliliter (f/ml) for sampling durations of 167-198 min, and 0.022-0.14 f/ml for 30 min samples. Airborne chrysotile fibers were detected for four of these nine personal samples, and the resulting asbestos adjusted airborne fiber concentrations ranged from 0.014 to 0.025 f/ml. These results indicate that work with asbestos fire sleeve and fire sleeve protected hose assemblies, does not produce regulatory noncompliant levels of asbestos exposure for persons who handle, cut and fit these asbestos-containing materials. Copyright © 2011 Elsevier Inc. All rights reserved.
Jam proof closure assembly for lidded pressure vessels
Cioletti, Olisse C.
1992-01-01
An expendable closure assembly is provided for use (in multiple units) with a lockable pressure vessel cover along its rim, such as of an autoclave. This assembly is suited to variable compressive contact and locking with the vessel lid sealing gasket. The closure assembly consists of a thick walled sleeve insert for retention in the under bores fabricated in the cover periphery and the sleeve is provided with internal threading only. A snap serves as a retainer on the underside of the sleeve, locking it into an under bore retention channel. Finally, a standard elongate externally threaded bolt is sized for mating cooperation with the so positioned sleeve, whereby the location of the bolt shaft in the cover bore hole determines its compressive contact on the underlying gasket.
NASA Technical Reports Server (NTRS)
Gheen, Darrell
2007-01-01
A tool makes a cut perpendicular to the cylindrical axis of a core hole at a predetermined depth to free the core at that depth. The tool does not damage the surrounding material from which the core was cut, and it operates within the core-hole kerf. Coring usually begins with use of a hole saw or a hollow cylindrical abrasive cutting tool to make an annular hole that leaves the core (sometimes called the plug ) in place. In this approach to coring as practiced heretofore, the core is removed forcibly in a manner chosen to shear the core, preferably at or near the greatest depth of the core hole. Unfortunately, such forcible removal often damages both the core and the surrounding material (see Figure 1). In an alternative prior approach, especially applicable to toxic or fragile material, a core is formed and freed by means of milling operations that generate much material waste. In contrast, the present tool eliminates the damage associated with the hole-saw approach and reduces the extent of milling operations (and, hence, reduces the waste) associated with the milling approach. The present tool (see Figure 2) includes an inner sleeve and an outer sleeve and resembles the hollow cylindrical tool used to cut the core hole. The sleeves are thin enough that this tool fits within the kerf of the core hole. The inner sleeve is attached to a shaft that, in turn, can be attached to a drill motor or handle for turning the tool. This tool also includes a cutting wire attached to the distal ends of both sleeves. The cutting wire is long enough that with sufficient relative rotation of the inner and outer sleeves, the wire can cut all the way to the center of the core. The tool is inserted in the kerf until its distal end is seated at the full depth. The inner sleeve is then turned. During turning, frictional drag on the outer core pulls the cutting wire into contact with the core. The cutting force of the wire against the core increases with the tension in the wire and, hence, with the frictional drag acting on the outer sleeve. As the wire cuts toward the center of the core, the inner sleeve rotates farther with respect to the outer sleeve. Once the wire has cut to the center of the core, the tool and the core can be removed from the hole. The proper choice of cutting wire depends on the properties of the core material. For a sufficiently soft core material, a nonmetallic monofilament can be used. For a rubber-like core material, a metal wire can be used. For a harder core material, it is necessary to use an abrasive wire, and the efficiency of the tool can be increased greatly by vacuuming away the particles generated during cutting. For a core material that can readily be melted or otherwise cut by use of heat, it could be preferable to use an electrically heated cutting wire. In such a case, electric current can be supplied to the cutting wire, from an electrically isolated source, via rotating contact rings mounted on the sleeves.
Mauriello, Claudio; Chouillard, Elie; d'alessandro, Antonio; Marte, Gianpaolo; Papadimitriou, Argyri; Chahine, Elias; Kassir, Radwan
2018-04-16
Evaluate the efficacy of single-port sleeve gastrectomy (SPSG) and then compare it to a less-invasive sleeve approach (three-port) (3PSG) according to a propensity score (PS) matching analysis. We analyzed all patients who underwent SG through a three-port or a single-port laparoscopic approach. After 2 years, the follow-up was completed in 84% patients treated with 3PSG and 95% patients of the SPSG group. Excess weight loss (EWL) was comparable for the first year of follow-up within the two groups except for the controls at 3 months in which the SPSG group showed a higher EWL (p = 0.0243). We demonstrated the efficacy of SPSG in bariatric surgery even compared to another, less invasive, laparoscopic SG approach (three-port).
PWR integral tie plate and locking mechanism
DOE Office of Scientific and Technical Information (OSTI.GOV)
Flora, B.S.; Osborne, J.L.
1980-08-26
A locking mechanism for securing an upper tie plate to the tie rods of a nuclear fuel bundle is described. The mechanism includes an upper tie plate assembly and locking sleeves fixed to the ends of the tie rods. The tie plate is part of the upper tie plate assembly and is secured to the fuel bundle by securing the entire upper tie plate assembly to the locking sleeves fixed to the tie rods. The assembly includes, in addition to the tie plate, locking nuts for engaging the locking sleeves, retaining sleeves to operably connect the locking nuts to themore » assembly, a spring biased reaction plate to restrain the locking nuts in the locked position and a means to facilitate the removal of the entire assembly as a unit from the fuel bundle.« less
The management of amputations of the leg using a new rigid foam plaster for prosthetic fitting.
Hölter, W; Echterhoff, M; Blömer, A; Verfürden, H
1980-01-01
This paper describes the use of a rigid polyurethane foam to construct a stump socket for immediate or early prosthetic fitting in 15 patients with amputation through the leg. The foam plaster is poured into a prepared cotton sleeve, with a zip incorporated, and rolled out to a layer 4 mm thick. The filled sleeve is put around the stump and the zip closed, moulding the sleeve firmly to the stump. The closed sleeve hardens into a rigid polyurethane shell within 20 min. Aferwards the skeletal prosthetic components are fixed with the same rigid foam. The polyurethane foam socket is quickly and cleanly prepared, only one third of the weight of a plaster of Paris cast and is easily removed by means of the zip, allowing access to the stump.
Wigner, E.P.; Young, G.J.
1958-10-14
A method is presented for loading and unloading rod type fuel elements of a neutronic reactor of the heterogeneous, solld moderator, liquid cooled type. In the embodiment illustrated, the fuel rods are disposed in vertical coolant channels in the reactor core. The fuel rods are loaded and unloaded through the upper openings of the channels which are immersed in the coolant liquid, such as water. Unloading is accomplished by means of a coffer dam assembly having an outer sleeve which is placed in sealing relation around the upper opening. A radiation shield sleeve is disposed in and reciprocable through the coffer dam sleeve. A fuel rod engaging member operates through the axial bore in the radiation shield sleeve to withdraw the fuel rod from its position in the reactor coolant channel into the shield, the shield snd rod then being removed. Loading is accomplished in the reverse procedure.
Transpiring purging access probe for particulate laden or hazardous environments
VanOsdol, John G
2013-12-03
An access probe for remote-sensing access through a viewing port, viewing volume, and access port into a vessel. The physical boundary around the viewing volume is partially formed by a porous sleeve lying between the viewing volume and a fluid conduit. In a first mode of operation, a fluid supplied to the fluid conduit encounters the porous sleeve and flows through the porous material to maintain the viewing volume free of ash or other matter. When additional fluid force is needed to clear the viewing volume, the pressure of the fluid flow is increased sufficiently to slidably translate the porous sleeve, greatly increasing the flow into the viewing volume. The porous sleeve is returned to position by an actuating spring. The access probe thereby provides for alternate modes of operation based on the pressure of an actuating fluid.
Composite drill pipe and method for forming same
Leslie, James C; Leslie, II, James C; Heard, James; Truong, Liem; Josephson, Marvin
2014-04-15
Metal inner and outer fittings configured, the inner fitting configured proximally with an external flange and projecting distally to form a cylindrical barrel and stepped down-in-diameter to form an abutment shoulder and then projecting further distally to form a radially inwardly angled and distally extending tapered inner sleeve. An outer sleeve defining a torque tube is configured with a cylindrical collar to fit over the barrel and is formed to be stepped up in diameter in alignment with the first abutment shoulder to then project distally forming a radially outwardly tapered and distally extending bonding surface to cooperate with the inner sleeve to cooperate with the inner sleeve in forming a annular diverging bonding cavity to receive the extremity of a composite pipe to abut against the abutment shoulders and to be bonded to the respective bonding surfaces by a bond.
Kizilcik, Nurcan; Koner, Ozge
2018-05-12
The purpose of the study was to investigate the effect of magnesium sulfate on pain management for pain after sleeve gastrectomy operation. A prospective, randomized, placebo-controlled clinical study. University hospital. Eighty patients undergoing sleeve gastrectomy. Visual analog scale for the evaluation of pain, sedation score, mean arterial pressure, heart rate, and total analgesic consumption was recorded. Serum magnesium levels were determined before the operation, at the end of the operation, and at 24 h. There were no significant differences between the groups with respect to demographics, and sedation scores. Cumulative morphine consumption and pain scores were found to be higher in the control group than the magnesium group. Perioperative use of magnesium sulfate reduced postoperative pain and opioid consumption in obese patients undergoing sleeve gastrectomy operations.
Management Options for Twisted Gastric Tube after Laparoscopic Sleeve Gastrectomy.
Abd Ellatif, Mohamed E; Abbas, Ashraf; El Nakeeb, Ayman; Magdy, Alaa; Salama, Asaad F; Bashah, Moataz M; Dawoud, Ibrahim; Gamal, Maged Ali; Sargsyan, Davit
2017-09-01
This study aims to determine the incidence, etiology, and management options for symptomatic gastric obstruction caused by axially twisted sleeve gastrectomy. In this retrospective study, we reviewed medical charts of all morbidly obese patients who underwent laparoscopic sleeve gastrectomy. Patients who developed gastric obstruction symptoms and were diagnosed with twisted sleeve gastrectomy were identified and included in this study. From October 2005 to December 2015, there are 3634 morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Eighty-six (2.3%) patients developed symptoms of gastric obstruction. Forty-five (1.23%) patients were included in this study. The mean time of presentation was 59.8 days after surgery. Upper GI contrast study was done routinely, and it was positive for axial twist in 37 (82%) patients. Abdominal CT with oral and IV contrast was done in eight (18%) when swallow study was equivocal. Endoscopic treatment was successful in 43 patients (95.5%). Sixteen patients were successfully managed by endoscopic stenting, and 29 patients had balloon dilation. The average numbers of dilation sessions were 1.7. Out of these 29 patients, 18 responded well to a single session of dilatation and did not require any further dilatation sessions. Two patients who failed to respond to three subsequent sessions of balloon dilation underwent laparoscopic adhesiolysis and gastropexy. Endoscopic stenting is an effective tool in management of axial rotation of sleeved stomach. Balloon dilation can also be effective in selected cases. Few cases might require laparoscopic adhesiolysis and gastropexy.
Kafalı, Mehmet Ertuğrul; Şahin, Mustafa; Ece, İlhan; Acar, Fahrettin; Yılmaz, Hüseyin; Alptekin, Hüsnü; Ateş, Leyla
2017-01-01
The objective of this study was to evaluate patients who underwent laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy in terms of weight loss, metabolic parameters, and postoperative complications. Data on patients who underwent laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy with a diagnosis of morbid obesity between January 2012 and June 2014 were retrospectively evaluated. Patients were compared in terms of age, sex, body mass index, duration of operation, American Society of Anesthesiologists score, perioperative complications, length of hospital stay, and long term follow-up results. During the study period, 91 patients (45 laparoscopic Roux-en-Y gastric bypass and 46 laparoscopic sleeve gastrectomy) underwent bariatric surgery. There was no difference between the two groups in terms of preoperative patient characteristics. Both groups showed statistically significant weight loss and improvement in co-morbidities when compared with the preoperative period. Weight loss and improvement in metabolic parameters were similar in both groups. The duration of operation and hospital stay was longer in the laparoscopic Roux-en-Y gastric bypass group. Furthermore, the rate of total complications was significantly lower in the laparoscopic sleeve gastrectomy group. Laparoscopic sleeve gastrectomy is a safe and effective method with a significantly lower complication rate and length of hospital stay than laparoscopic Roux-en-Y gastric bypass, with similar improvement rates in metabolic syndrome.
Welding fixture for nuclear fuel pin cladding assemblies
Oakley, David J.; Feld, Sam H.
1986-01-01
A welding fixture for locating a driver sleeve about the open end of a nuclear fuel pin cladding. The welding fixture includes a holder provided with an open cavity having shoulders for properly positioning the driver sleeve, the end cap, and a soft, high temperature resistant plastic protective sleeve that surrounds a portion of the end cap stem. Ejected contaminant particles spewed forth by closure of the cladding by pulsed magnetic welding techniques are captured within a contamination trap formed in the holder for ultimate removal and disposal of contaminating particles along with the holder.
1994-05-01
utilizes drill bits and tubing to cut through the soil. Unlike the auger method, a slurry mixture is used to keep the drill bit clean and assist in...is applied. In the sleeve pipe method, or also called tube -a-manchette, the sleeve pipe is installed in the grout hole, and sealed in place with a...acts as a one-way valve. allowing grout out of the pipe, but not back into the sleeve. A grouting tube with double packer is used to inject the grout
Unna sleeve for neurotic excoriations.
Paley, Kristina; Prevost, Noel; English, Joseph C
2010-03-01
Neurotic excoriations are self-induced skin lesions produced because of compulsive scratching or picking. We present the successful use of the venerable technique of an Unna boot used as an Unna sleeve for neurotic excoriations of the upper extremities.
New nut and sleeve improve flared connections
NASA Technical Reports Server (NTRS)
Garrard, J. S.
1965-01-01
Improved nut and sleeve of standard stainless steel flared tube connection allows forces on the mating surfaces to be uniformly applied. This can be applied to pressurized fluid systems such as refrigeration, air conditioning, and hydraulic systems.
Sleeve Push Technique: A Novel Method of Space Gaining.
Verma, Sanjeev; Bhupali, Nameksh Raj; Gupta, Deepak Kumar; Singh, Sombir; Singh, Satinder Pal
2018-01-01
Space gaining is frequently required in orthodontics. Multiple loops were initially used for space gaining and alignment. The most common used mechanics for space gaining is the use of nickel-titanium open coil springs. The disadvantage of nickel-titanium coil spring is that they cannot be used until the arches are well aligned to receive the stiffer stainless steel wires. Therefore, a new method of gaining space during initial alignment and leveling has been developed and named as sleeve push technique (SPT). The nickel-titanium wires, i.e. 0.012 inches and 0.014 inches along with archwire sleeve (protective tubing) can be used in a modified way to gain space along with alignment. This method helps in gaining space right from day 1 of treatment. The archwire sleeve and nickel-titanium wire in this new SPT act as a mutually synergistic combination and provide the orthodontist with a completely new technique for space opening.
Beaudreuil, Johann; Bendaya, Samy; Faucher, Marc; Coudeyre, Emmanuel; Ribinik, Patricia; Revel, Michel; Rannou, François
2009-12-01
To develop clinical practice guidelines concerning the use of bracing--rest orthosis, knee sleeves and unloading knee braces--for knee osteoarthritis. The French Physical Medicine and Rehabilitation Society (SOFMER) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by multidisciplinary expert panel, was used. Few high-level studies of bracing for knee osteoarthritis were found. No evidence exists for the effectiveness of rest orthosis. Evidence for knee sleeves suggests that they decrease pain in knee osteoarthritis, and their use is associated with subjective improvement. These actions do not appear to depend on a local thermal effect. The effectiveness of knee sleeves for disability is not demonstrated for knee osteoarthritis. Short- and mid-term follow-up indicates that valgus knee bracing decreases pain and disability in medial knee osteoarthritis, appears to be more effective than knee sleeves, and improves quality of life, knee proprioception, quadriceps strength, and gait symmetry, and decreases compressive loads in the medial femoro-tibial compartment. However, results of response to valgus knee bracing remain inconsistent; discomfort and side effects can result. Thrombophlebitis of the lower limbs has been reported with the braces. Braces, whatever kind, are infrequently prescribed in clinical practice for osteoarthritis of the lower limbs. Modest evidence exists for the effectiveness of bracing--rest orthosis, knee sleeves and unloading knee braces--for knee osteoarthritis, with only low level recommendations for its use. Braces are prescribed infrequently in French clinical practice for osteoarthritis of the knee. Randomized clinical trials concerning bracing in knee osteoarthritis are still necessary.
García-Díaz, Juan José; Ferrer-Márquez, Manuel; Moreno-Serrano, Almudena; Barreto-Rios, Rogelio; Alarcón-Rodríguez, Raquel; Ferrer-Ayza, Manuel
2016-01-01
Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy. A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study. There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series. Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.
Seismic retrofit of spliced sleeve connections for precast bridge piers.
DOT National Transportation Integrated Search
2017-03-01
Grouted Splice Sleeve (GSS) connectors are being considered for connecting bridge columns, footings, and pier caps in Accelerated Bridge Construction (ABC). A repair technique for precast reinforced concrete bridge column-to-footing and column-to-pie...
Park, Sin Hyung; Choi, Yeong-Jin; Moon, Sang Won; Lee, Byung Hoon; Shim, Jin-Hyung; Cho, Dong-Woo; Wang, Joon Ho
2018-01-01
To investigate the efficacy of the insertion of 3-dimensional (3D) bio-printed scaffold sleeves seeded with mesenchymal stem cells (MSCs) to enhance osteointegration between the tendon and tunnel bone in anterior cruciate ligament (ACL) reconstruction in a rabbit model. Scaffold sleeves were fabricated by 3D bio-printing. Before ACL reconstruction, MSCs were seeded into the scaffold sleeves. ACL reconstruction with hamstring tendon was performed on both legs of 15 adult rabbits (aged 12 weeks). We implanted 15 bone tunnels with scaffold sleeves with MSCs and implanted another 15 bone tunnels with scaffold sleeves without MSCs before passing the graft. The specimens were harvested at 4, 8, and 12 weeks. H&E staining, immunohistochemical staining of type II collagen, and micro-computed tomography of the tunnel cross-sectional area were evaluated. Histologic assessment was conducted with a histologic scoring system. In the histologic assessment, a smooth bone-to-tendon transition through broad fibrocartilage formation was identified in the treatment group, and the interface zone showed abundant type II collagen production on immunohistochemical staining. Bone-tendon healing histologic scores were significantly higher in the treatment group than in the control group at all time points. Micro-computed tomography at 12 weeks showed smaller tibial (control, 9.4 ± 0.9 mm 2 ; treatment, 5.8 ± 2.9 mm 2 ; P = .044) and femoral (control, 9.6 ± 2.9 mm 2 ; treatment, 6.0 ± 1.0 mm 2 ; P = .03) bone-tunnel areas in the treated group than in the control group. The 3D bio-printed scaffold sleeve with MSCs exhibited excellent results in osteointegration enhancement between the tendon and tunnel bone in ACL reconstruction in a rabbit model. If secure biological healing between the tendon graft and tunnel bone can be induced in the early postoperative period, earlier, more successful rehabilitation may be facilitated. Three-dimensional bio-printed scaffold sleeves with MSCs have the potential to accelerate bone-tendon healing in ACL reconstruction. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Welding fixture for nuclear fuel pin cladding assemblies
Oakley, D.J.; Feld, S.H.
1984-02-22
A welding fixture is described for locating a driver sleeve about the open end of a nuclear fuel pin cladding. The welding fixture includes a holder provided with an open cavity having shoulders for properly positioning the driver sleeve, the end cap, and a soft, high temperature resistant plastic protective sleeve that surrounds a portion of the end cap stem. Ejected contaminant particles spewed forth by closure of the cladding by pulsed magnetic welding techniques are captured within a contamination trap formed in the holder for ultimate removal and disposal of contaminating particles along with the holder.
Insulation Testing Using Cryostat Apparatus with Sleeve
NASA Technical Reports Server (NTRS)
Fesmire, J. E.; Augustynowicz, S. D.
1999-01-01
The method and equipment of testing continuously rolled insulation materials is presented in this paper. Testing of blanket and molded products is also facilitated. Materials are installed around a cylindrical copper sleeve using a wrapping machine. The sleeve is slid onto the vertical cold mass of the cryostat. The gap between the cold mass and the sleeve measures less than 1 mm. The cryostat apparatus is a liquid nitrogen boiloff calorimeter system that enables direct measurement of the apparent thermal conductivity (k-value) of the insulation system at any vacuum level between 5 x 10(exp -5) and 760 torr. Sensors are placed between layers of the insulation to provide complete temperature-thickness profiles. The temperatures of the cold mass (maintained at 77.8 kelvin (K)), the sleeve (cold boundary temperature (CBT)), the insulation outer surface (warm boundary temperature (WBT)), and the vacuum can (maintained at 313 K by a thermal shroud) are measured. Plots of CBT, WBT, and layer temperature profiles as functions of vacuum level show the transitions between the three dominant heat transfer modes. For this cryostat apparatus, the measureable heat gain is from 0.2 to 20 watts. The steady-state measurement of k-value is made when all temperatures and the boiloff rate are stable.
Status of the steam generator tube circumferential ODSCC degradation experienced at the Doel 4 plant
DOE Office of Scientific and Technical Information (OSTI.GOV)
Roussel, G.
1997-02-01
Since the 1991 outage, the Doel Unit 4 nuclear power plant is known to be affected by circumferential outside diameter intergranular stress corrosion cracking at the hot leg tube expansion transition. Extensive non destructive examination inspections have shown the number of tubes affected by this problem as well as the size of the cracks to have been increasing for the three cycles up to 1993. As a result of the high percentage of tubes found non acceptable for continued service after the 1993 in-service inspection, about 1,700 mechanical sleeves were installed in the steam generators. During the 1994 outage, allmore » the tubes sleeved during the 1993 outage were considered as potentially cracked to some extent at the upper hydraulic transition and were therefore not acceptable for continued service. They were subsequently repaired by laser welding. Furthermore all the tubes not sleeved during the 1993 outage were considered as not acceptable for continued service and were repaired by installing laser welded sleeves. During the 1995 outage, some unexpected degradation phenomena were evidenced in the sleeved tubes. This paper summarizes the status of the circumferential ODSCC experienced in the SG tubes of the Doel 4 plant as well as the other connected degradation phenomena.« less
Effect of insulator sleeve material on the x-ray emission from a plasma focus device
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hussain, S.; Badar, M. A.; Shafiq, M.
The effect of insulator sleeve material on x-ray emission from a 2.3 kJ Mather type plasma focus device operated in argon-hydrogen mixture is investigated. The time and space resolved x-ray emission characteristics are studied by using a three channel p-i-n diode x-ray spectrometer and a multipinhole camera. The x-ray emission depends on the volumetric ratio of argon-hydrogen mixture as well as the filling pressure and the highest x-ray emission is observed for a volumetric ratio 40% Ar to 60%H{sub 2} at 2.5 mbar filling pressure. The fused silica insulator sleeve produces the highest x-ray emission whereas nonceramic insulator sleeves suchmore » as nylon, Perspex, or Teflon does not produce focus or x-rays. The pinhole images of the x-ray emitting zones reveal that the contribution of the Cu K{alpha} line is weak and plasma x-rays are intense. The highest plasma electron temperature is estimated to be 3.3 and 3.6 keV for Pyrex glass and fused silica insulator sleeves, respectively. It is speculated that the higher surface resistivity of fused silica is responsible for enhanced x-ray emission and plasma electron temperature.« less
Nguyen, Ninh T; Nguyen, Brian; Gebhart, Alana; Hohmann, Samuel
2013-02-01
Laparoscopic sleeve gastrectomy is gaining popularity in the US; however, there has been no study examining the use of sleeve gastrectomy at a national level and its impact on the use of other bariatric operations. The aim of this study was to examine contemporary changes in use and outcomes of bariatric surgery performed at academic medical centers. Using ICD-9 diagnosis and procedure codes, clinical data obtained from the University HealthSystem Consortium database for all bariatric procedures performed for the treatment of morbid obesity between October 1, 2008 and September 30, 2012 were reviewed. Quartile trends in use for the 3 most commonly performed bariatric operations were examined, and a comparison of perioperative outcomes between procedures was performed within a subset of patients with minor severity of illness. A total of 60,738 bariatric procedures were examined. In 2008, the makeup of bariatric surgery consisted primarily of gastric bypass (66.8% laparoscopic, 8.6% open), followed by laparoscopic gastric banding (23.8%). In 2012, there was a precipitous increase in use of laparoscopic sleeve gastrectomy (36.3 %), with a concurrent reduction in the use of laparoscopic (56.4%) and open (3.2%) gastric bypass, and a major reduction in laparoscopic gastric banding (4.1%). The length of hospital stay, in-hospital morbidity and mortality, and costs for laparoscopic sleeve gastrectomy were found to be between those of laparoscopic gastric banding and laparoscopic gastric bypass. Within the context of academic medical centers, there has been a recent change in the makeup of bariatric surgery. There has been an increase in the use of laparoscopic sleeve gastrectomy, which has had an impact primarily on reducing the use of laparoscopic adjustable gastric banding. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Method for hot press forming articles
Baker, Robert R.; Hartsock, Dale L.
1982-01-01
This disclosure relates to an improved method for achieving the best bond strength and for minimizing distortion and cracking of hot pressed articles. In particular, in a method for hot press forming both an outer facing circumferential surface of and an inner portion of a hub, and of bonding that so-formed outer facing circumferential surface to an inner facing circumferential surface of a pre-formed ring thereby to form an article, the following improvement is made. Normally, in this method, the outside ring is restrained by a restraining sleeve of ring-shaped cross-section having an inside diameter. A die member, used to hot press form the hub, is so-formed as to have an outside diameter sized to engage the inside diameter of the restraining sleeve in a manner permitting relative movement therebetween. The improved method is one in which several pairs of matched restraining sleeve and die member are formed with each matched pair having a predetermined diameter. The predetermined diameter of each matched pair is different from another matched pair by stepped increments. The largest inside diameter of a restraining sleeve is equal to the diameter of the outer facing circumferential surface of the hub. Each pair of the matched restraining sleeve and die member is used to form an article in which an inside hub is bonded to an outside ring. The several samples so-formed are evaluated to determine which sample has the best bond formed between the hub and the ring with the least or no cracking or distortion in the ring portion of the article. Thereafter, the matched restraining sleeve and die member which form the article having the best bonding characteristics and least distortion cracking is then used for repeated formations of articles.
Hospital Variation in Perioperative Complications for Laparoscopic Sleeve Gastrectomy in Michigan
Pradarelli, Jason C.; Varban, Oliver A.; Ghaferi, Amir A.; Weiner, Matthew; Carlin, Arthur M.; Dimick, Justin B.
2015-01-01
Structured Abstract Background Laparoscopic sleeve gastrectomy has recently surpassed gastric bypass and laparoscopic adjustable gastric banding as the most common weight-loss procedure. Previously, substantial concerns existed regarding variation in perioperative safety with bariatric surgery. This study aimed to assess rates of perioperative complications for laparoscopic sleeve gastrectomy across hospitals and in relation to procedure volume. Study Design We analyzed 8,693 patients who underwent laparoscopic sleeve gastrectomy from 2013 through 2014 across 40 hospitals in the Michigan Bariatric Surgery Collaborative. Mixed-effects logistic regression was used to assess hospital variation in risk- and reliability-adjusted rates of overall and serious 30-day complications and their relationship with hospital annual stapling procedure volume (gastric bypass and sleeve gastrectomy). Results Overall, 5.4% of patients experienced perioperative complications. Adjusted rates of overall complications varied three-fold across hospitals, ranging from 3.6% (95% CI, 1.9–6.8%) to 11.0% (95% CI, 7.7–15.5%). Serious complications occurred in just 1.2% of patients and varied minimally. In this analysis, hospital volume was not associated with overall or serious complications. The 1 hospital with significantly lower overall complication rates was high-volume (≥125 procedures/year); however, of the 4 hospitals with significantly higher complication rates, 3 were medium-volume (50–124 procedures/year) and 1 was high-volume. The remaining hospitals were not significantly different than the cohort mean. Conclusions Serious complications among patients undergoing laparoscopic sleeve gastrectomy were relatively infrequent. Rates of overall complications varied widely across Michigan hospitals enrolled in a quality collaborative, although this variation was unrelated to volume standards required for accreditation as a comprehensive bariatric surgery center. PMID:26506567
Thermal characterization of phacoemulsification probes operated in axial and torsional modes.
Zacharias, Jaime
2015-01-01
To analyze temperature increases and identify potential sources of heat generated when sleeved and sleeveless phacoemulsification probes were operated in axial and torsional modes using the Infiniti Vision System with the Ozil torsional handpiece. Phacodynamics Laboratory, Pasteur Ophthalmic Clinic, Santiago, Chile. Experimental study. Two computer-controlled thermal transfer systems were developed to evaluate the contribution of internal metal stress and tip-to-sleeve friction on heat generation during phacoemulsification using axial and torsional ultrasound modalities. Both systems incorporated infrared thermal imaging and used a black-body film to accurately capture temperature measurements. Axial mode was consistently associated with greater temperature increases than torsional mode whether tips were operated with or without sleeves. In tests involving bare tips, axial mode and torsional mode peaked at 51.7°C and 34.2°C, respectively. In an example using sleeved tips in which a 30.0 g load was applied for 1 second, temperatures for axial mode reached 45°C and for torsional mode, 38°C. Friction between the sleeved probe and the incisional wall contributed more significantly to the temperature increase than internal metal stress regardless of the mode used. In all experiments, the temperature increase observed with axial mode was greater than that observed with torsional mode, even when conditions such as power or amplitude and flow rate were varied. Tip-to-sleeve friction was a more dominant source of phaco probe heating than internal metal stress. The temperature increase due to internal metal stress was greater with axial mode than with torsional mode. Dr. Zacharias received research funding from Alcon Laboratories, Inc., to conduct this study. He has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Saber, Alan A; Shoar, Saeed; Khoursheed, Mousa
2017-08-01
Despite its technical simplicity, laparoscopic sleeve gastrectomy (LSG) complications are increasingly reported. Intra-thoracic sleeve migration (ITSM ) is a rare complication after LSG which has been inconsistently addressed in the literature. The purpose of this study was to emphasize ITSM occurrence after LSG and evaluate the perioperative factors associated with its development. Between January and July 2016, LSG patients diagnosed with ITSM at two bariatric surgery departments were identified. Perioperative factors were assessed for all the patients and compared between two groups, LSG alone and LSG with concomitant hiatal hernia (HH) repair (HHR). A total of 19 patients (6 males and 13 females) were included. Central obesity was present in 18 patients (94.7%). Nine patients (47.4%) had concomitant hiatal hernia repair during their original LSG. Post-LSG GERD (94.7%) (38.9% de novo and 61.1% recurrent) and post-LSG constipation (57.9%) were commonly associated with ITSM. Severe refractory GERD was the most common presentation for ITSM (94.7%), followed by epigastric pain (47.4%), persistent nausea/vomiting (36.8%), and dysphagia (21.1%). Time interval between primary LSG and ITSM diagnosis ranged from 1 day to 3 years. Patients with LSG and concomitant HHR presented with higher post-LSG BMI compared to the LSG patients (37 ± 6.4 kg/m 2 vs. 30.1 ± 6.3 kg/m 2 , p = 0.03). All the patients underwent successful reduction of ITSM and subsequent HHR. Central obesity, chronic constipation, post-LSG GERD, and concomitant HHR are commonly seen in post-laparoscopic sleeve gastrectomy intra-thoracic sleeve migration.
High-Temperature Helical-Tube Solar Receiver
NASA Technical Reports Server (NTRS)
Robertson, C. S., Jr.; Mccreight, L.
1984-01-01
Solar-thermal receiver used with circular parabolic concentrator to supply about 58 kW thermal power to Brayton engine or industrial process. Solar radiation focused into open end of cylindrical ceramic thermal inertial sleeve 8 in. in diameter that reradiates energy to helical heatexchanger tube surrounding sleeve.
77 FR 39188 - Airworthiness Directives; the Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2012-07-02
... existing AD currently requires repetitive inspections to detect discrepancies of the wiring and surrounding... new sleeves, for certain airplanes; and repair or replacement of the wiring and sleeves with new parts... currently requires repetitive inspections to detect discrepancies of the wiring and surrounding Teflon...
Gandhi, Varun; Roberts, Philip J W; Stoesser, Thorsten; Wright, Harold; Kim, Jae-Hong
2011-07-01
Three-dimensional laser-induced fluorescence (3DLIF) was applied to visualize and quantitatively analyze mixing in a lab-scale UV reactor consisting of one lamp sleeve placed perpendicular to flow. The recirculation zone and the von Karman vortex shedding that commonly occur in flows around bluff bodies were successfully visualized. Multiple flow paths were analyzed by injecting the dye at various heights with respect to the lamp sleeve. A major difference in these pathways was the amount of dye that traveled close to the sleeve, i.e., a zone of higher residence time and higher UV exposure. Paths away from the center height had higher velocities and hence minimal influence by the presence of sleeve. Approach length was also characterized in order to increase the probability of microbes entering the region around the UV lamp. The 3DLIF technique developed in this study is expected to provide new insight on UV dose delivery useful for the design and optimization of UV reactors. Copyright © 2011 Elsevier Ltd. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cullen, W.K.; Keating, R.F.
1997-02-01
In the Spring and Fall of 1994, and the Spring of 1995, crack-like indications were found in the upper hybrid expansion joint (HEJ) region of Steam Generator (S/G) tubes which had been sleeved using Westinghouse HEJ sleeves. As a result of these findings, analytic and test evaluations were performed to assess the effect of the degradation on the structural, and leakage, integrity of the sleeve/tube joint relative to the requirements of the United States Nuclear Regulatory Commission`s (NRC) draft Regulatory Guide (RG) 1.121. The results of these evaluations demonstrated that tubes with implied or known crack-like circumferential parent tube indicationsmore » (PTIs) located 1.1 inches or farther below the bottom of the hardroll upper transition, have sufficient, and significant, integrity relative to the requirements of RG 1.121. Thus, the purpose of this report is to provide background information related to the justification of the modified tube repair boundary.« less
The effects of sleeve gastectomy on gastro-esophageal reflux and gastro-esophageal motility.
Hayat, Jamal O; Wan, Andrew
2014-05-01
Sleeve gastrectomy is an increasingly performed bariatric procedure associated with low morbidity and good short to medium term effects on weight loss and comorbid conditions. Studies assessing the prevalence of post-operative gastro-esophageal reflux disease (GERD), show sleeve gastrectomy may provoke de novo GERD symptoms or worsening of pre-existing GERD. Pathophysiological mechanisms of GERD after sleeve gastrectomy include a hypotensive lower esophageal sphincter, increased gastro-esophageal pressure gradient and intra-thoracic migration of the remnant stomach. A reduction in the compliance of the gastric remnant may provoke an increase in transient lower esophageal sphincter relaxations. Time-resolved MRI suggests relative gastric stasis in the proximal remnant and increased emptying from the antrum. A lack of standardisation of technique, along with heterogeneity of studies assessing GERD may explain the wide variability in reported results. Simultaneous and careful repair of an associated hiatus hernia may result in a reduction in the prevalence of post-operative GERD.
Apparatus for enhancing tissue repair in mammals
NASA Technical Reports Server (NTRS)
Goodwin, Thomas J. (Inventor); Parker, Clayton R. (Inventor)
2007-01-01
An apparatus is disclosed for enhancing tissue repair in mammals, with the apparatus comprising: a sleeve for encircling a portion of a mammalian body part, said sleeve comprising an electrically conductive coil capable of generating an electromagnetic field when an electrical current is applied thereto, means for supporting the sleeve on the mammalian body part; and means for supplying the electrically conductive coil with a square wave time varying electrical current sufficient to create a time varying electromagnetic force of from approximately 0.05 gauss to 0.05 gauss within the interior of the coil in order that when the sleeve is placed on a mammalian body part and the time varying electromagnetic force of from approximately 0.05 gauss to 0.05 gauss is generated on the mammalian body part for an extended period of time, tissue regeneration within the mammalian body part is increased to a rate in excess of the normal tissue regeneration rate that would occur without application of the time varying electromagnetic force.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Habibi, M., E-mail: mortezahabibi@aut.ac.ir; Sharifi, R.; Amrollahi, R.
2013-12-15
The variation of the X-ray intensity has been investigated with the Pyrex and quartz insulators surface contamination in a 4-kJ plasma focus device with argon gas at 11.5-kV charging voltage. Elemental analysis (EDAX) showed that the Cu evaporated from the electrode material and was deposited on the sleeve surface improves the breakdown conditions. A small level of sleeve contamination by copper is found to be essential for good focusing action and high HXR intensity. The SEM imaging showed the grain-type structure of Cu formed on the surface and it changed the surface property. Resistance measurements of original and coated Pyrexmore » surface proved that the copper deposition on the sleeve surface will reduce its resistance as compared to the almost infinitely large resistance of the uncontaminated sleeve. As the contamination is surpassed to some critical level, the HXR intensity from the device is deteriorated.« less
Pawanindra, Lal; Vindal, Anubhav; Midha, Manoj; Nagpal, Prashant; Manchanda, Alpana; Chander, Jagdish
2015-10-01
Pre- and post-operative stomach volumes can be important determinants for effectiveness of laparoscopic sleeve gastrectomy (LSG) in causing weight loss. There is little existing data on the volumes of stomach preoperatively and that excised during LSG. This study was designed to evaluate the change in gastric volume after LSG using multi-detector CT and to correlate it with early post-operative weight loss. Twenty consecutive patients with BMI ≥ 40 kg/m(2) and medical comorbidities underwent LSG between October 2011 and October 2013 and were analysed prospectively. The pre-operative stomach volume was measured by MDCT done 1-3 days before the surgery. LSG was performed in the standard manner using a 36F bougie. The volume of excised stomach was measured by distending the specimen with saline. MDCT of the upper abdomen was repeated 3 months postoperatively to calculate the gastric sleeve volume. Weight loss and resolution of comorbidities were documented. The mean pre-operative weight of patients was 123.90 kg, and the mean pre-operative stomach volume on MDCT was 1,067 ml. The stomach volume on pre-operative MDCT correlated with pre-operative weight and BMI. The mean volume of the excised stomach was 859 ml when measured by distension of the specimen and 850 ml on MDCT. After 3 months post surgery, the mean volume of gastric sleeve on MDCT was 217 ml, and the mean weight of the patients was 101.22 kg. The volume of the excised stomach calculated by MDCT correlated with the weight loss achieved 3 months postoperatively. However, no correlation was seen between the gastric sleeve volume 3 months postoperatively and weight loss during this period. MDCT is a good method to measure gastric volume before and after LSG. Early post-operative weight loss (3 months) correlates well with the volume of the excised stomach but not with that of the gastric sleeve.
Hjorth, M H; Egund, N; Mechlenburg, I; Gelineck, J; Jakobsen, S S; Soballe, K; Stilling, M
2016-12-01
Little is known about pseudotumor frequency and risk factors for pseudotumor formation among different types of metal-on-metal (MoM) hip arthroplasties. A lower release of chromium and cobalt have been reported in MoM hip arthroplasties with a titanium sleeve compared to MoM designs without a titanium sleeve, but yet it is unknown whether a titanium sleeve reduces the pseudotumor frequency. We conducted a cross-sectional study to investigate: 1) pseudotumor frequency, 2) risk factors of pseudotumor formation 3) and correlations between pseudotumors, serum metal-ions, implant position, and clinical symptoms. We expected a lower pseudotumor frequency in MoM hip articulation with a titanium sleeve than reported in MoM hip articulation designs using chromium-cobalt sleeve. A consecutive series of 41 patients/49 hips (31 males), mean age 52 (28-68) years, participated in a 5.5±0.5 (4-6.5) year follow-up study of their M2a_Magnum hip articulation (Biomet Inc., Warsaw, Indiana, USA). Patients were evaluated with magnetic resonance imaging (MRI), measurements of serum metal-ions, plain radiographs, and clinical outcome measures of Harris Hip Score (HHS) and Oxford Hip Score (OHS). Eighteen of 47 hips (38%) had MRI-verified pseudotumors, all cystic, with a mean dimension of 10.6×25.6×41mm. Digital measurements on plain radiographs revealed a higher cup anteversion in patients with a pseudotumor of mean 28.4°±5.05° compared to mean 23.5°±6.5° in patients without a pseudotumor (P=0.009). Serum metal-ion concentrations, acetabular cup inclination and measures of HHS and OHS were similar between patients with and without a pseudotumor (P>0.46). At 5.5±0.5years after surgery, MRI-verified cystic pseudotumors were frequently observed in M2a_Magnum hip articulations despite the use of titanium sleeves. The pseudotumors were related to high cup anteversion angles but not related to high serum metal-ions or clinical symptoms. IV: cross-sectional study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Bronchial and arterial sleeve resection for centrally-located lung cancers
D’Andrilli, Antonio; Venuta, Federico; Rendina, Erino Angelo
2016-01-01
The use of bronchial and arterial sleeve resections for the treatment of centrally-located lung cancers, when available, has become the option of choice in comparison with pneumonectomy (PN). Technical expertise, in particular in vascular reconstruction, and perioperative management improved over time allowing excellent short-term and long-term results. This is even truer if considering literature data from the main experiences published in the last years. These evidences have given to such lung sparing reconstructive procedures more and more acceptance among the surgical community. This article focuses on the main technical aspects and literature data regarding bronchovascular sleeve resections. PMID:27942409
NASA Technical Reports Server (NTRS)
Wang, D. S.; Warren, A. D. (Inventor)
1980-01-01
A method for installing fragile, high temperature insulation batting in an elongated cavity or in a resilient wire sleeve to form a resilient seal. The batting is preformed to rough dimensions and wrapped in a plastic film, the film being of a material which is fugitive at a high temperature. The film is heat sealed and trimmed to form a snugly fit skin which overlaps at least at one end to permit attachment of a pull cord. The film absorbs the tensile force of pulling the film enclosed batting through the cavity or wire mesh sleeve and is subsequently driven off by high temperature baking, leaving only the insulation in the cavity or wire mesh sleeve.
Study on coming out of the shaft from ceramic sleeve in terms of the residual displacement
NASA Astrophysics Data System (ADS)
Zhang, G. W.; Noda, N.-A.; Sano, Y.; Sakai, H.
2018-06-01
Ceramic roller can be used in the heating furnace conveniently because of its high temperature resistance. However, the coming out of the shaft may often happen from the ceramic sleeve under repeated load. In this paper, a two-dimensional shrink fitted structure is considered by replacing the shaft with the inner plate and by replacing the sleeve with the outer plate. Based on the model with stopper, the FEM simulation is performed under alternate loading with certain intervals newly added. The analysis results show that the coming out failure can be explained from the residual displacement accumulation during these intervals.
77 FR 36146 - Airworthiness Directives; Airbus Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-18
... airplanes to the applicability. We are issuing this AD to prevent degradation of the electrical insulation... could cause the level sensor to heat above acceptable limits, possibly resulting in a fuel tank... connector sleeves materials fitted to the MTI units. Degradation of the electrical insulation sleeves of the...
76 FR 68671 - Airworthiness Directives; Airbus Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2011-11-07
... incorrect connector sleeves materials fitted to the MTI units. Degradation of the electrical insulation... condition, if not corrected, could cause the level sensor to heat above acceptable limits, possibly.... Degradation of the electrical insulation sleeves of the Low- level indication lamps on the MTI of the flight...
77 FR 65501 - Airworthiness Directives; The Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2012-10-29
... done. (g) Retained Replacement of Wiring, Installation of Sleeving, and Associated Actions This... requires replacing wiring for the fuel boost pumps and override pumps with new wiring, installing Teflon sleeving on the wiring, and doing associated actions; and doing repetitive inspections to detect damage of...
78 FR 10499 - Airworthiness Directives; The Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2013-02-14
... done. (g) Retained Replacement of Wiring, Installation of Sleeving, and Associated Actions This... replacing wiring for the fuel boost pumps and override pumps with new wiring, installing Teflon sleeving on the wiring, and doing associated actions; and doing repetitive inspections to detect damage of the...
Effect of brace design on patients with ACL-ruptures.
Strutzenberger, G; Braig, M; Sell, S; Boes, K; Schwameder, H
2012-11-01
Different designs of functional knee braces for ACL-injury rehabilitation exist. In addition to the mechanical stabilization provided by rigid shell braces, sleeve braces also address proprioceptive mechanisms, but little is known if this leads to benefits for ACL-deficient subjects. Therefore the aim of this study was to investigate the effect of 2 different functional brace designs (shell and sleeve brace) on functional achievements in ACL-deficient patients. 28 subjects with ACL-ruptured knees performed tests for knee joint laxity, joint position sense, static and dynamic balance and isometric and dynamic lower limb extension strength in non-braced, sleeve braced and shell braced condition. The results showed a significant decrease in knee joint laxity for sleeve (33%; p<0.001) and rigid shell bracing (14%, p=0.039). The sleeve brace revealed a significant increase in dynamic balance after perturbation (20%; p=0.024) and a significant increase in dynamic lower limb peak rate of force development (17%; p=0.015) compared to the non-braced condition. The effects might be caused by the flexible area of support and the incorporated mechanisms to address proprioceptive aspects. Braces might not be needed in simple daily life tasks, but could provide beneficial support in more dynamic settings when patients return to sporting activities after an ACL-injury. © Georg Thieme Verlag KG Stuttgart · New York.
Avidov, R; Saadi, I; Krassnovsky, A; Hanan, A; Medina, Sh; Raviv, M; Chen, Y; Laor, Y
2017-09-01
Composting in polyethylene sleeves with forced aeration may minimize odor emissions, vectors attraction and leachates associated with open windrows. A disadvantage of this technology is the lack of mixing during composting, potentially leading to non-uniform products. In two pilot experiments using biosolids and green waste (1:1; v:v), thermophilic conditions (>45°C) were maintained for two months, with successful control of oxygen levels and sufficient moisture. Emitted odors declined from 1.5-3.8×10 5 to 5.9×10 3 -2.3×10 4 odor units m -3 -air in the first 3weeks of the process, emphasizing the need of odor control primarily during this period. Therefore, composting might be managed in two phases: (i) a closed sleeve for 6-8weeks during which the odor is treated; (ii) an open pile (odor control is not necessary). Reduction of salmonella, E. coli and coliforms was effective initially, meeting the standards of "Class A" biosolids; however, total and fecal coliforms density increased after opening the second sleeve and exceeded the standard of 1000 most probable number (MPN) per g dry matter. Compost maturity was achieved in the open piles following the two sleeves and the final compost was non-phytotoxic and beneficial as a soil additive. Copyright © 2017 Elsevier Ltd. All rights reserved.
Self-actuating and locking control for nuclear reactor
Chung, Dong K.
1982-01-01
A self-actuating, self-locking flow cutoff valve particularly suited for use in a nuclear reactor of the type which utilizes a plurality of fluid support neutron absorber elements to provide for the safe shutdown of the reactor. The valve comprises a substantially vertical elongated housing and an aperture plate located in the housing for the flow of fluid therethrough, a substantially vertical elongated nozzle member located in the housing and affixed to the housing with an opening in the bottom for receiving fluid and apertures adjacent a top end for discharging fluid. The nozzle further includes two sealing means, one located above and the other below the apertures. Also located in the housing and having walls surrounding the nozzle is a flow cutoff sleeve having a fluid opening adjacent an upper end of the sleeve, the sleeve being moveable between an upper open position wherein the nozzle apertures are substantially unobstructed and a closed position wherein the sleeve and nozzle sealing surfaces are mated such that the flow of fluid through the apertures is obstructed. It is a particular feature of the present invention that the valve further includes a means for utilizing any increase in fluid pressure to maintain the cutoff sleeve in a closed position. It is another feature of the invention that there is provided a means for automatically closing the valve whenever the flow of fluid drops below a predetermined level.
Desart, Kenneth; Rossidis, Georgios; Michel, Michael; Lux, Tamara; Ben-David, Kfir
2015-10-01
Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy. This study was conducted at the University Medical Center. This is a retrospective review of seven consecutive patients who had a laparoscopic LINX® magnetic sphincter device placement for patients with refractory gastroesophageal reflux disease after laparoscopic sleeve gastrectomy between July 2014 and April 2015. All patients were noted to have self-reported greatly improved gastroesophageal reflux symptoms 2-4 weeks after their procedure. They were all noted to have statistically significant improved severity and frequency of their reflux, regurgitation, epigastric pain, sensation of fullness, dysphagia, and cough symptoms in their postoperative GERD symptoms compared with their preoperative evaluation. This is the first reported pilot case series, illustrating that the LINX® device is a safe and effective option in patients with de novo refractory gastroesophageal reflux disease after a laparoscopic sleeve gastrectomy despite appropriate weight loss.
Using arm and hand gestures to command robots during stealth operations
NASA Astrophysics Data System (ADS)
Stoica, Adrian; Assad, Chris; Wolf, Michael; You, Ki Sung; Pavone, Marco; Huntsberger, Terry; Iwashita, Yumi
2012-06-01
Command of support robots by the warfighter requires intuitive interfaces to quickly communicate high degree-offreedom (DOF) information while leaving the hands unencumbered. Stealth operations rule out voice commands and vision-based gesture interpretation techniques, as they often entail silent operations at night or in other low visibility conditions. Targeted at using bio-signal inputs to set navigation and manipulation goals for the robot (say, simply by pointing), we developed a system based on an electromyography (EMG) "BioSleeve", a high density sensor array for robust, practical signal collection from forearm muscles. The EMG sensor array data is fused with inertial measurement unit (IMU) data. This paper describes the BioSleeve system and presents initial results of decoding robot commands from the EMG and IMU data using a BioSleeve prototype with up to sixteen bipolar surface EMG sensors. The BioSleeve is demonstrated on the recognition of static hand positions (e.g. palm facing front, fingers upwards) and on dynamic gestures (e.g. hand wave). In preliminary experiments, over 90% correct recognition was achieved on five static and nine dynamic gestures. We use the BioSleeve to control a team of five LANdroid robots in individual and group/squad behaviors. We define a gesture composition mechanism that allows the specification of complex robot behaviors with only a small vocabulary of gestures/commands, and we illustrate it with a set of complex orders.
Using Arm and Hand Gestures to Command Robots during Stealth Operations
NASA Technical Reports Server (NTRS)
Stoica, Adrian; Assad, Chris; Wolf, Michael; You, Ki Sung; Pavone, Marco; Huntsberger, Terry; Iwashita, Yumi
2012-01-01
Command of support robots by the warfighter requires intuitive interfaces to quickly communicate high degree-of-freedom (DOF) information while leaving the hands unencumbered. Stealth operations rule out voice commands and vision-based gesture interpretation techniques, as they often entail silent operations at night or in other low visibility conditions. Targeted at using bio-signal inputs to set navigation and manipulation goals for the robot (say, simply by pointing), we developed a system based on an electromyography (EMG) "BioSleeve", a high density sensor array for robust, practical signal collection from forearm muscles. The EMG sensor array data is fused with inertial measurement unit (IMU) data. This paper describes the BioSleeve system and presents initial results of decoding robot commands from the EMG and IMU data using a BioSleeve prototype with up to sixteen bipolar surface EMG sensors. The BioSleeve is demonstrated on the recognition of static hand positions (e.g. palm facing front, fingers upwards) and on dynamic gestures (e.g. hand wave). In preliminary experiments, over 90% correct recognition was achieved on five static and nine dynamic gestures. We use the BioSleeve to control a team of five LANdroid robots in individual and group/squad behaviors. We define a gesture composition mechanism that allows the specification of complex robot behaviors with only a small vocabulary of gestures/commands, and we illustrate it with a set of complex orders.
Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management.
López-Nava Breviere, Gontrand; Bautista-Castaño, Inmaculada; Fernández-Corbelle, Juan Pedro; Trell, Marta
2016-04-01
Many obese patients cannot lose weight or reject conventional obesity management. Endoscopic sleeve gastroplasty (the Apollo method) is a pioneering coadjuvant, interventionist technique for the integral management of obesity. The goals of this study were to report safety and efficacy results obtained at 6 months in patients undergoing endoscopic sleeve gastroplasty. A prospective study was performed in 55 patients (13 males, 42 females) who were subjected to the Apollo technique; mean age was 43.5 years (range 25-60) and mean BMI was 37.7 kg/m2 (range 30-48). All received multidisciplinary follow-up for weight loss. Weight changes and presence of complications were assessed. Through the endoscope a triangular pattern suture is performed consisting of approximately 3-6 transmural (mucosa to serosa) stitches, using a cinch device to bring them nearer and form a plication. A total of 6-8 plications are used to provide a tubular or sleeve-shaped restriction to the gastric cavity. No major complications developed and patients were discharged at 24 hours following the procedure. Endoscopic and radiographic follow-up at 6 months post-procedure showed a well preserved tubular form to the stomach. After 6 months patients had lost 18.9 kg and 55.3% of excess weight. Endoscopic sleeve gastroplasty, together with dietary and psycho-behavioral changes, is a safe, effective technique in the coadjuvant management of obese patients.
75 FR 12667 - Airworthiness Directives; Learjet Inc. Model 45 Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-17
... certain Model 45 airplanes. This AD requires a general visual inspection for cracked and missing ballscrew... sleeve or flap actuator for cracks, and replacement or modification of the flap actuator if necessary. This AD results from reports of cracked and missing ballscrew assembly sleeves of the flap actuators...
Section Work--Sleeves; Apparel Manufacturing: 9377.08.
ERIC Educational Resources Information Center
Dade County Public Schools, Miami, FL.
This course involves practice in a sleeve-making techniques. Prior to entry in this course the vocational student will have completed "Section Work--Pocket Setting." Upon completion of the course the student will be able to understand the underlying principles of sewing individual sections of garments using factory techniques comparable…
75 FR 77790 - Airworthiness Directives; The Boeing Company Model 767 Series Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-14
... repetitive inspections to detect discrepancies of the wiring and surrounding Teflon sleeves of the fuel tank... airplanes; and repair or replacement of the wiring and sleeves with new parts, as necessary. This proposed...).) That AD requires repetitive inspections to detect discrepancies of the wiring and surrounding Teflon...
Moving body velocity arresting line. [stainless steel cables with energy absorbing sleeves
NASA Technical Reports Server (NTRS)
Hull, R. A. (Inventor)
1981-01-01
The arresting of a moving body is improved through the use of steel cables that elongate to absorb the kinetic energy of the body. A sleeve surrounds the cables, protecting them from chafing and providing a failsafe energy absorbing system should the cables fail.
Digital single-channel seismic-reflection data from western Santa Monica basin
Normark, William R.; Piper, David J.W.; Sliter, Ray W.; Triezenberg, Peter; Gutmacher, Christina E.
2006-01-01
During a collaborative project in 1992, Geological Survey of Canada and United States Geological Survey scientists obtained about 850 line-km of high-quality single-channel boomer and sleeve-gun seismic-reflection profiles across Hueneme, Mugu and Dume submarine fans, Santa Monica Basin, off southern California. The goals of this work were to better understand the processes that lead to the formation of sandy submarine fans and the role of sea-level changes in controlling fan development. This report includes a trackline map of the area surveyed, as well as images of the sleeve-gun profiles and the opportunity to download both images and digital data files (SEG-Y) of all the sleeve-gun profiles.
Slide release mechanism. [for space shuttle orbiter/external tank connection device
NASA Technical Reports Server (NTRS)
Bunker, J. W.; Ritchie, R. S. (Inventor)
1985-01-01
A releasable support device is described which is comprised of a hollow body with a sleeve extending transversely there-through for receiving the end of a support shank. A slider-latch, optionally lubricated, extends through side recesses in the sleeve to straddle the shank, respectively, in latched and released positions. The slider-latch is slid from its latched to its unlatched position by a pressure squib whereupon a spring or other pressure means pushes the shank out of the sleeve. At the same time, a follower element is lodged in and closed the hole in the body wall from which the shank was discharged. The mechanism was designed for the shuttle orbiter/external tank connection device.
Retention sleeve for a thermal medium carrying tube in a gas turbine
Lathrop, Norman Douglas; Czachor, Robert Paul
2003-01-01
Multiple tubes are connected to steam supply and spent cooling steam return manifolds for supplying cooling steam to buckets and returning spent cooling steam from the buckets to the manifolds, respectively. The tubes are prevented from axial movement in one direction by flanges engaging end faces of the spacer between the first and second-stage wheels. Retention sleeves are disposed about cantilevered ends of the tubes. One end of the retention sleeve engages an enlarged flange on the tube, while an opposite end is spaced axially from an end face of the adjoining wheel, forming a gap, enabling thermal expansion of the tubes and limiting axial displacement of the tube in the opposite direction.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leslie, James C.; Leslie, II, James C.; Heard, James
A method for making a metal to composite tube joint including selecting an elongated interior fitting constructed with an exterior barrel, reduced in exterior diameter to form a distally facing annular shoulder and then projecting still further distally to form an interior sleeve having a radially outwardly facing bonding surface. Selecting an elongated metal outer sleeve formed proximally with a collar constructed for receipt over the barrel and increased in interior diameter and projecting distally to form an exterior sleeve having a radially inwardly facing bonding surface cooperating with the first bonding surface to form an annulus receiving an extremitymore » of a composite tube and a bond bonding the extremity of the tube to the bonding surfaces.« less
Protection of tree seedlings from deer browsing
Jeffrey S. Ward; George R. Stephens
1995-01-01
Browsing by large deer herds has seriously impaired successful regeneration on some Connecticut forests. Six plots were established in 1990 to examine the effectiveness of 5 deer browsing protection devices for 5 tree species. Protective devices included plastic mesh sleeves (60-cm), Reemay (spunbonded polypropylene) sleeves (60-cm), Tubex tree shelters (120 and 180-cm...
1989-03-01
the embayment indicating extensive inundation by the sea during these epochs. Some Oligocene and Miocene deposits can be found in the southern part of...accurately measure sleeve fric- tion in low-strength materials without careful calibration and equipment warm -up. The tension cone measures sleeve
Hydraulic servo control spool valve
Miller, Donald M.
1983-01-01
A servo operated spool valve having a fixed sleeve and axially movable spool. The sleeve is machined in two halves to form a long, narrow tapered orifice slot across which a transverse wall of the spool is positioned. The axial position of the spool wall along the slot regulates the open orifice area with extreme precision.
Improved material-bagging device
Wach, C.G.; Nelson, R.E.; Brak, S.B.
1982-01-19
A bagging device for transferring material; specifically contaminated material, from one chamber through an opening in a wall to a second chamber includes a cylindrical housing communicating with the opening and defining a passage between the chambers. A cylindrical cartridge is slidably received within the housing. The cartridge has a substantially rigid cylindrical sleeve to which is affixed a pliable tube. The pliable tube is positioned concentrically about the sleeve and has a pleated portion capable of unfolding from the sleeve and a closed end extending over a terminal end of the sleeve. Sealing means are interposed in sealed relationship between the cartridge and the housing. Material from one chamber is inserted into the cartridge secured in the housing and received in the closed end of the tube which unfolds into the other chamber enclosing the material therein. The tube may then be sealed behind the material and then severed to form a bag-like enclosure defined by the tube's closed terminal end and the new seal. The new seal then forms a terminal end for the unsevered portion of the pliable tube into which additional material may be placed and the bagging process repeated.
Wach, Charles G.; Nelson, Robert E.; Brak, Stephen B.
1984-01-01
A bagging device for transferring material from one chamber through an opening in a wall to a second chamber includes a cylindrical housing communicating with the opening and defining a passage between the chambers. A cylindrical cartridge is slidably received within the housing. The cartridge has a substantially rigid cylindrical sleeve to which is affixed a pliable tube. The pliable tube is positioned concentrically about the sleeve and has a pleated portion capable of unfolding from the sleeve and a closed end extending over a terminal end of the sleeve. Sealing means are interposed in sealed relationship between the cartridge and the housing. Material from one chamber is inserted into the cartridge secured in the housing and received in the closed end of the tube which unfolds into the other chamber enclosing the material therein. The tube may then be sealed behind the material and then severed to form a bag-like enclosure defined by the tube's closed terminal end and the new seal. The new seal then forms a terminal end for the unsevered portion of the pliable tube into which additional material may be placed and the bagging process repeated.
Nozzle cavity impingement/area reduction insert
Yu, Yufeng Phillip; Itzel, Gary Michael; Osgood, Sarah Jane
2002-01-01
A turbine vane segment is provided that has inner and outer walls spaced from one another, a vane extending between the inner and outer walls and having leading and trailing edges and pressure and suction sides, the vane including discrete leading edge, intermediate, aft and trailing edge cavities between the leading and trailing edges and extending lengthwise of the vane for flowing a cooling medium; and an insert sleeve within at least one of the cavities and spaced from interior wall surfaces thereof. The insert sleeve has an inlet for flowing the cooling medium into the insert sleeve and has impingement holes defined in first and second walls thereof that respectively face the pressure and suction sides of the vane. The impingement holes of at least one of those first and second walls are defined along substantially only a first, upstream portion thereof, whereby the cooling flow is predominantly impingement cooling along a first region of the insert wall corresponding to the first, upstream portion and the cooling flow is predominantly convective cooling along a second region corresponding to a second, downstream portion of the at least one wall of the insert sleeve.
Obermeyer, F.D.
1993-11-16
Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube, so that the threaded ends of the instrumentation tube do not unthread when subjected to vibration, such an instrumentation tube being suitable for use in a nuclear reactor pressure vessel. The instrumentation tube has a first member having a threaded end portion that has a plurality of first holes circumferentially around the outside surface thereof. The instrumentation tube also has a second member having a threaded end portion that has a plurality of second holes circumferentially around the outside surface thereof. The threads of the second member are caused to threadably engage the threads of the first member for defining a threaded joint there between. A sleeve having an inside surface surrounds the end portion of the first member and the end portion of the second member and thus surrounds the threaded joint. The sleeve includes a plurality of first projections and second projections that outwardly extend from the inside surface to engage the first holes and the second holes, respectively. The outside surface of the sleeve is crimped or swaged at the locations of the first projections and second projections such that the first projections and the second projections engage their respective holes. In this manner, independent rotation of the first member with respect to the second member is prevented, so that the instrumentation tube will not unthread at its threaded joint. 10 figures.
Obermeyer, Franklin D.
1993-01-01
Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube, so that the threaded ends of the instrumentation tube do not unthread when subjected to vibration, such an instrumentation tube being suitable for use in a nuclear reactor pressure vessel. The instrumentation tube has a first member having a threaded end portion that has a plurality of first holes circumferentially around the outside surface thereof. The instrumentation tube also has a second member having a threaded end portion that has a plurality of second holes circumferentially around the outside surface thereof. The threads of the second member are caused to threadably engage the threads of the first member for defining a threaded joint therebetween. A sleeve having an inside surface surrounds the end portion of the first member and the end portion of the second member and thus surrounds the threaded joint. The sleeve includes a plurality of first projections and second projections that outwardly extend from the inside surface to engage the first holes and the second holes, respectively. The outside surface of the sleeve is crimped or swaged at the locations of the first projections and second projections such that the first projections and the second projections engage their respective holes. In this manner, independent rotation of the first member with respect to the second member is prevented, so that the instrumentation tube will not unthread at its threaded joint.
Patellar Sleeve Fracture With Ossification of the Patellar Tendon.
Damrow, Derek S; Van Valin, Scott E
2017-03-01
Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation. On presentation, he had patella alta, diminished strength, 5° of extensor lag, and radiographs that revealed bone formation along the patellar tendon. Despite this, he was able to maintain a high level of activity. This case report explores how the patient could have maintained a high level of activity despite having a patellar sleeve fracture. Also, because of the delayed presentation, the patella was ossified and the quadriceps was retracted, which led to a novel approach to reconstructing his distal extensor mechanism. This approach included a V-Y advancement of the quadriceps tendon and patellar tendon reconstruction using the patient's hamstring tendon (semitendinosus). This technique, combined with physical therapy postoperatively, resulted in his return to varsity high school soccer. To the best of the authors' knowledge, this technique has not been reported for this rare condition. [Orthopedics. 2017; 40(2):e357-e359.]. Copyright 2016, SLACK Incorporated.
Microclimatic Variation Within Sleeve Cages Used in Ecological Studies
Nelson, Lori A.; Rieske, Lynne K.
2014-01-01
Abstract Sleeve cages for enclosing or excluding arthropods are essential components of field studies evaluating trophic interactions. Microclimatic variation in sleeve cages was evaluated to characterize its potential effects on subsequent long-term experiments. Two sleeve cage materials, polyester and nylon, and two cage sizes, 400 and 6000 cm 2 , were tested on eastern hemlock, Tsuga canadensis (L.) Carrière. Temperature and relative humidity inside and outside cages, and the cost and durability of the cage materials, were compared. Long-term effects of the sleeve cages were observed by measuring new growth on T. canadensis branches. The ultimate goal was to identify a material that minimizes bag-induced microclimatic variation. Bagged branches whose microclimates mimic those of surrounding unbagged branches should have minimal effects on plant growth and may prove ideal venues for assessing herbivore and predator behavior under natural conditions. No differences were found in temperature or humidity between caging materials. Small cages had higher average temperatures than large cages, especially in the winter, but this difference was confounded by the fact that small cages were positioned higher in trees than large cages. Differences in plant growth were detected. Eastern hemlock branches enclosed within polyester cages produced fewer new growth tips than uncaged controls. Both polyester and nylon cages reduced the length of new shoot growth relative to uncaged branches. In spite of higher costs, nylon cages were superior to polyester with respect to durability and ease of handling. PMID:25368083
Monitoring techniques for high accuracy interference fit assembly processes
NASA Astrophysics Data System (ADS)
Liuti, A.; Vedugo, F. Rodriguez; Paone, N.; Ungaro, C.
2016-06-01
In the automotive industry, there are many assembly processes that require a high geometric accuracy, in the micrometer range; generally open-loop controllers cannot meet these requirements. This results in an increased defect rate and high production costs. This paper presents an experimental study of interference fit process, aimed to evaluate the aspects which have the most impact on the uncertainty in the final positioning. The press-fitting process considered, consists in a press machine operating with a piezoelectric actuator to press a plug into a sleeve. Plug and sleeve are designed and machined to obtain a known interference fit. Differential displacement and velocity measurements of the plug with respect to the sleeve are measured by a fiber optic differential laser Doppler vibrometer. Different driving signals of the piezo actuator allow to have an insight into the differences between a linear and a pulsating press action. The paper highlights how the press-fit assembly process is characterized by two main phases: the first is an elastic deformation of the plug and sleeve, which produces a reversible displacement, the second is a sliding of the plug with respect to the sleeve, which results in an irreversible displacement and finally realizes the assembly. The simultaneous measurements of the displacement and the force have permitted to define characteristic features in the signal useful to identify the start of the irreversible movement. These indicators could be used to develop a control logic in a press assembly process.
Ecker, Brett L; Maduka, Richard; Ramdon, Andre; Dempsey, Daniel T; Dumon, Kristoffel R; Williams, Noel N
2016-02-01
Robotic technology is increasingly prevalent in bariatric surgery, yet there are national deficiencies in exposure of surgical residents to robotic techniques. The purpose of this study is to accurately characterize the perioperative outcomes of a resident teaching model using the robotic-assisted sleeve gastrectomy. University Hospital. We identified 411 consecutive patients who underwent robotic sleeve gastrectomy at our institution from a prospectively maintained administrative database. Perioperative morbidity, operative time, and supply cost of the procedure were analyzed. Mean operative time was 96.4±24.9 minutes; mean robot usage time was 63.9 minutes (range 30.0-122.0 min). Ninety-day morbidities included reoperation (0.72%), major bleeding complications (0.48%), staple line leak (0.24%), stricture (0.97%), need for blood transfusion (3.86%), surgical site infection (1.69%), deep vein thrombosis (0.48%), and pulmonary embolism (0.48%). Mortality was nil. The resident cohort achieved operative time plateaus after five consecutive cases. Subset analysis for fiscal year 2014 demonstrated significantly increased supply cost for robotic sleeve gastrectomy compared with its laparoscopic equivalent. Robotic-assisted sleeve gastrectomy can be instituted as a model for resident robotic education with rates of morbidity and operative times equivalent to historical laparoscopic controls. The robot's enhanced ergonomics and its opportunity for resident education must be weighed against its increased supply cost. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Indocyanine green-enhanced fluorescence in laparoscopic sleeve gastrectomy.
Frattini, Francesco; Lavazza, Matteo; Mangano, Alberto; Amico, Francesco; Rausei, Stefano; Rovera, Francesca; Boni, Luigi; Dionigi, Gianlorenzo
2015-05-01
The aim of this study is to present our preliminary experience with indocyanine green fluorescence (IGF) imaging in laparoscopic sleeve gastrectomy. After dissection of the greater curve sleeve, gastrectomy is performed using a linear articulated stapler. Once the stomach is resected, an indocyanine green solution is prepared and injected in a periferic vein. A laparoscopic system with a high-definition camera system connected to a laparoscope equipped with a specific filter for optimal detection of the near-infrared fluorescence was used at all times as previously reported in a paper of Boni et al. A methylene blue test is routinely performed after near-infrared fluorescence, and a routine gastrografin upper gastrointestinal study is performed on postoperative day 2. We retrospectively identified 15 patients undergoing laparoscopic sleeve gastrectomy between April and October 2014. IGF imaging was used for all patients. A regular and homogeneous perfusion was observed along the entire gastric sleeve including the esophago-gastric junction. On the contrary, the excised specimen appeared devascularized at IGF imaging as expected. Intraoperative methylene blue test was negative in all cases. The contrast swallow did not document any leak. Neither clinical leak nor other complications occurred postoperatively (minimum follow-up of 2 months). IGF is a recent development in minimally invasive surgery. In this preliminary experience, IGF results resemble to intraoperative methylene blue test and postoperative contrast swallow ones. IGF allows a real-time assessment and gives a direct image of tissue perfusion and vascularization. Moreover, IGF may be helpful to explain the exact pathogenesis of gastric leak.
Franklin, Ashanti L; Koeck, Emily S; Hamrick, Miller C; Qureshi, Faisal G; Nadler, Evan P
2015-08-01
In adults undergoing gastric bypass surgery, it is routine practice to perform pre-operative testing for Helicobacter pylori infection. Evidence suggests that infection impairs anastomotic healing and contributes to complications. There currently are no data for adolescents undergoing bariatric procedures. Despite few patients with pre-operative symptoms, we noted occasional patients with H. pylori detected after sleeve gastrectomy. We reviewed our experience with our adolescent sleeve gastrectomy cohort to determine the prevalence of H. pylori infection, its predictive factors, and association with outcomes. We hypothesized that H. pylori infection would be associated with pre-operative symptoms, but not surgical outcomes. All patients undergoing sleeve gastrectomy at our hospital were included. We conducted a chart review to determine pre- or post-operative symptoms of gastroesophageal reflux disease GERD or gastritis, operative complications, and long-term anti-reflux therapy after surgery. Pathology reports were reviewed for evidence of gastritis and H. pylori infection. 78 adolescents had laparoscopic sleeve gastrectomy from January 2010 through July 2014. The prevalence of chronic gastritis was 44.9% (35/78) and 11.4% of those patients had H. pylori (4/35). Only one patient with H. pylori had pre-operative symptoms, and only 25.7% (9/35) of patients with pathology-proven gastritis had symptoms. One staple line leak occurred but this patient did not have H. pylori or gastritis. Mean patient follow-up was 10 (3-26) mos. There is a moderate prevalence of gastritis among adolescents undergoing sleeve gastrectomy, but only a small number of these patients had H. pylori infection. Neither the presence of chronic gastritis nor H. pylori infection correlated with symptoms or outcomes. Thus, in the absence of predictive symptomology or adverse outcome in those who are infected, we advocate for continued routine pathologic evaluation without the required need for pre-operative determination unless or until H. pylori infection is associated with adverse surgical outcomes.
Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy.
Sethi, Monica; Zagzag, Jonathan; Patel, Karan; Magrath, Melissa; Somoza, Eduardo; Parikh, Manish S; Saunders, John K; Ude-Welcome, Aku; Schwack, Bradley F; Kurian, Marina S; Fielding, George A; Ren-Fielding, Christine J
2016-03-01
Staple line leak is a serious complication of sleeve gastrectomy. Intraoperative methylene blue and air leak tests are routinely used to evaluate for leak; however, the utility of these tests is controversial. We hypothesize that the practice of routine intraoperative leak testing is unnecessary during sleeve gastrectomy. A retrospective cohort study was designed using a prospectively collected database of seven bariatric surgeons from two institutions. All patients who underwent sleeve gastrectomy from March 2012 to November 2014 were included. The performance of intraoperative leak testing and the type of test (air or methylene blue) were based on surgeon preference. Data obtained included BMI, demographics, comorbidity, presence of intraoperative leak test, result of test, and type of test. The primary outcome was leak rate between the leak test (LT) and no leak test (NLT) groups. SAS version 9.4 was used for univariate and multivariate analyses. A total of 1550 sleeve gastrectomies were included; most were laparoscopic (99.8%), except for one converted and two open cases. Routine intraoperative leak tests were performed in 1329 (85.7%) cases, while 221 (14.3%) did not have LTs. Of the 1329 cases with LTs, there were no positive intraoperative results. Fifteen (1%) patients developed leaks, with no difference in leak rate between the LT and NLT groups (1 vs. 1%, p = 0.999). After adjusting for baseline differences between the groups with a propensity analysis, the observed lack of association between leak and intraoperative leak test remained. In this cohort, leaks presented at a mean of 17.3 days postoperatively (range 1-67 days). Two patients with staple line leaks underwent repeat intraoperative leak testing at leak presentation, and the tests remained negative. Intraoperative leak testing has no correlation with leak due to laparoscopic sleeve gastrectomy and is not predictive of the later development of staple line leak.
Chang, Yunhee; Jeong, Bora; Kang, Sungjae; Ryu, Jeicheong; Kim, Gyoosuk
2017-01-01
The evaluation of multisegment coordination is important in gaining a better understanding of the gait and physical activities in humans. Therefore, this study aims to verify whether the use of knee sleeves affects the coordination of lower-limb segments during level walking and one-leg hopping. Eleven healthy male adults participated in this study. They were asked to walk 10 m on a level ground and perform one-leg hops with and without a knee sleeve. The segment angles and the response velocities of the thigh, shank, and foot were measured and calculated by using a motion analysis system. The phases between the segment angle and the velocity were then calculated. Moreover, the continuous relative phase (CRP) was calculated as the phase of the distal segment subtracted from the phase of the proximal segment and denoted as CRPTS (thigh–shank), CRPSF (shank–foot), and CRPTF (thigh–foot). The root mean square (RMS) values were used to evaluate the in-phase or out-of-phase states, while the standard deviation (SD) values were utilized to evaluate the variability in the stance and swing phases during level walking and in the preflight, flight, and landing phases during one-leg hopping. The walking velocity and the flight time improved when the knee sleeve was worn (p < 0.05). The segment angles of the thigh and shank also changed when the knee sleeve was worn during level walking and one-leg hopping. The RMS values of CRPTS and CRPSF in the stance phase and the RMS values of CRPSF in the preflight and landing phases changed (p < 0.05 in all cases). Moreover, the SD values of CRPTS in the landing phase and the SD values of CRPSF in the preflight and landing phases increased (p < 0.05 in all cases). These results indicated that wearing a knee sleeve caused changes in segment kinematics and coordination. PMID:28533981
Choi, Jae-Won; Yamashita, Masaki; Sakakibara, Jun; Kaji, Yuichi; Oshika, Tetsuro; Wicker, Ryan B
2010-10-01
Microstereolithography (microSL) technology can fabricate complex, three-dimensional (3D) microstructures, although microSL has difficulty producing macrostructures with micro-scale features. There are potentially many applications where 3D micro-features can benefit the overall function of the macrostructure. One such application involves a medical device called a coaxial phacoemulsifier where the tip of the phacoemulsifier is inserted into the eye through a relatively small incision and used to break the lens apart while removing the lens pieces and associated fluid from the eye through a small tube. In order to maintain the eye at a constant pressure, the phacoemulsifier also includes an irrigation solution that is injected into the eye during the procedure through a coaxial sleeve. It has been reported, however, that the impinging flow from the irrigation solution on the corneal endothelial cells in the inner eye can damage these cells during the procedure. As a result, a method for reducing the impinging flow velocities and the resulting shear stresses on the endothelial cells during this procedure was explored, including the design and development of a complex, 3D micro-vane within the sleeve. The micro-vane introduces swirl into the irrigation solution, producing a flow with rapidly dissipating flow velocities. Fabrication of the sleeve and fitting could not be accomplished using microSL alone, and thus, a two-part design was accomplished where a sleeve with the micro-vane was fabricated with microSL and a threaded fitting used to attach the sleeve to the phacoemulsifier was fabricated using an Objet Eden 333 rapid prototyping machine. The new combined device was tested within a water container using particle image velocimetry, and the results showed successful swirling flow with an ejection of the irrigation fluid through the micro-vane in three different radial directions corresponding to the three micro-vanes. As expected, the sleeve produced a swirling flow with rapidly dissipating streamwise flow velocities where the maximum measured streamwise flow velocities using the micro-vane were lower than those without the micro-vane by 2 mm from the tip where they remained at approximately 70% of those produced by the conventional sleeve as the flow continued to develop. It is believed that this new device will reduce damage to endothelial cells during cataract surgery and significantly improve patient outcomes from this procedure. This unique application demonstrates the utility of combining microSL with a macro rapid prototyping technology for fabricating a real macro-scale device with functional, 3D micro-scale features that would be difficult and costly to fabricate using alternative manufacturing methods.
El Chaar, Maher; Stoltzfus, Jill; Melitics, Maureen; Claros, Leonardo; Zeido, Ahmad
2018-06-06
The number of bariatric revisional cases has nearly doubled since 2011, and now comprises 13.6% of the total number of cases. The objective of this study is to evaluate the outcomes and safety of the two most common stapling revisional procedures, namely, sleeve and gastric bypass in comparison to primary stapling procedures using the MBSAQIP data registry. We reviewed all the sleeve and gastric bypass cases entered between January 1, 2015, and December 31, 2015, in the MBSAQIP data registry. We, then, identified sleeve and bypass patients who have had a previous bariatric procedure. Demographics and 30 day outcomes of all sleeve and gastric bypass patients were analyzed. We conducted within group comparisons comparing primary sleeve gastrectomy (PS) and primary gastric bypass (PB) patients to revisional sleeve (RS) and revisional gastric bypass (RB) patients, respectively. We, then, conducted group comparisons comparing RS to RB patients. The total number of patients analyzed was 141,577 (98,292 or 69% sleeve patients and 43,285 or 31% gastric bypass patients). Among the sleeve patients, 92,666 (94%) had a PS and 5626 (6%) had RS. Among the bypass patients, 39,567 (91%) had a PB and 3718 patients (9%) had RB. 30-day readmission rate of RS was significantly higher as compared to PS (4.1 vs 0.4%, p < 0.05). The incidence of at least one complication requiring reoperation or reintervention within 30 days following RS was twice as high as compared to PS (1.9 and 2% for RS vs 0.9 and 1.1% for PS respectively, p < 0.05). Length of stay and 30 day mortality rates for PS and RS were the same. 30-day readmission rate of RB as compared to PB was 8.3 vs 6.3% (p < 0.05). Also, the incidence of at least one complication requiring reoperation or reintervention following RB was 3.9 and 4%, respectively vs 2.4 and 2.7% for PB (p < 0.05). In addition, readmission rates and unplanned admission rates to the ICU were significantly higher for RB compared to RS (8.3 and 2% for RB vs 4.1 and 0.9% for RS respectively, p < 0.05). The incidence of at least one reoperation or one intervention following RB were also significantly higher compared to RS (3.9 vs 1.9% and 4 vs 2% respectively, p < 0.05). Revisional stapling procedures are safe but the rates of complications following RS and RB are twice as high compared to PS and PB. Also, RB are more likely to develop complications compared to RS.
SiC-CMC-Zircaloy-4 Nuclear Fuel Cladding Performance during 4-Point Tubular Bend Testing
DOE Office of Scientific and Technical Information (OSTI.GOV)
IJ van Rooyen; WR Lloyd; TL Trowbridge
2013-09-01
The U.S. Department of Energy Office of Nuclear Energy (DOE NE) established the Light Water Reactor Sustainability (LWRS) program to develop technologies and other solutions to improve the reliability, sustain the safety, and extend the life of current reactors. The Advanced LWR Nuclear Fuel Development Pathway in the LWRS program encompasses strategic research focused on improving reactor core economics and safety margins through the development of an advanced fuel cladding system. Recent investigations of potential options for “accident tolerant” nuclear fuel systems point to the potential benefits of silicon carbide (SiC) cladding. One of the proposed SiC-based fuel cladding designsmore » being investigated incorporates a SiC ceramic matrix composite (CMC) as a structural material supplementing an internal Zircaloy-4 (Zr-4) liner tube, referred to as the hybrid clad design. Characterization of the advanced cladding designs will include a number of out-of-pile (nonnuclear) tests, followed by in-pile irradiation testing of the most promising designs. One of the out-of-pile characterization tests provides measurement of the mechanical properties of the cladding tube using four point bend testing. Although the material properties of the different subsystems (materials) will be determined separately, in this paper we present results of 4-point bending tests performed on fully assembled hybrid cladding tube mock-ups, an assembled Zr-4 cladding tube mock-up as a standard and initial testing results on bare SiC-CMC sleeves to assist in defining design parameters. The hybrid mock-up samples incorporated SiC-CMC sleeves fabricated with 7 polymer impregnation and pyrolysis (PIP) cycles. To provide comparative information; both 1- and 2-ply braided SiC-CMC sleeves were used in this development study. Preliminary stress simulations were performed using the BISON nuclear fuel performance code to show the stress distribution differences for varying lengths between loading points and clad configurations. The 2-ply sleeve samples show a higher bend momentum compared to those of the 1-ply sleeve samples. This is applicable to both the hybrid mock-up and bare SiC-CMC sleeve samples. Comparatively both the 1- and 2-ply hybrid mock-up samples showed a higher bend stiffness and strength compared with the standard Zr-4 mock-up sample. The characterization of the hybrid mock-up samples showed signs of distress and preliminary signs of fraying at the protective Zr-4 sleeve areas for the 1-ply SiC-CMC sleeve. In addition, the microstructure of the SiC matrix near the cracks at the region of highest compressive bending strain shows significant cracking and flaking. The 2-ply SiC-CMC sleeve samples showed a more bonded, cohesive SiC matrix structure. This cracking and fraying causes concern for increased fretting during the actual use of the design. Tomography was proven as a successful tool to identify open porosity during pre-test characterization. Although there is currently insufficient data to make conclusive statements regarding the overall merit of the hybrid cladding design, preliminary characterization of this novel design has been demonstrated.« less
78 FR 42411 - Airworthiness Directives; The Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-16
... rear spar, and installation of a TFE sleeve if necessary. This new AD also adds airplanes to the... sources in the auxiliary (center) fuel tank, main fuel tanks, and surge tanks caused by a wiring short or... clamp location on the rear spar, and installation of a TFE sleeve if necessary. The NPRM also proposed...
Kang, Hye-Won; Lee, Du-Hyeong
2015-09-01
The existing techniques for drilling a screw access hole in cement-retained restorations are limited by inaccurate drill guidance and ineffective cooling of the drilling area. An approach for fabricating a guide template to provide screw retrievability using computer-aided design and computer-aided manufacturing (CAD/CAM) is described. A handpiece sleeve was made by 3-dimensional printing and incorporating it into a vacuum-formed template. The handpiece sleeve not only guides the head of the handpiece accurately but also enables the cooling water to reach the area of drilling directly. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
NASA Technical Reports Server (NTRS)
Arrington, Lynn A.; Reed, Brian D.
1992-01-01
An experimental performance comparison of two geometrically different fuel film coolant injection sleeves was conducted on a 110 N gaseous hydrogen/oxygen rocket. One sleeve had slots milled axially down the walls and the other had a smooth surface to give axisymmetric flow. The comparison was made to investigate a conclusion in an earlier study that attributed a performance underprediction to a symplifying modeling assumption of axisymmetric fuel film flow. The smooth sleeve had higher overall performance at one film coolant percentage and approximately the same or slightly better at another. The study showed that the lack of modeling of three-dimensional effects was not the cause of the performance underprediction as speculated in earlier analytical studies.
The weight is over: RN first assisting techniques for laparoscopic sleeve gastrectomy.
Wentzell, Joanne; Neff, Marc
2015-08-01
Obesity-related laparoscopic sleeve gastrectomy is a common yet technically challenging bariatric procedure that requires specialized surgical knowledge and training for OR personnel. Critical components of care include an effective preoperative assessment, positioning of the patient, and operation and maintenance of laparoscopic equipment and instrumentation. The purpose of this article is to explain the steps of laparoscopic sleeve gastrectomy and illustrate principles and surgical techniques for the RN who is first assisting during the procedure. Also provided is a perioperative nursing care plan for the patient undergoing bariatric surgery, to aid perioperative nurses in understanding the sequence of events and special considerations for this patient population. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Gastroesophageal Reflux Disease and Sleeve Gastrectomy.
Melissas, John; Braghetto, Italo; Molina, Juan Carlos; Silecchia, Gianfranco; Iossa, Angelo; Iannelli, Antonio; Foletto, Mirto
2015-12-01
Gastroesophageal reflux disease (GERD) and/or hiatus hernia (HH) are one of the most common disorders of the upper gastrointestinal tract. Despite the positive effect of sleeve gastrectomy (SG) regarding weight loss and improvement in obesity co-morbidities, there are concerns about the development of de novo gastroesophageal reflux disease or worsening the existing GERD after this bariatric operation. Furthermore, controversy exists on the consequences of SG in lower esophageal sphincter function and about the ideal procedure when a hiatus hernia is preoperatively diagnosed or discovered during the laparoscopic SG. This review systematically investigates the incidence, the pathophysiology of GERD and/or HH in morbidly obese individuals before and after SG, and the treatment options for concomitant HH repair during laparoscopic sleeve gastrectomy.
Method of making a composite tube to metal joint
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leslie, James C.; Leslie, II, James C.; Heard, James
A method for making a metal to composite tube joint including selecting an elongated interior fitting constructed with an exterior barrel, reduced in exterior diameter to form a distally facing annular shoulder and then projecting still further distally to form an interior sleeve having a radially outwardly facing bonding surface. Selecting an elongated metal outer sleeve formed proximally with a collar constructed for receipt over the barrel and increased in interior diameter and projecting distally to form an exterior sleeve having a radially inwardly facing bonding surface cooperating with the first bonding surface to form an annulus receiving an extremitymore » of a composite tube and a bond bonding the extremity of the tube to the bonding surfaces.« less
NASA Astrophysics Data System (ADS)
Zhang, Changqin; Zhang, Haifeng; Sun, Qilei; Liu, Kegao
2018-03-01
Zr41.2Ti13.8Ni10Cu12.5Be22.5 (Vit 1) bulk metallic glass with Cu sleeves at different positions was prepared by the Cu mold casting method, and the effects of different geometric confinements offered by Cu sleeves on the mechanical properties of Vit 1 were investigated. It was found that the mechanical properties were prominently influenced by different geometric confinements and the plasticity could be modified by optimizing the positions of Cu sleeves. The results revealed that shear band initiation and propagation could be efficiently intervened by changing the radial boundary restraints, which led to quite different mechanical behaviors.
Bronchial and bronchovascular sleeve resection for treatment of central lung tumors.
Lausberg, H F; Graeter, T P; Wendler, O; Demertzis, S; Ukena, D; Schäfers, H J
2000-08-01
To improve postoperative pulmonary reserve, we have employed parenchyma-sparing resections for central lung tumors irrespective of pulmonary function. The results of lobectomy, pneumonectomy, and sleeve resection were analyzed retrospectively. From October 1995 to June 1999, 422 typical lung resections were performed for lung cancer. Of these, 301 were lobectomies (group I), 81 were sleeve resections (group II), and 40 were pneumonectomies (group III). Operative mortality was 2% in group I, 1.2% in group II, and 7.5% in group III (group I and II vs. group III, p<0.03). Mean time of intubation was 1.0+/-4.1 days in group I, 0.9+/-1.3 days in group II, and 3.6+/-11.2 days in group III (groups I and II vs. group III, p<0.01). The incidence of bronchial complications was 1.3% in group I, none in group II, and 7.5% in group III (group I and II vs group III, p<0.001). After 2 years, survival was 64% in group I, 61.9% in group II, and 56.1% in group III (p = NS). Freedom from local disease recurrence was 92.1% in group I, 95.7% in group II, and 90.9% in group III after 2 years (p = NS). Sleeve resection is a useful surgical option for the treatment of central lung tumors, thus avoiding pneumonectomy with its associated risks. Morbidity, early mortality, long-term survival, and recurrence of disease after sleeve resection are similar to those seen after lobectomy.
Ozone, Sachiko; Sato, Mikiya; Takayashiki, Ayumi; Sakamoto, Naoto; Yoshimoto, Hisashi; Maeno, Tetsuhiro
2018-05-01
To assess the extent to which long-term care facilities in Japan adhere to blood pressure (BP) measurement guidelines. Cross-sectional, observational survey. Japan (nationwide). Geriatric health service facilities that responded to a questionnaire among 701 facilities that provide short-time daycare rehabilitation services in Japan. A written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients' arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered. Proportion of geriatric health service facilities adherent to BP measurement guidelines. The response rate was 63.2% (443/701). Appropriate upper-arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre-measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%). BP measurement guidelines were not necessarily followed by long-term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit-to-visit basis might be needed.
Design test request No. 1263 K Reactor graphite key and VSR channel sleeve test
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kempf, F.J.
1964-12-10
The objectives of this test were: (1) Determine the coefficient of friction between two adjacent layers of K Reactor graphite at room temperature. (2) Determine the average load required to cause failure of an unirradiated K Reactor side reflector bar, when subjected to tensile loading applied through the reflector keys. (3) Determine the average load at failure and the average deflection at failure of a single VSR channel key when loaded in keyways with clearances equal to those used in original stack construction. (4) Determine the average load and deflection required to break the four K Reactor VSR keys whenmore » loaded simultaneously in both `3-layer` and `7-layer` mockups. Also determine the mode of key failure; i.e., shear, flexure or combined compression and bending. Following these key rupture tests, determine the strength and deflection characteristics of the proposed K Reactor VSR channel sleeve when loaded in a manner identical to that used to fracture the keys. (5) Determine the average load and deflection at failure of both the proposed K Reactor VSR channel sleeves and the proposed C Reactor sleeves when subjected to crushing loads. (6) Determine the extent of damage to the proposed K Reactor VSR channel sleeve when subjected to the following vertical rod loading conditions. (a) Full rod drop in a channel mockup which has been misaligned 2 1/2 inches. (b) Full rod drop in a channel which has been misaligned an amount equal to the maximum flexibility of a `universal` VSR.« less
Squara, Fabien; Liuba, Ioan; Chik, William; Santangeli, Pasquale; Zado, Erica S; Callans, David J; Marchlinski, Francis E
2015-03-01
Capture of the myocardial sleeves of the pulmonary veins (PV) during PV pacing is mandatory for assessing exit block after PV isolation (PVI). However, previous studies reported that a significant proportion of PVs failed to demonstrate local capture after PVI. We designed this study to evaluate the prevalence and the clinical significance of loss of PV capture after PVI. Thirty patients (14 redo) undergoing antral PVI were included. Before and after PVI, local PV capture was assessed during circumferential pacing (10 mA/2 milliseconds) with a circular multipolar catheter (CMC), using EGM analysis from each dipole of the CMC and from the ablation catheter placed in ipsilateral PV. Pacing output was varied to optimize identification of sleeve capture. All PVs demonstrated sleeve capture before PVI, but only 81% and 40% after first time and redo PVI, respectively (P < 0.001 vs. before PVI). In multivariate analysis, absence of spontaneous PV depolarizations after PVI and previous PVI procedures were associated with less PV sleeve capture after PVI (40% sleeve capture, P < 0.001 for both). Loss of PV local capture by design was coincident with the development of PV entrance block and importantly predicted absence of acute reconnection during adenosine challenge with 96% positive predictive value (23% negative predictive value). Loss of PV local capture is common after antral PVI resulting in entrance block, and may be used as a specific alternate endpoint for PV electrical isolation. Additionally, loss of PV local capture may identify PVs at very low risk of acute reconnection during adenosine challenge. © 2014 Wiley Periodicals, Inc.
Early Australian experience in robotic sleeve gastrectomy: a single site series.
Silverman, Candice D; Ghusn, Michael A
2017-05-01
The use of robotic platforms in bariatric surgery has recently gained relevance. With an increased use of this technology come concerns regarding learning curve effects during the initial implementation phase. The sleeve gastrectomy though may represent an ideal training procedure for introducing the robot into bariatric surgical practice. The present review of the first 10 consecutive robotic sleeve gastrectomy procedures performed in an Australian bariatric programme by a single surgeon describes the evolution of the technique, learning curve and initial patient outcomes. Between 2014 and 2015, robotic sleeve gastrectomies were performed as primary and revisional procedures by a consistent surgeon-assistant team. Technique evolution and theatre set-up were documented. Patient demographics, operative time (robot docking and total operation time), additional operative procedures performed, operative and post-operative complications at 1, 3 and 6 months post-procedure and weight loss achieved at 6 months were retrospectively reviewed from a prospectively maintained database. Ten robotic sleeve gastrectomies were performed without significant operative complications. One patient was treated as an outpatient with oral antibiotics for a superficial wound infection. The median total operative time was 123 min (interquartile range (IQR) 108.8-142.5), with a median incision to docking time of 19 min (IQR 15.0-31.8). Length of stay in hospital was 2-3 days. Median excess weight loss achieved at 6 months was 50% (IQR 33.9-66.5). This study describes a method of safely introducing the da Vinci robot into bariatric surgical practice. © 2016 Royal Australasian College of Surgeons.
Protected Nuclear Fuel Element
Kittel, J. H.; Schumar, J. F.
1962-12-01
A stainless steel-clad actinide metal fuel rod for use in fast reactors is reported. In order to prevert cladding failures due to alloy formation between the actinide metal and the stainless steel, a mesh-like sleeve of expanded metal is interposed between them, the sleeve metal being of niobium, tantalum, molybdenum, tungsten, zirconium, or vanadium. Liquid alkali metal is added as a heat transfer agent. (AEC)
Improved Gustatory Sensitivity in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy.
Altun, Huseyin; Hanci, Deniz; Altun, Hasan; Batman, Burcin; Serin, Rahmi Kursat; Karip, Aziz Bora; Akyuz, Umit
2016-07-01
The reduction in the preferences for sweet and fat containing tastes in obese patients who underwent bariatric surgery was relatively well shown; however, there are only limited data on the changes in the sensitivity of other tastes like sour, salty, and bitter. We investigated the changes in gustatory sensitivity of 52 morbidly obese patients (M/F, 22/30; age range, 19-60 years; BMI range, 32.5-63.0 kg/m(2)) after laparoscopic sleeve gastrectomy. The surgery was performed by the same surgeon using 5 ports technique. Gustatory sensitivity was tested preoperatively and 1 and 3 months after the surgery using standardized Taste Strips test. There was a statistically significant improvement in the taste acuity to sweet, sour, salty, and bitter tastants in morbidly obese patients after the laparoscopic sleeve gastrectomy during the follow-up period of 3 months. Median whole test scores of the patients were increased from 11.5 preoperatively to 14 in the first and third months. In this study, we were able to show the significant improvement in gustatory sensitivity of morbidly obese patients after laparoscopic sleeve gastrectomy for the first time in literature. © The Author(s) 2016.
Shotgun cartridge rock breaker
Ruzzi, Peter L.; Morrell, Roger J.
1995-01-01
A rock breaker uses shotgun cartridges or other firearm ammunition as the explosive charge at the bottom of a drilled borehole. The breaker includes a heavy steel rod or bar, a gun with a firing chamber for the ammunition which screws onto the rod, a long firing pin running through a central passage in the rod, and a firing trigger mechanism at the external end of the bar which strikes the firing pin to fire the cartridge within the borehole. A tubular sleeve surround the main body of the rod and includes slits the end to allow it to expand. The rod has a conical taper at the internal end against which the end of the sleeve expands when the sleeve is forced along the rod toward the taper by a nut threaded onto the external end of the rod. As the sleeve end expands, it pushes against the borehole and holds the explosive gasses within, and also prevents the breaker from flying out of the borehole. The trigger mechanism includes a hammer with a slot and a hole for accepting a drawbar or drawpin which, when pulled by a long cord, allows the cartridge to be fired from a remote location.
An AC-electromagnetic bearing for flywheel energy storage in space
NASA Technical Reports Server (NTRS)
Nikolajsen, Jorgen L.
1993-01-01
A repulsive type AC-electromagnetic bearing was developed and tested. It was conceived on the basis of the so-called Magnetic River suspension for high-speed trains. The appearance of the bearing is similar to the traditional DC-type electromagnetic bearing but the operating principle is different. The magnets are fed with alternating current instead of direct current and the rotor is fitted with a conducting sleeve (e.g. aluminum) instead of a ferromagnetic sleeve. The repulsion is due to induction of eddy-currents in the conducting sleeve. The bearing is inherently stable and requires no feedback control. It provides support in five degrees of freedom such that a short rotor may be fully supported by a single bearing. These capabilities were demonstrated experimentally. On the down side, the load carrying capacity and the damping obtained so far were quite low compared to the DC-type bearing. Also, significant heating of the conducting sleeve was experienced. The AC-bearing is essentially a modified induction motor and there are strong indications that it can be run both as a motor and as a generator with no commutator requirements. It is therefore considered to be a good candidate for support of energy storage flywheels in space.
Decoding static and dynamic arm and hand gestures from the JPL BioSleeve
NASA Astrophysics Data System (ADS)
Wolf, M. T.; Assad, C.; Stoica, A.; You, Kisung; Jethani, H.; Vernacchia, M. T.; Fromm, J.; Iwashita, Y.
This paper presents methods for inferring arm and hand gestures from forearm surface electromyography (EMG) sensors and an inertial measurement unit (IMU). These sensors, together with their electronics, are packaged in an easily donned device, termed the BioSleeve, worn on the forearm. The gestures decoded from BioSleeve signals can provide natural user interface commands to computers and robots, without encumbering the users hands and without problems that hinder camera-based systems. Potential aerospace applications for this technology include gesture-based crew-autonomy interfaces, high degree of freedom robot teleoperation, and astronauts' control of power-assisted gloves during extra-vehicular activity (EVA). We have developed techniques to interpret both static (stationary) and dynamic (time-varying) gestures from the BioSleeve signals, enabling a diverse and adaptable command library. For static gestures, we achieved over 96% accuracy on 17 gestures and nearly 100% accuracy on 11 gestures, based solely on EMG signals. Nine dynamic gestures were decoded with an accuracy of 99%. This combination of wearableEMGand IMU hardware and accurate algorithms for decoding both static and dynamic gestures thus shows promise for natural user interface applications.
Apparatus and method for the acceleration of projectiles to hypervelocities
Hertzberg, Abraham; Bruckner, Adam P.; Bogdanoff, David W.
1990-01-01
A projectile is initially accelerated to a supersonic velocity and then injected into a launch tube filled with a gaseous propellant. The projectile outer surface and launch tube inner surface form a ramjet having a diffuser, a combustion chamber and a nozzle. A catalytic coated flame holder projecting from the projectile ignites the gaseous propellant in the combustion chamber thereby accelerating the projectile in a subsonic combustion mode zone. The projectile then enters an overdriven detonation wave launch tube zone wherein further projectile acceleration is achieved by a formed, controlled overdriven detonation wave capable of igniting the gaseous propellant in the combustion chamber. Ultrahigh velocity projectile accelerations are achieved in a launch tube layered detonation zone having an inner sleeve filled with hydrogen gas. An explosive, which is disposed in the annular zone between the inner sleeve and the launch tube, explodes responsive to an impinging shock wave emanating from the diffuser of the accelerating projectile thereby forcing the inner sleeve inward and imparting an acceleration to the projectile. For applications wherein solid or liquid high explosives are employed, the explosion thereof forces the inner sleeve inward, forming a throat behind the projectile. This throat chokes flow behind, thereby imparting an acceleration to the projectile.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Abbott, Mark W.
2013-07-01
Throughout power generation, delivery and waste remediation, the ability to control process streams in difficult or impossible locations becomes increasingly necessary as the complexity of processes increases. Example applications include radioactive environments, inside concrete installations, buried in dirt, or inside a shielded or insulated pipe. In these situations, it is necessary to implement innovative solutions to tackle such issues as valve maintenance, valve control from remote locations, equipment cleaning in hazardous environments, and flow stream analysis. The Extended Sleeve family of products provides a scalable solution to tackle some of the most challenging applications in hazardous environments which require flowmore » stream control and monitoring. The Extended Sleeve family of products is defined in three groups: Extended Sleeve (ESV), Extended Bonnet (EBV) and Instrument Enclosure (IE). Each of the products provides a variation on the same requirements: to provide access to the internals of a valve, or to monitor the fluid passing through the pipeline through shielding around the process pipe. The shielding can be as simple as a grout filled pipe covering a process pipe or as complex as a concrete deck protecting a room in which the valves and pipes pass through at varying elevations. Extended Sleeves are available between roughly 30 inches and 18 feet of distance between the pipeline centerline and the top of the surface to which it mounts. The Extended Sleeve provides features such as ± 1.5 inches of adjustment between the pipeline and deck location, internal flush capabilities, automatic alignment of the internal components during assembly and integrated actuator mounting pads. The Extended Bonnet is a shorter fixed height version of the Extended Sleeve which has a removable deck flange to facilitate installation through walls, and is delivered fully assembled. The Instrument Enclosure utilizes many of the same components as an Extended Sleeve, yet allows the installation of process monitoring instruments, such as a turbidity meter to be placed in the flow stream. The basis of the design is a valve body, which, rather than having a directly mounted bonnet has lengths of concentric pipe added, which move the bonnet away from the valve body. The pipe is conceptually similar to an oil field well, with the various strings of casing, and tubing installed. Each concentric pipe provides a required function, such as the outermost pipes, the valve sleeve and penetration sleeve, which provide structural support to the deck flange. For plug valve based designs, the next inner pipe provides compression on the environmental seals at the top of the body to bonnet joint, followed by the innermost pipe which provides rotation of the plug, in the same manner as an extended stem. Ball valve ESVs have an additional pipe to provide compressive loading on the stem packing. Due to the availability of standard pipe grades and weights, the product can be configured to fit a wide array of valve sizes, and application lengths, with current designs as short as seven inches and as tall as 18 feet. Central to the design is the requirement for no special tools or downhole tools to remove parts or configure the product. Off the shelf wrenches, sockets or other hand tools are all that is required. Compared to other products historically available, this design offers a lightweight option, which, while not as rigidly stiff, can deflect compliantly under extreme seismic loading, rather than break. Application conditions vary widely, as the base product is 316 and 304 stainless steel, but utilizes 17-4PH, and other allows as needed based on the temperature range and mechanical requirements. Existing designs are installed in applications as hot as 1400 deg. F, at low pressure, and separately in highly radioactive environments. The selection of plug versus ball valve, metal versus soft seats, and the material of the seals and seats is all dependent on the application requirements. The design of the Extended Sleeve family of products provides a platform which solves a variety of accessibility problems associated with controlling process flow streams in remote, hard to reach locations in harsh environments. Installation of the equipment described has shown to allow access to flow streams that otherwise would require exceptional means to access and control. The Extended Sleeve family of products provides a scalable solution to both control and monitor process fluid flow through shielding, walls or floors when direct connection is advantageous. (authors)« less
Behavior of a nuclear steel containment equipment hatch at large strain
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fanous, F.; Greimann, L.
1988-05-01
During a severe accident, buckling of a steel containment hatch door, large deformation and ovaling of the hatch sleeve are potential causes of mismatch at the sealing surface which can result in a leakage path. A three-dimensional nonlinear finite element analysis of a typical steel containment/sleeve/hatch assembly that includes containment stiffeners, pretensioned swing bolts, and hatch door geometric imperfection is presented. The analysis was carried out to the nonlinear range up to large strains. The results indicated that the buckling load occurs at pressure, far above that which causes gross yielding of the shell plate. Although buckling of the hatchmore » door increased the relative motions of the hatch sleeve and the hatch door, the motions remained sufficiently small to prevent leakage.« less
Ducting arrangement for cooling a gas turbine structure
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lee, Ching-Pang; Morrison, Jay A.
2015-07-21
A ducting arrangement (10) for a can annular gas turbine engine, including: a duct (12, 14) disposed between a combustor (16) and a first row of turbine blades and defining a hot gas path (30) therein, the duct (12, 14) having raised geometric features (54) incorporated into an outer surface (80); and a flow sleeve (72) defining a cooling flow path (84) between an inner surface (78) of the flow sleeve (72) and the duct outer surface (80). After a cooling fluid (86) traverses a relatively upstream raised geometric feature (90), the inner surface (78) of the flow sleeve (72)more » is effective to direct the cooling fluid (86) toward a landing (94) separating the relatively upstream raised geometric feature (90) from a relatively downstream raised geometric feature (94).« less
Karimova, V M; Pustovit, K B; Abramochkin, D V; Kuz'min, V S
2017-03-01
We studied the effect of extracellular purine nucleotides (NAD + and ATP) on spontaneous arrhythmogenic activity caused by norepinephrine in myocardial sleeves of pulmonary veins. In pulmonary veins, NAD + and ATP reduced the frequency of action potentials and their duration at regular type of spontaneous activity caused by norepinephrine. NAD + and ATP lengthened the intervals between spike bursts at periodic (burst) type of spontaneous activity. In addition, ATP shortened the duration of spike bursts and the number of action potentials in the "bursts" caused by norepinephrine in the pulmonary veins. It was hypothesized that NAD + and ATP attenuate the effects of sympathetic stimulation and when released together with norepinephrine from sympathetic endings in vivo, probably, reduce arrhythmogenic activity in myocardial sleeves of pulmonary veins.
Apparatus and method for enhancing tissue repair in mammals
NASA Technical Reports Server (NTRS)
Goodwin, Thomas J. (Inventor); Parker, Clayton R. (Inventor)
2009-01-01
An apparatus is introduced for the use of enhancing tissue repair in mammals. The apparatus includes a sleeve; an electrically conductive coil; a sleeve support; an electrical circuit configured to supply the coil with a square wave time varying electrical current sufficient to create approximately 0.05 gauss to 0.5 gauss. When in use, the sleeve of the apparatus is placed on a mammalian body part and the time varying electromagnetic force of from approximately 0.05 gauss to 0.5 gauss is generated on the mammalian body for an extended period of time so that the tissue is encouraged to be regenerated in the mammalian body part at a rate in excess of the normal tissue regeneration rate relative to regeneration without application of the time varying electromagnetic force.
Anderson, J.B.
1960-01-01
A reactor is described which comprises a tank, a plurality of coaxial steel sleeves in the tank, a mass of water in the tank, and wire grids in abutting relationship within a plurality of elongated parallel channels within the steel sleeves, the wire being provided with a plurality of bends in the same plane forming adjacent parallel sections between bends, and the sections of adjacent grids being normally disposed relative to each other.
NASA Technical Reports Server (NTRS)
Carter, Robert W. (Inventor); Payton, Lewis N. (Inventor)
2007-01-01
A friction stir weld tool sleeve is supported by an underlying support pin. The pin material is preferably selected for toughness and fracture characteristics. The pin sleeve preferably has a geometry which employs the use of an interrupted thread, a plurality of flutes and/or eccentric path to provide greater flow through. Paddles have been found to assist in imparting friction and directing plastic metal during the welding process.
NASA Technical Reports Server (NTRS)
Carter, Robert W. (Inventor); Payton, Lewis N. (Inventor)
2007-01-01
A friction stir weld tool sleeve is supported by an underlying support pin. The pin material is preferably selected for toughness and fracture characteristics. The pin sleeve preferably has a geometry which employs the use of an interrupted thread, a plurality of flutes and/or eccentric path to provide greater flow through. Paddles have been found to assist in imparting friction and directing plastic metal during the welding process.
Cooling air recycling for gas turbine transition duct end frame and related method
Cromer, Robert Harold; Bechtel, William Theodore; Sutcu, Maz
2002-01-01
A method of cooling a transition duct end frame in a gas turbine includes the steps of a) directing cooling air into the end frame from a region external of the transition duct and the impingement cooling sleeve; and b) redirecting the cooling air from the end frame into the annulus between the transition duct and the impingement cooling sleeve.
A Method to Estimate Fabric Particle Penetration Performance
2014-09-08
may be needed to improve the correlation between wind tunnel component sleeve tests and bench top swatch test. The ability to predict multi-layered...within the fabric/component gap may be needed to improve the correlation between wind tunnel component sleeve tests and bench top swatch test...impermeable garment . Heat stress becomes a major problem with this approach however, as normal physiological heat loss mechanisms (especially sweat
LINER FOR EXTRUSION BILLET CONTAINERS
Shrink-fit assembly device for buildup of ceramic-coated liner and sleeve assemblies was tested and modified to develop desired temperatures and...preliminary evaluation of suitability for extrusion liner use. Procedures were developed for welding short, hollow ceramic cylinders of high-strength metal...carbides and borides to form a ceramic extrusion liner of suitable length. Disassembly tooling for rapid separation of shrink-fitted sleeves from a worn
DEVELOPMENT OF PERMANENT MECHANICAL REPAIR SLEEVE FOR PLASTIC PIPE
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hitesh Patadia
2004-09-30
The report presents a comprehensive summary of the project status related to the development of a permanent mechanical repair fitting intended to be installed on damaged PE mains under blowing gas conditions. Specifically, the product definition has been developed taking into account relevant codes and standards and industry input. A conceptual design for the mechanical repair sleeve has been developed which meets the product definition.
A beam-splitter-type 3-D endoscope for front view and front-diagonal view images.
Kamiuchi, Hiroki; Masamune, Ken; Kuwana, Kenta; Dohi, Takeyoshi; Kim, Keri; Yamashita, Hiromasa; Chiba, Toshio
2013-01-01
In endoscopic surgery, surgeons must manipulate an endoscope inside the body cavity to observe a large field-of-view while estimating the distance between surgical instruments and the affected area by reference to the size or motion of the surgical instruments in 2-D endoscopic images on a monitor. Therefore, there is a risk of the endoscope or surgical instruments physically damaging body tissues. To overcome this problem, we developed a Ø7- mm 3-D endoscope that can switch between providing front and front-diagonal view 3-D images by simply rotating its sleeves. This 3-D endoscope consists of a conventional 3-D endoscope and an outer and inner sleeve with a beam splitter and polarization plates. The beam splitter was used for visualizing both the front and front-diagonal view and was set at 25° to the outer sleeve's distal end in order to eliminate a blind spot common to both views. Polarization plates were used to avoid overlap of the two views. We measured signal-to-noise ratio (SNR), sharpness, chromatic aberration (CA), and viewing angle of this 3-D endoscope and evaluated its feasibility in vivo. Compared to the conventional 3-D endoscope, SNR and sharpness of this 3-D endoscope decreased by 20 and 7 %, respectively. No significant difference was found in CA. The viewing angle for both the front and front-diagonal views was about 50°. In the in vivo experiment, this 3-D endoscope can provide clear 3-D images of both views by simply rotating its inner sleeve. The developed 3-D endoscope can provide the front and front-diagonal view by simply rotating the inner sleeve, therefore the risk of damage to fragile body tissues can be significantly decreased.
A Case Report of Sleeve Fracture of the Patella in a Shield.
Tsubosaka, Masanori; Makino, Takeshi; Kishimoto, Shin-Ichiro; Yamaura, Kohei
2016-01-01
Sleeve fractures of the patella are rare fractures that only occur in children. The diagnosis is difficult both clinically and radiologically since the distal bony fragment may be too small to be detectable by radiography. A high-riding patella and hemarthrosis are important signs of sleeve fractures. A 12-year-old boy was admitted to the emergency room after having felt a severe pain in his left knee on kicking the ground while skateboarding earlier that day. Knee swelling, tense hemarthrosis, and periarticular tenderness were noted. On physical examination, an extension lag of 15 was observed. The active range of motion of the injured knee was 45-90° of flexion. Radiography showed an avulsion fracture of the lower pole of the patella and a high-riding patella. At the next day after the injury, we performed open reduction and internal fixation surgery. Open reduction with transosseous tunneling and cerclage wiring was performed because the distal bony fragment was too small for tension band wiring to be used. At 9 months after surgery, there was no extension lag, and the active range of motion of the injured knee was 0-140° of flexion. Callus formation over the fracture site and bone union was confirmed, and the cerclage wire was removed. To date, he had no further symptoms and has been able to carry out all types of physical activities, including skateboarding. Although sleeve fractures in children are uncommon, it should be considered a possibility in children with a chief complaint of pain around the knee. Open reduction and internal fixation was effective in the treatment of sleeve fracture of the patella.
Zachariah, Pulimuttil James; Chen, Chih-Yen; Lee, Wei-Jei; Chen, Shu-Chu; Ser, Kong-Han; Chen, Jung-Chien; Lee, Yi-Chih
2016-12-01
Functional studies of how duodenal-jejunal exclusion (DJE) brings a superior glycemic control when added to sleeve gastrectomy in duodenal-jejunal bypass with sleeve gastrectomy (DJB-SG) patients, are lacking. To study this, we compared the appetite sensations and the β-cell response following a standard mixed meal in patients with DJB-SG, versus those with sleeve gastrectomy (SG) alone. Twenty one patients who underwent DJB-SG and 25 with SG, who participated in mixed-meal tests (MMTT) preoperatively and at 1 year, with complete data were included and compared. Blood glucose, C-peptide, and insulin levels were estimated, along with the visual analogue scale (VAS) scoring of the six appetite sensations, as a part of the MMTT. At 1 year following surgery, compared to SG group, DJB-SG group had greater complete remission rates (HbA1C <6.0 %) of 62 versus 32 % (p < 0.05), with similar total body weight loss (25.7 vs. 22 %). There were significantly lower post-prandial blood glucose and lower C-peptide levels during the MMTT in the patients with DJB-SG compared to SG group. There were no significant differences in the appetite sensations (mean VAS) scores between the groups. The addition of DJE component to SG, as in DJB-SG, was associated with higher diabetes remission rates, lower glycemic fluctuations, and lower C-peptide levels. This may point to a β-cell preserving glucose control which could result in longer remission of type 2 diabetes mellitus (T2DM). This effect also may be unrelated to food intake as there were no significant differences in the appetite sensations.
Loss-of-Control Eating Following Sleeve Gastrectomy Surgery
Ivezaj, Valentina; Kessler, Erin E.; Lydecker, Janet A.; Barnes, Rachel D.; White, Marney A.; Grilo, Carlos M.
2016-01-01
Background Post-operative loss-of-control (LOC) eating is related to poorer weight loss outcomes following bariatric surgery, but little is known about LOC eating following sleeve gastrectomy surgery. Objectives To examine LOC eating severity and weight loss following sleeve gastrectomy. Setting University School of Medicine, U.S. Methods Participants were 71 individuals (84.5% female; n=60) who underwent sleeve gastrectomy surgery within the previous 4–9 months and reported LOC eating at least once weekly during the previous 28 days. LOC eating was assessed using the Eating Disorder Examination (EDE) Bariatric Surgery Version. Current mean age and body mass index were 47.3 (SD=10.1) years and 37.9 (SD=8.2) kg/m2. Two groups, bariatric binge-eating disorder (Bar-BED) and loss-of-control eating only (LOC-Only) were created based on modified binge-eating disorder (BED) criteria, which excluded the “unusually large quantity of food” criterion due to limited gastric capacity post-surgery. Bar-BED criteria mirrored BED criteria and consisted of the following: at least 12 LOC eating episodes over the prior three months (once weekly), 3 of 5 associated symptoms, marked distress over LOC eating, and lack of regular compensatory behaviors. Results Based on these revised criteria, 49.3% (n=35) were classified as the Bar-BED group and 50.7% (n=36) as the LOC-Only group. Compared to the LOC-Only group, the Bar-BED group had significantly greater EDE global and subscale scores and lower percent weight loss by six months post-surgery. Conclusions Findings suggest LOC eating that parallels BED post-surgery is associated with poorer outcomes following sleeve gastrectomy including poorer weight loss and greater severity of eating-disorder psychopathology. PMID:27913121
DOE Office of Scientific and Technical Information (OSTI.GOV)
Spachner, S. A.
1963-05-01
A shrink-fit assembly device for buildup of ceramiccoated liner and sleeve assemblies was tested and modified to develop desired temperatures and suitable heat distribution in sleeves, which were heated. Nine different compositions of fiber metal reinforced ceramic compacts were produced for preliminary evaluation of suitability for extrusion liner use. Procedures were developed for welding short, hollow ceramic cylinders of high-strength metal carbides and borides to form a ceramic extrusion liner of suitable length. Dissassembly tooling for rapid separation of shrink-fitted sleeves from a worn liner was designed, fabricated, and tested. Preliminary extrusion testing of an alumina-coated liner was carried out,more » using SAE 4340 steel billets extruded to rod at 12 : 1 and 16 : 1 ratios. No coating wear was noted after extrusion of 3 billets. (auth)« less
Combustor assembly in a gas turbine engine
Wiebe, David J; Fox, Timothy A
2015-04-28
A combustor assembly in a gas turbine engine includes a combustor device, a fuel injection system, a transition duct, and an intermediate duct. The combustor device includes a flow sleeve for receiving pressurized air and a liner surrounded by the flow sleeve. The fuel injection system provides fuel to be mixed with the pressurized air and ignited in the liner to create combustion products. The intermediate duct is disposed between the liner and the transition duct so as to define a path for the combustion products to flow from the liner to the transition duct. The intermediate duct is associated with the liner such that movement may occur therebetween, and the intermediate duct is associated with the transition duct such that movement may occur therebetween. The flow sleeve includes structure that defines an axial stop for limiting axial movement of the intermediate duct.
Biosleeve Human-Machine Interface
NASA Technical Reports Server (NTRS)
Assad, Christopher (Inventor)
2016-01-01
Systems and methods for sensing human muscle action and gestures in order to control machines or robotic devices are disclosed. One exemplary system employs a tight fitting sleeve worn on a user arm and including a plurality of electromyography (EMG) sensors and at least one inertial measurement unit (IMU). Power, signal processing, and communications electronics may be built into the sleeve and control data may be transmitted wirelessly to the controlled machine or robotic device.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-22
... Community. The MCAI AD reports the separation and loss of a stainless steel ring (75 millimeter (mm) in... of a stainless steel ring (75 mm in diameter) from a blade sleeve resulting in severe, high-frequency... information specifies checking the blade sleeve for slippage of the stainless steel ring (75 mm in diameter...
Laparoscopic sleeve gastrectomy for morbid obesity with natural orifice specimen extraction (NOSE).
Gunkova, P; Gunka, I; Zonca, P; Dostalik, J; Ihnat, P
2015-01-01
An experience with laparoscopic sleeve gastrectomy using the natural orifice specimen extraction (NOSE) technique. Bariatric surgery is nowadays the only long term effective obesity treatment method. Twenty one consecutive patients underwent laparoscopic sleeve gastrectomy with the use of natural orifice specimen extraction (NOSE) in the Surgical Clinic of Faculty Hospital Ostrava between May 2012 and August 2012. Inclusion criteria were the body mass index (BMI) higher than 35 kg/m2 or higher than 32 kg/m2 accompanied with relevant comorbidities. Among 21 patients in this series, there were three men (14.3%) and 18 women (85.7%). Their mean age was 40.9±10.2 years. Their mean preoperative BMI was 40.4±4.6 kg/m2. No patient had previous bariatric surgery, one patient had laparoscopic fundoplication. All operations were completed laparoscopically with no conversions to an open procedure. In two cases, laparoscopic cholecystectomy was performed and the gallbladder was extracted along with the gastric specimen by transgastric approach. Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure with low morbidity and mortality. Based on our initial experiences it could be an indication for NOSE with transgastric approach. Obese patients would benefit from this approach due to the elimination of wound complications (Tab. 2, Fig. 3, Ref. 22).
Effects of wearing lower leg compression sleeves on locomotion economy.
Kurz, Eduard; Anders, Christoph
2018-09-01
The purpose of this investigation was to assess the effect of compression sleeves on muscle activation cost during locomotion. Twenty-two recreationally active men (age: 25 ± 3 years) ran on a treadmill at four different speeds (ordered sequence of 2.8, 3.3, 2.2, and 3.9 m/s). The tests were performed without (control situation, CON) and while wearing specially designed lower leg compression sleeves (SL). Myoelectric activity of five lower leg muscles (tibialis anterior, fibularis longus, lateral and medial head of gastrocnemius, and soleus) was captured using Surface EMG. To assess muscle activation cost, the cumulative muscle activity per distance travelled (CMAPD) of the CON and SL situations was determined. Repeated measures analyses of variance were performed separately for each muscle. The analyses revealed a reduced lower leg muscle activation cost with respect to test situation for SL for all muscles (p < 0.05, η p 2 > 0.18). The respective significant reductions of CMAPD values during SL ranged between 4% and 16% and were largest at 2.8 m/s. The findings presented point towards an improved muscle activation cost while wearing lower leg compression sleeves during locomotion that have potential to postpone muscle fatigue.
Coming out prevention by stopper for the shrink fitted sandwiched shaft from the ceramic sleeve
NASA Astrophysics Data System (ADS)
Zhang, Guowei; Noda, Nao-Aki; Sano, Yoshikazu; Sakai, Hiromasa; Oda, Kazuhiro
2017-05-01
Ceramic roller can be used in the heating furnace conveniently because of its high temperature resistance. The roller consists of sleeve and steel shaft connected only under a small shrink fitting ratio because of the brittleness. However, the coming out of the shaft may often happen from the ceramic sleeve under repeated bending load. Therefore, how to prevent the coming out failure becomes an important issue. Based on the previous study, a two-dimensional shrink fitted structure is considered by replacing the shaft with the inner plate and by replacing the sleeve with the outer plate. Then, this research focuses on preventing the inner plate coming out from the outer plate by introducing a newly designed stopper on the outer plate. The simulation results shows that the coming out phenomenon can be prevented effectively due to the contact between the inter plate and the stopper installed on the outer plate. In order to evaluate the contact force between the inner plate and the stopper, the coming out mechanism is clarified. To prevent the coming out by stopper safely, the effects of the magnitude of repeated load and the friction coefficient upon the contact compressive force are investigated under large number of loading cycles by using 2D simulation.
Laparoscopic Sleeve Gastrectomy Improves Olfaction Sensitivity in Morbidly Obese Patients.
Hancı, Deniz; Altun, Huseyin; Altun, Hasan; Batman, Burcin; Karip, Aziz Bora; Serin, Kursat Rahmi
2016-03-01
Olfactory abilities of the patients are known to be altered by eating and metabolic disorders, including obesity. There are only a number of studies investigating the effect of obesity on olfaction, and there is limited data on the changes in olfactory abilities of morbidly obese patients after surgical treatment. Here we investigated the changes in olfactory abilities of 54 morbidly obese patients (M/F, 22/32; age range 19-57 years; body mass index (BMI) range 30.5-63.0 kg/m(2)) after laparoscopic sleeve gastrectomy. A laparoscopic sleeve gastrectomy was performed by the same surgeon using five-port technique. Olfactory abilities were tested preoperatively and 1, 3, and 6 months after the surgery using a standardized Sniffin' Sticks Extended Test kit. Analyses of variance indicated statistically significant improvement in T, D, and I scores of morbidly obese patients within time factors (preoperative vs. 1, 3, and 6 months; 1 vs. 3 and 6 months; and 3 vs. 6 months; p < 0.001 for all). There was a statistically significant improvement in overall TDI scores with an increase from 25 to 41 during the 6 months follow-up period (p < 0.001 for all). Here, for the first time in literature, we were able to show the significant improvement in olfactory abilities of morbidly obese patients after laparoscopic sleeve gastrectomy.
Knee braces can decrease tibial rotation during pivoting that occurs in high demanding activities.
Giotis, Dimitrios; Tsiaras, Vasilios; Ristanis, Stavros; Zampeli, Franceska; Mitsionis, Grigoris; Stergiou, Nicholas; Georgoulis, Anastasios D
2011-08-01
The purpose of this study was to investigate whether knee braces could effectively decrease tibial rotation during high demanding activities. Using an in vivo three-dimensional kinematic analysis, 21 physically active, healthy, male subjects were evaluated. Each subject performed two tasks that were used extensively in the literature because they combine increased rotational and translational loads on the knee, (1) descending from a stair and subsequent pivoting and (2) landing from a platform and subsequent pivoting under three conditions: (A) wearing a prophylactic brace (braced), (B) wearing a patellofemoral brace (sleeved), and (C) unbraced condition. In the first task, tibial rotation during the pivoting phase was significantly decreased in the braced condition as compared to the sleeved condition (P = 0.019) and the non-braced condition (P = 0.002). In the second task, the same variable was significantly decreased in the braced condition as compared to the sleeved (P = 0.001) and the unbraced condition (P < 0.001). The sleeved condition also produced significantly decreased tibial rotation with respect to the unbraced condition (P = 0.021). Bracing decreased tibial rotation in activities where increased translational and rotational forces were applied. Because knee braces decreased tibial rotation, they can possibly be used with ACL-reconstructed and ACL-deficient patients to prevent such problems. Case-control study, Level III.
[The technique of sleeve resection on the bronchial and pulmonary vascular tree].
Branscheid, D; Beshay, M
2013-06-01
Sleeve resections of the lungs have affected the oncologic radicality, parenchyma and lung function-saving resections and extended the indications for operations in thoracic surgery. Whenever lung amputations can be avoided by bronchoplastic and/or angioplastic procedures with the same radicality, sleeve resection should be performed. In centrally located distinct malignomas, intraluminal tumor growth (T3) infiltrations of peribronchial or extrabronchial areas, the lobular ostia and the pulmonary artery (T2/T3) as well as lymph node involvement (N1/N2), these procedures give a better qualitative survival and lower morbidity and mortality rates. Broncoscope-guided localization of a double lumen tube and routine anesthesia monitoring are mandatory. Before performing sleeve resections a complete lymph node dissection should be done without denuding the area of the anastomosis and sparing the bronchial arteries. Preoperative endoscopic biopsies, knowledge of the topography and mobilization of the vascular and bronchial tree, subtile operation techniques, perioperative and postoperative videobronchoscopic guidance as well as intraoperative frozen sections and a tension-free and smooth anastomosis, avoid postoperative complications. Depending on the blood supply of the bronchial tree a vascularized flap is indicated. Operability can therefore be achieved in elderly patients with limited pulmonary function, particularly those under adjuvant or neoadjuvant therapy who are no longer suitable for pneumonectomy.
Endoscopic Sleeve Gastroplasty - A New Tool to Manage Obesity
Jain, Deepanshu; Bhandari, Bharat Singh; Arora, Ankit; Singhal, Shashideep
2017-01-01
Obesity is a growing pandemic across the world. Dietary restrictions and behavior modifications alone have a limited benefit. Bariatric surgery, despite being the current gold standard, has limited acceptance by patients due to cost and associated morbidity. In our review, we have discussed nine original studies describing endoscopic sleeve gastroplasty (ESG). A total of 172 subjects successfully underwent ESG. Of 65 subjects with follow up data, 95.4% (62/65) had intact gastric sleeve confirmed via esophagogastroduodenoscopy or oral contrast study at the end of study specific follow up interval (the longest being 6 months). Individual studies reported a technical success rate for intact gastric sleeve from as low as 50% to as high as 100%. A statistically significant p<0.05) weight loss was reported in seven of the eight studies with available data. None of the patients experienced any intra-procedure complications, and approximately 2.3% (4/172) of patients experienced major post-procedure complications; however, no mortality was reported. Majority of the studies reported relatively high incidence of minor post-procedure complications, which improved with symptomatic treatment alone. Good patient tolerance with comparable clinical efficacy in achieving and sustaining desired weight loss makes ESG an attractive option to consider among other bariatric therapies. PMID:28607328
Rushing, F.C.
1960-09-01
A vibration damping device effective to dampen vibrations occurring at the several critical speeds encountered in the operation of a high-speed centrifuge is described. A self-centering bearing mechanism is used to protect both the centrifuge shaft and the damping mechanism. The damping mechanism comprises spaced-apant, movable, and stationary sleeve members arranged concentrically of a rotating shaft with a fluid maintained between the members. The movable sleeve member is connected to the shaft for radial movement therewith.
A high-speed photography study of cavitation in a dynamically loaded journal bearing
NASA Technical Reports Server (NTRS)
Sun, D. C.; Brewe, D. E.
1990-01-01
The earlier study made by Jacobson and Hamrock on the cavitation of liquid lubricant films in a dynamically loaded journal bearing was repeated with a quartz sleeve, which was more rigid than the Polymethylmethacrylate (PMMA) sleeve used previously. Various improvements of the test rig were made concomitantly so that the experimental errors could be better controlled and assessed. The updated speed photography experiment and its results are described.
A high speed photography study of cavitation in a dynamically loaded journal bearing
NASA Technical Reports Server (NTRS)
Sun, D. C.; Brewe, D. E.
1991-01-01
The earlier study made by Jacobson and Hamrock on the cavitation of liquid lubricant films in a dynamically loaded journal bearing was repeated with a quartz sleeve, which was more rigid than the Polymethylmethacrylate (PMMA) sleeve used previously. Various improvements of the test rig were made concomitantly so that the experimental errors could be better controlled and assessed. The updated speed photography experiment and its results are described.
GRIPPING DEVICE FOR CYLINDRICAL OBJECTS
Pilger, J.P.
1964-01-21
A gripping device is designed for fragile cylindrical objects such as for drawing thin-walled tubes. The gripping is done by multiple jaw members held in position by two sets of slots, one defined by keystone-shaped extensions of the outer shell of the device and the other in a movable sleeve held slidably by the extensions. Forward movement oi the sleeve advances the jaws, thereby exerting a controlled, radial pressure on the object being gripped. (AEC)
Caller, J.M.
1962-05-01
An electrical connector is designed for utilization in connection with either round or flat coaxial cables. The connector comprises a bayonet-type coupling arrangement with a splined movable locking sleeve adapted to lock together components of the connector. A compression spring is attached to one of the connector components and functions to forcibly separate mating components when the locking sleeve is in an unlocked condition so as to minimize the possibility of leaving the conductors electrically coupled. (AEC)
Cap assembly for a bundled tube fuel injector
DOE Office of Scientific and Technical Information (OSTI.GOV)
LeBegue, Jeffrey Scott; Melton, Patrick Benedict; Westmoreland, III, James Harold
2016-04-26
A cap assembly for a bundled tube fuel injector includes an impingement plate and an aft plate that is disposed downstream from the impingement plate. The aft plate includes a forward side that is axially separated from an aft side. A tube passage extends through the impingement plate and the aft plate. A tube sleeve extends through the impingement plate within the tube passage towards the aft plate. The tube sleeve includes a flange at a forward end and an aft end that is axially separated from the forward end. A retention plate is positioned upstream from the impingement plate.more » A spring is disposed between the retention plate and the flange. The spring provides a force so as to maintain contact between at least a portion of the aft end of the tube sleeve and the forward side of the aft plate.« less
Ion-plasma gun for ion-milling machine
Kaminsky, Manfred S.; Campana, Jr., Thomas J.
1976-01-01
An ion gun includes an elongated electrode with a hollow end portion closed by a perforated end plate. The end plate is positioned parallel to a perforated flat electrode of opposite electrical polarity. An insulated sleeve encompasses the elongated electrode and extends outwardly from the perforated end towards the flat electrode. The sleeve length is separated into two portions of different materials. The first is formed of a high-temperature material that extends over the hollow portion of the elongated electrode where the arc is initiated by a point source electrode. The second sleeve portion extending over the remainder of the elongated electrode is of a resilient material for enhanced seal-forming ability and retention of plasma gas. Perforations are arranged in the flat electrode in a mutually opposing triangular pattern to project a plasma beam having a generally flat current profile towards a target requiring precision milling.
IMPROVEMENTS IN OR RELATING TO NUCLEAR REACTORS
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dennis, W.E.; Lindley, P.A.
1958-05-01
A unique feature of the GEC Hunterston power station is the use of what the firm call the 'replaceable channel fuel element' and the patent covers the idea. The actual metallic element is generally simlar to those used in other power stations--a uranium bar sheathed in a helically-finned can--but it is supported inside a sleeve of graphite or other material. The composite elements are stacked inside channels through the core and are charged and discharged as complete units. The advantages claimed are: the core channels are protected against mechanical abrasion during fuelling operation, the moderator is protected against chemical attackmore » and mass transfer from the coolant, and if there is a burst slug it is only the sleeve which is contaminated. The sleeve also takes all the weight, thus elements are unlformly stressed. Working on this idea, the specification covers several variants, including the use of plate-type elements.« less
Method for making an elastomeric member with end pieces
Hoppie, L.O.; McNinch, J.H. Jr.; Nowell, G.C.
1984-10-23
A molding process is described for molding an elongated elastomeric member with wire mesh sleeves bonded to the ends. A molding preform of elastomeric material is positioned within a seamless mold cylinder, and the open ends of the wire mesh sleeves are mounted to end plug assemblies slidably received into the mold cylinder and positioned against the ends of the preform. A specialized profile is formed into surfaces of the respective end plug assemblies and by heating of the mold, the ends of the elastomeric preform are molded to the profile, as well as bonded to the reinforcing wire mesh sleeves. Vacuum is applied to the interior of the mold to draw outgassing vapors through relief spaces there through. The completed elastomeric member is removed from the mold cylinder by stretching, the consequent reduction in diameter enabling ready separation from the mold cylinder and removal thereof. 9 figs.
Silicon-based sleeve devices for chemical reactions
Northrup, M. Allen; Mariella, Jr., Raymond P.; Carrano, Anthony V.; Balch, Joseph W.
1996-01-01
A silicon-based sleeve type chemical reaction chamber that combines heaters, such as doped polysilicon for heating, and bulk silicon for convection cooling. The reaction chamber combines a critical ratio of silicon and silicon nitride to the volume of material to be heated (e.g., a liquid) in order to provide uniform heating, yet low power requirements. The reaction chamber will also allow the introduction of a secondary tube (e.g., plastic) into the reaction sleeve that contains the reaction mixture thereby alleviating any potential materials incompatibility issues. The reaction chamber may be utilized in any chemical reaction system for synthesis or processing of organic, inorganic, or biochemical reactions, such as the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction, which are examples of a synthetic, thermal-cycling-based reaction. The reaction chamber may also be used in synthesis instruments, particularly those for DNA amplification and synthesis.
Silicon-based sleeve devices for chemical reactions
Northrup, M.A.; Mariella, R.P. Jr.; Carrano, A.V.; Balch, J.W.
1996-12-31
A silicon-based sleeve type chemical reaction chamber is described that combines heaters, such as doped polysilicon for heating, and bulk silicon for convection cooling. The reaction chamber combines a critical ratio of silicon and silicon nitride to the volume of material to be heated (e.g., a liquid) in order to provide uniform heating, yet low power requirements. The reaction chamber will also allow the introduction of a secondary tube (e.g., plastic) into the reaction sleeve that contains the reaction mixture thereby alleviating any potential materials incompatibility issues. The reaction chamber may be utilized in any chemical reaction system for synthesis or processing of organic, inorganic, or biochemical reactions, such as the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction, which are examples of a synthetic, thermal-cycling-based reaction. The reaction chamber may also be used in synthesis instruments, particularly those for DNA amplification and synthesis. 32 figs.
Preliminary engineering study: Quick opening valve MSFC high Reynolds number wind tunnel
NASA Technical Reports Server (NTRS)
1983-01-01
FluiDyne Engineering Corporation has conducted a preliminary engineering study of a quick-opening valve for the MSFC High Reynolds Number Wind Tunnel under NASA Contract NAS8-35056. The subject valve is intended to replace the Mylar diaphragm system as the flow initiation device for the tunnel. Only valves capable of opening within 0.05 sec. and providing a minimum of 11.4 square feet of flow area were considered. Also, the study focused on valves which combined the quick-opening and tight shutoff features in a single unit. A ring sleeve valve concept was chosen for refinement and pricing. Sealing for tight shutoff, ring sleeve closure release and sleeve actuation were considered. The resulting cost estimate includes the valve and requisite modifications to the facility to accommodate the valve as well as the associated design and development work.
Drive piston assembly for a valve actuator assembly
Sun, Zongxuan
2010-02-23
A drive piston assembly is provided that is operable to selectively open a poppet valve. The drive piston assembly includes a cartridge defining a generally stepped bore. A drive piston is movable within the generally stepped bore and a boost sleeve is coaxially disposed with respect to the drive piston. A main fluid chamber is at least partially defined by the generally stepped bore, drive piston, and boost sleeve. First and second feedback chambers are at least partially defined by the drive piston and each are disposed at opposite ends of the drive piston. At least one of the drive piston and the boost sleeve is sufficiently configured to move within the generally stepped bore in response to fluid pressure within the main fluid chamber to selectively open the poppet valve. A valve actuator assembly and engine are also provided incorporating the disclosed drive piston assembly.
Ultra high performance connectors for power transmission applications
Wang, Jy-An; Ren, Fei; Lee, Dominic F; Jiang, Hao
2014-03-04
Disclosed are several examples of an apparatus for connecting the free ends of two electrical power transmission lines having conductor strands disposed around a central, reinforcing core. The examples include an inner sleeve having a body defining an inner bore passing through an axially-extending, central axis, an outer rim surface disposed radially outward from the central bore, and one or more axially-extending grooves penetrating the body at the outer rim surface. Also included is an outer splice having a tubular shaped body with a bore passing coaxially through the central axis, the bore defining an inner rim surface for accepting the inner sleeve. The inner bore of the inner sleeve accepts the reinforcement cores of the two conductors, and the grooves accept the conductor strands in an overlapping configuration so that a majority of the electrical current flows between the overlapped conductor strands when the conductors are transmitting electrical current.
Computed tomography of cystic nerve root sleeve dilatation.
Neave, V C; Wycoff, R R
1983-10-01
A case of cystic nerve root sleeve dilatation in the lumbar area associated with a chronic back pain syndrome is presented. Prominent computed tomography (CT) findings include: (a) rounded masses in the region of the foramina isodense with cerebrospinal fluid in the subarachnoid space; (b) associated asymmetry of epidural fat distribution; (c) enlargement of the neural foramina in axial sections with scalloped erosion of the adjacent posteriolateral vertebral body, pedicle, and pedicular-laminar junction with preservation of cortex and without bony sclerosis or infiltrative appearance; (d) prominent or ectatic dural sac with lack of usual epidural landmarks between the sac and vertebral body; and (e) multilevel abnormalities throughout the entire lumbar region. Myelographic and CT correlations are demonstrated with a review of the literature. A discussion of the various cystic abnormalities involving nerve root sheaths is undertaken in an attempt to clarify the confusing nomenclature applied to nerve root sleeve pathology.
Richter, H.G.; Gillespie, A.S. Jr.
1963-11-12
A flexible Geiger counter constructed from materials composed of vinyl chloride polymerized with plasticizers or co-polymers is presented. The counter can be made either by attaching short segments of corrugated plastic sleeving together, or by starting with a length of vacuum cleaner hose composed of the above materials. The anode is maintained substantially axial Within the sleeving or hose during tube flexing by means of polystyrene spacer disks or an easily assembled polyethylene flexible cage assembly. The cathode is a wire spiraled on the outside of the counter. The sleeving or hose is fitted with glass end-pieces or any other good insulator to maintain the anode wire taut and to admit a counting gas mixture into the counter. Having the cathode wire on the outside of the counter substantially eliminates the objectional sheath effect of prior counters and permits counting rates up to 300,000 counts per minute. (AEC)
Incidental gastric accessory spleen during laparoscopic sleeve gastrectomy.
Almazeedi, Sulaiman; Alhaddad, Eliana; Al-Khithr, Talal; Alhunaidi, Mohammed
2017-01-01
Bariatric surgery has shown to produce the most predictable and tangible results for weight loss, with laparoscopic sleeve gastrectomy's being the most popular one of them. However, the occurrence of previously undiagnosed diseases can be encountered during bariatric operations. The work has been reported in line with the SCARE criteria. This is the case of a 54year old morbidly obese female, presenting to our hospital for a laparoscopic sleeve gastrectomy. During her procedure, it was discovered that she has an accessory spleen on the fundus of her stomach. The decision was made to resect it with the specimen of the stomach for histopathalogical examination. Incidental findings during routine bariatric surgery are a common occurance, and therefore prompt and effective intra-op management is key to the prognosis of the patient. Accessory spleens, although uncommon, tend to be asymptomatic. However, if undiagnosed, could present with dangerous consequences. Copyright © 2017. Published by Elsevier Ltd.
Design of light guide sleeve on hyperspectral imaging system for skin diagnosis
NASA Astrophysics Data System (ADS)
Yan, Yung-Jhe; Chang, Chao-Hsin; Huang, Ting-Wei; Chiang, Hou-Chi; Wu, Jeng-Fu; Ou-Yang, Mang
2017-08-01
A hyperspectral imaging system is proposed for early study of skin diagnosis. A stable and high hyperspectral image quality is important for analysis. Therefore, a light guide sleeve (LGS) was designed for the embedded on a hyperspectral imaging system. It provides a uniform light source on the object plane with the determined distance. Furthermore, it can shield the ambient light from entering the system and increasing noise. For the purpose of producing a uniform light source, the LGS device was designed in the symmetrical double-layered structure. It has light cut structures to adjust distribution of rays between two layers and has the Lambertian surface in the front-end to promote output uniformity. In the simulation of the design, the uniformity of illuminance was about 91.7%. In the measurement of the actual light guide sleeve, the uniformity of illuminance was about 92.5%.
Long term (7 or more years) outcomes of the sleeve gastrectomy: a meta-analysis.
Clapp, Benjamin; Wynn, Matthew; Martyn, Colin; Foster, Chase; O'Dell, Montana; Tyroch, Alan
2018-03-06
The laparoscopic sleeve gastrectomy is now the most common bariatric operation in the United States and has become an established procedure in the armamentarium of the bariatric surgeon. However, this has happened without the strong support of long-term outcomes data, namely the rate of revision and durability of the weight loss. Newly published data from around the world are starting to show alarming trends in these 2 areas. This paper will examine the published and presented data with at least a 7-year follow-up. This is a meta-analysis on published data with at least 7 years of follow-up from the laparoscopic sleeve gastrectomy. Online published articles. We performed a meta-analysis of publications with at least 7 years of follow-up with the keywords "laparoscopic, bariatric, sleeve gastrectomy, sleeve, long-term, long, term, results, follow-up, follow up, conversion, 7 years, 8 years, 9 years, 10 years, 11 years." We queried the PubMed, MEDLINE, and ClinicalKey search engines, which included abstracts as well. The I 2 statistic was used to determine the heterogeneity across the studies. In presence of heterogeneity, a random effect model using the Dersimonian and Laird method was used to estimate the pooled estimates. The results were summarized using effect size along with a 95% confidence interval (CI). Meta-regression was also used to assess the effect of body mass index and follow-up years on the incidence of recidivism at ≥7 years. Nine cohort studies met the inclusion criteria, with a total of 2280 patients included initially. Only 652 patients had completed ≥7 years of follow-up. At ≥7 years, the long-term weight recidivism rate was estimated to be 27.8% (I 2 = .60%; 95% CI: 22.8%-32.7%) with a range of 14% to 37%. The overall revision rate was estimated to be 19.9% (I 2 = 93.8%; 95% CI: 11.3%-28.5%). This was broken down into 13.1% (I 2 = 93.8%; 95% CI: 5.6%-20.6%) due to weight regain (5 studies) and 2.9% (I 2 = 60.8%; 95% CI: 1%-4.9%) due to gastroesophageal reflux disease (5 studies). Based on available data up to the beginning of 2017, bariatric surgeons should be aware of the long-term outcomes of the sleeve gastrectomy, especially regarding revisions and weight regain. It is incumbent on the surgeon to make sure that bariatric patients are truly informed regarding the long-term results of the sleeve gastrectomy. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Electrical connector composite housing and method of making same
Silva, Frank A.
1979-01-01
A sleeve-like insert of conductive elastomeric material of a type which serves as an internal shield in electrical connectors for connecting high voltage cables has an end portion folded upon itself, the enfolded portion being substantially permanently retained in its desired position by allowing insulative elastomeric material to fill apertures in the end portion and become bonded thereto in a void free manner, during molding of an insulating outer sleeve-like jacket about the insert.
Compliant hydrodynamic fluid journal bearing
NASA Technical Reports Server (NTRS)
Warren, E. L. (Inventor)
1985-01-01
An air bearing structure is described that prevents destructive bending moments within the top foil. Welds are eliminated by mounting the top bearing foil in the bearing cartridge sleeve without using a space block. Tabs or pins at the end of the top bearing foil are restrained by slots or stops formed in the cartridge sleeve. These structural members are free to move in a direction normal to the shaft while being restrained from movement in the direction of shaft rotation.
Caldron For High-Temperature Alloys
NASA Technical Reports Server (NTRS)
Geringer, Henry J.
1989-01-01
Induction-heated caldron melts high-temperature alloys. Prevents sort of contamination of melts occurring during arc melting in ceramic crucibles. Liquefies 200 grams of solid metal components of alloy like niobium aluminum and makes alloy homogeneous in less than 3 minutes. Plugged sleeve constitutes main body of caldron. Coolant flows through sleeve to prevent it from melting. Mandrel-wound induction coils adjusted to tune source of power. Also serves as mold for casting alloys into such shapes as bars.
Sealed fiber-optic bundle feedthrough
Tanner, Carol E.
2002-01-01
A sealed fiber-optic bundle feedthrough by which a multitude of fiber-optic elements may be passed through an opening or port in a wall or structure separating two environments at different pressures or temperatures while maintaining the desired pressure or temperature in each environment. The feedthrough comprises a rigid sleeve of suitable material, a bundle of individual optical fibers, and a resin-based sealing material that bonds the individual optical fibers to each other and to the rigid sleeve.
Niemann, Ralph C.; Gonczy, John D.; Nicol, Thomas H.
1987-01-01
A cryogenic support member is comprised of a non-metallic rod having a depression in at least one end and a metallic end connection assembled to the rod. The metallic end connection comprises a metallic plug which conforms to the shape and is disposed in the depression and a metallic sleeve is disposed over the rod and plug. The plug and the sleeve are shrink-fitted to the depression in the rod to form a connection good in compression, tension and bending.
Trotta, Manuela; Da Broi, Joël; Salerno, Angelo; Testa, Rosa M; Marinari, Giuseppe M
2017-03-01
The aim of this study is to investigate the effects of sleeve gastrectomy on hormone replacement therapy and on hypothalamic obesity in patients affected by craniopharyngioma with post-surgical pan-hypopituitarism. A retrospective review of three patients, treated for hypothalamic obesity with laparoscopic sleeve gastrectomy, who have previously undergone surgery for craniopharyngioma in their childhood, was done. Patients' mean age and BMI were 22.3 years (range 21-24) and 49.2 kg/m 2 (range 41.6-58.1), respectively. The mean time of delay between neurosurgery and bariatric surgery was 12.3 years (range 6-16). There were no major complications or deaths. At 24 months follow-up, the mean BMI was 35.3 kg/m 2 (range 31.2-40.6). No hydrocortisone and sex steroids dose changes were observed, while levothyroxine was decreased in two patients. Growth hormone replacement therapy was increased in two patients, whereas it was started in one patient. Desmopressin was significantly decreased in all of them. Patients with surgically induced pan-hypopituitarism after craniopharyngioma who become obese, can expect good results from sleeve gastrectomy: this procedure does not have significant negative effects on hormone substitution and leads to a good stabilization of body weight in a mid-term follow-up.
The Surgical Management of Complex Fistulas After Sleeve Gastrectomy.
Nguyen, David; Dip, Fernando; Hendricks, LéShon; Lo Menzo, Emanuele; Szomstein, Samuel; Rosenthal, Raul
2016-02-01
Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance as the preferred option for treating obesity. Risks of leak and subsequent fistula after sleeve gastrectomy still present significant concerns in clinical practice. This current series presents unusual fistulas post-LSG and their surgical management. The series presents chronic leaks that have progressed into fistulas. Three patients with fistulas are presented: gastrocolic, gastropleural, and gastrosplenic. Surgical intervention was warranted in all cases with en-bloc resection of the fistula with subtotal gastrectomy and Roux-en-Y esophagojejunostomy reconstruction. A subtotal colectomy with ileo-descending colon anastomosis was additionally necessary in the gastrocolic patient. The patients with the gastropleural and gastrosplenic fistulas were discharged home on postoperative Day 6 and Day 7, respectively. The patient with the gastrocolic fistula had an extended postoperative hospital course and was discharged home on postoperative Day 35. All cases were negative for staple line leaks. To date, the fistulas healed with no recurrence. En-bloc resection of the fistula with proximal gastrectomy and Roux-en-Y esophagojejunostomy (PGRYEJ) is a surgical option to treat chronic staple line leakage when non-operative therapy is rendered ineffective. Adequate preoperative planning with optimization of nutritional status and control of local and systemic sepsis is paramount for ultimate success. A symptomatic leak requires immediate operation regardless of the time interval between the primary sleeve operation and appearance of the leak.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kelogrigoris, M., E-mail: kelogre.mic@hotmail.com; Sotiropoulou, E.; Stathopoulos, K.
This study was designed to evaluate the efficacy and safety of computed tomography (CT)-guided drainage in treating infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity. From January 2007 to June 2009, 21 patients (9 men and 12 women; mean age, 39.2 (range, 26-52) years) with infected collections due to gastric leak after laparoscopic sleeve gastrectomy for morbid obesity underwent image-guided percutaneous drainage. All procedures were performed using CT guidance and 8- to 12-Fr pigtail drainage catheters. Immediate technical success was achieved in all 21 infected collections. In 18 of 21 collections, we obtained progressive shrinkagemore » of the collection with consequent clinical success (success rate 86%). In three cases, the abdominal fluid collection was not resolved, and the patients were reoperated. Among the 18 patients who avoided surgery, 2 needed replacement of the catheter due to obstruction. No major complications occurred during the procedure. The results of our study support that CT-guided percutaneous drainage is an effective and safe method to treat infected abdominal fluid collections due to gastric leak in patients who had previously underwent laparoscopic sleeve gastrectomy for morbid obesity. It may be considered both as a preparatory step for surgery and a valuable alternative to open surgery. Failure of the procedure does not, however, preclude a subsequent surgical operation.« less
Data Transmission System For A Downhole Component
Hall, David R.; Hall, Jr., H. Tracy; Pixton, David; Dahlgren, Scott; Sneddon, Cameron; Fox, Joe; Briscoe, Michael
2005-01-18
The invention is a system for transmitting data through a string of downhole components. In accordance with one aspect of the invention, the system includes a plurality of downhole components, such as sections of pipe in a drill string. Each component has a first and second end, with a first communication element located at the first end and a second communication element located at the second end. Each communication element includes a first contact and a second contact. The system also includes a coaxial cable running between the first and second communication elements, the coaxial cable having a conductive tube and a conductive core within it. The system also includes a first and second connector for connecting the first and second communication elements respectively to the coaxial cable. Each connector includes a conductive sleeve, lying concentrically within the conductive tube, which fits around and makes electrical contact with the conductive core. The conductive sleeve is electrically isolated from the conductive tube. The conductive sleeve of the first connector is in electrical contact with the first contact of the first communication element, the conductive sleeve of the second connector is in electrical contact with the first contact of the second communication element, and the conductive tube is in electrical contact with both the second contact of the first communication element and the second contact of the second communication element.
Data transmission system for a downhole component
Hall, David R.; Hall, Jr., Tracy H.; Pixton, David S.; Dahlgren, Scott Steven; Fox, Joe; Sneddon, Cameron; Briscoe, Michael A.
2006-05-09
The invention is a system for transmitting data through a string of downhole components. In accordance with one aspect of the invention, the system includes a plurality of downhole components, such as sections of pipe in a drill string. Each component has a first and second end, with a first communication element located at the first end and a second communication element located at the second end. Each communication element includes a first contact and a second contact. The system also includes a coaxial cable running between the first and second communication elements, the coaxial cable having a conductive tube and a conductive core within it. The system also includes a first and second connector for connecting the first and second communication elements respectively to the coaxial cable. Each connector includes a conductive sleeve, lying concentrically within the conductive tube, which fits around and makes electrical contact with the conductive core. The conductive sleeve is electrically isolated from the conductive tube. The conductive sleeve of the first connector is in electrical contact with the first contact of the first communication element, the conductive sleeve of the second connector is in electrical contact with the first contact of the second communication element, and the conductive tube is in electrical contact with both the second contact of the first communication element and the second contact of the second communication element.
Konca, Can; Yılmaz, Ali Abbas; Çelik, Süleyman Utku; Kayılıoğlu, Selami Ilgaz; Paşaoğlu, Özge Tuğçe; Ceylan, Halil Arda; Genç, Volkan
2018-05-29
Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted. To evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy. A randomized and controlled animal experiment with 1:1:1:1 allocation ratio. Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12-Fr bougies were used in groups 1 and 3, 8-Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure and hydroxyproline levels at the esophagogastric junction were measured and compared among groups. Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, tissue oxygen partial pressure and tissue hydroxyproline levels among the 4 groups. The use of narrower bougie along with fibrin sealant has not had a negative effect on tissue perfusion and wound healing.
Sun protective behaviors and vitamin D levels in the US population: NHANES 2003–2006
Linos, Eleni; Keiser, Elizabeth; Kanzler, Matthew; Sainani, Kristin L.; Lee, Wayne; Vittinghoff, Eric; Chren, Mary-Margaret; Tang, Jean Y.
2013-01-01
Background Sun protection is recommended for skin cancer prevention, yet little is known about the role of sun protection on vitamin D levels. Our aim was to investigate the relationship between different types of sun protective behaviors and serum 25(OH)D levels in the general US population. Methods Cross-sectional, nationally representative survey of 5,920 adults aged 18–60 years in the US National Health and Nutrition Examination Survey 2003–2006. We analyzed questionnaire responses on sun protective behaviors: staying in the shade, wearing long sleeves, wearing a hat, using sunscreen and SPF level. Analyses were adjusted for multiple confounders of 25(OH)D levels and stratified by race. Our primary outcome measures were serum 25(OH)D levels (ng/ml) measured by radioimmunoassay and vitamin D deficiency, defined as 25(OH)D levels <20 ng/ml. Results Staying in the shade and wearing long sleeves were significantly associated with lower 25(OH)D levels. Subjects who reported frequent use of shade on a sunny day had −3.5 ng/ml (ptrend < 0.001) lower 25(OH)D levels compared to subjects who reported rare use. Subjects who reported frequent use of long sleeves had −2.2 ng/ml (ptrend = 0.001) lower 25(OH)D levels. These associations were strongest for whites, and did not reach statistical significance among Hispanics or blacks. White participants who reported frequently staying in the shade or wearing long sleeves had double the odds of vitamin D deficiency compared with those who rarely did so. Neither wearing a hat nor using sunscreen was associated with low 25(OH)D levels or vitamin D deficiency. Conclusions White individuals who protect themselves from the sun by seeking shade or wearing long sleeves may have lower 25(OH)D levels and be at risk for vitamin D deficiency. Frequent sunscreen use does not appear to be linked to vitamin D deficiency in this population. PMID:22045154
pH monitoring of gastro-oesophageal reflux before and after laparoscopic sleeve gastrectomy.
Thereaux, J; Barsamian, C; Bretault, M; Dusaussoy, H; Lamarque, D; Bouillot, J-L; Czernichow, S; Carette, C
2016-03-01
Gastro-oesophageal reflux disease (GORD) is a common obesity-related co-morbidity that is assessed objectively by 24-h pH monitoring. Some concerns have been raised regarding the risk of de novo GORD or exacerbation of pre-existing GORD after laparoscopic sleeve gastrectomy. Here, 24-h pH monitoring was used to assess the influence of laparoscopic sleeve gastrectomy on postoperative GORD in obese patients with or without preoperative GORD. From July 2012 to September 2014, all patients scheduled for laparoscopic sleeve gastrectomy were invited to participate in a prospective follow-up. Patients who underwent preoperative 24-h pH monitoring were asked to repeat the examination 6 months after operation. GORD was defined as an oesophageal pH < 4 for at least 4·2 per cent of the total time recorded. Of 89 patients, 76 had preoperative pH monitoring for GORD evaluation and 50 had postoperative reassessment. Patients without (group 1, 29 patients) or with (group 2, 21 patients) preoperative GORD were similar regarding age, sex ratio and body mass index. In group 1, the median (i.q.r.) total time at pH < 4 was significantly higher after surgery than before: 5·6 (2·5-9·5) versus 1·6 (0·7-2·9) per cent (P < 0·001). Twenty of the 29 patients experienced de novo GORD as determined by 24-h pH monitoring (P < 0·001). In group 2, total time at pH < 4 after surgery was no different from the preoperative value: 5·9 (3·9-10·7) versus 7·7 (5·2-10·3) per cent (P = 0·296). Laparoscopic sleeve gastrectomy was associated with de novo GORD in over two-thirds of patients, but did not seem to exacerbate existing GORD. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.
Van Wicklin, Sharon A
2016-05-01
Variations in documenting surgical wound classification Key words: surgical wound classification, clean, clean-contaminated, contaminated, dirty. Wearing long-sleeved jackets while preparing and packaging items for sterilization Key words: long-sleeved jackets, organic material, sterile processing. Endoscopic transmission of prions Key words: prions, high-risk tissue, low-risk tissue, Creutzfeldt-Jakob disease (CJD), variant Creutzfeldt-Jakob disease (vCJD). Wearing gloves when handling flexible endoscopes Key words: gloves, low-protein, powder-free, natural rubber latex gloves, latex-free gloves. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.
Demonstration of Corrosion-Resistant Fire Hydrant Retrofits for Military Installations
2013-10-01
diene M-class rubber ( EPDM )/powder coated steel sleeve inserted into the top of the hy- drant barrel at the traffic breakaway allowing the seat for...The insert seat of the valve shall be made of a ethylene propylene diene M-class rubber ( EPDM )/powder coated steel sleeve in- serted into the top of...intentional water-supply contamination. The technology was installed on 90 fire hy- drants of various makes, models, and ages at Fort Leonard Wood, MO. To
Development of a system to measure local measurement conditions around textile electrodes.
Kim, Saim; Oliveira, Joana; Roethlingshoefer, Lisa; Leonhard, Steffen
2010-01-01
The three main influence factors on the interface between textile electrode an skin are: temperature, contact pressure and relative humidity. This paper presents first results of a prototype, which measures these local measurement conditions around textile electrodes. The wearable prototype is a data acquisition system based on a microcontroller with a flexible sensor sleeve. Validation measurements included variation of ambient temperature, contact pressures and sleeve material. Results show a good correlation with data found in literature.
Open end protection for solid oxide fuel cells
Zafred, Paolo R.; Dederer, Jeffrey T.; Tomlins, Gregory W.; Toms, James M.; Folser, George R.; Schmidt, Douglas S.; Singh, Prabhakar; Hager, Charles A.
2001-01-01
A solid oxide fuel cell (40) having a closed end (44) and an open end (42) operates in a fuel cell generator (10) where the fuel cell open end (42) of each fuel cell contains a sleeve (60, 64) fitted over the open end (42), where the sleeve (60, 64) extends beyond the open end (42) of the fuel cell (40) to prevent degradation of the interior air electrode of the fuel cell by fuel gas during operation of the generator (10).
Fixture For Drilling And Tapping A Curved Workpiece
NASA Technical Reports Server (NTRS)
Espinosa, P. S.; Lockyer, R. T.
1992-01-01
Simple fixture guides drilling and tapping of holes in prescribed locations and orientations on workpiece having curved surface. Tool conceived for use in reworking complexly curved helicopter blades made of composite materials. Fixture is block of rigid foam with epoxy filler, custom-fitted to surface contour, containing bushings and sleeves at drilling and tapping sites. Bushings changed, so taps and drills of various sizes accommodated. In use, fixture secured to surface by hold-down bolts extending through sleeves and into threads in substrate.
Fuel or irradiation subassembly
Seim, O.S.; Hutter, E.
1975-12-23
A subassembly for use in a nuclear reactor is described which incorporates a loose bundle of fuel or irradiation pins enclosed within an inner tube which in turn is enclosed within an outer coolant tube and includes a locking comb consisting of a head extending through one side of the inner sleeve and a plurality of teeth which extend through the other side of the inner sleeve while engaging annular undercut portions in the bottom portion of the fuel or irradiation pins to prevent movement of the pins.
FUEL ELEMENT FOR A NUCLEAR REACTOR
Davidson, J.K.
1963-11-19
A fuel element structure particularly useful in high temperature nuclear reactors is presented. Basically, the structure comprises two coaxial graphite sleeves integrally joined together by radial fins. Due to the high structural strength of graphite at high temperatures and the rigidity of this structure, nuclear fuel encased within the inner sleeve in contiguous relation therewith is supported and prevented from expanding radially at high temperatures. Thus, the necessity of relying on the usual cladding materials with relatively low temperature limitations for structural strength is removed. (AEC)
Chen, J H; Lee, C H; Chang, C M; Yin, W Y
2016-04-01
In kidney transplantation, obesity is associated with poorer graft survival and patient survival. Bariatric surgery may provide benefit for these patients, not only by inducing weight loss, but also via reduction of diabetes. We report a case of morbid obesity, poorly controlled new-onset diabetes mellitus, and gout after kidney transplantation that was treated with laparoscopic sleeve gastrectomy 3 years after kidney transplantation. After 1 year of follow-up, 76% excessive body weight loss was attained. No complications were noted. The operation also provided total remission of diabetes and gout as well as good graft survival. Based on our experience, laparoscopic sleeve gastrectomy may be a feasible treatment for obese patients after renal transplantation to help resolve obesity and control new-onset diabetes. However, the timing of operation and the long-term potential for graft and patient survivals with this operation require further study. Copyright © 2016 Elsevier Inc. All rights reserved.
Method for making an elastomeric member with end pieces
Hoppie, Lyle O.; McNinch, Jr., Joseph H.; Nowell, Gregory C.
1984-01-01
A molding process for molding an elongated elastomeric member (60) with wire mesh sleeves (16) bonded to the ends (14). A molding preform (10) of elastomeric material is positioned within a seamless mold cylinder (26), and the open ends of the wire mesh sleeves (16) are mounted to end plug assemblies (30) slidably received into the mold cylinder (26) and positioned against the ends (14) of the preform (10). A specialized profile is formed into surfaces (44) of the respective end plug assemblies (30) and by heating of the mold (26), the ends (14) of the elastomeric preform (10) are molded to the profile, as well as bonded to the reinforcing wire mesh sleeves (16). Vacuum is applied to the interior of the mold to draw outgassing vapors through relief spaces therethrough. The completed elastomeric member (60) is removed from the mold cylinder (26) by stretching, the consequent reduction in diameter enabling ready separation from the mold cylinder (26) and removal thereof.
Elastomeric member and method of manufacture therefor
Hoppie, L.O.
1985-12-10
An energy storage device is disclosed consisting of a stretched elongated elastomeric member disposed within a tubular housing, which elastomeric member is adapted to be torsionally stressed to store energy. The elastomeric member is configured in the relaxed state with a uniform diameter body section, and transition end sections, attached to rigid end piece assemblies of a lesser diameter. The profile and deflection characteristic of the transition sections are such that upon stretching of the elastomeric member, a substantially uniform diameter assembly results, to minimize the required volume of the surrounding housing. Each of the transition sections are received within and bonded to a woven wire mesh sleeve having helical windings at a particular helix angle to control the deflection of the transition section. Each sleeve also contracts with the contraction of the associated transition section to maintain the bond therebetween. During manufacture, the sleeves are forced against a forming surface and bonded to the associated transition section to provide the correct profile and helix angle. 12 figs.
Hoppie, L.O.
1985-07-30
An energy storage device is disclosed consisting of a stretched elongated elastomeric member disposed within a tubular housing, which elastomeric member is adapted to be torsionally stressed to store energy. The elastomeric member is configured in the relaxed state with a uniform diameter body section, and transition end sections, attached to rigid end piece assemblies of a lesser diameter. The profile and deflection characteristic of the transition sections are such that upon stretching of the elastomeric member, a substantially uniform diameter assembly results, to minimize the required volume of the surrounding housing. Each of the transition sections are received within and bonded to a woven wire mesh sleeve having helical windings at a particular helix angle to control the deflection of the transition section. Each sleeve also contracts with the contraction of the associated transition section to maintain the bond there between. During manufacture, the sleeves are forced against a forming surface and bonded to the associated transition section to provide the correct profile and helix angle. 12 figs.
Kock, L.J.
1959-09-22
A device is presented for loading and unloading fuel elements containing material fissionable by neutrons of thermal energy. The device comprises a combination of mechanical features Including a base, a lever pivotally attached to the base, an Indexing plate on the base parallel to the plane of lever rotation and having a plurality of apertures, the apertures being disposed In rows, each aperture having a keyway, an Index pin movably disposed to the plane of lever rotation and having a plurality of apertures, the apertures being disposed in rows, each aperture having a keyway, an index pin movably disposed on the lever normal to the plane rotation, a key on the pin, a sleeve on the lever spaced from and parallel to the index pin, a pair of pulleys and a cable disposed between them, an open collar rotatably attached to the sleeve and linked to one of the pulleys, a pin extending from the collar, and a bearing movably mounted in the sleeve and having at least two longitudinal grooves in the outside surface.
Microfabricated sleeve devices for chemical reactions
Northrup, M. Allen
2003-01-01
A silicon-based sleeve type chemical reaction chamber that combines heaters, such as doped polysilicon for heating, and bulk silicon for convection cooling. The reaction chamber combines a critical ratio of silicon and non-silicon based materials to provide the thermal properties desired. For example, the chamber may combine a critical ratio of silicon and silicon nitride to the volume of material to be heated (e.g., a liquid) in order to provide uniform heating, yet low power requirements. The reaction chamber will also allow the introduction of a secondary tube (e.g., plastic) into the reaction sleeve that contains the reaction mixture thereby alleviating any potential materials incompatibility issues. The reaction chamber may be utilized in any chemical reaction system for synthesis or processing of organic, inorganic, or biochemical reactions, such as the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction, which are examples of a synthetic, thermal-cycling-based reaction. The reaction chamber may also be used in synthesis instruments, particularly those for DNA amplification and synthesis.
Architecture and permeability of post-cytokinesis plasmodesmata lacking cytoplasmic sleeves.
Nicolas, William J; Grison, Magali S; Trépout, Sylvain; Gaston, Amélia; Fouché, Mathieu; Cordelières, Fabrice P; Oparka, Karl; Tilsner, Jens; Brocard, Lysiane; Bayer, Emmanuelle M
2017-06-12
Plasmodesmata are remarkable cellular machines responsible for the controlled exchange of proteins, small RNAs and signalling molecules between cells. They are lined by the plasma membrane (PM), contain a strand of tubular endoplasmic reticulum (ER), and the space between these two membranes is thought to control plasmodesmata permeability. Here, we have reconstructed plasmodesmata three-dimensional (3D) ultrastructure with an unprecedented level of 3D information using electron tomography. We show that within plasmodesmata, ER-PM contact sites undergo substantial remodelling events during cell differentiation. Instead of being open pores, post-cytokinesis plasmodesmata present such intimate ER-PM contact along the entire length of the pores that no intermembrane gap is visible. Later on, during cell expansion, the plasmodesmata pore widens and the two membranes separate, leaving a cytosolic sleeve spanned by tethers whose presence correlates with the appearance of the intermembrane gap. Surprisingly, the post-cytokinesis plasmodesmata allow diffusion of macromolecules despite the apparent lack of an open cytoplasmic sleeve, forcing the reassessment of the mechanisms that control plant cell-cell communication.
Estupinam, Oscar; Oliveira, André Lacerda de Abreu; Antunes, Fernanda; Galvão, Manoel; Phillips, Henrique; Scheffer, Jussara Peters; Rios, Marcelo; Zorron, Ricardo
2018-01-01
To perform technically the laparoscopic sleeve gastrectomy (LSG) using a unique Intragastric Single Port (IGSG) in animal swine model, evidencing an effective and safe procedure, optimizing the conventional technique. IGSG was performed in 4 minipigs, using a percutaneous intragastric single port located in the pre-pyloric region. The gastric stapling of the greater curvature started from the pre-pyloric region towards the angle of His by Endo GIA™ system and the specimen was removed through the single port. In the postoperative day 30, the animals were sacrificed and submitted to autopsy. All procedures were performed without conversion, and all survived 30 days. The mean operative time was 42 min. During the perioperative period no complications were observed during invagination and stapling. No postoperative complications occurred. Post-mortem examination showed no leaks or infectious complications. Intragastric Single Port is a feasible procedure that may be a suitable alternative technique of sleeve gastrectomy for the treatment of morbid obesity.
Cable tensioned membrane solar collector module with variable tension control
Murphy, Lawrence M.
1985-01-01
Disclosed is a solar collector comprising a membrane for concentrating sunlight, a plurality of elongated structural members for suspending the membrane member thereon, and a plurality of control members for adjustably tensioning the membrane member, as well as for controlling a focus produced by the membrane members. Each control member is disposed at a different corresponding one of the plurality of structural members. The collector also comprises an elongated flexible tensioning member, which serves to stretch the membrane member and to thereafter hold it in tension, and a plurality of sleeve members, which serve to provide the membrane member with a desired surface contour during tensioning of the membrane member. The tensioning member is coupled to the structural members such that the tensioning member is adjustably tensioned through the structural members. The tensioning member is also coupled to the membrane member through the sleeve members such that the sleeve members uniformly and symmetrically stretch the membrane member upon applying tension to the tensioning member with the control members.
Cable tensioned membrane solar collector module with variable tension control
Murphy, L.M.
1984-01-09
Disclosed is a solar collector comprising a membrane member for concentrating sunlight, a plurality of elongated structural members for suspending the membrane member thereon, and a plurality of control members for adjustably tensioning the membrane member, as well as for controlling a focus produced by the membrane members. Each control member is disposed at a different corresponding one of the plurality of structural members. The collector also comprises an elongated flexible tensioning member, which serves to stretch the membrane member and to thereafter hold it in tension, and a plurality of sleeve members which serve to provide the membrane member with a desired surface contour during tensioning of the membrane member. The tensioning member is coupled to the structural members such that the tensioning member is adjustably tensioned through the structural members. The tensioning member is also coupled to the membrane member through the sleeve members such that the sleeve members uniformly and symmetrically stretch the membrane member upon applying tension to the tensioning member with the control members.
Macintyre, Lisa; Gilmartin, Sian; Rae, Michelle
2007-01-01
We sought to establish the impact of pressure garment design variables, moisturizer use, and laundry method on the ability of pressure garments to maintain their pressure delivering potential, indicated here by garment tension, over time and use. Twenty-six sets of three replicate pressure garment sleeves were constructed from four powernet fabrics, using three reduction factors and six sleeve dimensions. These pressure garment sleeves were extended for 23 hours on static cylinder models followed by hand or machine laundry up to 28 times. Some sleeves were additionally exposed to moisturizers during their extension. Garment tension and dimensions were measured before and during the simulated wear and wash period to indicate each garment's ability to maintain its tension and therefore pressure throughout a period of "use." The results of the investigation were analyzed in groups where each group contained only 1 variable, thereby allowing the variables with the most significant impact on tension degradation to be identified. The investigation confirmed that all pressure garments lost tension and therefore pressure delivering ability over time and use. It further revealed that pressure garments designed to exert greater pressures degraded faster than those designed to exert lower pressures. Contact between pressure garments and moisturizers accelerated tension degradation, and machine-washing pressure garments tended to prolong their pressure-delivering properties compared with hand-washing them. To maintain the initial pressure delivered by pressure garments, powernet fabrics should be prestressed before being designed/constructed and they should be machine-washed by patients.
Kikuchi, Rieko; Irie, Junichiro; Yamada-Goto, Nobuko; Kikkawa, Eri; Seki, Yosuke; Kasama, Kazunori; Itoh, Hiroshi
2018-06-01
Bariatric surgery improves metabolic diseases and alters the intestinal microbiota in animals and humans, but different procedures reportedly have different impacts on the intestinal microbiota. We developed laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB) as an alternative to laparoscopic Roux-en-Y gastric bypass (LRYGB) in addition to laparoscopic sleeve gastrectomy (LSG) for Japanese patients with obesity. We investigated the precise change in the intestinal microbiota induced by these procedures in the present study. A prospective observational study of 44 Japanese patients with obesity was conducted [22 patients underwent LSG, 18 underwent LSG-DJB, and 4 underwent laparoscopic adjustable gastric banding (LAGB)]. The patients' clinical parameters and intestinal microbiota were investigated before and for 6 months after surgery. The microbiota was analyzed by a 16S rDNA method. LSG and LSG-DJB significantly improved the metabolic disorders in the patients with obesity. The proportion of the phylum Bacteroidetes and order Lactobacillales increased significantly in the LSG group, and that of the order Enterobacteriales increased significantly in the LSG-DJB group. LSG and LSG-DJB improved obesity and type 2 diabetes in Japanese patients with obesity, but the impact of LSG-DJB on the intestinal microbiota differed from that of LSG. This difference in the impact on the intestinal environment could explain the different efficacies of LSG and LSG-DJB in terms of their ability to resolve metabolic disorders in the clinical setting.
Cho, Jun-Min; Kim, Hyun Jung; Lo Menzo, Emanuele; Park, Sungsoo; Szomstein, Samuel; Rosenthal, Raul J
2015-01-01
Until recently, Roux-en-Y gastric bypass (RYGB) was the most frequently performed procedure in bariatric surgery. In the last decade, sleeve gastrectomy (SG) has emerged as a more popular, simpler, and less morbid form of bariatric surgery. This study compares the efficacy of SG and RYGB for the treatment of type 2 diabetes mellitus (T2D). Systemic review and meta-analysis. MEDLINE, EMBASE, and the Cochrane Library were searched for entries up to December 2013. Search terms included "Sleeve gastrectomy," "Gastric bypass," and "Type 2 diabetes mellitus." The chosen articles described both "Sleeve gastrectomy" and "Gastric bypass" and included over 1 year of follow-up data. Data analysis was performed with Review Manager 5.2 and SPSS version 20. The data set is comprised of 3 retrospective clinical studies, 6 prospective clinical studies, and 2 randomized controlled trials (RCTs), which involved 429 patients in the SG group and 428 patients in the RYGB group. In nonrandomized clinical studies, SG displayed similar efficacy in remission of T2D compared with the standard RYGB. In the RCTs, SG had a lower effect than that of RYGB. T2D remission was not correlated with the percent of excess weight loss for either procedure. Based on the current evidence, SG has a similar effect on T2D remission as RYGB. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Sultana, Farhana; Nizame, Fosiul A; Southern, Dorothy L; Unicomb, Leanne; Winch, Peter J; Luby, Stephen P
2017-12-01
Schools convene many people together for a prolonged time, facilitating spread of respiratory pathogens and amplifying epidemics. Crowded Bangladeshi schools lack the infrastructure to support optimal cough etiquette behaviors. We collected formative data on current practices from four elementary schools, and developed and piloted a low-cost cough etiquette intervention, promoting coughing and sneezing into upper sleeves at four additional schools. We trained teachers to lead behavior change sessions during regular hygiene classes for 4 weeks. We evaluated intervention acceptability, feasibility, and potential for sustainability at 1 month and at 14 months after the intervention commenced. At baseline, among 63 observed students, 58 (92%) coughed/sneezed into open air, five (8%) covered coughs/sneezes with their hands, which were not subsequently washed with soap and water as they judged this infeasible. After 4 weeks, among 70 observed students, 27 (39%) coughed/sneezed into upper sleeves, 33 (47%) into open air, and 10 (12%) covered with hands. After 14 months, among 230 observed students, 13 (6%) used upper sleeves, 154 (67%) coughed/sneezed into open air, and 59 (26%) covered with hands. Students reported that coughing/sneezing into upper sleeves was simple and protected them and their classmates from germs. This school-based intervention was acceptable and feasible, and resulted in short-term reductions in coughing/sneezing into open air, but these habits of comparatively new behavior were not sustained as teachers ceased behavior change session delivery. Strategies to support longer-term adoption of habits should be considered.
Splice connector with internal heat transfer jacket
Silva, Frank A.; Mayer, Robert W.
1977-01-01
A heat transfer jacket is placed over the terminal portions of the conductors of a pair of high voltage cables which are connected in a splice connection wherein a housing surrounds the connected conductor portions, the heat transfer jacket extending longitudinally between the confronting ends of a pair of adaptor sleeves placed upon the insulation of the cables to engage and locate the adaptor sleeves relative to one another, and laterally between the conductors and the housing to provide a path of relatively high thermal conductivity between the connected conductor portions and the housing.
Wright, Donald G.
1982-01-01
An oil burner nozzle for use with liquid fuels and solid-containing liquid fuels. The nozzle comprises a fuel-carrying pipe, a barrel concentrically disposed about the pipe, and an outer sleeve retaining member for the barrel. An atomizing vapor passes along an axial passageway in the barrel, through a bore in the barrel and then along the outer surface of the front portion of the barrel. The atomizing vapor is directed by the outer sleeve across the path of the fuel as it emerges from the barrel. The fuel is atomized and may then be ignited.
Interior of building 16 section, view north of machine shop, ...
Interior of building 16 section, view north of machine shop, showing shrink-fitting a bearing sleeve onto a section of the propeller shaft for the aircraft carrier John F. Kennedy. The lathe on the extreme left of the photograph was used to machine bearing sleeves to final dimensions. This work, in August 1994, was the final major machine shop job done for the U.S. Navy. Photograph by Robert Stewart, August 1994. - Naval Base Philadelphia-Philadelphia Naval Shipyard, Machine Shops, League Island, Philadelphia, Philadelphia County, PA
Surface controlled blade stabilizer
Russell, Larry R.
1983-01-01
Drill string stabilizer apparatus, controllable to expand and retract entirely from the surface by control of drill string pressure, wherein increase of drill string pressure from the surface closes a valve to create a piston means which is moved down by drill string pressure to expand the stabilizer blades, said valve being opened and the piston moving upward upon reduction of drill string pressure to retract the stabilizer blades. Upward and downward movements of the piston and an actuator sleeve therebelow are controlled by a barrel cam acting between the housing and the actuator sleeve.
Is a sleeve lobectomy significantly better than a pneumonectomy?
Stallard, Joseph; Loberg, Anna; Dunning, Joel; Dark, John
2010-11-01
A best evidence topic was written according to a structured protocol. The question addressed was 'whether a sleeve lobectomy results in a better survival rate than a pneumonectomy in suitable patients?' Altogether, more than 327 papers were found using the reported search, of which 15 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude in the biggest meta-analysis of nearly 3000 patients, the five-year survival was 50% for sleeve lobectomy compared to 30% for pneumonectomy. Operative mortality was 3% vs. 6% for pneumonectomy, and locoregional recurrence was 17% vs. 30%. These results are broadly consistent across all the 13 cohort studies presented here many of which document a 20-year single centre experience or more. There are significant issues in all cohort studies on this subject as, due to their non-randomized nature, the reason for not performing a sleeve resection may well have been more advanced disease, which would necessarily mean that the pneumonectomy patients would have a lower expected survival and higher local recurrence. In addition, there have been many large cohort studies to date and thus no more are required, as future studies are unlikely to resolve this issue. Thus, the only study that would adequately correct for this issue would be a randomized trial, but to prove a 10% increase in five-year survival a 300 patient study would be needed. This is bigger than any study ever done in this area and as some centres took 30 years to collect these numbers of potential sleeve patients an RCT is not a realistic possibility. Therefore, we conclude that no more cohort studies should be performed, as the results will be consistent with the meta-analyses and an RCT to eliminate their bias is unattainable, and thus no more research should be done on this topic and surgeons should use the figures presented above and in more detail in this best evidence topic to govern their management in the future.
NASA Astrophysics Data System (ADS)
Zhao, Jianhua; Zhou, Songlin; Lu, Xianghui; Gao, Dianrong
2015-09-01
The double flapper-nozzle servo valve is widely used to launch and guide the equipment. Due to the large instantaneous flow rate of servo valve working under specific operating conditions, the temperature of servo valve would reach 120°C and the valve core and valve sleeve deform in a short amount of time. So the control precision of servo valve significantly decreases and the clamping stagnation phenomenon of valve core appears. In order to solve the problem of degraded control accuracy and clamping stagnation of servo valve under large temperature difference circumstance, the numerical simulation of heat-fluid-solid coupling by using finite element method is done. The simulation result shows that zero position leakage of servo valve is basically impacted by oil temperature and change of fit clearance. The clamping stagnation is caused by warpage-deformation and fit clearance reduction of the valve core and valve sleeve. The distribution rules of the temperature and thermal-deformation of shell, valve core and valve sleeve and the pressure, velocity and temperature field of flow channel are also analyzed. Zero position leakage and electromagnet's current when valve core moves in full-stroke are tested using Electro-hydraulic Servo-valve Characteristic Test-bed of an aerospace sciences and technology corporation. The experimental results show that the change law of experimental current at different oil temperatures is roughly identical to simulation current. The current curve of the electromagnet is smooth when oil temperature is below 80°C, but the amplitude of current significantly increases and the hairy appears when oil temperature is above 80°C. The current becomes smooth again after the warped valve core and valve sleeve are reground. It indicates that clamping stagnation is caused by warpage-deformation and fit clearance reduction of valve core and valve sleeve. This paper simulates and tests the heat-fluid-solid coupling of double flapper-nozzle servo valve, and the obtained results provide the reference value for the design of double flapper-nozzle force feedback servo valve.
Wang, Peiji; Zhao, Jiaju; Jiang, Bo; Zhang, Yong
2015-05-01
Although epineurium neurorrhaphy is the most reliable and conventional method for the repair of peripheral nerve injury and is accepted as the gold standard, it is still far from ideal. Many attempts have been made to develop nerve anastomosis techniques. The aim of this study was to investigate the use of small gap anastomosis performed by cutting and sleeve jointing the epineurium for nerve repair. A 12-week study was performed using small gap anastomosis via cutting and sleeve jointing the epineurium, compared with epineurium neurorrhaphy in situ, to repair a rat sciatic nerve rupture. Three experimental groups were included: sham control (n = 8), small gap anastomosis (n = 16), and epineurium neurorrhaphy (n = 16). About 12 weeks after surgery, recovery was assessed with walking track analysis, electrophysiology, hematoxylin and eosin staining, immunohistochemistry, and electron microscopy. The sciatic nerve functional index observed in the small gap anastomosis group was significantly higher than that in the epineurium neurorrhaphy group (p < 0.05). In vivo electrophysiological analysis confirmed that the small gap anastomosis group showed a significantly higher conduction velocity than the epineurium neurorrhaphy group (p < 0.05). Postoperative morphometric analysis revealed better results after small gap anastomosis compared with epineurium neurorrhaphy. Small gap anastomosis via cutting and sleeve jointing the epineurium could be an alternative to epineurium neurorrhaphy for the repair of peripheral nerve injury, particularly, considering that the epineurium originates from native tissue that provides a suitable microenvironment for the selective regeneration of axons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Major, Piotr; Wysocki, Michał; Pędziwiatr, Michał; Pisarska, Magdalena; Małczak, Piotr; Wierdak, Mateusz; Dembiński, Marcin; Migaczewski, Marcin; Rubinkiewicz, Mateusz; Budzyński, Andrzej
2018-03-01
Staple-line bleeding and leakage are the most common serious complications of laparoscopic sleeve gastrectomy. The relationship between multiple stapler firings and higher risk of postoperative complications is well defined in colorectal surgery but has not been addressed in bariatric procedures so far. Identification of new factors such as "the numbers of stapler firings used during laparoscopic sleeve gastrectomy (LSG)" as a predictor for complications can lead to optimization of the patient care at bariatric centers. To determine the association between perioperative morbidity and the number of stapler firings during laparoscopic sleeve gastrectomy. This observational study was based on retrospective analysis of prospectively collected data in patients operated on for morbid obesity in a teaching hospital/tertiary referral center for general surgery. The patients who underwent LSG were analyzed in terms of the number of stapler firings used as a new potential risk predictor for postoperative complications after surgery, adjusting for other patient- and treatment-related factors. The study included 333 patients (209 women, 124 men, mean age: 40 ±11). During the first 30 days after surgery, complications were observed in 18 (5.41%) patients. Multivariate analysis showed that prolonging operative time increased morbidity (every minute, OR = 1.01; 95% CI: 1.00-1.02) and the complication rate increased with the number of stapler firings (every firing, OR = 1.91; 95% CI: 1.09-3.33; p = 0.023). Additional stapler firings above the usual number and a prolonged operation should alert a surgeon and the whole team about increased risk of postoperative complications.
Tsai, Ying-Nan; Wang, Hsiu-Po; Huang, Chih-Kun; Chang, Po-Chin; Lin, I-Chang; Tai, Chi-Ming
2018-01-01
Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy. We examined the timing of stent placement, size of the leak, stent migration and its complications, total stent treatment duration, and treatment outcome. Between January 2011 and April 2015, seven patients underwent covered SEMS placement for leak after bariatric surgery, including laparoscopic sleeve gastrectomy (LSG) (n = 5) and laparoscopic loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) (n = 2). A stent was placed in one patient for infection control and bridging to revisional surgery. Among the other six patients, one patient who received stent placement one year after leak diagnosis failed to achieve leak closure, and five patients with early stent placement achieved leak closure. Three patients with small leak achieved leak closure more quickly. Stent migration was found in six patients, and associated ulcers occurred in five patients. We conclude that stenting is effective in the management of staple-line leaks following LSG and LDJB-SG. Stent migration and associated ulcers are common after stent placement. Early stent removal can be achieved in patients with small leaks. Copyright © 2017. Published by Elsevier Taiwan.
Gagner, Michel; Huang, Rose Y
2016-04-01
Placement of a bougie for sleeve sizing during laparoscopic sleeve gastrectomy (LSG) is recommended. We compared this standard with a suction calibration system (SCS) that performs all functions with one insertion, and measured each step's duration. Primary LSG was performed using a bougie and SCS in alternating order. Number of tube movements to achieve optimal placement, durations of decompression, leak testing, and overall operative time, and remnant linear measurements were obtained. LSG was performed in 26 patients (15 women, 11 men; mean age 36.8 years; mean BMI 45.3 kg/m(2)). The mean number of tube movements was significantly greater for the bougie than for the SCS (8.13 vs. 3.58; p < 0.0001). Percent reductions achieved using the SCS were: time to full decompression of the stomach, 62% (21 vs. 8 s; p < 0.138); tube placement, 51% (101 vs. 49 s; p < 0.0001); leak testing, 78% (119 vs. 26 s; p < 0.0003); and mean operative duration (from tube insertion to end of stapling), 21% (875 vs. 697 s; p < 0.019). Variance of the staple-line distance, measured from the greater curvature to the staple line, was 1.64 and 0.92 for the bougie and SCS, respectively, indicating a reduction in corkscrewing, for a 43.9% straighter sleeve. SCS maintained the gastric wall in place, thereby preventing corkscrewing, and reducing total operating time. Reducing the number of tube insertions may prevent esophageal damage and accidental tube stapling.
Elastomeric member and method of manufacture therefor
Hoppie, Lyle O.
1985-01-01
An energy storage device (10) is disclosed consisting of a stretched elongated elastomeric member (16) disposed within a tubular housing (14), which elastomeric member (16) is adapted to be torsionally stressed to store energy. The elastomeric member (16) is configured in the relaxed state with a uniform diameter body section (74), and transition end sections (76, 78), attached to rigid end piece assemblies (22, 24) of a lesser diameter. The profile and deflection characteristic of the transition sections (76, 78) are such that upon stretching of the elastomeric member (16), a substantially uniform diameter assembly results, to minimize the required volume of the surrounding housing (14). Each of the transition sections (76, 78) are received within and bonded to a woven wire mesh sleeve (26, 28) having helical windings at a particular helix angle to control the deflection of the transition section. Each sleeve (26, 28) also contracts with the contraction of the associated transition section to maintain the bond therebetween. During manufacture, the sleeves (26, 28) are forced against a forming surface and bonded to the associated transition section (76, 78) to provide the correct profile and helix angle.
Hoppie, Lyle O.
1985-01-01
An energy storage device (10) is disclosed consisting of a stretched elongated elastomeric member (16) disposed within a tubular housing (14), which elastomeric member (16) is adapted to be torsionally stressed to store energy. The elastomeric member (16) is configured in the relaxed state with a uniform diameter body section (74), and transition end sections (76, 78), attached to rigid end piece assemblies (22, 24) of a lesser diameter. The profile and deflection characteristic of the transition sections (76, 78) are such that upon stretching of the elastomeric member (16), a substantially uniform diameter assembly results, to minimize the required volume of the surrounding housing (14). Each of the transition sections (76, 78) are received within and bonded to a woven wire mesh sleeve (26, 28) having helical windings at a particular helix angle to control the deflection of the transition section. Each sleeve (26, 28) also contracts with the contraction of the associated transition section to maintain the bond therebetween. During manufacture, the sleeves (26, 28) are forced against a forming surface and bonded to the associated transition section (76, 78) to provide the correct profile and helix angle.
Double-Acting Sleeve Muscle Actuator for Bio-Robotic Systems.
Zheng, Hao; Shen, Xiangrong
2013-11-25
This paper presents a new type of muscle-like actuator, namely double-acting (DA) sleeve muscle actuator, which is suitable for the actuation of biologically-inspired and biomedical robotic systems, especially those serving human-assistance purposes (prostheses, orthoses, etc .). Developed based on the traditional pneumatic muscle actuator, the new DA sleeve muscle incorporates a unique insert at the center. With the insert occupying the central portion of the internal volume, this new actuator enjoys multiple advantages relative to the traditional pneumatic muscle, including a consistent increase of force capacity over the entire range of motion, and a significant decrease of energy consumption in operation. Furthermore, the insert encompasses an additional chamber, which generates an extension force when pressurized. As such, this new actuator provides a unique bi-directional actuation capability, and, thus, has a potential to significantly simplify the design of a muscle actuator-powered robotic system. To demonstrate this new actuator concept, a prototype has been designed and fabricated, and experiments conducted on this prototype demonstrated the enhanced force capacity and the unique bi-directional actuation capability.
Biomechanical study of the tibia in knee replacement revision.
Quílez, M P; Pérez, M A; Seral-García, B
2015-01-01
The best management of severe bone defects following total knee replacement is still controversial. Metal augments, tantalum cones and porous tibial sleeves could help the surgeon to manage any type of bone loss, providing a stable and durable knee joint reconstruction. Five different types of prostheses have been analysed: one prosthesis with straight stem; two prostheses with offset stem, with and without supplement, and two prostheses with sleeves, with and without stem. The purpose of this study is to report a finite element study of revision knee tibial implants. The main objective was to analyse the tibial bone density changes and Von Misses tension changes following different tibial implant designs. In all cases, the bone density decreases in the proximal epiphysis and medullary channels, with a bone density increase also being predicted in the diaphysis and at the bone around the stems tips. The highest value of Von Misses stress has been obtained for the straight tibial stem, and the lowest for the stemless metaphyseal sleeves prosthesis. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.
Blank fire configuration for automatic pistol
Teague, Tommy L.
1990-01-01
A pistol configured to fire blank cartridges includes a modified barrel with a breech portion connected to an aligned inner sleeve. Around the inner sleeve, there is disposed an outer sleeve having a vent therein through which the cartridge discharges. The breech portion is connected to a barrel anchor to move backward in a slight arc when the pistol is fired. A spring retention rod projects from the barrel anchor and receives a shortened recoil spring therearound which recoil spring has one end abutting a stop on the barrel anchor and the other end in abutment with the end of a spring retaining cup. The spring retaining cup is engaged by a flange projecting from a slide so that when the pistol is fired, the slide moves rearwardly against the compression of the spring to eject the spent cartridge and then moves forwardly under the urging of the spring to load a fresh cartridge into the breech portion. The spring then returns all of the slidable elements to their initial position so that the pistol may again be fired.
Abouzahr, Omar; Garofalo, Fabio; Garneau, Pierre Y
2016-06-01
The female population represents three-fourths of patients undergoing a bariatric procedure and could be scheduled for surgery in their postpartum period. We report a difficult case of a female patient who underwent a laparoscopic sleeve gastrectomy 6 weeks postpartum. The postpartum period is accompanied by pronounced vasodilatation with transient portal hypertension. Most of the hemodynamic alterations occurring during pregnancy return to baseline within 6-8 weeks after delivery. Bariatric surgery in the postpartum period should be avoided in order for the cardiovascular system to regain its normality.
Article of Clothing for Storing and Deploying a Scarf
NASA Technical Reports Server (NTRS)
Romero, Robert (Inventor)
2015-01-01
A clothing article surrounds a wearer's upper torso. The article includes connected front portion, a collar. A sleeve is formed in the front portion. A jacket, and coat with an attachable/detachable scarf will be folded and stored in the inter portion of the front side of the collar area with elastic at each end and Velcro onto the inner portion of your collar, therefore eliminating the lost of them by any consumers, and especially children. A sleeve like collar attached to the coat and jacket for storing a scarf and making it easily deployable while in use.
Miniature electrical connector
Casper, Robert F.
1976-01-01
A miniature coaxial cable electrical connector includes an annular compressible gasket in a receptacle member, the gasket having a generally triangular cross section resiliently engaging and encircling a conically tapered outer surface of a plug member to create an elongated current leakage path at their interface; means for preventing rotation of the plug relative to the receptacle; a metal sleeve forming a portion of the receptacle and encircling the plug member when interconnected; and a split ring in the plug having outwardly and rearwardly projecting fingers spaced from and encircling a portion of a coaxial cable and engageable with the metal sleeve to interlock the receptacle and plug.
Compliant sleeve for ceramic turbine blades
Cai, Hongda; Narasimhan, Dave; Strangman, Thomas E.; Easley, Michael L.; Schenk, Bjoern
2000-01-01
A compliant sleeve for attaching a ceramic member to a metal member is comprised of a superalloy substrate having a metal contacting side and a ceramic contacting side. The ceramic contacting side is plated with a layer of nickel followed by a layer of platinum. The substrate is then oxidized to form nickel oxide scale on the ceramic contacting side and a cobalt oxide scale on the metal contacting side. A lubricious coating of boron nitride is then applied over the metal contacting side, and a shear-stress limiting gold coating is applied over the ceramic contacting side.
Pathfinder Atomic Power Plant Nozzle Galling Test, Final Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
1961-12-29
Galling tests of 304, 17-4PH, and chrome-plated 304 stainless-steel nozzles with 304 stainless-steel sleeves were conducted at Pathflnder reactor conditions of 480 deg F, 600 psig. A horizontal force was imposed on the sleeve with the nozzle inserted; and the nozzle was moved axially to determine galling tendencies. Galling was produced on both the 304 and 17-4PH stainless-steel nozzles. The chrome-plated 304-stainless-steel nozzles were cycled numerous times without galling. On the basis of these tests, chrome-plated 304-stainless- steel is the material selected for the Pathfinder boiler fuel-element nozzle.
Moon, Rena C; Teixeira, Andre F; Jawad, Muhammad A
2017-04-01
Laparoscopic sleeve gastrectomy has become a popular bariatric surgery in recent years. However, it has been linked to worsening or newly developed gastroesophageal reflux disease (GERD) in the postoperative period. The purpose of this study is to determine the safety and effectiveness of anterior fundoplication sleeve gastrectomy in patients with reflux. Academic hospital, United States. We prospectively collected data on 31 sleeve gastrectomy patients who concurrently underwent anterior fundoplication between July 2014 and March 2016. Patients were selected when they reported severe reflux before the procedure. Each patient was interviewed using the GERD score questionnaire (scaled severity and frequency of heartburn, regurgitation, epigastric pain, epigastric fullness, dysphagia, and cough) before and 4 months after the procedure. Our patients comprised 27 females and 4 males with a mean age of 49.9±9.6 years (range, 29-63 yr). They had a mean preoperative body mass index of 42.8±5.6 kg/m 2 (range, 33.3-58.4 kg/m 2 ), and 67.7% (n = 21) of these patients underwent hiatal hernia repair as well. Preoperatively, patients had a mean heartburn score of 7.4±3.6 (range, 1-12), regurgitation score of 5.4±4.1 (range, 0-12), epigastric pain score of 2.1±3.2 (range, 0-12), epigastric fullness score of 2.7±3.9 (range, 0-12), dysphagia score of 1.3±2.2 (range, 0-9), and cough score of .9±1.8 (range, 0-6). Mean preoperative GERD score was 18.9±9.8 (range, 6-36) in these patients. Patients were interviewed with the same questionnaire approximately 4 months postoperative. Patients had a mean heartburn score of 1.5±3.2 (range, 0-12), regurgitation score of .9±1.7 (range, 0-8), epigastric pain score of .4±1.1 (range, 0-4), epigastric fullness score of 1.1±2.4 (range, 0-8), dysphagia score of .3±1.1 (range, 0-6), and cough score of 0. Mean postoperative GERD score dropped down to 4.1±5.8 (range, 0-28), and the difference was statistically significant (P<.01). One patient was readmitted 28 days later for a staple line leakage, and was treated conservatively. No patient required a reoperation due to the procedure within 30 days. Anterior fundoplication sleeve gastrectomy may be a safe and effective alternative in obese patients with severe reflux who want to undergo sleeve gastrectomy. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY TREATMENT: TWO YEARS OF EXPERIENCE.
Lopez-Nava, Gontrand; Galvão, M P; Bautista-Castaño, I; Fernandez-Corbelle, J P; Trell, M; Lopez, N
2017-01-01
Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation. Of the154 initial patients, 143 were available for 1-month of follow-up, 133 for 6-month, 64 for 12-month and 28 completed the 24 month assessment. Follow-up was carried out by a multidisciplinary team (nutritionist and psychologist). Outcomes evaluated were: change in BMI; change in body weight (TBWL); % of loss of initial body weight (%TBWL); % of excess body weight loss (%EWL) (segregated in > or <25% and adverse effects. Voluntary oral contrasted radiological examinations were scheduled to assess the gastroplasty at different times post-procedure. Mean age was 44.9 (23-69) years. At 24 months after the procedure baseline mean BMI change from 38.3 to 30.8 kg/m2. TBWL, %TBWL and %EWL were of 21.3 kg, 19.5% and 60.4% respectively. 85.7% of patients achieve the goal of >25% %EWL. There were no mayor adverse events intraprocedure or during the 24 months of follow-up . Endoscopic sleeve gastroplasty with regular monitoring by a multidisciplinary team can be considered an effective, safe and well tolerated procedure for obesity treatment, at least for two years of follow-up. As técnicas de endoscopia bariátrica são minimamente invasivas e induzem à redução do volume gástrico para tratar a obesidade. Avaliar a gastroplastia sleeve endoscópica (método Apollo) usando um método de sutura direcionado para a grande curvatura, bem como os cuidados perioperatórios, segurança em dois anos e perda de peso. Estudo prospectivo em um único centro com 154 pacientes (108 mulheres) usando o procedimento endoscópico de gastroplastia sleeve sob anestesia geral com observação do paciente internado durante a noite. Dos 154 pacientes iniciais, 143 estiveram disponíveis para acompanhamento de um mês, 133 durante seis meses, 64 durante 12 meses e 28 completaram a avaliação de 24 meses. O acompanhamento foi realizado por equipe multidisciplinar (nutricionista e psicólogo). Foram avaliados nos resultados as mudanças no IMC, no peso corporal (TWBL), no % de perda do peso corporal inicial (% TBWL) no % de excesso de perda de peso corporal (%EWL) segregado em > ou < 25% e efeitos adversos. Estudos radiológicos contratados orais voluntários foram programados para avaliar a gastroplastia em diferentes tempos após o procedimento. A idade média foi de 44,9 anos (23-69). Aos 24 meses após o procedimento a linha de base média do IMC mudou de 38,3 para 30,8 kg/m2. O TBWL, %TBWL e %EWL foram de 21,3 kg, 19,5% e 60,4%, respectivamente, e 85,7% dos pacientes alcançaram o objetivo de >25% EWL. Não houve eventos adversos graves peroperatórios ou durante os 24 meses de acompanhamento. A gastroplastia sleeve endoscópica com monitoramento regular por equipe multidisciplinar pode ser considerado procedimento eficaz, seguro e bem tolerado para o tratamento de pacientes com obesidade, pelo menos nos dois anos de acompanhamento.
Joselyn, Anita; Bhalla, Tarun; McKee, Christopher; Pepper, Victoria; Diefenbach, Karen; Michalsky, Marc; Tobias, Joseph D
2015-01-01
One of the major advantages for patients undergoing minimally invasive surgery as compared to an open surgical procedure is the improved recovery profile and decreased opioid requirements in the perioperative period. There are no definitive studies comparing the analgesic requirements in patients undergoing two different types of minimally invasive procedure. This study retrospectively compares the perioperative analgesic requirements in severely obese adolescents and young adults undergoing laparoscopic versus robotic-assisted, laparoscopic gastric sleeve resection. With Institutional Review Board approval, the medication administration records of all severely obese patients who underwent gastric sleeve resection were retrospectively reviewed. Intra-operative analgesic and adjuvant medications administered, postoperative analgesic requirements, and visual analog pain scores were compared between those undergoing a laparoscopic procedure versus a robotic-assisted procedure. This study cohort included a total of 28 patients who underwent gastric sleeve resection surgery with 14 patients in the laparoscopic group and 14 patients in the robotic-assisted group. Intra-operative adjuvant administration of both intravenous acetaminophen and ketorolac was similar in both groups. Patients in the robotic-assisted group required significantly less opioid during the intra-operative period as compared to patients in the laparoscopic group (0.15 ± 0.08 mg/kg vs. 0.19 ± 0.06 mg/kg morphine, P = 0.024). Cumulative opioid requirements for the first 72 postoperative h were similar in both the groups (0.64 ± 0.25 vs. 0.68 ± 0.27 mg/kg morphine, P = NS). No difference was noted in the postoperative pain scores. Although intraoperative opioid administration was lower in the robotic-assisted group, the postoperative opioid requirements, and the postoperative pain scores were similar in both groups.
Mihmanli, Mehmet; Isil, Riza Gurhan; Bozkurt, Emre; Demir, Uygar; Kaya, Cemal; Bostanci, Ozgur; Isil, Canan Tulay; Sayin, Pinar; Oba, Sibel; Ozturk, Feyza Yener; Altuntas, Yuksel
2016-01-01
Laparoscopic Sleeve Gastrectomy has become one of the most popular bariatric surgery types and helps treating not only obesity but also endocrinological diseases related to obesity. Therefore we aimed to evaluate the effects of laparoscopic sleeve gastrectomy on the treatment of type 2 diabetes. All patients, who underwent morbid obesity surgery during 2013-2014 and had a HbA1c >6 % were included in this prospective study. Demographical data, usage of oral antidiabetic drugs or insulin were recorded, and laboratory findings as HbA1c and fasting plasma glucose were evaluated preoperatively and postoperatively at the 6th and 12th months. Diabetes remission criteria were used to assess success of the surgical treatment. Totally 88 patients were included in this study. 55 patients were using oral antidiabetic drugs and 33 patients were using insulin. At the 6th month complete remission was observed in 80 (90.9 %), partial remission in 3 (3.4 %) and persistent diabetes in 5 (5.6 %) patients. At the 12th month complete remission was observed in 84 (95.4 %), partial remission in 1 (1.1 %) and persistent diabetes in 3 (3.4 %) patients. This study indicated that laparoscopic sleeve gastrectomy surgery achieved a complete remission of diabetes in 95.4 % patients having type 2 diabetes during a 1 year fallow up period. However, complete remission of type 2 diabetes has been reported as 80 % during long term fallow up in the literature. In our opinion this rate may change with longer follow up periods and studies involving more patients suffering type 2 diabetes.
Gołębiowski, Tomasz; Weyde, Wacław; Letachowicz, Krzysztof; Kusztal, Mariusz; Augustyniak-Bartosik, Hanna; Penar, Jan; Madziarska, Katarzyna; Zmonarski, Sławomir; Krajewska, Magdalena; Klinger, Marian
2017-09-11
Creation of an arteriovenous fistula (AVF) in patients with advanced atherosclerotic changes of the artery is often a challenge for the physician due to difficulties in suturing the vein to the side of the frangible artery. The sleeve technique relies on advancing the end of the artery into the lumen of the vein and protecting the anastomosis by adventitial sutures. The sleeve technique was performed in 23 patients with chronic kidney disease stage IV and V and included hemodialysis patients. Their mean age was 60.8 ± 14.8 years and hemodialysis treatment time 49.8 ± 40.2 months. The most frequent causes of chronic kidney disease are ischemic nephropathy (43%, n = 10) and type l diabetes (21%, n = 5). Only patients with extremely advanced atherosclerotic were recruited and analyzed. The primary patency rate was 67%, 59%, 44% and 28% at 6, 12, 24, and 36 months, respectively. The secondary patency rate was 67%, 61%, 50% and 37% at 6, 12, 24, and 36 months, respectively. In three patients the AVF failed directly after the operation. Delayed fistula failure occurred in seven patients. The overall success in the creation of a functioning fistula was achieved in 15 of the 23 patients (65%). No serious complications were observed. In patients with calcified atherosclerotic plaques, which constitute a barrier or make it difficult to suture the vein to the side of the artery, the sleeve method may be considered as an alternative before abandoning the creation of a fistula on the forearm. The technique is much simpler than the standard end-to-side or side-to-side anastomosis.
Major, Piotr; Pędziwiatr, Michał; Pisarska, Magdalena; Małczak, Piotr; Wierdak, Mateusz; Dembiński, Marcin; Migaczewski, Marcin; Rubinkiewicz, Mateusz; Budzyński, Andrzej
2017-01-01
Introduction Staple-line bleeding and leakage are the most common serious complications of laparoscopic sleeve gastrectomy. The relationship between multiple stapler firings and higher risk of postoperative complications is well defined in colorectal surgery but has not been addressed in bariatric procedures so far. Identification of new factors such as “the numbers of stapler firings used during laparoscopic sleeve gastrectomy (LSG)” as a predictor for complications can lead to optimization of the patient care at bariatric centers. Aim To determine the association between perioperative morbidity and the number of stapler firings during laparoscopic sleeve gastrectomy. Material and methods This observational study was based on retrospective analysis of prospectively collected data in patients operated on for morbid obesity in a teaching hospital/tertiary referral center for general surgery. The patients who underwent LSG were analyzed in terms of the number of stapler firings used as a new potential risk predictor for postoperative complications after surgery, adjusting for other patient- and treatment-related factors. The study included 333 patients (209 women, 124 men, mean age: 40 ±11). Results During the first 30 days after surgery, complications were observed in 18 (5.41%) patients. Multivariate analysis showed that prolonging operative time increased morbidity (every minute, OR = 1.01; 95% CI: 1.00–1.02) and the complication rate increased with the number of stapler firings (every firing, OR = 1.91; 95% CI: 1.09–3.33; p = 0.023). Conclusions Additional stapler firings above the usual number and a prolonged operation should alert a surgeon and the whole team about increased risk of postoperative complications. PMID:29643964
Operating room fire prevention: creating an electrosurgical unit fire safety device.
Culp, William C; Kimbrough, Bradly A; Luna, Sarah; Maguddayao, Aris J
2014-08-01
To reduce the incidence of surgical fires. Operating room fires represent a potentially life-threatening hazard and are triggered by the electrosurgical unit (ESU) pencil. Carbon dioxide is a fire suppressant and is a routinely used medical gas. We hypothesize that a shroud of protective carbon dioxide covering the tip of the ESU pencil displaces oxygen, thereby preventing fire ignition. Using 3-dimensional modeling techniques, a polymer sleeve was created and attached to an ESU pencil. This sleeve was connected to a carbon dioxide source and directed the gas through multiple precisely angled ports, generating a cone of fire-suppressive carbon dioxide surrounding the active pencil tip. This device was evaluated in a flammability test chamber containing 21%, 50%, and 100% oxygen with sustained ESU activation. The sleeve was tested with and without carbon dioxide (control) until a fuel was ignited or 30 seconds elapsed. Time to ignition was measured by high-speed videography. Fires were ignited with each control trial (15/15 trials). The control group median ± SD ignition time in 21% oxygen was 3.0 ± 2.4 seconds, in 50% oxygen was 0.1 ± 1.8 seconds, and in 100% oxygen was 0.03 ± 0.1 seconds. No fire was observed when the fire safety device was used in all concentrations of oxygen (0/15 trials; P < 0.0001). The exact 95% confidence interval for absolute risk reduction of fire ignition was 76% to 100%. A sleeve creating a cone of protective carbon dioxide gas enshrouding the sparks from an ESU pencil effectively prevents fire in a high-flammability model. Clinical application of this device may reduce the incidence of operating room fires.
Morales-Conde, Salvador; Del Agua, Isaías Alarcón; Moreno, Antonio Barranco; Macías, María Socas
2017-04-01
Laparoscopic approach is the gold standard for surgical treatment of morbid obesity. The single-port (SP) approach has been demonstrated to be a safe and effective technique for the treatment of morbid obesity in several case control studies. Compare conventional multiport laparoscopy (LAP) with an SP approach for the treatment of morbid obesity using sleeve gastrectomy in terms of postoperative pain using a visual analog scale (VAS) 0-100, surgical outcome, weight loss, and aesthetical satisfaction at 6 months after surgery. University Hospital, Spain. Randomized, controlled pilot study. The trial enrolled patients suitable for bariatric surgery, with a body mass index lower than 50 kg/m 2 and xiphoumbilical distance lower than 25 cm. Patients were randomly assigned to receive LAP or SP sleeve gastrectomy. A total of 30 patients were enrolled; 15 were assigned to LAP group and 15 to SP group. No patients were lost during follow-up. Baseline characteristics were similar in both groups. A significantly higher level of pain during movement was noted for the patients in the LAP group on the first (mean VAS 49.3±12.2 versus 34.1±8.9, P = .046) and second days (mean VAS 35.9±10.2 versus 22.1±7.9, P = .044) but not the third day (mean VAS 20.1±5.2 versus 34.12.9 ±4.3, P = .620). No differences regarding pain at rest, operative time, complications, or weight loss at 6 months were observed. Higher aesthetical satisfaction was noticed in SP group. In selected patients, SP surgery presented less postoperative pain in sleeve gastrectomy compared with the conventional laparoscopic approach with similar surgical results. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Enabling recruitment success in bariatric surgical trials: pilot phase of the By-Band-Sleeve study.
Paramasivan, S; Rogers, C A; Welbourn, R; Byrne, J P; Salter, N; Mahon, D; Noble, H; Kelly, J; Mazza, G; Whybrow, P; Andrews, R C; Wilson, C; Blazeby, J M; Donovan, J L
2017-11-01
Randomized controlled trials (RCTs) involving surgical procedures are challenging for recruitment and infrequent in the specialty of bariatrics. The pilot phase of the By-Band-Sleeve study (gastric bypass versus gastric band versus sleeve gastrectomy) provided the opportunity for an investigation of recruitment using a qualitative research integrated in trials (QuinteT) recruitment intervention (QRI). The QRI investigated recruitment in two centers in the pilot phase comparing bypass and banding, through the analysis of 12 in-depth staff interviews, 84 audio recordings of patient consultations, 19 non-participant observations of consultations and patient screening data. QRI findings were developed into a plan of action and fed back to centers to improve information provision and recruitment organization. Recruitment proved to be extremely difficult with only two patients recruited during the first 2 months. The pivotal issue in Center A was that an effective and established clinical service could not easily adapt to the needs of the RCT. There was little scope to present RCT details or ensure efficient eligibility assessment, and recruiters struggled to convey equipoise. Following presentation of QRI findings, recruitment in Center A increased from 9% in the first 2 months (2/22) to 40% (26/65) in the 4 months thereafter. Center B, commencing recruitment 3 months after Center A, learnt from the emerging issues in Center A and set up a special clinic for trial recruitment. The trial successfully completed pilot recruitment and progressed to the main phase across 11 centers. The QRI identified key issues that enabled the integration of the trial into the clinical setting. This contributed to successful recruitment in the By-Band-Sleeve trial-currently the largest in bariatric practice-and offers opportunities to optimize recruitment in other trials in bariatrics.
Transition nozzle combustion system
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kim, Won-Wook; McMahan, Kevin Weston; Maldonado, Jaime Javier
The present application provides a combustion system for use with a cooling flow. The combustion system may include a head end, an aft end, a transition nozzle extending from the head end to the aft end, and an impingement sleeve surrounding the transition nozzle. The impingement sleeve may define a first cavity in communication with the head end for a first portion of the cooling flow and a second cavity in communication with the aft end for a second portion of the cooling flow. The transition nozzle may include a number of cooling holes thereon in communication with the secondmore » portion of the cooling flow.« less
Method for manufacturing magnetohydrodynamic electrodes
Killpatrick, D.H.; Thresh, H.R.
1980-06-24
A method of manufacturing electrodes for use in a magnetohydrodynamic (MHD) generator is described comprising the steps of preparing a billet having a core of a first metal, a tubular sleeve of a second metal, and an outer sheath of an extrusile metal; evacuating the space between the parts of the assembled billet; extruding the billet; and removing the outer jacket. The extruded bar may be made into electrodes by cutting and bending to the shape required for an MHD channel frame. The method forms a bond between the first metal of the core and the second metal of the sleeve strong enough to withstand a hot and corrosive environment.
Carbon Fiber Reinforced Carbon Composites Rotary Valves for Internal Combustion Engines
NASA Technical Reports Server (NTRS)
Northam, G. Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)
1999-01-01
Carbon fiber reinforced carbon composite rotary, sleeve, and disc valves for internal combustion engines and the like are disclosed. The valves are formed from knitted or braided or warp-locked carbon fiber shapes. Also disclosed are valves fabricated from woven carbon fibers and from molded carbon matrix material. The valves of the present invention with their very low coefficient of thermal expansion and excellent thermal and self-lubrication properties, do not present the sealing and lubrication problems that have prevented rotary, sleeve, and disc valves from operating efficiently and reliably in the past. Also disclosed are a sealing tang to further improve sealing capabilities and anti-oxidation treatments.
Method and apparatus for pressurizing vaporous fluids
Bingham, Dennis N.; Ferguson, Russell L.
2001-01-01
Pump apparatus according to the present invention may comprise a pump body having a bore therein and a piston mounted within the bore so that the piston may be reciprocated within the bore between first and second positions. A sleeve seal assembly mounted to the pump body contacts the piston as the piston moves between the first and second positions. A piston seal assembly mounted to the piston contacts the bore in the pump body and is located on the piston so that the piston seal assembly does not contact the sleeve seal assembly as the piston is reciprocated between the first and second positions within the bore of the pump body.
Sheath-Based Rollable Lenticular-Shaped and Low-Stiction Composite Boom
NASA Technical Reports Server (NTRS)
Fernandez, Juan M. (Inventor)
2018-01-01
Various embodiments provide rollable and deployable composite booms that may be used in a wide range of applications both for space and terrestrial structural solutions. Various embodiment composite booms may be bistable, i.e. having a stable strain energy minimum in the coiled configuration as well as the in the deployed configuration. In various embodiments, a boom may be fabricated by aligning two independent tape-springs front-to-front encircled by a durable seamless polymer sleeve. The durable seamless polymer sleeve may allow the two tape-springs to slide past each other during the coiling/deployment process so as to reduce, e.g., minimize, shear and its derived problems.
Locking support for nuclear fuel assemblies
Ledin, Eric
1980-01-01
A locking device for supporting and locking a nuclear fuel assembly within a cylindrical bore formed by a support plate, the locking device including a support and locking sleeve having upwardly extending fingers forming wedge shaped contact portions arranged for interaction between an annular tapered surface on the fuel assembly and the support plate bore as well as downwardly extending fingers having wedge shaped contact portions arranged for interaction between an annularly tapered surface on the support plate bore and the fuel assembly whereby the sleeve tends to support and lock the fuel assembly in place within the bore by its own weight while facilitating removal and/or replacement of the fuel assembly.
Skin blood flow with elastic compressive extravehicular activity space suit.
Tanaka, Kunihiko; Gotoh, Taro M; Morita, Hironobu; Hargens, Alan R
2003-10-01
During extravehicular activity (EVA), current space suits are pressurized with 100% oxygen at approximately 222 mmHg. A tight elastic garment, or mechanical counter pressure (MCP) suit that generates pressure by compression, may have several advantages over current space suit technology. In this study, we investigated local microcirculatory effects produced with negative ambient pressure with an MCP sleeve. The MCP glove and sleeve generated pressures similar to the current space suit. MCP remained constant during negative pressure due to unchanged elasticity of the material. Decreased skin capillary blood flow and temperature during MCP compression was counteracted by greater negative pressure or a smaller pressure differential.
Evaluations of bit sleeve and twisted-body bit designs for controlling roof bolter dust
Beck, T.W.
2015-01-01
Drilling into coal mine roof strata to install roof bolts has the potential to release substantial quantities of respirable dust. Due to the proximity of drill holes to the breathing zone of roof bolting personnel, dust escaping the holes and avoiding capture by the dust collection system pose a potential respiratory health risk. Controls are available to complement the typical dry vacuum collection system and minimize harmful exposures during the initial phase of drilling. This paper examines the use of a bit sleeve in combination with a dust-hog-type bit to improve dust extraction during the critical initial phase of drilling. A twisted-body drill bit is also evaluated to determine the quantity of dust liberated in comparison with the dust-hog-type bit. Based on the results of our laboratory tests, the bit sleeve may reduce dust emissions by one-half during the initial phase of drilling before the drill bit is fully enclosed by the drill hole. Because collaring is responsible for the largest dust liberations, overall dust emission can also be substantially reduced. The use of a twisted-body bit has minimal improvement on dust capture compared with the commonly used dust-hog-type bit. PMID:26257435
Floating Probe Assembly for Measuring Temperature of Water
NASA Technical Reports Server (NTRS)
Stewart, Randy; Ruffin, Clyde
2002-01-01
A floating apparatus denoted a temperature probe aquatic suspension system (TPASS) has been developed for measuring the temperature of an ocean, lake, or other natural body of water at predetermined depths. Prior instruments built for the same purpose were found to give inaccurate readings because the apparatuses themselves significantly affected the temperatures of the water in their vicinities. The design of the TPASS is intended to satisfy a requirement to minimize the perturbation of the temperatures to be measured. The TPASS includes a square-cross-section aluminum rod 28 in. (=71 cm) long with floats attached at both ends. Each float includes five polystyrene foam disks about 3/4 in.(=1.9 cm) thick and 2.5 in. (=6.4 cm) in diameter. The disks are stacked to form cylinders, bolted to the rod, and covered with hollow plastic sleeves. A metal sleeve is clamped to the middle of the aluminum rod, from whence it hangs down into the water. Temperature probes (which can be thermocouples, thermistors, or resistance temperature devices) are placed within the sleeve at the desired measurement depths. Wires from the temperature probes are routed to the input terminals of a data logger.
Floating Probe Assembly for Measuring Temperature of Water
NASA Technical Reports Server (NTRS)
Selinsky, T.; Stewart, Randy; Ruffin, Clyde
2002-01-01
A floating apparatus denoted a temperature probe aquatic suspension system (TPASS) has been developed for measuring the temperature of an ocean, lake, or other natural body of water at predetermined depths. Prior instruments built for the same purpose were found to give inaccurate readings because the apparatuses themselves significantly affected the temperatures of the water in their vicinities. The design of the TPASS is intended to satisfy a requirement to minimize the perturbation of the temperatures to be measured. The TPASS includes a square-cross-section aluminum rod 28 in. (approx. = 71 cm) long with floats attached at both ends. Each float includes five polystyrene foam disks about 3/4 in. (approx. = 1.9 cm) thick and 2.5 in. (approx. = 6.4 cm) in diameter. The disks are stacked to form cylinders, bolted to the rod, and covered with hollow plastic sleeves. A metal sleeve is clamped to the middle of the aluminum rod, from whence it hangs down into the water. Temperature probes (which can be thermocouples, thermistors, or resistance temperature devices) are placed within the sleeve at the desired measurement depths. Wires from the temperature probes are routed to the input terminals of a data logger. This work was done by Randy
Rhabdomyolysis after sleeve gastrectomy: increase in muscle enzymes does not predict fatal outcome.
Foresteri, Pietro; Pietro, Forestieri; Formato, Antonio; Antonio, Formato; Pilone, Vincenzo; Vincenzo, Pilone; Romano, Antonietta; Antonietta, Romano; Monda, Antonietta; Angela, Monda; Tramontano, Salvatore; Salvatore, Tramontano
2008-03-01
Rhabdomyolysis (RML) is a clinical and biochemical syndrome caused by destruction of skeletal muscles and constitutes a complication of bariatric surgery, with an incidence near to 22%. It is accompanied by increase in serum of intracellular enzymes. Laboratory data as predictive of prognosis have been evaluated by some authors. We report a case of RML after a sleeve gastrectomy, with good prognosis despite a very extensive muscle damage and very high seric and urinary peaks of intracellular enzymes. We describe a 34-years-old super-obese male (body mass index, 54.3 kg/m2) who underwent to laparoscopic sleeve gastrectomy. After 24 h, patient complained of pain in gluteal region, oliguria, and high levels of creatine phosphokinase that reached to 58,395 IU/l. Acute renal failure related to RML was diagnosed. Dialysis was not necessary. Ambulatorial control of renal function after dimission did not reveal a permanent damage. RML is a biochemical syndrome recently associated with bariatric surgery. Early diagnosis is ever necessary. Laboratory data represent markers for diagnosis and prognostic indicator of renal failure. There is no clear relation between seric levels of intracellular enzymes and irreversible renal damage and RML-related mortality.
Plasma Chamber Restraints in Ignitor and Relevant Disruption Analysis
NASA Astrophysics Data System (ADS)
Gasparotto, M.; Cucchiaro, A.; Capriccioli, A.; Celentano, G.; Rita, C.; Roccella, M.; Macco, B.; Micheli, I.; Ferrari, G.; Orlandi, S.; Coppi, B.
2000-10-01
The plasmas chamber (PC) of Ignitor is made of 12 D-shaped toroidal sectors of Inconel 625 welded together by automatic remote equipment. The thickness of the inboard wall is 17 mm while the middle and outboard walls are 26 mm thick. The PC is supported through the ports by the C-Clamp structure of the toroidal magnet. The main function of the PC supports is to resist the vertical and radial electromagnetic loads and to allow for free movement under thermal loads while providing electrical insulation from the C-Clamps and cryostat. The largest estimated loads are due to a Vertical Displacement Event (VDE) disruption that is followed by a thermal quench and then by the current quench. The vertical supports involve a connection of each radial port to the C-Clamp structure by a link system that withstands the calculated loads. The radial supports resist, with high stiffness, the centripetal and centrifugal forces. The end flange of each radial port is connected to the C-Clamp structure by a clamping sleeve device. The clamping sleeves are hydraulically operated to provide locking during discharge. The clamping sleeves of the radial support system have been validated by an appropriate series of tests.
Cao, Ran; Zhou, Tao; Wang, Bin; Yin, Yingying; Yuan, Zuqing; Li, Congju; Wang, Zhong Lin
2017-08-22
Currently, a triboelectric nanogenerator (TENG) and an electromagnetic generator (EMG) have been hybridized to effectively scavenge mechanical energy. However, one critical issue of the hybrid device is the limited output power due to the mismatched output impedance between the two generators. In this work, impedance matching between the TENG and EMG is achieved facilely through commercial transformers, and we put forward a highly integrated hybrid device. The rotating-sleeve triboelectric-electromagnetic hybrid nanogenerator (RSHG) is designed by simulating the structure of a common EMG, which ensures a high efficiency in transferring ambient mechanical energy into electric power. The RSHG presents an excellent performance with a short-circuit current of 1 mA and open-circuit voltage of 48 V at a rotation speed of 250 rpm. Systematic measurements demonstrate that the hybrid nanogenerator can deliver the largest output power of 13 mW at a loading resistance of 8 kΩ. Moreover, it is demonstrated that a wind-driven RSHG can light dozens of light-emitting diodes and power an electric watch. The distinctive structure and high output performance promise the practical application of this rotating-sleeve structured hybrid nanogenerator for large-scale energy conversion.
Method for manufacturing magnetohydrodynamic electrodes
Killpatrick, Don H.; Thresh, Henry R.
1982-01-01
A method of manufacturing electrodes for use in a magnetohydrodynamic (MHD) generator comprising the steps of preparing a billet having a core 10 of a first metal, a tubular sleeve 12 of a second metal, and an outer sheath 14, 16, 18 of an extrusile metal; evacuating the space between the parts of the assembled billet; extruding the billet; and removing the outer jacket 14. The extruded bar may be made into electrodes by cutting and bending to the shape required for an MDH channel frame. The method forms a bond between the first metal of the core 10 and the second metal of the sleeve 12 strong enough to withstand a hot and corrosive environment.
Apel, Charles T.; Layman, Lawrence R.; Gallimore, David L.
1988-01-01
A nebulizer for generating aerosol having small droplet sizes and high efficiency at low sample introduction rates. The nebulizer has a cylindrical gas permeable active surface. A sleeve is disposed around the cylinder and gas is provided from the sleeve to the interior of the cylinder formed by the active surface. In operation, a liquid is provided to the inside of the gas permeable surface. The gas contacts the wetted surface and forms small bubbles which burst to form an aerosol. Those bubbles which are large are carried by momentum to another part of the cylinder where they are renebulized. This process continues until the entire sample is nebulized into aerosol sized droplets.
Carbon Fiber Reinforced Carbon Composite Rotary Valve for an Internal Combustion Engine
NASA Technical Reports Server (NTRS)
Northam, G.Burton (Inventor); Ransone, Philip O. (Inventor); Rivers, H. Kevin (Inventor)
2000-01-01
Carbon fiber reinforced carbon composite rotary sleeve, and disc valves for internal combustion engines and the like are disclosed. The valves are formed from knitted or braided or wrap-locked carbon fiber shapes. Also disclosed are valves fabricated from woven carbon fibers and from molded carbon matrix material. The valves of the present invention with their very low coefficient of thermal expansion and excellent thermal and self-lubrication properties do not present the sealing and lubrication problems that have prevented rotary sleeve and disc valves from operating efficiently and reliably in the past. Also disclosed are a sealing tang to further improve sealing capabilities and anti-oxidation treatments.
Beltran, Marcelo A; Pujado, Blazenko; Méndez, Pedro E; Gonzáles, Francisco J; Margulis, David I; Contreras, Mario A; Cruces, Karina S
2010-03-01
The incidence of incidental pathology found during laparoscopic bariatric surgery has been estimated to be around 2%, and gastric gastrointestinal stromal tumors (GISTs) have been found in 0.8% of patients, constituting a rather uncommon finding. Safe laparoscopic resection of gastric GISTs is an established procedure and has been described associated to gastric Roux-en-Y bypass for morbid obesity. We discuss one case of a gastric GIST incidentally discovered during laparoscopic sleeve gastrectomy for morbid obesity. The procedure was performed via laparoscopy, and the patient recovered without any complication. Currently, the patient has lost weight according to what was expected, is asymptomatic, and free of disease.
Design and optimization of LTE 1800 MIMO antenna.
Wong, Huey Shin; Islam, Mohammad Tariqul; Kibria, Salehin
2014-01-01
A multiple input and multiple output (MIMO) antenna that comprises a printed microstrip antenna and a printed double-L sleeve monopole antenna for LTE 1800 wireless application is presented. The printed double-L sleeve monopole antenna is fed by a 50 ohm coplanar waveguide (CPW). A novel T-shaped microstrip feedline printed on the other side of the PCB is used to excite the waveguide's outer shell. Isolation characteristics better than -15 dB can be obtained for the proposed MIMO antenna. The proposed antenna can operate in LTE 1800 (1710 MHz-1880 MHz). This antenna exhibits omnidirectional characteristics. The efficiency of the antenna is greater than 70% and has high gain of 2.18 dBi.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gusman, M.T.; Konstantinov, L.P.; Malkin, B.D.
1974-04-16
Mounted on the exterior of a nonrotatable core barrel is an end of a resilient tape, the other end of which extends inward into the barrel and is connected to a device for pulling the tape inward into the barrel. The apparatus also is provided with an arrangement which forms a sleeve from the tape as this is being pulled into the core barrel. During the coring operation, the tape is being pulled inward into the barrel and a sleeve is formed from the tape with the aid of the arrangement to encase and protect the core from disturbance. Themore » coring apparatus is intended for core drilling in soft, unconsolidated, and fractured formations. (3 claims)« less
Loomis, C.C.; Ash, W.J.
1957-11-26
An improved retort assembly useful in the thermal reduction of volatilizable metals such as magnesium and calcium is described. In this process a high vacuum is maintained in the retort, however the retort must be heated to very high temperatures while at the same time the unloading end must bo cooled to condense the metal vapors, therefore the retention of the vacuum is frequently difficult due to the thermal stresses involved. This apparatus provides an extended condenser sleeve enclosed by the retort cover which forms the vacuum seal. Therefore, the seal is cooled by the fluid in the condenser sleeve and the extreme thermal stresses found in previous designs together with the deterioration of the sealing gasket caused by the high temperatures are avoided.
Battery cell feedthrough apparatus
Kaun, Thomas D.
1995-01-01
A compact, hermetic feedthrough apparatus comprising interfitting sleeve portions constructed of chemically-stable materials to permit unique battery designs and increase battery life and performance.
Reduction in nerve root compression by the nucleus pulposus after Feng's Spinal Manipulation☆
Feng, Yu; Gao, Yan; Yang, Wendong; Feng, Tianyou
2013-01-01
Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng's Spinal Manipulation, hot fomentation, and bed rest (treatment group). The remaining 46 patients were treated with hot fomentation and bed rest only (control group). After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng's Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root. PMID:25206408
Portable containment sleever apparatus
Rea, Michael J.; Brown, Roger A.
2000-01-01
A sleever apparatus includes an inner member with a central passage through which an item to be sleeved is passed. An outer member surrounds the inner member and defines a space between the members for holding a supply of containment material, which is preferably plastic sleeving. The apparatus has a handle which allows a user to hold the apparatus and walk the apparatus along the length of the item to be sleeved. As the user passes the item through the sleever apparatus, the containment material exits through a slit at one end of the apparatus in order to contain the item. The sleever apparatus may be formed of disposable materials, such as cardboard, and may be intended for a single use application. Alternatively, the sleever apparatus may be comprised of more permanent materials such as PVC or fiberglass. The sleever apparatus may include a serrated end for cutting the containment material and may include appropriate tubing and valves for either directing an inert gas into the containment material around the item or for withdrawing air from within the containment material in order to create a vacuum. In one embodiment, the sleever apparatus has a cartridge that can be replaced with another cartridge once the supply of the containment material has been depleted.
Alternative design of pipe sleeve for liquid removal mechanism in mortar slab layer
NASA Astrophysics Data System (ADS)
Nazri, W. M. H. Wan; Anting, N.; Lim, A. J. M. S.; Prasetijo, J.; Shahidan, S.; Din, M. F. Md; Anuar, M. A. Mohd
2017-11-01
Porosity is one of the mortar’s characteristics that can cause problems, especially in the room space that used high amount of water, such as bathrooms. Waterproofing is one of the technology that normally used to minimize this problem which is preventing deep penetration of liquid water or moisture into underlying concrete layers. However, without the proper mechanism to remove liquid water and moisture from mortar system, waterproofing layer tends to be damaged after a long period of time by the static formation of liquid water and moisture at mortar layer. Thus, a solution has been proposed to drain out water that penetrated into the mortar layer. This paper introduces a new solution using a Modified Pipe Sleeve (MPS) that installed at the mortar layer. The MPS has been designed considering the percentage surface area of the pipe sleeve that having contact with mortar layer (2%, 4%, 6%, 8% and 10%) with angle of holes of 60°. Infiltration test and flow rate test have been conducted to identify the effectiveness of the MPS in order to drain out liquid water or moisture from the mortar layer. In this study shows that, MPS surface area 10%, angled 60°, function effectively as a water removal compared to other design.
Analysis of dry friction damping characteristics for short cylindrical shell structures
NASA Astrophysics Data System (ADS)
Wang, Nengmao; Wang, Yanrong
2018-05-01
An efficient mathematical model to describe the friction of short cylindrical shell structures with a dry friction damping sleeve is proposed. The frictional force in the circumference and axial direction is caused by the opposing bending strains at the interface. Slipping will occur at part region of the interface and the mathematic model of the slipping region is established. Ignoring the effect of contact stiffness on the vibration analysis, the friction energy dissipation capability of damping sleeve would be calculated. Structural vibration mode, positive pressure at the interface and vibration stress of the short cylindrical shell structures is analyzed as influence factors to the critical damping ratio. The results show that the circumferential friction energy dissipation is more sensitive to the number of nodal diameter, and the circumferential friction damping ratio increases rapidly with the number of nodal diameter. The slipping frictional force would increase along with the positive pressure, but the slipping region would decrease with it. The peak damping ratio keeps nearly constant. But the vibration stress corresponding to peak damping ratio would increases with the positive pressure. The dry friction damping ratio of damping sleeve contains the effect of frictional force in the circumference and axial direction, and the axial friction plays a major role.
Sharma, Aditya; Aggarwal, Sandeep; Ahuja, Vineet; Bal, Chandrashekhar
2014-01-01
The effect of laparoscopic sleeve gastrectomy (SG) on gastroesophageal reflux disease (GERD) has been a controversial issue. There have been limited studies on this aspect and most of the published studies are retrospective. Therefore, a prospective study was designed to objectively assess the problem. The objective of this study was to assess the impact of SG on symptoms of gastroesophageal reflux using questionnaire, endoscopy, and radionuclide scintigraphy. Thirty-two patients undergoing laparoscopic sleeve gastrectomy were assessed for gastroesophageal reflux using Carlsson Dent Questionnaire and GERD questionnaire before and after surgery at three monthly intervals. They were also subjected to upper GI endoscopy (UGIE) and radionuclide scintigraphy both pre- and postoperatively. Mean preoperative weight and body mass index were 126.5 kg and 47.8 kg/m2, respectively. Mean percent excess weight loss at 12 months was 64.3 ± 18.4. Both the Carlsson Dent Score (CDS) and Severity Score (SS) exhibited a decline from 2.88 to 1.63 (p<0.05) and 2.28 to 1.06 (p<0.05), respectively after 12 months. Radionuclide scintigraphy revealed a significant rise of GERD from 6.25% to 78.1% in the postoperative period (p<0.001). UGIE showed a rise in incidence of esophagitis from 18.8% to 25%; however, there was improvement in all patients except one in terms of reduction of severity of esophagitis. Presence of GERD may not be considered as a contra-indication for sleeve gastrectomy. There is improvement of GERD as assessed by symptom questionnaires, as well as improvement in grade of esophagitis. The new onset GERD detected on scintigraphy may not be pathologic as there is a decrease in total acid production postsurgery; however, it still remains an important issue and needs long-term follow-up. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Bruna, Marcos; Gumbau, Verónica; Guaita, Marcos; Canelles, Enrique; Mulas, Claudia; Basés, Carla; Celma, Isabel; Puche, José; Marcaida, Goitzane; Oviedo, Miguel; Vázquez, Antonio
2014-03-01
Different hormones and peptides involved in lipid and carbohydrate metabolism have been studied in relation to morbid obesity and its variation after bariatric surgery. The aim of this study is toevaluate variations in different molecules related to glico-lipidic metabolism during the first year after sleeve gastrectomy in morbidly obese patients. Prospective study in patients undergoing sleeve gastrectomy between November 2009 and January 2011. We analyzed changes in different clinical, anthropometric and analytic parameters related with glico-lipidic metabolism in all patients in the preoperative period, first postoperative day, fifth day, one month, 6 months and one year after surgery. Statistical analysis was performed using SPSS 20.0. We included 20 patients, 60% were women with a median of age of 45 years. Median of body mass index (IMC) was 48,5 kg/m(2) and 70% had obstructive sleep apnea syndrome (SAOS), 65% arterial hypertension (HTA), 45% dyslipidemia and 40% diabetes mellitus. One year after surgery, the percentage of excess of BMI loss was 72% and the rate of cure or improvement of dyslipidemia was 100%, diabetes 87,5%, HTA 84,6% and SAOS 57,1%. At this time, glycemia levels decreased significantly (P<.001), and levels of IGF-1 and HDL-cholesterol increased significantly. Levels of adiponectine increased and leptine (P=.003), insulin (P=.004) and triglycerides (P=.016) decreased significantly one year after the surgery. ACTH levels (that decreased during first 6 months after surgery), glycosilated hemoglobin, total cholesterol and LDL-cholesterol had no changes one year after surgery. Sleeve gastrectomy is a surgical technique with good results of weight loss and cure of comorbidities. This procedure induces significant modifications in blood levels of glico-lipidic metabolism related peptides and hormones, such as glucose, IGF-1, insulin, leptin, triglycerides and HDL-cholesterol. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.
Rogers, C A; Reeves, B C; Byrne, J; Donovan, J L; Mazza, G; Paramasivan, S; Andrews, R C; Wordsworth, S; Thompson, J; Blazeby, J M; Welbourn, R
2017-08-01
Recruitment into surgical RCTs can be threatened if new interventions available outside the trial compete with those being evaluated. Adapting the trial to include the new intervention may overcome this issue, yet this is not often done in surgery. This paper describes the challenges, rationale and methods for adapting an RCT to include a new intervention. The By-Band study was designed in the UK in 2009-2010 to compare the effectiveness of laparoscopic adjustable gastric band and Roux-en-Y gastric bypass for severe obesity. It contained a pilot phase to establish whether recruitment was possible, and the grant proposal specified that an adaptation to include sleeve gastrectomy would be considered if practice changed and recruitment was successful. Information on changing obesity surgery practice, updated evidence and expert opinion about trial design were used to inform the adaptation. The pilot phase recruited over 13 months in 2013-2014 and randomized 80 patients (79 anticipated). During this time, major changes in obesity practice in the UK were observed, with gastric band reducing from 32·6 to 15·8 per cent and sleeve gastrectomy increasing from 9·0 to 28·1 per cent. The evidence base had not changed markedly. The British Obesity and Metabolic Surgery Society and study oversight committees supported an adaptation to include sleeve gastrectomy, and a proposal to do so was approved by the funder. Adaptation of a two-group surgical RCT can allow evaluation of a third procedure and maintain relevance of the RCT to practice. It also optimizes the use of existing trial infrastructure to answer an additional important research question. Registration number: ISRCTN00786323 (http://www.isrctn.com/). © 2017 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
Code of Federal Regulations, 2010 CFR
2010-04-01
... of the following processes: Welding, flame spraying, surface machining, knurling, plating, sleeving...” means a person who grows, raises, mines, harvests, fishes, traps, hunts, manufactures, processes...
Apel, C.T.; Layman, L.R.; Gallimore, D.L.
1988-05-10
A nebulizer is described for generating aerosol having small droplet sizes and high efficiency at low sample introduction rates. The nebulizer has a cylindrical gas permeable active surface. A sleeve is disposed around the cylinder and gas is provided from the sleeve to the interior of the cylinder formed by the active surface. In operation, a liquid is provided to the inside of the gas permeable surface. The gas contacts the wetted surface and forms small bubbles which burst to form an aerosol. Those bubbles which are large are carried by momentum to another part of the cylinder where they are renebulized. This process continues until the entire sample is nebulized into aerosol sized droplets. 2 figs.
Elimination of Lifetime Limiting Mechanism of Hall Thrusters
NASA Technical Reports Server (NTRS)
Jacobson, David T. (Inventor); Manzella, David H. (Inventor)
2009-01-01
A Hall thruster includes inner and outer electromagnets, with the outer electromagnet circumferentially surrounding the inner electromagnet along a centerline axis and separated therefrom, inner and outer poles, in physical connection with their respective inner and outer electromagnets, with the inner pole having a mostly circular shape and the outer pole having a mostly annular shape, a discharge chamber separating the inner and outer poles, a combined anode electrode/gaseous propellant distributor, located at an upstream portion of the discharge chamber and supplying propellant gas and an actuator, in contact with a sleeve portion of the discharge chamber. The actuator is configured to extend the sleeve portion or portions of the discharge chamber along the centerline axis with respect to the inner and outer poles.
Design and Optimization of LTE 1800 MIMO Antenna
Wong, Huey Shin; Islam, Mohammad Tariqul
2014-01-01
A multiple input and multiple output (MIMO) antenna that comprises a printed microstrip antenna and a printed double-L sleeve monopole antenna for LTE 1800 wireless application is presented. The printed double-L sleeve monopole antenna is fed by a 50 ohm coplanar waveguide (CPW). A novel T-shaped microstrip feedline printed on the other side of the PCB is used to excite the waveguide's outer shell. Isolation characteristics better than −15 dB can be obtained for the proposed MIMO antenna. The proposed antenna can operate in LTE 1800 (1710 MHz–1880 MHz). This antenna exhibits omnidirectional characteristics. The efficiency of the antenna is greater than 70% and has high gain of 2.18 dBi. PMID:24967440
Battery cell feedthrough apparatus
Kaun, T.D.
1995-03-14
A compact, hermetic feedthrough apparatus is described comprising interfitting sleeve portions constructed of chemically-stable materials to permit unique battery designs and increase battery life and performance. 8 figs.
Poder, Thomas G; Pruneau, Denise; Dorval, Josée; Thibault, Louis; Fisette, Jean-François; Bédard, Suzanne K; Jacques, Annie; Beauregard, Patrice
2016-01-01
Blood warmers were developed to reduce the risk of hypothermia associated with the infusion of cold blood products. During massive transfusion, these devices are used with compression sleeve, which induce a major stress to red blood cells. In this setting, the combination of blood warmer and compression sleeve could generate hemolysis and harm the patient. We conducted this study to compare the impact of different pressure rates on the hemolysis of packed red blood cells and on the outlet temperature when a blood warmer set at 41.5°C is used. Pressure rates tested were 150 and 300 mmHg. Ten packed red blood cells units were provided by Héma-Québec and each unit was sequentially tested. We found no increase in hemolysis either at 150 or 300 mmHg. By cons, we found that the blood warmer was not effective at warming the red blood cells at the specified temperature. At 150 mmHg, the outlet temperature reached 37.1°C and at 300 mmHg, the temperature was 33.7°C. To use a blood warmer set at 41.5°C in conjunction with a compression sleeve at 150 or 300 mmHg does not generate hemolysis. At 300 mmHg a blood warmer set at 41.5°C does not totally avoid a risk of hypothermia.
Yan, Lingling; Zhu, Zhanyong; Wu, Dan; Zhou, Qixing; Wu, Yiping
2011-12-01
This study examined the effects of a combined surgery of sleeve gastrectomy (SG) and modified jejunoileal bypass (JIB) on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 (GLP-1) and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol: SG-JIB (n=12), SG (n=12), JIB (n=12) and sham surgery groups (n=10). In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum (25 cm from the ligament of Treitz) to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.
Quilez, María Paz; Seral, Belen; Pérez, María Angeles
2017-01-01
The best methods to manage tibial bone defects following total knee arthroplasty remain under debate. Different fixation systems exist to help surgeons reconstruct knee osseous bone loss (such as tantalum cones, cement, modular metal augments, autografts, allografts and porous metaphyseal sleeves) However, the effects of the various solutions on the long-term outcome remain unknown. In the present work, a bone remodeling mathematical model was used to predict bone remodeling after total knee arthroplasty (TKA) revision. Five different types of prostheses were analyzed: one with a straight stem; two with offset stems, with and without supplements; and two with sleeves, with and without stems. Alterations in tibia bone density distribution and implant Von Mises stresses were quantified. In all cases, the bone density decreased in the proximal epiphysis and medullary channels, and an increase in bone density was predicted in the diaphysis and around stem tips. The highest bone resorption was predicted for the offset prosthesis without the supplement, and the highest bone formation was computed for the straight stem. The highest Von Mises stress was obtained for the straight tibial stem, and the lowest was observed for the stemless metaphyseal sleeves prosthesis. The computational model predicted different behaviors among the five systems. We were able to demonstrate the importance of choosing an adequate revision system and that in silico models may help surgeons choose patient-specific treatments. PMID:28886100
Current status of robotic bariatric surgery: a systematic review.
Cirocchi, Roberto; Boselli, Carlo; Santoro, Alberto; Guarino, Salvatore; Covarelli, Piero; Renzi, Claudio; Listorti, Chiara; Trastulli, Stefano; Desiderio, Jacopo; Coratti, Andrea; Noya, Giuseppe; Redler, Adriano; Parisi, Amilcare
2013-11-07
Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review. A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science. Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days). The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy).
Current status of robotic bariatric surgery: a systematic review
2013-01-01
Background Bariatric surgery is an effective treatment to obtain weight loss in severely obese patients. The feasibility and safety of bariatric robotic surgery is the topic of this review. Methods A search was performed on PubMed, Cochrane Central Register of Controlled Trials, BioMed Central, and Web of Science. Results Twenty-two studies were included. Anastomotic leak rate was 8.51% in biliopancreatic diversion. 30-day reoperation rate was 1.14% in Roux-en-Y gastric bypass and 1.16% in sleeve gastrectomy. Major complication rate in Roux-en-Y gastric bypass resulted higher than in sleeve gastrectomy ( 4,26% vs. 1,2%). The mean hospital stay was longer in Roux-en-Y gastric bypass (range 2.6-7.4 days). Conclusions The major limitation of our analysis is due to the small number and the low quality of the studies, the small sample size, heterogeneity of the enrolled patients and the lack of data from metabolic and bariatric outcomes. Despite the use of the robot, the majority of these cases are completed with stapled anastomosis. The assumption that robotic surgery is superior in complex cases is not supported by the available present evidence. The major strength of the robotic surgery is strongly facilitating some of the surgical steps (gastro-jejunostomy and jejunojejunostomy anastomosis in the robotic Roux-en-Y gastric bypass or the vertical gastric resection in the robotic sleeve gastrectomy). PMID:24199869
Vibration dampener for dampening vibration of a tubular member
Obermeyer, Franklin D.; Middlebrooks, Willis B.; DeMario, Edmund E.
1994-01-01
Vibration dampener for dampening vibration of a tubular member, such as an instrumentation tube of the type found in nuclear reactor pressure vessels. The instrumentation tube is received in an outer tubular member, such as a guide thimble tube. The vibration dampener comprises an annular sleeve which is attachable to the inside surface of the guide thimble tube and which is sized to surround the instrumentation tube. Dimples are attached to the interior wall of the sleeve for radially supporting the instrumentation tube. The wall of the sleeve has a flexible spring member, which is formed from the wall, disposed opposite the dimples for biasing the instrumentation tube into abutment with the dimples. Flow-induced vibration of the instrumentation tube will cause it to move out of contact with the dimples and further engage the spring member, which will flex a predetermined amount and exert a reactive force against the instrumentation tube to restrain its movement. The amount by which the spring member will flex is less than the unrestrained amplitude of vibration of the instrumentation tube. The reactive force exerted against the instrumentation tube will be sufficient to return it to its original axial position within the thimble tube. In this manner, vibration of the instrumentation tube is dampened so that in-core physics measurements are accurate and so that the instrumentation tube will not wear against the inside surface of the guide thimble tube.
Composite drill pipe and method for forming same
Leslie, James C; Leslie, II, James C; Heard, James; Truong, Liem V; Josephson, Marvin
2012-10-16
A lightweight and durable drill pipe string capable of short radius drilling formed using a composite pipe segment formed to include tapered wall thickness ends that are each defined by opposed frustoconical surfaces conformed for self-aligning receipt and intimate bonding contact within an annular space between corresponding surfaces of a coaxially nested set of metal end pieces and a set of nonconductive sleeves. The distal peripheries of the nested end pieces and sleeves are then welded to each other and the sandwiched and bonded portions are radially pinned. The composite segment may include imbedded conductive leads and the axial end portions of the end pieces are shaped to form a threaded joint with the next pipe assembly that includes contact rings in the opposed surfaces of the pipe joint for contact together.
A kind of fast shutter for Z pinch diagnosis device.
Wang, Liangping; Zhang, Xinjun; Sun, Tieping; Mao, Wentin
2016-09-01
A kind of fast shutter for protecting the diagnosis devices in Z pinch experiments is introduced in this paper. The shutter is composed of a pulling rod, a magnetic core, and a solenoid. Different from the traditional coils which were used at the voltage of 220 V, the solenoid we used must endure the high voltage of 5-10 kV and the deformation which maybe caused by the 5-10 T intense magnetic field. A creative configuration for the solenoid is developed including the winding guide, insulating sleeve, and stainless-steel sleeve. The experimental results show that the configuration of the solenoid is effective. The velocity of the valve is nearly 19 m/s and the time jitter of the shutdown is within 75 μs.
A kind of fast shutter for Z pinch diagnosis device
NASA Astrophysics Data System (ADS)
Wang, Liangping; Zhang, Xinjun; Sun, Tieping; Mao, Wentin
2016-09-01
A kind of fast shutter for protecting the diagnosis devices in Z pinch experiments is introduced in this paper. The shutter is composed of a pulling rod, a magnetic core, and a solenoid. Different from the traditional coils which were used at the voltage of 220 V, the solenoid we used must endure the high voltage of 5-10 kV and the deformation which maybe caused by the 5-10 T intense magnetic field. A creative configuration for the solenoid is developed including the winding guide, insulating sleeve, and stainless-steel sleeve. The experimental results show that the configuration of the solenoid is effective. The velocity of the valve is nearly 19 m/s and the time jitter of the shutdown is within 75 μs.
Electromagnetic valve for controlling the flow of molten, magnetic material
Richter, T.
1998-06-16
An electromagnetic valve for controlling the flow of molten, magnetic material is provided, which comprises an induction coil for generating a magnetic field in response to an applied alternating electrical current, a housing, and a refractory composite nozzle. The nozzle is comprised of an inner sleeve composed of an erosion resistant refractory material (e.g., a zirconia ceramic) through which molten, magnetic metal flows, a refractory outer shell, and an intermediate compressible refractory material, e.g., unset, high alumina, thermosetting mortar. The compressible refractory material is sandwiched between the inner sleeve and outer shell, and absorbs differential expansion stresses that develop within the nozzle due to extreme thermal gradients. The sandwiched layer of compressible refractory material prevents destructive cracks from developing in the refractory outer shell. 5 figs.
Electromagnetic valve for controlling the flow of molten, magnetic material
Richter, Tomas
1998-01-01
An electromagnetic valve for controlling the flow of molten, magnetic material is provided, which comprises an induction coil for generating a magnetic field in response to an applied alternating electrical current, a housing, and a refractory composite nozzle. The nozzle is comprised of an inner sleeve composed of an erosion resistant refractory material (e.g., a zirconia ceramic) through which molten, magnetic metal flows, a refractory outer shell, and an intermediate compressible refractory material, e.g., unset, high alumina, thermosetting mortar. The compressible refractory material is sandwiched between the inner sleeve and outer shell, and absorbs differential expansion stresses that develop within the nozzle due to extreme thermal gradients. The sandwiched layer of compressible refractory material prevents destructive cracks from developing in the refractory outer shell.
Holt, W.E.; Kuban, D.P.; Martin, H.L.
1988-10-25
An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.
Holt, William E.; Kuban, Daniel P.; Martin, H. Lee
1988-01-01
An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.
Leak or Fistula After Sleeve Gastrectomy: Treatment with Pigtail Drain by the Rendezvous Technique.
Soufron, Jacques
2015-10-01
After a sleeve gastrectomy, a leak or fistula is a serious complication. Laparoscopic drainage, drainage under US or CT scan control, or endoscopic insertion of a stent can be used, but a major re-operation is sometimes unavoidable. Endoscopic drainage with a pigtail catheter could give more success and fewer complications, but the insertion of the drain is not always possible nor does it always provide a perfect drainage. If a laparoscopic second look appears necessary, it is possible to insert a pigtail drain laparoscopically, but under endoscopic control, ensuring a correct positioning of the drain both in the peritoneal cavity and in the gastric tube. This simultaneous "rendezvous" technique could combine in this situation the advantages of purely surgical techniques and of purely endoscopic or image-guided techniques.
Study on Ferroelectric Thick Film Insulator Sleeve On Plasma Focus
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sylvester, Gustavo; Silva, Patricio; Moreno, Jose
The effect of ferroelectric lead germanate Pb5Ge3O11 (PGO) thick film in the alumina insulator sleeve of the 400 Joule Mather-type plasma focus device, PF-400J is studied. The breakdown phase along the insulator is fundamental for the formation of a homogeneous and symmetric current sheath, that is essential for a good plasma pinching, high neutron yield and X-ray emissions. For over several hundreds of electrical discharges, the films show good mechanical and electric performance. From the beginning the operating system is highly reproducible, shot to shot, with a clear definition of the plasma pinch on the axis of discharge. The grademore » of influence of the electron emission from the ferroelectric is experimentally studied.« less
NASA Astrophysics Data System (ADS)
Momenei, M.; Khodabakhshei, Z.; Panahi, N.; Mohammadi, M. A.
2017-03-01
The length of insulator sleeve is varied to investigate its effect on the pinch formation in the plasma focus facility. In this paper, the effect of insulator length on the time to pinch at various pressures and working voltages in the 1.15 kJ Mather type plasma focus is investigated. The results show that with 4.5 cm insulator length the time to pinch at all pressures is minimum. Other results also confirm that with increasing of pressure the time to pinch is increased. Moreover, with increasing working voltage the time to pinch is decreased. Pictures, captured using a digital single lens reflex (DSLR) Canon EOS 7D system, show that multipinch phenomenon is formed.
Temperature compensated sleeve type mirror mount
NASA Technical Reports Server (NTRS)
1973-01-01
The primary mirror of a large (26-inch diameter aperture) solar telescope was made of glass ceramic and designed with an integral hub on the back of the center of the mirror. This permits heat from the mirror to radiate off its back to a nearby cold plate. To permit mounting without high stresses, the hub was ground down to a smooth cylindrical surface 3.5 inch in diameter. The ground surface was then acid-etched to remove 0.007 inch (on the diameter) by immersion for five minutes in a mixture of four parts 92% sulfuric acid and three parts 50% hydrofluoric acid. The acid etching removes microcracks from the ground Cer-Vit surface. An Invar sleeve was fabricated to fit over the hub with about 0.010 inch radial (0.020 inch diametral) clearance.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-01
...; input/output assemblies; electromagnetic interference support walls; bumpers; adhesives; sleeves; rubber... shroud assemblies; mechanism bases; storage; busbars; button dim links; electromagnetic interference fans...
Wijnen, M; Olsson, D S; van den Heuvel-Eibrink, M M; Wallenius, V; Janssen, J A M J L; Delhanty, P J D; van der Lely, A J; Johannsson, G; Neggers, S J C M M
2017-02-01
Hypothalamic obesity is a devastating consequence of craniopharyngioma. Bariatric surgery could be a promising therapeutic option. However, its efficacy and safety in patients with craniopharyngioma-related hypothalamic obesity remain largely unknown. We investigated the efficacy of bariatric surgery for inducing weight loss in patients with craniopharyngioma-related hypothalamic obesity. In addition, we studied the safety of bariatric surgery regarding its effects on hormone replacement therapy for pituitary insufficiency. In this retrospective matched case-control study, we compared weight loss after bariatric surgery (that is, Roux-en-Y gastric bypass and sleeve gastrectomy) between eight patients with craniopharyngioma-related hypothalamic obesity and 75 controls with 'common' obesity during 2 years of follow-up. We validated our results at 1 year of follow-up in a meta-analysis. In addition, we studied alterations in hormone replacement therapy after bariatric surgery in patients with craniopharyngioma. Mean weight loss after bariatric surgery was 19% vs 25% (difference -6%, 95% confidence of interval (CI) -14.1 to 4.6; P=0.091) at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity compared with control subjects with 'common' obesity. Mean weight loss was 25% vs 29% (difference -4%, 95% CI -11.6 to 8.1; P=0.419) after Roux-en-Y gastric bypass and 10% vs 20% (difference -10%, 95% CI -14.1 to -6.2; P=0.003) after sleeve gastrectomy at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity vs control subjects with 'common' obesity. Our meta-analysis demonstrated significant weight loss 1 year after Roux-en-Y gastric bypass, but not after sleeve gastrectomy. Seven patients with craniopharyngioma suffered from pituitary insufficiency; three of them required minor adjustments in hormone replacement therapy after bariatric surgery. Weight loss after Roux-en-Y gastric bypass, but not sleeve gastrectomy, was comparable between patients with craniopharyngioma-related hypothalamic obesity and control subjects with 'common' obesity at 2 years of follow-up. Bariatric surgery seems safe regarding its effects on hormone replacement therapy.
Laparoscopic sleeve gastrectomy in patients over 59 years: early recovery and 12-month follow-up.
Leivonen, Marja Kaarina; Juuti, Anne; Jaser, Nabil; Mustonen, Harri
2011-08-01
Bariatric surgery has shown to be safe for patients over 60 years with good results especially considering resolving of comorbidities. Sleeve gastrectomy is considered to be safer than gastric bypass (GBP) and more effective than gastric banding with less adverse symptoms. Weight loss may be more modest than after GBP, but the effect on vitamins may also be milder. Since 2007, we collected prospectively 12-month follow-up data from 55 sleeve gastrectomy patients of whom 12 were over 59 years of age. Vitamin and calcium supplements were used postoperatively. The recovery from the operation was recorded during hospital stay, at 1- and 12-month follow-up visits using a standard protocol including laboratory tests. The results between patients over and under 59 years were compared. The preoperative weight and weight loss were comparable between the groups. Operation time was shorter and hospital stay was longer for older patients, p = ns. There was no operative mortality. Early major complications were seen more often in the older age group, 42% vs 9% (p = 0.02), but late complications were more common in younger patients, 17% vs 44%, p = ns. Early complications were mostly bleedings, which did not lengthen the hospital stay, neither were re-operations nor endoscopic procedures needed. Excess weight loss and resolving of comorbidities after 12 months was comparable between the groups. However, vitamin deficiencies and hypoalbuminemia were more common in the older age group, 42% and 23% for vitamins and 44% and 29% for proteins, p = ns. The older patients had more adverse effects related to surgery, 25% vs 9%, and younger had more adverse psychiatric effects, p = ns. Sleeve gastrectomy is effective and safe for older bariatric patients. Weight loss is comparable to younger patients and enough to resolve the comorbidities in most of the patients. With standardized nutritional supplementation, the older patients had more often vitamin deficiencies and hypoalbuminemia. Although operative treatment of older bariatric patients is safe, their postoperative care is demanding considering vitamins and protein.
Reliability and Failure Modes of a Hybrid Ceramic Abutment Prototype.
Silva, Nelson Rfa; Teixeira, Hellen S; Silveira, Lucas M; Bonfante, Estevam A; Coelho, Paulo G; Thompson, Van P
2018-01-01
A ceramic and metal abutment prototype was fatigue tested to determine the probability of survival at various loads. Lithium disilicate CAD-milled abutments (n = 24) were cemented to titanium sleeve inserts and then screw attached to titanium fixtures. The assembly was then embedded at a 30° angle in polymethylmethacrylate. Each (n = 24) was restored with a resin-cemented machined lithium disilicate all-ceramic central incisor crown. Single load (lingual-incisal contact) to failure was determined for three specimens. Fatigue testing (n = 21) was conducted employing the step-stress method with lingual mouth motion loading. Failures were recorded, and reliability calculations were performed using proprietary software. Probability Weibull curves were calculated with 90% confidence bounds. Fracture modes were classified with a stereomicroscope, and representative samples imaged with scanning electron microscopy. Fatigue results indicated that the limiting factor in the current design is the fatigue strength of the abutment screw, where screw fracture often leads to failure of the abutment metal sleeve and/or cracking in the implant fixture. Reliability for completion of a mission at 200 N load for 50K cycles was 0.38 (0.52% to 0.25 90% CI) and for 100K cycles was only 0.12 (0.26 to 0.05)-only 12% predicted to survive. These results are similar to those from previous studies on metal to metal abutment/fixture systems where screw failure is a limitation. No ceramic crown or ceramic abutment initiated fractures occurred, supporting the research hypothesis. The limiting factor in performance was the screw failure in the metal-to-metal connection between the prototyped abutment and the fixture, indicating that this configuration should function clinically with no abutment ceramic complications. The combined ceramic with titanium sleeve abutment prototype performance was limited by the fatigue degradation of the abutment screw. In fatigue, no ceramic crown or ceramic abutment components failed, supporting the research hypothesis with a reliability similar to that of all-metal abutment fixture systems. A lithium disilcate abutment with a Ti alloy sleeve in combination with an all-ceramic crown should be expected to function clinically in a satisfactory manner. © 2016 by the American College of Prosthodontists.
... doctors recommend weight loss surgery (also known as bariatric surgery ) for very overweight teens if they've tried ... it is at a children's hospital with a bariatric surgery program that involves a team of specialists. Members ...
... Vaginal bleeding (heavier than usual or after menopause) First Aid First aid is appropriate for external bleeding. If bleeding is ... pant leg or sleeve. If you have a first-aid kit that comes with a tourniquet, apply it ...
Evaluation of Safety and Efficacy of the EndoLift Liver Retractor
2015-08-03
Minimally Invasive Surgical Procedure; Laparoscopic Gastric Banding; Laparoscopic Roux-en-Y Gastric Bypass; Laparoscopic Sleeve Gastrectomy; Laparoscopic Fundoplication Procedure; Laparoscopic Heller Myotomy; Laparoscopic Paraesophageal Hernia Repair; Laparoscopic Gastric Resection
49 CFR 192.717 - Transmission lines: Permanent field repair of leaks.
Code of Federal Regulations, 2012 CFR
2012-10-01
... encirclement welded split sleeve of appropriate design, unless the transmission line is joined by mechanical... method that reliable engineering tests and analyses show can permanently restore the serviceability of...
49 CFR 192.717 - Transmission lines: Permanent field repair of leaks.
Code of Federal Regulations, 2014 CFR
2014-10-01
... encirclement welded split sleeve of appropriate design, unless the transmission line is joined by mechanical... method that reliable engineering tests and analyses show can permanently restore the serviceability of...
49 CFR 192.717 - Transmission lines: Permanent field repair of leaks.
Code of Federal Regulations, 2013 CFR
2013-10-01
... encirclement welded split sleeve of appropriate design, unless the transmission line is joined by mechanical... method that reliable engineering tests and analyses show can permanently restore the serviceability of...
49 CFR 192.717 - Transmission lines: Permanent field repair of leaks.
Code of Federal Regulations, 2011 CFR
2011-10-01
... encirclement welded split sleeve of appropriate design, unless the transmission line is joined by mechanical... method that reliable engineering tests and analyses show can permanently restore the serviceability of...
Steam generator feedwater nozzle transition piece replacement experience at Salem Unit 1
DOE Office of Scientific and Technical Information (OSTI.GOV)
Patten, D.B.; Perrin, J.S.; Roberts, A.T.
Cracking of steam generator feedwater piping adjacent to the feedwater nozzles has been a recurring problem since 1979 at Salem Unit 1 owned and operated by Public Service Electric and Gas Company. In addition to the cracking problem, erosion-corrosion at the leading edge of the feedwater nozzle thermal sleeve was also observed in 1992. To provide a long-term solution for the pipe cracking and thermal sleeve erosion-corrosion problems, a unique transition piece forging was specially designed, fabricated, and installed for each of the four steam generators during the 1995 outage. This paper discusses the design, fabrication, and installation of themore » transition piece forgings at Salem Unit 1, and the experiences gained from this project. It is believed that these experiences may help other utilities when planning similar replacements in the future.« less
A revolutionary design change to improve stapler safety.
Arteaga-González, Iván J
2013-01-01
Postoperative staple line leaks and bleeding are the most common reasons for complications in surgical procedures that involve organ resection, such as sleeve gastrectomy. Increasing the safety of these operations requires improving the instruments (endostaplers or endocutters) used for stapling and sectioning the tissues. We present a new prototype stapler for marketing in resection surgery, especially designed for the sleeve gastrectomy. We suggest that the medical instrument industry creates devices in which the channel along which the knife blade runs is located asymmetrically. This would allow more staples to be placed on the side of the gastric remnant, thus improving the sealing and hemostasis of the suture line and reducing the number of complications for patients as a result. The application of new concepts in medical surgical devices can improve the safety of the procedures in our patients.
Post STS-133 Evaluation of Main Flame Deflector Witness Materials
NASA Technical Reports Server (NTRS)
Long, Victoria
2011-01-01
NASA and USA Structures engineers submitted main flame deflector witness materials for evaluation after the launch of STS-133. The following items were submitted for analysis: HY-80 steel witness rods, 304 stainless steel caps, tungsten pistons, 17-4 precipitation hardened (PH) stainless steel and A-286 piston sleeves, Medtherm Corporation calorimeters, and Nanmac Corporation thermocouples. All of the items were photographed in order to document their condition after the launch of STS-133, and before they were reinstalled at the launch pad for future launches. The HY -80 witness rods, 304 stainless steel caps, and the piston sleeves were dimensionally measured in order to determine the amount of material lost during launch. Microstructural changes were observed in the HY-80 witness rod and 304 stainless steel cap metallographic samples due to the heat of the launch.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1997-04-01
When piping develops leaks, the natural instinct is to shut the process down, purge the lines and call in maintenance crews to make the repairs. There is, however, an alternative: on-the-fly repairs. Through the use of specialized tools, equipment and technicians, shut-off valves can be installed and leaks repaired without interrupting production. The split sleeve offers one of the simpler approaches to on-the-fly repairs. Two half cylinders with inside diameter slightly larger than the outside diameter slightly larger than the outside diameter of the pipe to be repaired are slipped over the latter some distance form the leak and looselymore » bolted together. The cylinder is then slid over the leaking area and the bolts tightened. Gaskets inside the half cylinders provide the needed seal between the pipe and the cylinder. Installing a shut-off valve in an operating pipeline requires much more specialized equipment and skills than does repairing a leak with a split sleeve. A device available from International Piping Services Co. allows a trained crew to isolate a section of pipe, drill out the isolated portion, install a blocking valve and then remove the isolation system--all while continuing to operate the pipeline at temperatures to 700 F and pressures to 700 psi. But Herb Porter, CEO of Ipsco, cautions that unlike the repairing leaks with a split sleeve, installing a blocking valve on-the-fly always demands the services of a highly trained crew.« less
NASA Astrophysics Data System (ADS)
Mazlan, MIS; Mohd, SA; Bahar, ND; Aziz, SAA
2018-03-01
This research work is focused on shrink disc operation at high temperature. Geometrical and material design selections have been done by taking into consideration the existing shrink disc operating at high temperature condition. The existing shrink disc confronted slip between shaft and shaft sleeve during thermal loading condition. The assessment has been obtained through virtual experiment by using Finite Element Analysis (FEA) -Thermal Transient Stress for 900 seconds with 300 °C of thermal loading. This investigation consists of the current and improved version of shrink disc, where identical geometries and material properties were utilized. High Thermal Expansion (HTE) material has been introduced to overcome the current design of the shrink disc. Brass (Cu3Zn2) has been selected as the HTE material in the improved shrink disc design due to its high thermal expansion properties. The HTE has shown a significant improvement on the total contact area and contact pressure on the shaft and the shaft sleeve. The improved shrink disc embedded with HTE during thermal loading exhibit a minimum of 1244.1 mm2 of the total area on shaft and shaft sleeve which uninfluenced the total contact area at normal condition which is 1254.3 mm2. Meanwhile, the total pressure of improved shrink disc had an increment of 108.1 MPa while existing shrink disc total pressure has lost 17.2 MPa during thermal loading.
Kaya, Seyda Ors; Sevinc, Serpil; Ceylan, Kenan Can; Usluer, Ozan; Unsal, Saban
2013-01-01
Tracheobronchial-angle tumors involve the right main bronchus, the right upper lobar bronchus, and the lateral wall of the lower trachea. Resecting these tumors is one of the most complex procedures in thoracic surgery. In cases of high-caliber mismatch, the selection of a suitable anastomotic technique can be challenging. We found that our use of a one-stoma carinoplasty technique overcame high-caliber mismatch after the resection of these tumors. From 2009 through 2012, 8 men (mean age, 59 ± 6.2 yr; range, 46-66 yr) underwent complete resection of non-small-cell right-tracheobronchial-angle tumors at our institution. In every case, right upper sleeve lobectomy, wedge carinal resection, and one-stoma carinoplasty were applied. After tumor resection, one patient with hemoptysis and bronchopleural fistula underwent a completion pneumonectomy and died 10 days postoperatively. Bronchoscopy was necessary in 2 patients who had atelectasis in the contralateral lung. At a mean follow-up duration of 19.43 ± 8.4 months (range, 0.2-27.1 mo), 6 patients were alive and free of disease. We conclude that our one-stoma carinoplasty technique enables the resection of tumors at the right tracheobronchial angle, with acceptable morbidity and mortality rates. This method saves the unaffected part of the ipsilateral lung and can overcome high-caliber mismatch. Because of these and other advantages, we suggest that using our method first might preclude having to perform a right carinal sleeve pneumonectomy or using Barclay's method.
Pylorus preserving loop duodeno-enterostomy with sleeve gastrectomy - preliminary results
2014-01-01
Background Bariatric operations mostly combine a restrictive gastric component with a rerouting of the intestinal passage. The pylorus can thereby be alternatively preserved or excluded. With the aim of performing a “pylorus-preserving gastric bypass”, we present early results of a proximal postpyloric loop duodeno-jejunostomy associated with a sleeve gastrectomy (LSG) compared to results of a parallel, but distal LSG with a loop duodeno-ileostomy as a two-step procedure. Methods 16 patients underwent either a two-step LSG with a distal loop duodeno-ileostomy (DIOS) as revisional bariatric surgery or a combined single step operation with a proximal duodeno-jejunostomy (DJOS). Total small intestinal length was determined to account for inter-individual differences. Results Mean operative time for the second-step of the DIOS operation was 121 min and 147 min for the combined DJOS operation. The overall intestinal length was 750.8 cm (range 600-900 cm) with a bypassed limb length of 235.7 cm in DJOS patients. The mean length of the common channel in DIOS patients measured 245.6 cm. Overall excess weight loss (%EWL) of the two-step DIOS procedure came to 38.31% and 49.60%, DJOS patients experienced an %EWL of 19.75% and 46.53% at 1 and 6 months, resp. No complication related to the duodeno-enterostomy occurred. Conclusions Loop duodeno-enterosomies with sleeve gastrectomy can be safely performed and may open new alternatives in bariatric surgery with the possibility for inter-individual adaptation. PMID:24725654
Vibration dampener for dampening vibration of a tubular member
Obermeyer, F.D.; Middlebrooks, W.B.; DeMario, E.E.
1994-10-18
Vibration dampener for dampening vibration of a tubular member, such as an instrumentation tube of the type found in nuclear reactor pressure vessels is disclosed. The instrumentation tube is received in an outer tubular member, such as a guide thimble tube. The vibration dampener comprises an annular sleeve which is attachable to the inside surface of the guide thimble tube and which is sized to surround the instrumentation tube. Dimples are attached to the interior wall of the sleeve for radially supporting the instrumentation tube. The wall of the sleeve has a flexible spring member, which is formed from the wall, disposed opposite the dimples for biasing the instrumentation tube into abutment with the dimples. Flow-induced vibration of the instrumentation tube will cause it to move out of contact with the dimples and further engage the spring member, which will flex a predetermined amount and exert a reactive force against the instrumentation tube to restrain its movement. The amount by which the spring member will flex is less than the unrestrained amplitude of vibration of the instrumentation tube. The reactive force exerted against the instrumentation tube will be sufficient to return it to its original axial position within the thimble tube. In this manner, vibration of the instrumentation tube is dampened so that in-core physics measurements are accurate and so that the instrumentation tube will not wear against the inside surface of the guide thimble tube. 14 figs.
Wahby, M; Salama, A F; Elezaby, A F; Belgrami, F; Abd Ellatif, M E; El-Kaffas, H F; Al-Katary, M
2013-11-01
The current standard of care is to perform a postoperative gastrografin study following laparoscopic sleeve gastrectomy (LSG) to detect leakage or obstruction. This study evaluated the usefulness of this routine procedure. A retrospective chart review was performed in December 2012. All patients had routine intraoperative methylene blue testing to check for possible leakage from the staple line, and any leaking points were oversewn. We also performed postoperative contrast study (gastrografin) routinely in the first 24-48 h for all patients. From June 2007 to December 2012, 712 cases underwent LSG during the study period. Patients included in this study were 556 women (78.1%) and 156 men (21.9%). The mean age was 35 years. The mean BMI was 48 kg/m2. The operative time was 107 ± 29 min, and there were no conversions to open surgery. Intraoperative methylene blue test detected leakage in 28 cases (3.93%). Postoperative contrast study (gastrografin) was negative for leakage in all cases. Computed tomography (CT) scan with oral contrast study detected leakage in 1.4% (ten cases); none of these cases were detected by regular contrast study. Our study showed that intraoperative methylene blue test for leakage is a very sensitive and effective method for detecting leakage during sleeve gastrectomy and should be done routinely in all cases. Routine postoperative contrast study is not needed to detect leakage unless clinically indicated in selected cases, and in such cases contrast-enhanced CT scans are the modality of choice.
Analysis of particle size to erosion wear of sliding sleeve ball seat based on fluent software
NASA Astrophysics Data System (ADS)
Ding, Kun; Yin, Hongcheng; Wan, Bingqian; Cheng, Hao; Xiang, Lu; Li, Jianmin
2017-04-01
The fracturing has become the most offensive stimulation treatment in the low permeability reservoir. But, as the construction displacement and sand dosage of overlong horizontal well were increased continuously, the erosion wear of ball seat of pitching sliding sleeve was increasingly serious, which might lead to the failure of opening the sliding sleeve. In the existing literature, there were many researches on the erosion wear of liquid-solid two-phase flow in the diameter of sudden expansion pipe, but the influence of solid particle with mixed particle size to the erosion wear was not considered. This paper studied the erosion wear of ball seat according to the mixed proppant with different particle sizes, and carried out the numerical simulation with Fluent software with the Euler two-fluid theory. The results showed that: the erosion wear rate of ball seat is in inversely proportional to the particle size of proppant; the erosion wear rate of ball seat is different when the volume fraction of proppant with different particle sizes is changed; and for the mixed proppant of which the particle size is 0.3mm and 0.8mm, the erosion wear rate of ball seat is minimum when the volume fraction of proppant, of which the particle size is 0.3mm, is about 20%. The simulated result contributed to the deep study on erosion wear law of solid particle, and meanwhile, provided a certain reference basis for the selection of staged fracturing material of horizontal well.
Pruneau, Denise; Dorval, Josée; Thibault, Louis; Fisette, Jean-François; Bédard, Suzanne K.; Jacques, Annie; Beauregard, Patrice
2016-01-01
Background Blood warmers were developed to reduce the risk of hypothermia associated with the infusion of cold blood products. During massive transfusion, these devices are used with compression sleeve, which induce a major stress to red blood cells. In this setting, the combination of blood warmer and compression sleeve could generate hemolysis and harm the patient. We conducted this study to compare the impact of different pressure rates on the hemolysis of packed red blood cells and on the outlet temperature when a blood warmer set at 41.5°C is used. Methods Pressure rates tested were 150 and 300 mmHg. Ten packed red blood cells units were provided by Héma-Québec and each unit was sequentially tested. Results We found no increase in hemolysis either at 150 or 300 mmHg. By cons, we found that the blood warmer was not effective at warming the red blood cells at the specified temperature. At 150 mmHg, the outlet temperature reached 37.1°C and at 300 mmHg, the temperature was 33.7°C. Conclusion To use a blood warmer set at 41.5°C in conjunction with a compression sleeve at 150 or 300 mmHg does not generate hemolysis. At 300 mmHg a blood warmer set at 41.5°C does not totally avoid a risk of hypothermia. PMID:27711116
DOE Office of Scientific and Technical Information (OSTI.GOV)
Seol, Yongkoo, E-mail: Yongkoo.Seol@netl.doe.gov; Choi, Jeong-Hoon; Dai, Sheng
With the increase in the interest of producing natural gas from methane hydrates as well as potential risks of massive hydrate dissociation in the context of global warming, studies have recently shifted from pure hydrate crystals to hydrates in sediments. Such a research focus shift requires a series of innovative laboratory devices that are capable of investigating various properties of hydrate-bearing sediments (HBS). This study introduces a newly developed high pressure testing chamber, i.e., multi-property characterization chamber (MPCC), that allows simultaneous investigation of a series of fundamental properties of HBS, including small-strain stiffness (i.e., P- and S-waves), shear strength, large-strainmore » deformation, stress-volume responses, and permeability. The peripheral coolant circulation system of the MPCC permits stable and accurate temperature control, while the core holder body, made of aluminum, enables X-ray computer tomography scanning to be easily employed for structural and morphological characterization of specimens. Samples of hydrate-bearing sediments are held within a rubber sleeve inside the chamber. The thick sleeve is more durable and versatile than thin membranes while also being much softer than oedometer-type chambers that are incapable of enabling flow tests. Bias introduced by the rubber sleeve during large deformation tests are also calibrated both theoretically and experimentally. This system provides insight into full characterization of hydrate-bearing sediments in the laboratory, as well as pressure core technology in the field.« less
Adjustable hinge permits movement of knee in plaster cast
NASA Technical Reports Server (NTRS)
Maley, W. E.
1967-01-01
Metal knee hinge with an adjustable sleeve worn on the outside of a leg cast facilitates movement of the knee joint. This helps eliminate stiffness of the knee and eliminates bulkiness and adjustment difficulty.
Tube swaging device uses explosive force
NASA Technical Reports Server (NTRS)
Mc Smith, D. G.
1968-01-01
Tool joins a sleeve to a tube by explosive swaging, thus providing a leakproof, lightweight, and strong assembly. No new or different material is used in this method and therefore the thermal and galvanic properties are maintained.
Modified RF coaxial connector ends vacuum chamber wiring problem
NASA Technical Reports Server (NTRS)
Weiner, D.
1964-01-01
A standard radio frequency coaxial connector is modified so that a plastic insulating sleeve can be mounted in the wall of a vacuum chamber. This eliminates ground loops and interference from cable connections.
19 CFR 10.223 - Articles eligible for preferential treatment.
Code of Federal Regulations, 2010 CFR
2010-04-01
... “sleeve header,” of woven or weft-inserted warp knit construction and of coarse animal hair or man-made... expenses incurred in the growth, production, manufacture, or other processing of the components, findings...
19 CFR 10.223 - Articles eligible for preferential treatment.
Code of Federal Regulations, 2014 CFR
2014-04-01
... “sleeve header,” of woven or weft-inserted warp knit construction and of coarse animal hair or man-made... expenses incurred in the growth, production, manufacture, or other processing of the components, findings...
19 CFR 10.223 - Articles eligible for preferential treatment.
Code of Federal Regulations, 2011 CFR
2011-04-01
... “sleeve header,” of woven or weft-inserted warp knit construction and of coarse animal hair or man-made... expenses incurred in the growth, production, manufacture, or other processing of the components, findings...
19 CFR 10.223 - Articles eligible for preferential treatment.
Code of Federal Regulations, 2012 CFR
2012-04-01
... “sleeve header,” of woven or weft-inserted warp knit construction and of coarse animal hair or man-made... expenses incurred in the growth, production, manufacture, or other processing of the components, findings...
19 CFR 10.223 - Articles eligible for preferential treatment.
Code of Federal Regulations, 2013 CFR
2013-04-01
... “sleeve header,” of woven or weft-inserted warp knit construction and of coarse animal hair or man-made... expenses incurred in the growth, production, manufacture, or other processing of the components, findings...
Foolproof quick-release locking pin
NASA Technical Reports Server (NTRS)
Nelson, E. P.; Othman, T. E.; Zmuda, L. J.
1970-01-01
Locking pin can be withdrawn only when stress on the joint is negligible. Pin consists of a forward-pointing sleeve, a spring-loaded sliding handle, and a sliding plunger. Plunger movement controls installation and withdrawal of pin.
... recommended if you have: A body mass index (BMI) of 40 or more. Someone with a BMI of 40 or more is at least 100 ... 45 kilograms) over their recommended weight. A normal BMI is between 18.5 and 25. A BMI ...
19 CFR 10.35 - Models of women's wearing apparel.
Code of Federal Regulations, 2011 CFR
2011-04-01
... which the apparel is made, and shall contain a description of the lining and the trimming, stating... to how the trimming is applied, that is, whether on the cuffs, collar, sleeves, or elsewhere, and the...
Masia, D-R; Castus, P; Delia, G; Casoli, V; Martine, D
2008-02-01
Scrotal elephantiasis is a pathology of often unknown etiology. Symptomatology is characterized by an oedematius infiltration of skin and subcutaneous tissue, hard-bound aspect and purplished color. The scrotum, the penis and the perineal area are gradually affected. This pathology is very invalidating for the patient, on functional, sexual and aesthetic aspects. The authors present the case of a 58-year-old man with an enormous scrotal mass invading the penis and drowning the testicular elements, which were impossible to palpate. The aetiology was determined by exclusion and an iatrogenic origin following the cure of bilateral inguinal hernia was retained. Resection of the scrotal mass was performed. The reconstruction of the scrotal purse and the cutaneous sleeve of the penis were carried out using local flaps of the remaining healthy skin.
Laparoscopic sleeve gastrectomy and gastroesophageal reflux
Stenard, Fabien; Iannelli, Antonio
2015-01-01
Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. Sleeve gastrectomy (SG) has emerged over the last few years to be an ideal bariatric procedure because it has several advantages compared to more complex bariatric procedures, including avoiding an intestinal bypass. However, several published follow-up studies report an increased rate of gastroesophageal reflux (GERD) after a SG. GERD is described as either de novo or as being caused by aggravation of preexisting symptoms. However, the literature on this topic is ambivalent despite the potentially increased rate of GERDs that may occur after this common bariatric procedure. This article reviews the mechanisms responsible for GERD in obese subjects as well as the results after a SG with respect to GERD. Future directions for clinical research are discussed along with the current surgical options for morbidly obese patients with GERD and undergoing bariatric surgery. PMID:26420961
Perioperative complications of sleeve gastrectomy: Review of the literature.
Iannelli, Antonio; Treacy, Patrick; Sebastianelli, Lionel; Schiavo, Luigi; Martini, Francesco
2018-05-04
Sleeve gastrectomy (SG) has known a spectacular rise worldwide during the last decade. The absence of digestive anastomosis simplifies the surgical technique, reducing anastomosis-related complications such as fistula, stricture and marginal ulcer. Furthermore, the respect for digestive continuity preserves the functions of pylorus, that regulates gastric emptying, and duodenum, where calcium, B vitamins and iron are absorbed. Despite the multiple advantages, SG also has specific complications such as bleeding, stenosis, portal thrombosis and leak. The staple line leak at the oesophagogastric junction is the most feared complication and its prevention remains difficult, as the involved mechanisms have been only partially elucidated. Its management is long and requires a multidisciplinary technical platform including Intensive Care Unit, digestive endoscopy and interventional radiology as well as a specialised surgeon. The aim of this review is to explain in detail the perioperative complications of SG, their prevention and treatment, referring to the most recent available literature.
Elastomeric member for energy storage device
Hoppie, Lyle O.; Chute, Richard
1985-01-01
An energy storage device (10) is disclosed consisting of a stretched elongated elastomeric member (16), disposed within a tubular housing (14), which elastomeric member (16) is adapted to be torsionally stressed to store energy. The elastomeric member (16) is configured in the relaxed state with a uniform diameter body section, transition end sections, and is attached to rigid end piece assemblies (22, 24) of a lesser diameter. The profile and deflection characteristic of the transition sections (76, 78) are such that upon stretching of the member, a substantially uniform diameter assembly results to minimize the required volume of the surrounding housing (14). During manufacture, woven wire mesh sleeves (26, 28) are forced against a forming surface and bonded to the associated transition section (76, 78) to provide the correct profile and helix angle. Each sleeve (26, 28) contracts with the contraction of the associated transition section to maintain the bond therebetween.
Prather, W.S.; O'Rourke, P.E.
1994-08-02
A support structure is described bearing at least one probe for making spectrophotometric measurements of a fluid using a source of light and a spectrophotometer. The probe includes a housing with two optical fibers and a planoconvex lens. A sleeve bearing a mirror surrounds the housing. The lens is separated from the mirror by a fixed distance, defining an interior space for receiving a volume of the fluid sample. A plurality of throughholes extending through the sleeve communicate between the sample volume and the exterior of the probe, all but one hole bearing a screen. A protective jacket surrounds the probe. A hollow conduit bearing a tube is formed in the wall of the probe for venting any air in the interior space when fluid enters. The probe is held at an acute angle so the optic fibers carrying the light to and from the probe are not bent severely on emergence from the probe. 3 figs.
Prather, William S.; O'Rourke, Patrick E.
1994-01-01
A support structure bearing at least one probe for making spectrophotometric measurements of a fluid using a source of light and a spectrophotometer. The probe includes a housing with two optical fibers and a planoconvex lens. A sleeve bearing a mirror surrounds the housing. The lens is separated from the mirror by a fixed distance, defining an interior space for receiving a volume of the fluid sample. A plurality of throughholes extending through the sleeve communicate between the sample volume and the exterior of the probe, all but one hole bearing a screen. A protective jacket surrounds the probe. A hollow conduit bearing a tube is formed in the wall of the probe for venting any air in the interior space when fluid enters. The probe is held at an acute angle so the optic fibers carrying the light to and from the probe are not bent severely on emergence from the probe.
Feedthrough terminal for high-power cell
Kaun, T.D.
1982-05-28
A feedthrough terminal for a high power electrochemical storage cell providing low resistance coupling to the conductive elements therein while isolating the terminal electrode from the highly corrosive environment within the cell is disclosed. A large diameter, cylindrical copper electrode is enclosed in a stainless steel tube with a BN powder feedthrough seal maintained around the stainless steel tube by means of facing insulative bushings and an outer sleeve. One end of the copper conductor is silver-brazed directly to a flat, butterfly bus bar within the cell, with the adjacent end of the surrounding outer feedthrough sleeve welded to the bus bar. A threaded seal is fixedly positioned on a distal portion of the stainless steel tube immediately adjacent the distal insulative bushing so as to compress the feedthrough seal in tight fitting relation around the stainless steel tube in providing a rugged, leak-proof electrical feedthrough terminal for the power cell.
Simulation and Experiment Research on Fatigue Life of High Pressure Air Pipeline Joint
NASA Astrophysics Data System (ADS)
Shang, Jin; Xie, Jianghui; Yu, Jian; Zhang, Deman
2017-12-01
High pressure air pipeline joint is important part of high pressure air system, whose reliability is related to the safety and stability of the system. This thesis developed a new type-high pressure air pipeline joint, carried out dynamics research on CB316-1995 and new type-high pressure air pipeline joint with finite element method, deeply analysed the join forms of different design schemes and effect of materials on stress, tightening torque and fatigue life of joint. Research team set up vibration/pulse test bench, carried out joint fatigue life contrast test. The result shows: the maximum stress of the joint is inverted in the inner side of the outer sleeve nut, which is consistent with the failure mode of the crack on the outer sleeve nut in practice. Simulation and experiment of fatigue life and tightening torque of new type-high pressure air pipeline joint are better than CB316-1995 joint.
Novel technique for airless connection of artificial heart to vascular conduits.
Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka
2017-12-01
Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.
Combustor assembly in a gas turbine engine
Wiebe, David J; Fox, Timothy A
2013-02-19
A combustor assembly in a gas turbine engine. The combustor assembly includes a combustor device coupled to a main engine casing, a first fuel injection system, a transition duct, and an intermediate duct. The combustor device includes a flow sleeve for receiving pressurized air and a liner disposed radially inwardly from the flow sleeve. The first fuel injection system provides fuel that is ignited with the pressurized air creating first working gases. The intermediate duct is disposed between the liner and the transition duct and defines a path for the first working gases to flow from the liner to the transition duct. An intermediate duct inlet portion is associated with a liner outlet and allows movement between the intermediate duct and the liner. An intermediate duct outlet portion is associated with a transition duct inlet section and allows movement between the intermediate duct and the transition duct.
Barrak, Ibrahim; Joób-Fancsaly, Árpád; Braunitzer, Gábor; Varga, Endre; Boa, Kristóf; Piffkó, József
2018-06-01
To investigate drill wear and consequent intraosseous temperature elevation during freehand and guided bone drilling, with attention to the effect of metal-on-metal contact during guided drilling. Osteotomies were performed on bovine ribs, with 2.0 mm diameter stainless steel drill bits of the SMART Guide System, under 3 sterilization protocols, at 800, 1200, 1500, and 2000 rpm. Sterilization was performed after every 3 drilling. Temperature was measured after every 30 drilling. The studied contributing factors had a cumulative effect, and each contributed significantly to temperature elevation. Whether guide use led to a near-necrotic (47°C) temperature increment depended largely on the applied sterilization protocol. The metal sleeve is a significant contributing factor to heat generation during guided osteotomy, but its effect can be offset by keeping the other studied factors under control.
Human Grasp Assist Device Soft Goods
NASA Technical Reports Server (NTRS)
Ihrke, Chris A. (Inventor); Davis, Donald R. (Inventor); Bergelin, Bryan (Inventor); Bridgwater, Lyndon B. J. (Inventor); Bibby, Heather (Inventor); Schroeder, Judy (Inventor); Linn, Douglas Martin (Inventor); Erkkila, Craig (Inventor)
2015-01-01
A grasp assist system includes a glove and a flexible sleeve. The glove includes a digit such as a finger or thumb, a force sensor configured to measure a grasping force applied to an object by an operator wearing the glove, and adjustable phalange rings positioned with respect to the digit. A saddle is positioned with respect to the finger. A flexible tendon is looped at one end around the saddle. A conduit contains the tendon. A conduit anchor secured within a palm of the glove receives the conduit. The sleeve has pockets containing an actuator assembly connected to another end of the tendon and a controller. The controller is in communication with the force sensor, and calculates a tensile force in response to the measured grasping force. The controller commands the tensile force from the actuator assembly to tension the tendon and thereby move the finger.
Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure?
Benaiges, David; Más-Lorenzo, Antonio; Goday, Albert; Ramon, José M; Chillarón, Juan J; Pedro-Botet, Juan; Roux, Juana A Flores-Le
2015-01-01
Sleeve gastrectomy (SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications. PMID:26557004
2003-09-24
KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (left) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.
2003-09-24
KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Japanese astronaut Koichi Wakata looks over the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.
2003-09-24
KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, technicians on the floor watch as a tray is extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.
2003-09-24
KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (right) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.
Control of a Glove-Based Grasp Assist Device
NASA Technical Reports Server (NTRS)
Bergelin, Bryan J (Inventor); Ihrke, Chris A. (Inventor); Davis, Donald R. (Inventor); Linn, Douglas Martin (Inventor); Sanders, Adam M (Inventor); Askew, R. Scott (Inventor); Laske, Evan (Inventor); Ensley, Kody (Inventor)
2015-01-01
A grasp assist system includes a glove and sleeve. The glove includes a digit, i.e., a finger or thumb, and a force sensor. The sensor measures a grasping force applied to an object by an operator wearing the glove. The glove contains a tendon connected at a first end to the digit. The sleeve has an actuator assembly connected to a second end of the tendon and a controller in communication with the sensor. The controller includes a configuration module having selectable operating modes and a processor that calculates a tensile force to apply to the tendon for each of the selectable operating modes to assist the grasping force in a manner that differs for each of the operating modes. A method includes measuring the grasping force, selecting the mode, calculating the tensile force, and applying the tensile force to the tendon using the actuator assembly.
Ruiz-Tovar, Jaime; Muñoz, Jose Luis; Gonzalez, Juan; Garcia, Alejandro; Ferrigni, Carlos; Jimenez, Montiel; Duran, Manuel
2017-12-01
The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course. A prospective study of 208 morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between 2012 and 2015 was performed. Blood analysis was performed 24 h after surgery. Acute-phase parameters (C-reactive protein, procalcitonin, fibrinogen, and White Blood Cell count) were investigated. Staple line leak appeared in eight patients (3.8%). Using receiver operating characteristic analysis at 24 h postoperatively, a cutoff level of CRP at 9 mg/dL achieved 85% sensitivity and 90% specificity for predicting staple line leak, a cutoff level of procalcitonin at 0.85 ng/mL achieved 70% sensitivity and 90% specificity, and a cutoff level of fibrinogen at 600 mg/dL achieved 80% sensitivity and 87.5% specificity. An elevation of CRP > 9 mg/dL, procalcitonin > 0.85 ng/mL and fibrinogen > 600 mg/dL should alert the surgeon the possibility of occurrence of postoperative staple line leak.
A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy.
Bingham, Jason; Kaufman, Jedediah; Hata, Kai; Dickerson, James; Beekley, Alec; Wisbach, Gordon; Swann, Jacob; Ahnfeldt, Eric; Hawkins, Devon; Choi, Yong; Lim, Robert; Martin, Matthew
2017-09-01
Staple line leaks after sleeve gastrectomy are dreaded complications. Many surgeons routinely perform an intraoperative leak test (IOLT) despite little evidence to validate the reliability, clinical benefit, and safety of this procedure. To determine the efficacy of IOLT and if routine use has any benefit over selective use. Eight teaching hospitals, including private, university, and military facilities. A multicenter, retrospective analysis over a 5-year period. The efficacy of the IOLT for identifying unsuspected staple line defects and for predicting postoperative leaks was evaluated. An anonymous survey was also collected reflecting surgeons' practices and beliefs regarding IOLT. From January 2010 through December 2014, 4284 patients underwent sleeve gastrectomy. Of these, 37 patients (.9%) developed a postoperative leak, and 2376 patients (55%) received an IOLT. Only 2 patients (0.08%) had a positive finding. Subsequently, 21 patients with a negative IOLT developed a leak. IOLT demonstrated a sensitivity of only 8.7%. There was a nonsignificant trend toward increased leak rates when an IOLT was performed versus when IOLT was not performed. Leak rates were not statistically different between centers that routinely perform IOLT versus those that selectively perform IOLT. Routine IOLT had very poor sensitivity and was negative in 91% of patients who later developed postoperative leaks. The use of IOLT was not associated with a decrease in the incidence of postoperative leaks, and routine IOLT had no benefit over selective leak testing. IOLT should not be used as a quality indicator or "best practice" for bariatric surgery. Published by Elsevier Inc.
Gálvez-Valdovinos, Ramiro; Marín-Santillán, Ernesto; Funes-Rodríguez, Juan Francisco; López-Ambriz, Gustavo
2016-01-01
Acute gastric volvulus is a rare, but potentially life-threatening, cause of upper gastrointestinal obstruction. Male of 60 years old with severe epigastric pain and abdominal distension with haematemesis on two occasions. The patient was haemodynamically stable, with abdominal distension and palpable epigastric fullness. Hematic cytology showed: haemoglobin 8.2g/dl and haematocrit 27%. Abdominal X-ray showed an elevation of left diaphragm with a hugely dilated stomach. A nasogastric tube was inserted. Endoscopy was performed. There was no active bleeding, but it was impossible to reach the duodenum due to the stomach distortion. The upper gastrointestinal X-ray study showed the appearance of an inverted stomach in the chest and an organoaxial gastric torsion. The CT scans of thorax and abdomen showed a gastric ascent into the thoracic cavity. Laparoscopic surgery was performed, finding the left hemi-diaphragm elevated, and the stomach, splenic angle of the colon, the spleen and tail of the pancreas were also raised. A linear gastrectomy (gastric sleeve) was performed. The postoperative progress was satisfactory. Oral feeding was started 72 hours after surgery, and the patient was discharged, and has remained asymptomatic during the following by 8 years. Emergency physicians must maintain a high level of suspicion in patients that present with signs and symptoms suggesting upper digestive tract occlusion. The gastric sleeve is an excellent alternative to avoid recurrence of gastric volvulus. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
Rath-Wolfson, Lea; Varona, Roy; Bubis, Golan; Tatarov, Alexander; Koren, Rumelia; Ram, Edward
2017-04-01
Laparoscopic sleeve gastrectomy (LSG) is a therapeutic option in severely obese patients. The aim of this study was to evaluate the presence of Helicobacter pylori (HP) gastritis and non-Helicobacter gastritis in the gastrectomy specimens, and its association to other variables.One hundred six sleeve gastrectomy specimens were examined histopathologically for the presence of gastritis and its relation to other factors like ethnicity, glycemic control, and postoperative complications.Twelve patients had HP gastritis, 39 had non-HP gastritis, and 55 had normal mucosa. There was a statistical difference between the Arab and Jewish Israeli patients in our study. Twenty-eight of the Arab patients had HP gastritis and 48% had non-HP gastritis. In the Jewish population 6% had HP gastritis and 34% had non-HP gastritis. The preoperative glycemic control was worse in the gastritis group with a mean HbA1c of 8.344% while in the normal mucosa group the mean HbA1c was 6.55. After operation the glycemic control reverted to normal in most the diabetic patients. There were few postoperative complications however, they were not related to HP.There is a high incidence of gastritis in obese patients. The incidence of gastritis in the Arab population in our study was higher than that in the Jewish population. The glycemic control before surgery was worse in patients with gastritis than in the normal mucosa group. HP bares no risk for postoperative complications after LSG and does not affect weight loss. However a larger cohort of patients must be studied to arrive at conclusive results.
Gastritis in patients undergoing sleeve gastrectomy
Rath-Wolfson, Lea; Varona, Roy; Bubis, Golan; Tatarov, Alexander; Koren, Rumelia; Ram, Edward
2017-01-01
Abstract Laparoscopic sleeve gastrectomy (LSG) is a therapeutic option in severely obese patients. The aim of this study was to evaluate the presence of Helicobacter pylori (HP) gastritis and non-Helicobacter gastritis in the gastrectomy specimens, and its association to other variables. One hundred six sleeve gastrectomy specimens were examined histopathologically for the presence of gastritis and its relation to other factors like ethnicity, glycemic control, and postoperative complications. Twelve patients had HP gastritis, 39 had non-HP gastritis, and 55 had normal mucosa. There was a statistical difference between the Arab and Jewish Israeli patients in our study. Twenty-eight of the Arab patients had HP gastritis and 48% had non-HP gastritis. In the Jewish population 6% had HP gastritis and 34% had non-HP gastritis. The preoperative glycemic control was worse in the gastritis group with a mean HbA1c of 8.344% while in the normal mucosa group the mean HbA1c was 6.55. After operation the glycemic control reverted to normal in most the diabetic patients. There were few postoperative complications however, they were not related to HP. There is a high incidence of gastritis in obese patients. The incidence of gastritis in the Arab population in our study was higher than that in the Jewish population. The glycemic control before surgery was worse in patients with gastritis than in the normal mucosa group. HP bares no risk for postoperative complications after LSG and does not affect weight loss. However a larger cohort of patients must be studied to arrive at conclusive results. PMID:28422853
Aggarwal, Sandeep; Modi, Shrey; Jose, Toney
2014-10-01
The impact of laparoscopic sleeve gastrectomy (LSG) on various co-morbidities including type II diabetes mellitus, hypertension, and sleep apnea is well established. However, its effect on hypothyroidism has not been given due attention evidenced by the scant literature on the subject. The purpose of this report is to assess the change in thyroxine (T4) requirement in morbidly obese patients with clinical hypothyroidism after LSG. We conducted a retrospective review of morbidly obese patients on T4 replacement therapy for clinical hypothyroidism who underwent LSG from August 2009 to July 2012 at our institution. Of the 200 patients who underwent LSG during this period, 21 (10.5 %) were on T4 replacement therapy preoperatively for clinical hypothyroidism. Two patients were lost to follow-up. The remaining 19 patients were categorized into two groups. Group 1 comprised 13 patients with decreased T4 requirements after LSG. Group 2 comprised six patients in whom the T4 dose remained unaltered. The mean change in T4 requirement in group 1 was 42.07 % (12-100 %). Group 1 patients had a significantly higher mean preoperative body mass index (48.7 vs. 43.0 kg/m(2); p = 0.03) than the group 2 patients. There was a significant correlation between the percentage excess weight loss and the percentage change in T4 requirement in group 1 (r = 0.607, p = 0.028). Sleeve gastrectomy has a favorable impact on hypothyroid status as seen by a reduction in T4 requirement in the majority of morbidly obese patients with overt hypothyroidism.
Aldaqal, Saleh M; Sehlo, Mohammad G
2013-01-01
To evaluate the self-esteem and quality of life in adolescents with extreme obesity before and one year after laparoscopic sleeve gastrectomy as obesity is a major challenging medical problem, not only in adults but also in children and adolescents in Saudi Arabia. In a prospective cohort study, 32 adolescents (aged 13-17 years) with extreme obesity (Group 1) presenting for laparoscopic sleeve gastrectomy (LSG) were compared with 32 matched, healthy, nonobese adolescents (aged 14-17 years) (Group 2) with regards to self-esteem and quality of life. Assessment was done using the Rosenberg Self-Esteem Scale and Pediatric Quality of Life Inventory version 4.0 (self- and parent report), respectively. Body mass index (BMI) Z scores were calculated for both groups. We found significantly poor self-esteem and impairment in all domains of quality of life (self- and parent report) in Group 1 compared with Group 2 (P<.001). Self esteem and quality of life (self- and parent reports) significantly improved 1 year after LSG (P<.001), and the weight loss induced by LSG, reflected by a decrease in BMI Z scores, was a significant predictor for the improvement in self-esteem (R2=0.28 and P=.003) and quality of life (R(2)=0.67 and P<.001). LSG was found to be a safe and effective operation in adolescents with extreme obesity: LSG leads to weight loss, with subsequent improvement in self-esteem and quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.
Benedix, Frank; Benedix, Diana D; Knoll, Christian; Weiner, Rudolf; Bruns, Christiane; Manger, Thomas; Stroh, Christine
2014-10-01
Laparoscopic sleeve gastrectomy (LSG) is currently being performed with increasing frequency worldwide. It offers an excellent weight loss and resolution of comorbidities in the short term with a very low incidence of complications. However, the ever present risk of a staple line leak is still a major concern. Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered in an online database and analyzed at the Institute of Quality Assurance in Surgical Medicine. For the current analysis, all patients that had undergone primary sleeve gastrectomy for morbid obesity within a 7-year period were considered. Using the GBSR, data from 5.400 LSGs were considered for analysis. Staple line leak rate decreased during the study period from 6.5 to 1.4 %. Male gender, higher BMI, concomitant sleep apnea, conversion to laparotomy, longer operation time, use of both buttresses and oversewing, and the occurrence of intraoperative complications were associated with a significantly higher leakage rate. On multivariate analysis, operation time and year of procedure only had a significant impact on staple line leak rate. The results of the current study demonstrated that there are factors that increase the risk of a leakage which would enable surgeons to define risk groups, to more carefully select patients, and to offer a closer follow-up during the postoperative course with early recognition and adequate treatment. All future efforts should be focused on a further reduction of serious complications to make the LSG a widely accepted and safer procedure.
Aburajab, Murad A; Max, Joshua B; Ona, Mel A; Gupta, Kapil; Burch, Miguel; Michael Feiz, F; Lo, Simon K; Jamil, Laith H
2017-11-01
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity in treating morbid obesity. Prior studies showed a 3.5% risk of gastric sleeve stenosis (GSS). There is no consensus on how to treat these patients, and the role of endoscopic therapy has been addressed in only a few studies. We aim to assess the efficacy and safety of endoscopic stenting in the management of GSS following LSG. Retrospective data were reviewed from July 2009 to November 2013. Patients were referred for endoscopic therapy for symptoms or imaging findings suggestive of gastric leak or narrowing following LSG. Endoscopic therapy included the use of fully covered self-expanding esophageal metal stents (FCSEMS) in addition to over-the-scope clip system (OTSC) when necessary. All 27 patients were females with mean age of 40 years; six patients were excluded from the study. Major symptom was nausea and vomiting in 57% of the patients. Five of 21 patients had concomitant leaks. All 21 patients underwent FCSEMS placement, and four out of five patients (80%) with concomitant leak had OTSC. The success rate in both groups for resolution of stricture and leak was 100%, and no surgical intervention was required. There were no immediate or delayed complications of endoscopic therapy. Median follow-up of 6 months was available for 20/21 patients. Among patients with gastric leak, 80% had resolution of their symptoms compared with 93% of patients with GSS. Endoscopic therapy for LSG-related GSS or leaks with FCSEMS is highly effective and safe.
Tool for Coupling a Torque Wrench to a Round Cable Connector
NASA Technical Reports Server (NTRS)
Hacker, Scott C.; Dean, Richard J.; Burge, Scott W.
2006-01-01
A tool makes it possible to couple a torque wrench to an externally knurled, internally threaded, round cable connector. The purpose served by the tool is to facilitate the tightening of multiple such connectors (or the repeated tightening of the same connector) to repeatable torques. The design of a prior cable-connector/ torque-wrench coupling tool provided for application of the torque-wrench jaws to a location laterally offset from the axis of rotation of the cable connector, making it necessary to correct the torque reading for the offset. Unlike the design of the prior tool, the design of the present tool provides for application of the torque-wrench jaws to a location on the axis of rotation, obviating correction of the torque reading for offset. The present tool (see figure) consists of a split collet containing a slot that provides clearance for inserting and bending the cable, a collet-locking sleeve, a collet-locking nut, and a torque-wrench adaptor that is press-fit onto the collet. Once the collet is positioned on the cable connector, the collet-locking nut is turned to force the collet-locking sleeve over the collet, compressing the collet through engagement of tapered surfaces on the outside of the collet and the inside of the locking sleeve. Because the collet is split and therefore somewhat flexible, this compression forces the collet inward to grip the connector securely. The torque wrench is then applied to the torque-wrench adaptor in the usual manner for torquing a nut or a bolt.
... screens on the windows and doors. Use a mosquito net over your bed. Spray the net with permethrin, a spray that repels mosquitoes. Wear light-colored pants and shirts with long sleeves. Protect yourself with a bug repellent spray that contains no more than 35% of ...
Equipment for surgical interventions and childbirth in weightlessness
NASA Astrophysics Data System (ADS)
Mutke, H. G.
A transparent plastic sack has been devised for surgical interventions in space. Fixed airtight on the patient, containing sterilized medical equipment and comprising long sleeves for the operations, it retains all its contents for the rest of the flight.
Seismic retrofit of spliced sleeve connections for precast bridge piers : research brief.
DOT National Transportation Integrated Search
2017-03-01
The rehabilitation method described in this paper concerns connections between precast columns and footings, and precast columns and pier caps. This research uses high-performance materials, including headed reinforcing bar, epoxy, nonshrink or expan...
Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery.
Saif, Taha; Strain, Gladys W; Dakin, Gregory; Gagner, Michel; Costa, Ricardo; Pomp, Alfons
2012-01-01
Laparoscopic sleeve gastrectomy evolved as a primary bariatric procedure with little information on its nutritional effects. Our objective was to assess the longer term micronutrient and vitamin status after laparoscopic sleeve gastrectomy at a university hospital. Measurements of ferritin, iron, total iron binding capacity, hemoglobin, hematocrit, parathyroid hormone, albumin, calcium, magnesium, phosphorus, zinc, folate, and vitamins A, B1, B12, and D were obtained at baseline and 1, 3, and 5 years after surgery. Two-sample t tests with multiple adjusted comparisons and Fisher's exact test were used to determine deficiency. A total of 82 patients (67% women), with a mean age of 46.4 years and a baseline body mass index 55.7 kg/m2 were included in the present study (35 at 1, 27 at 3, and 30 at 5 years postoperatively). The percentage of excess body mass index loss was 58.5% at year 1 in 35 patients, 63.1% at year 3 in 27 patients, and 46.1% at year 5 in 30 patients. The parathyroid hormone level decreased from 75.0 to 49.6 ng/mL in year 1 to 40.7 ng/mL in year 3. The year 5 levels increased to 99.6 ng/mL. The mean vitamin D level increased from 23.6 ng/mL to 35.0, 32.1 and 34.8 at years 1, 3, and 5 (P = .05 for baseline to year 1). The vitamin D level was less than normal in 42% of the patients at year 5. After normalization from baseline, by year 5, parathyroid hormone had increased in 58.3% of patients. At year 5, vitamin B1 was less than normal in 30.8% of patients, and hemoglobin and hematocrit were less than normal in for 28.6% and 25% of patients, respectively. Finally, 28.9% of patients reported taking supplements in year 1, 42.9% in year 3, and 63.3% in year 5. The other variables were not significantly different. Laparoscopic sleeve gastrectomy resulted in health improvements through year 3. At year 5, the nutrient levels had reverted toward the baseline values. These observations provide focus for necessary clinical monitoring. Copyright © 2012 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Wu, Haifu; Zhong, Ming; Zhou, Di; Shi, Chenye; Jiao, Heng; Wu, Wei; Chang, Xinxia; Cang, Jing; Bian, Hua
2017-04-25
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy. The treatment of pulmonary artery embolism includes remittance of pulmonary arterial hypertension, anticoagulation, thrombolysis, operative thrombectomy, interventional therapy and extracorporeal membrane oxygenation (ECMO). Hemorrhage is a rarely occurred but relatively serious complication after bariatric surgery. The primary cause of anastomotic bleeding after laparoscopic gastric bypass is incomplete hemostasis or weak laparoscopic repair. The common bleeding site in laparoscopic sleeve gastrectomy is gastric stump and close to partes pylorica, and the bleeding may be induced by malformation and weak repair technique. Patients with hemodynamic instability caused by active bleeding or excessive bleeding should timely received surgical treatment. Anastomotic fistula in gastric bypass can be divided into gastrointestinal anastomotic fistula and jejunum-jejunum anastomotic fistula. The treatment of postoperative anastomotic fistula should vary with each individual, and conservative treatment or operative treatment should be adopted. Anastomotic stenosis is mainly related to the operative techniques. Stenosis after sleeve gastrectomy often occurs in gastric angle, and the treatment methods include balloon dilatation and stent implantation, and surgical treatment should be performed when necessary. Marginal ulcer after gastric bypass is a kind of peptic ulcer occurring close to small intestine mucosa in the junction point of stomach and jejunum. Ulcer will also occur in the vestige stomach after laparoscopic sleeve gastrectomy, and the occurrence site locates mostly in the gastric antrum incisal margin. Preoperative anti-HP (helicobacter pylorus) therapy and postoperative continuous administration of proton pump inhibitor (PPI) for six months is the main means to prevent and treat marginal ulcer. For patients on whom conservative treatment is invalid, endoscopic repair or surgical repair should be considered. Different surgical procedures will generate different related operative complications. Fully understanding and effectively dealing with the complications of various surgical procedures through multidisciplinary cooperation is a guarantee for successful operation.
Is Right Sleeve Lower Lobectomy Necessary? Is It Safe?
Kocaturk, Celalettin Ibrahim; Saydam, Ozkan; Sezen, Celal Bugra; Kalafat, Cem Emrah; Cansever, Levent; Kutluk, Ali Cevat; Akin, Hasan; Metin, Muzaffer
2018-05-23
The right sleeve lower lobectomy is the least used of the bronchial sleeve operations. There are only case-based studies in the literature. In this study, we compared this technique to those used in patients who underwent a right lower bilobectomy. We retrospectively reviewed the data of patients who had been operated on due to non-small cell lung cancer (NSCLC) from January 2005 to December 2015 from a dataset that was formed prospectively. Of the 4,166 patients who underwent resections due to NSCLC, the files of those who had a right sleeve lower lobectomy (group S) and those who had a right lower bilobectomy (group B) were evaluated. The remaining 25 patients in group B and 18 patients in group S were compared in terms of demographic data, morbidity, hospitalization time, mortality, histopathology, recurrence, and total survival. No significant differences in the demographic or clinical characteristics were observed between the two groups, except that group S had more female patients. Postoperative complications developed in 52% of the patients in group B and 11.1% of the patients in group S ( p = 0.006). Mean hospitalization time was 9.6 ± 3.6 (range, 6-19) days in group B and 6.72 ± 1.5 (range, 4-9) days in group S ( p = 0.001). All patients received complete resections. The mean patient follow-up time was 42.9 months. No significant difference was found between local and distant recurrences ( p = 1, p = 0.432). Mean survival time was 89.6 months (5-year rate = 73%), which was 90.6 months (5-year rate = 75.3%) in group B and 63.1 months (5-year rate = 69.3%) in group S ( p = 0.82). This technique allows for reduced filling of the thoracic cavity by a prolonged air leak and a reduced prevalence of complications. Additionally, the hospitalization time is shortened. It does not produce any additional mortality burden, and total survival and oncological outcomes are reliable. This technique can be used in selected patients at experienced centers. Georg Thieme Verlag KG Stuttgart · New York.
[10 years of sleeve gastrectomy in the Czech Republic in terms of the surgical procedure].
Kasalický, M; Bařinka, A; Čierny, M; Fried, M; Gryga, A; Holéczy, P; Hrubý, M; Malčánková, K; Michalský, D; Procházka, V; Satinský, I; Šimonik, I; Vraný, M; Zonča, P
Sleeve gastrectomy (SG) as a single bariatric/metabolic procedure has been performed since 2003 in the world, and since 2006 in the Czech Republic. We report 10 years experience with SG in the Czech Republic from 2006 to 2015. Prospectively collected data from 14 surgical departments was evaluated retrospectively using descriptive statistics for every year from 2006 to 2015 and subsequently evaluated and compared for the entire period. The number of the patients, mean age, mean weight and BMI at the time of surgery, the number of patients with T2DM after SG, mean follow-up, mean %BMIL (% Body Mass Index Loss), distance of the starting point of the resection line from the pylorus, the size of the calibration bougie, the rate of complications, and the number and type of conversion procedures were evaluated. 4134 sleeve gastrectomies were done in the Czech Republic from 2006 to 2015 with the mean follow-up of 32.9 months (range 2145 months) from the procedure. The mean weight at the time of surgery fluctuated between 114.2 kg and 128.9 kg; mean BMI fluctuated between 42.3 and 46.7. Mean %BMIL was 63.2% for the entire evaluated period. The distance of the starting point of the resection line from the pylorus changed from the mean 6.1 cm (range 67 cm) to mean 4.2 cm (range 36 cm) and the size of the calibration bougie changed from the mean 39.2 F (range 3642 F) to mean 37.1 F (range 3542 F). As regards early postoperative complications, bleeding from the resection line occurred in 1.4% and a leak from the staple line occurred in 1.1%. The gastroesophageal reflux disease and hiatal hernia occurred in 17.3% as the most frequent late complications. Conversion to another bariatric procedure was approached in 3.8% in the event of an unsatisfactory effect of the SG. Bariatric or metabolic surgery, respectively, is a safe and effective surgical method for the treatment of severe obesity and T2DM in morbidly obese patients. Currently, SG is the most widely used bariatric/metabolic procedure in the Czech Republic as well as in most other countries and the long-time results are similar in comparison with other authors.Key words: bariatric surgery - sleeve gastrectomy - resection line - complications.
Chikungunya: Information for the General Public
... air conditioning or window/door screens o Use mosquito repellents on exposed skin o Wear long-sleeved shirts and long pants o Wear permethrin-treated clothing o Empty ... you are sick with chikungunya, avoiding mosquito bites will help prevent further spread of the ...
DOT National Transportation Integrated Search
2015-08-01
The seismic cone penetration test with pore pressure measurement (SCPTu) is a geotechnical investigation technique which : involves pushing a sensitized cone into the subsurface at a constant rate while continuously measuring tip resistance, sleeve :...
32 CFR 161.5 - Responsibilities.
Code of Federal Regulations, 2014 CFR
2014-07-01
... telephone center support, and telecommunications engineering and network control center assistance. (7) In... Acquisition, Technology, and Logistics (USD(AT&L)), and the DoD Chief Information Officer (DoD CIO) establish..., printer consumables, and electromagnetically opaque sleeves to Defense Manpower Data Center (DMDC). (7...
NASA Technical Reports Server (NTRS)
Pessin, R.
1983-01-01
Tool locally expands small-diameter tubes. Tube expander locally expands and deforms tube: Compressive lateral stress induced in elastomeric sleeve by squeezing axially between two metal tool parts. Adaptable to situations in which tube must have small bulge for mechanical support or flow control.
40 CFR 86.090-2 - Definitions.
Code of Federal Regulations, 2010 CFR
2010-07-01
...) Light heavy-duty diesel engines usually are non-sleeved and not designed for rebuild; their rated... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF... any motor vehicle (or motor vehicle engine) engineered and designed to be operated using a single fuel...
40 CFR 86.090-2 - Definitions.
Code of Federal Regulations, 2011 CFR
2011-07-01
...) Light heavy-duty diesel engines usually are non-sleeved and not designed for rebuild; their rated... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF... any motor vehicle (or motor vehicle engine) engineered and designed to be operated using a single fuel...
Tool Enlarges Hard-to-Reach Holes
NASA Technical Reports Server (NTRS)
Geddes, J. P.
1984-01-01
Tool centers itself and cuts precise depth. Tool consists of crosscut carbide bur; sleeve that serves as depth stop and pilot; length of flexible, strong piano wire; and standard drive socket. Parts brazed together. Piano wire transmits torque and axial force to cutting tool.
Jerome F. Grant; James Rusty Rhea; Paris Lambdin; Greg Wiggins; Abdul Hakeem
2009-01-01
While commonly used approaches (petri dishes, small arenas, growth chambers, greenhouse studies, sleeve cages, etc.) for evaluation of natural enemies provide important information, does the small size of these arenas limit their...
Cryogenic Blackbody-Radiation Calibration Source
NASA Technical Reports Server (NTRS)
Burkett, Cecil G., Jr.; Daryabeigi, Kamran
1993-01-01
Operating temperatures range from ambient down to minus 100 degrees C. V-grooved front face of source body blackened and recessed in black sleeve. Semiairtight chamber that houses source purged with dry nitrogen gas to prevent formation of dew or frost at low operating temperature.
77 FR 54796 - Airworthiness Directives; Eurocopter France Helicopters
Federal Register 2010, 2011, 2012, 2013, 2014
2012-09-06
... Airworthiness Directives; Eurocopter France Helicopters AGENCY: Federal Aviation Administration (FAA), DOT... France Model AS350 helicopters. This AD requires installing protection sleeves over certain forward... helicopters have been approved by the aviation authority of France and are approved for operation in the...
Blood Test: Immunoglobulin A (IgA)
... before this test. On the day of the test, having your child wear a T-shirt or short-sleeved shirt can ... The blood sample will be processed by a machine. The results are commonly ... further tests. Risks This test is considered a safe procedure. ...
Arman, Gustavo A; Himpens, Jacques; Dhaenens, Jeroen; Ballet, Thierry; Vilallonga, Ramon; Leman, Guido
2016-12-01
More than 10 years of outcomes for sleeve gastrectomy (LSG) have not yet been documented. Analysis of>11 years of outcomes of isolated LSG in terms of progression of weight, patient satisfaction, and evolution of co-morbidities and gastroesophageal reflux disease (GERD) treatment. Two European private hospitals. Chart review and personal interview in consecutive patients who underwent primary isolated LSG (2001-2003). Of the 110 consecutive patients, complete follow-up data was available in 65 (59.1%). Mean follow-up was 11.7±.4 years. Two patients had died of non-procedure-related causes. Twenty (31.7%) patients required 21 reoperations: 14 conversions (10 duodenal switch (DS), 4 Roux-en-Y gastric bypass (RYGB), and 3 resleeve procedures) for weight issues and 2 conversions (RYGB), and 2 hiatoplasties for gastroesophageal reflux disease (GERD). For the 47 (74.6%) individuals who thus kept the simple sleeve construction, percentage of excess body mass index loss (%EBMIL) at 11+years was 62.5%, versus 81.7% (P = .015) for the 16 patients who underwent conversion to another construction. Mean %EBMIL for the entire cohort was 67.4%. At 11+years postoperatively, 30 patients versus 28 preoperatively required treatment for co-morbidities. None of the 7 patients preoperatively suffering from GERD were cured by the LSG procedure. Nine additional patients developed de novo GERD. Overall satisfaction rate was 8 (interquartile range 2) on a scale of 0-10. Isolated LSG provides a long-term %EBMIL of 62.5%. Conversion to another construction, required in 25% of the cases, provides a %EBMIL of 81.7% (P = .015). Patient satisfaction score remains good despite unfavorable GERD outcomes. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Cosse, C; Rebibo, L; Brazier, F; Hakim, S; Delcenserie, R; Regimbeau, J M
2018-04-01
Gastric leak is the most feared surgical postoperative complication after sleeve gastrectomy. An endoscopic procedure is usually required to treat the leak. No data are available on the cost-effectiveness of different stent types in this procedure. Between April 2005 and July 2016, patients with a confirmed gastric leak undergoing endoscopic treatment using a covered stent (CS) or double-pigtail stent (DPS) were included. The primary objective of the study was to assess overall costs of the stent types after primary sleeve gastrectomy. Secondary objectives were the cost-effectiveness of each stent type expressed as an incremental cost-effectiveness ratio (ICER); the incremental net benefit; the probability of efficiency, defined as the probability of being cost-effective at a threshold of €30 000, and identification of the key drivers of ICER derived from a multivariable analysis. One hundred and twelve patients were enrolled. The overall mean costs of gastric leak were €22 470; the mean(s.d.) cost was €24 916(12 212) in the CS arm and €20 024(3352) in the DPS arm (P = 0·018). DPS was more cost-effective than CS (ICER €4743 per endoscopic procedure avoided), with an incremental net benefit of €25 257 and a 27 per cent probability of efficiency. Key drivers of the ICER were the inpatient ward after diagnosis of gastric leak (surgery versus internal medicine), type of institution (private versus public) and duration of hospital stay per endoscopic procedure. DPS for the treatment of gastric leak is more cost-effective than CS and should be proposed as the standard regimen whenever possible. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.
Schmoelz, W; Mayr, R; Schlottig, F; Ivanovic, N; Hörmann, R; Goldhahn, J
2016-03-01
Screw anchorage in osteoporotic bone is still limited and makes treatment of osteoporotic fractures challenging for surgeons. Conventional screws fail in poor bone quality due to loosening at the screw-bone interface. A new technology should help to improve this interface. In a novel constant amelioration process technique, a polymer sleeve is melted by ultrasound in the predrilled screw hole prior to screw insertion. The purpose of this study was to investigate in vitro the effect of the constant amelioration process platform technology on primary screw anchorage. Fresh frozen femoral heads (n=6) and vertebrae (n=6) were used to measure the maximum screw insertion torque of reference and constant amelioration process augmented screws. Specimens were cut in cranio-caudal direction, and the screws (reference and constant amelioration process) were implanted in predrilled holes in the trabecular structure on both sides of the cross section. This allowed the pairwise comparison of insertion torque for constant amelioration process and reference screws (femoral heads n=18, vertebrae n=12). Prior to screw insertion, a micro-CT scan was made to ensure comparable bone quality at the screw placement location. The mean insertion torque for the constant amelioration process augmented screws in both, the femoral heads (44.2 Ncm, SD 14.7) and the vertebral bodies (13.5 Ncm, SD 6.3) was significantly higher than for the reference screws of the femoral heads (31.7 Ncm, SD 9.6, p<0.001) and the vertebral bodies (7.1 Ncm, SD 4.5, p<0.001). The interconnection of the melted polymer sleeve with the surrounding trabecular bone in the constant amelioration process technique resulted in a higher screw insertion torque and can improve screw anchorage in osteoporotic trabecular bone. Copyright © 2016 Elsevier Ltd. All rights reserved.
Wait, Isaac W; Johnston, Cliff T; Blatchley, Ernest R
2007-06-01
Ultraviolet (UV) disinfection systems are incorporated into drinking water production facilities because of their broad-spectrum antimicrobial capabilities, and the minimal disinfection by-product formation that generally accompanies their use. Selection of an optimal location for a UV system within a drinking water treatment facility depends on many factors; a potentially important consideration is the effect of system location on operation and maintenance issues, including the potential for fouling of quartz surfaces. To examine the effect of system location on fouling, experiments were conducted at a groundwater treatment facility, wherein aeration, chlorination, and sand filtration were applied sequentially for treatment. In this facility, access to the water stream was available prior to and following each of the treatment steps. Therefore, it was possible to examine the effects of each of these unit operations on fouling dynamics within a UV system. Results indicated zero-order formation kinetics for the fouling reactions at all locations. Increases in oxidation reduction potential, caused by water treatment steps such as aeration and chlorination, increased the rate of sleeve fouling and the rate of irradiance loss within the reactor. Analysis of metals in the sleeve foulant showed that calcium and iron predominate, and relative comparisons of foulant composition to water chemistry highlighted a high affinity for incorporation into the foulant matrix for both iron and manganese, particularly after oxidizing treatment steps. Fouling behavior was observed to be in qualitative agreement with representations of the degree of saturation, relative to the metal:ligand combinations that are believed to comprise a large fraction of the foulants that accumulate on the surfaces of quartz jackets in UV systems used to treat water.
Endoscopic management of post-laparoscopic sleeve gastrectomy stenosis.
Al Sabah, Salman; Al Haddad, Eliana; Siddique, Iqbal
2017-09-01
Laparoscopic sleeve gastrectomy (LSG) is becoming an increasingly popular form of bariatric surgery, accounting for more than 50% of these procedures performed in the USA. Given this popularity, more is being understood about the complications associated with LSG, which, though uncommon, include the formation of strictures and stenosis. The purpose of this study is to establish a safe and effective protocol for the treatment of stenosis post-LSG using endoscopic balloon dilatation. This is a prospective review of 26 patients who had undergone LSG in Kuwait, followed by sleeve gastrectomy stenosis (SGS) and were then referred to Amiri Hospital for endoscopic balloon dilatation from October 2008 up to June 2016. A total of 26 patients (four males; 22 females) presented with symptoms of stenosis post-LSG during the study period. The mean age of the patients was 34.6 ± 10.8 years. The mean body mass index at the time of surgery was 43 ± 1.6 kg/m 2 . The median interval from the initial LSG surgery was 95 days. Nine patients had an early presentation (≤3 months from surgery), while 17 presented late (>3 months). The patients were followed for a mean duration of 156 ± 20 days from the last endoscopic balloon dilatation. A total of 23 (88.5%) patients had complete resolution of their symptoms. Adverse events were observed in one patients, who was removed from the study. Gastric stenosis is a rare but potentially serious complication of LSG. Serial dilatation of SGS employing endoscopic balloons is a safe method of treatment, with high efficacy rates. This new method may offer a less invasive alternative to surgical revision. However, if endoscopic treatment fails, surgery is necessary.
On-line wall-free cell for laser-induced fluorescence detection in capillary electrophoresis.
Yu, Chang-Zhu; He, You-Zhao; Xie, Hai-Yang; Gao, Yong; Gan, Wu-Er; Li, Jun
2009-05-15
A wall-free detection method based on liquid junction in a capillary gap was proposed for laser-induced fluorescence (LIF) of capillary electrophoresis (CE). The capillary gap of the wall-free cell was fabricated by etching a 10-mm x 50-microm I.D. fused-silica capillary to obtain a polyimide coating sleeve, decoating about 6mm at one end of both 50 microm I.D. separation and liquid junction capillary, inserting the treated capillary ends into the coating sleeve oppositely, fixing the capillaries with a gap distance of 140 microm by epoxy glue and removing the coating sleeve by burning. The theoretical model, experimental results and wall-free cell images indicated that the gap distance and applied voltage were main influence factors on the wall-free detection. Since the wall-free cell increased the absorption light path and avoided the stray light from the capillary wall, it improved the ratio of signal to noise and limit of detection (LOD) of CE-LIF. Three flavin compounds of riboflavin (RF), flavin mononucleotide sodium (FMN) and flavin adenine dinucleotide disodium (FAD) were used to evaluate the wall-free detection method. Compared with on-column cell, the LODs of the wall-free cell were improved 15-, 6- and 9-fold for RF, FMN and FAD, respectively. The linear calibration concentrations of the flavins ranged from 0.005 to 5.0 micromol/L. The column efficiency was in the range from 1.0 x 10(5) to 2.5 x 10(5) plates. The wall-free detection of CE-LIF was applied to the analysis of the flavins in spinach and lettuce leaves.
Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results
Stefani, Giacomo; Mattiuzzo, Valerio; Prestini, Greta
2017-01-01
Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 ( p < 0.01); WOMAC score improved from 76 to 41 ( p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series. PMID:29270557
Open total gastrectomy with Roux-en-Y reconstruction for a chronic fistula after sleeve gastrectomy.
Bruzzi, Matthieu; Douard, Richard; Voron, Thibault; Berger, Anne; Zinzindohoue, Franck; Chevallier, Jean-Marc
2016-12-01
Surgery appears to be the best treatment option for a chronic fistula after laparoscopic sleeve gastrectomy (LSG). Conservative procedures (conversion into a Roux-en-Y gastric bypass, Roux-limb placement) have proven their feasibility and efficacy, but an open total gastrectomy (TG) is sometimes required in challenging situations. To assess outcomes from 12 consecutive patients who underwent surgery for a post-sleeve gastrectomy chronic fistula (PSGCF) between January 2004 and February 2012. University public hospital, France. Patients with a PSGCF who underwent surgery were included in this retrospective study. Mortality, morbidity (i.e., Clavien-Dindo score), weight loss, and nutritional status were assessed. Twelve of 57 patients (21%) with a post-LSG leak developed a PSGCF. There were 3 men (25%). Mean age was 39±9 years and mean preoperative body mass index was 35±5 kg/m 2 . All 12 patients underwent an open total gastrectomy with an esojejunostomy (TG). Conservative procedures were considered but not possible. The mean follow-up period was 38±11 months. The mean delay between LSG and TG was 12±6 months. Intraoperative discovery of multiple (>2) gastric fistulas was reported in 9 patients (75%). There were no deaths, but morbidity rate was 50%. Early postoperative fistula occurred in 3 patients (anastomosis n = 1, duodenal stump n = 2). None of these patients required further surgery. The median healing time of the fistula was 37 days (range 24-53). Promising results from weight loss and nutritional status were found at the end of the follow-up. A salvage open TG is a well-tolerated and reproducible salvage procedure for cases of a PSGCF, when conservative procedures are not possible. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Stimson, J.; Docker, P.; Ward, M.; Kay, J.; Chapon, L.; Diaz-Moreno, S.
2017-12-01
The work detailed here describes how a novel approach has been applied to overcome the challenging task of cryo-cooling the first monochromator crystals of many of the world’s synchrotrons’ more challenging beam lines. The beam line configuration investigated in this work requires the crystal to diffract 15 Watts of 4-34 keV X-ray wavelength and dissipate the additional 485 watts of redundant X-ray power without significant deformation of the crystal surface. In this case the beam foot print is 25 mm by 25 mm on a crystal surface measuring 38 mm by 25 mm and maintain a radius of curvature of more than 50 km. Currently the crystal is clamped between two copper heat exchangers which have LN2 flowing through them. There are two conditions that must be met simultaneously in this scenario: the crystal needs to be clamped strongly enough to prevent the thermal deformation developing whilst being loose enough not to mechanically deform the diffracting surface. An additional source of error also occurs as the configuration is assembled by hand, leading to human error in the assembly procedure. This new approach explores making the first crystal cylindrical with a sleeve heat exchanger. By manufacturing the copper sleeve to be slightly larger than the silicon crystal at room temperature the sleeve can be slid over the silicon and when cooled will form an interference fit. This has the additional advantage that the crystal and its heat exchanger become a single entity and will always perform the same way each time it is used, eliminating error due to assembly. Various fits have been explored to investigate the associated crystal surface deformations under such a regime
Wang, Yao; Yi, Xiao-Yan; Gong, Li-Lin; Li, Qi-Fu; Zhang, Jun; Wang, Zhi-Hong
2018-01-01
This systematic review and meta-analysis was performed to compare the influence of different calibrating bougie sizes on clinical outcomes in laparoscopic sleeve gastrectomy (LSG) for patients with obesity. A systematic review of the literature was performed using the key words: "laparoscopic sleeve gastrectomy", "bougie size", "calibration", "obesity", and "obese" for searches of electronic databases up to October 2017. Clinical characteristics such as, the percentage of excess weight loss (%EWL), overall complications, gastrointestinal leaks, gastroesophageal reflux disease (GERD) were pooled by meta-analysis. Stata 12.0 (Stata Corp, College Station, TX, USA) was used to perform the meta-analysis. Data were extracted from 11 original studies matching our inclusion criteria. In our review, the group of patients who had operations with thinner bougies had a greater %EWL (SMD 0.23, 95% CI 0.14-0.33, P < .001) than the group where larger diameters were used. Furthermore, no significant differences were found in the incidence of overall complications (OR 1.00, 95% CI 0.73-1.37, P = .978), postoperative gastrointestinal leaks (OR 0.91, 95% CI 0.67-1.24, P = .554), and GERD (OR 0.77, 95% CI 0.37-1.59, P = .476) between the two groups. A robust result could not be made about remission of comorbidities using differing diameter bougies due to insufficient data. Use of thinner diameter bougies in LSG was more effective in enabling weight loss and did not increase the risk of overall complications, gastrointestinal leaks or GERD compared with larger diameter bougies. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
[Sleeve resection of right main bronchus for posttraumatic bronchial stenosis].
Bobocea, Andrei Cristian; Matache, Radu; Codreşi, Mihaela; Bolca, Ciprian; Cordoş, Ioan
2011-01-01
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. A high index of clinical suspicion and accurate interpretation of radiological findings are necessary for prompt surgical intervention with primary repair of the airway. Delays in treatment increases the risk of partial to complete bronchial stenosis. A 21 years old male was admitted to our hospital following a workplace accident. A chest radiograph showed bilateral pneumothorax, cephalic and mediastinal emphysema. Chest tubes were placed on each side, with full pulmonary expansion and remission of emphysema. Minimal lesions of the right main bronchus were found at fiberoptic bronchoscopy. Daily chest X-rays showed an uncomplicated recovery. A stenosis was suspected due to right lung pneumonia evolving under specific antibiotherapy. Right main bronchus posttraumatic stricture was diagnosed by fiberoptic bronchoscopy. He underwent a right lateral thoracotomy with sleeve resection of stenotic bronchi. Control bronchoscopy reveals main bronchus widely patent with untraceable suture line. Main bronchus rupture in blunt chest trauma is an additive effect of chest wall compression between two solid surfaces, traction on the carina and sudden increase in intraluminal pressure. Symptoms may vary: soft air leak, pneumothorax or limited mediastinal emphysema. Bronchoscopy should be performed immediately or when available. Granulation tissue leads to progressive bronchial obstruction, with distal infection and permanent parenchymal damage. Sleeve resection of the stenosed segment is the treatment of choice and restores fully the lung function. Rupture of main bronchus is a complication of blunt chest trauma. Flexible bronchoscopy is useful and reliable for early diagnosis of traumatic tracheobronchial injuries. Delayed diagnosis can lead to lung parenchyma alteration due to retrostenotic pneumonia. Resection and end-to-end anastomosis is the key of successful in these cases.
Devadas, M; Ku, D J
2018-02-17
Bariatric surgery is the most effective treatment for severe obesity, capable of producing more than 50% excess weight loss at 10-year follow-up (James Clin Dermatol 1; 22:276-80; O'Brien Br J Surg 2; 102:611-17; Buchwald et al. Metab Syndr 3; 347-56). The success of bariatric surgery extends far beyond weight loss, with up to 80-90% of patients having improvement or resolution of many of their weight-related co-morbidities including type II diabetes mellitus and hypertension (Puzziferri et al. JAMA 4; 312:934-42; Buchwald et al. Am J Med 5; 122:248-56). However, there is a paucity of data regarding conversional bariatric surgery. This study aims to explore the efficacy, safety and feasibility of conversional surgery. This study represents the largest Australasian series focusing on conversional bariatric surgery. The study was conducted in the Norwest Private Hospital and Hospital for Specialist Surgery (HSS), both private Hospitals in Sydney, Australia. Data was collected prospectively at regular intervals for more than 12 months from 1 January 2012 to 1st November 2015 for all patients requiring a laparoscopic sleeve gastrectomy (LSG) as secondary procedure after prior laparoscopic adjustable gastric band (LAGB). Excess weight loss (EWL), percentage total body weight loss (TWL) and excess BMI loss (EBMIL) as well as any complications were recorded. There were low rates of morbidity (1.1%) and no mortality at 12-month follow-up. Satisfactory EWL of 60% (95% CI: 56.6-63.4%), EBMIL of 60.1% (95% CI: 48.8-71.4%) and 16% TWL was achieved at 12-month follow-up. We therefore conclude that sleeve gastrectomy is a safe and valid option for conversional bariatric surgery following LAGB.
Duct attachment and extension for an air conditioning unit
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lang, R.D.; Frenia, F.J.
1986-12-16
An apparatus is described for attaching a fixed duct extension to the discharge opening of an air conditioning unit, the unit slidably inserted in and removed from a fixed through-the-wall sleeve, for supplying conditioned air to the space containing the unit and an adjacent space comprising: a discharge plenum assembly adapted to be connected to the unit encase the discharge opening. The discharge plenum assembly defines an air flow path for the conditioned air discharged from the unit and includes a first housing member having a forward wall, a rear wall, and a pair of opposed side walls joining themore » front wall to the rear wall, and a second housing member having a top wall connected to a front wall. The top wall and the front wall are fixedly attached to the rear wall and the forward wall respectively of the first housing member and forming a duct outlet in one of the side walls. The top wall and the front wall of the second housing member and one of the pair of opposed side walls of the lower housing member having longitudinal flanges extending therefrom forming a C-like flange; a bracket removably secured to the through the wall sleeve having an outwardly extending flange member at the top of the bracket; and a duct extension means secured to the outwardly extending flange of the bracket near one end and to the wall of the adjacent space at the opposite end. The duct extension means has a collar at one end configured to engage with the C-like flange whereby the unit with the discharge plenum assembly attached thereto slidably engages with and disengages from the through-the-wall sleeve while the duct extension is secured to the bracket.« less
Friedmacher, Florian; Till, Holger
2015-11-01
In recent years, the use of robotic-assisted surgery (RAS) has expanded within pediatric surgery. Although increasing numbers of pediatric RAS case-series have been published, the level of evidence remains unclear, with authors mainly focusing on the comparison with open surgery rather than the corresponding laparoscopic approach. The aim of this study was to critically appraise the published literature comparing pediatric RAS with conventional minimally invasive surgery (MIS) in order to evaluate the current best level of evidence. A systematic literature-based search for studies comparing pediatric RAS with corresponding MIS procedures was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. A total of 20 studies met defined inclusion criteria, reporting on five different procedures: fundoplication (n=8), pyeloplasty (n=8), nephrectomy (n=2), gastric banding (n=1), and sleeve gastrectomy (n=1). Included publications comprised 5 systematic reviews and 15 cohort/case-control studies (OCEBM Level 3 and 4, respectively). No studies of OCEBM Level 1 or 2 were identified. Limited evidence indicated reduced operative time (pyeloplasty) and shorter hospital stay (fundoplication) for pediatric RAS, whereas disadvantages were longer operative time (fundoplication, nephrectomy, gastric banding, and sleeve gastrectomy) and higher total costs (fundoplication and sleeve gastrectomy). There were no differences reported for complications, success rates, or short-term outcomes between pediatric RAS and conventional MIS in these procedures. Inconsistency was found in study design and follow-up with large clinical heterogeneity. The best available evidence for pediatric RAS is currently OCEBM Level 3, relating only to fundoplication and pyeloplasty. Therefore, higher-quality studies and comparative data for other RAS procedures in pediatric surgery are required.
Pediatric laparoscopic sleeve gastrectomy in Turkey: Short-term results.
Ates, Ufuk; Ergun, Ergun; Gollu, Gulnur; Sozduyar, Sumeyye; Can, Ozlem Selvi; Yagmurlu, Aydin
2018-05-01
Obesity is one of the most rapidly increasing health problems in children. Laparoscopic sleeve gastrectomy (LSG) is one of the best treatment options and is feasible and safe in children. The aim of this study was to present the short-term results of a laparoscopic sleeve gastrectomy series in children. Children who underwent LSG in 2014-2017 were included in the study. Charts were investigated retrospectively and short-term weight loss was analyzed. Patients who had surgery in 2014-2017 were included in the study. There were six girls and two boys, and the median age was 15 years (range, 11-18 years). Mean weight was 159.25 ± 19.78 kg, and mean body mass index was 61.05 ± 8.5 kg/m 2 . Mean operation time was 70 min (range, 65-90 min), mean hospital stay was 5.1 days (range, 3-7 days), and mean follow up was 19.2 months (range, 1-43 months). Of these patients, five had hypertension and were under medication and two of these five also had hyperinsulinemia. One of the five children had Bardet-Biedl syndrome and one had bronchial asthma. After operation, medication was stopped in four of the eight children. At the time of writing, six patients were doing well without postoperative complications, or the need for reoperation. Even though the follow-up period was short and the number of patients was small, LSG was a feasible and promising surgical method for morbidly obese children. A multidisciplinary approach and lifelong behavior therapy are key steps for success. © 2018 Japan Pediatric Society.
Trauma potential and ballistic parameters of cal. 9 mm P.A. dummy launchers.
Frank, Matthias; Bockholdt, Britta; Philipp, Klaus-Peter; Ekkernkamp, Axel
2010-07-15
Blank cartridge actuated dummy launching devices are used by migratory bird hunters to train dogs to retrieve downed birds. The devices create a loud noise while simultaneously propelling a hard foam dummy for retrieval. A newly developed dummy launcher is based on a modified cal. 9 mm P.A. blank handgun with an extension tube pinned and welded to the barrel imitation. Currently, there are no experimental investigations on the ballistic background and trauma potential of these uncommon shooting devices. An experimental test set-up consisting of a photoelectric infrared light barrier was used for measurement of the velocity of hard foam dummies propelled with an automatic dummy launcher. Ballistic parameters of the dummies and an aluminium sleeve as improvised projectile (kinetic energy (E), impulse (p), energy density (E') and threshold velocity (v(tsh)) to cause penetrating wounds as a function of cross-sectional density (S)) were calculated. The average velocity (v) of the dummies was measured 25.71 m/s exerting an average impulse (p) of 3.342 Ns. The average kinetic energy (E) was calculated 43.04 J with an average energy density (E') of 0.069 J/mm(2). The average velocity (v) of the aluminium sleeves as improvised projectiles was measured 79.58 m/s exerting an average impulse (p) of 2.228 Ns. The average kinetic energy (E) of the aluminium sleeves was calculated as 88.70 J with an average energy density (E') of 0.282 J/mm(2). The energy delivered by these shooting devices is high enough to cause relevant injuries. The absence of skin penetration must not mislead the emergency physician or forensic expert into neglecting the potential damage from these devices. (c) 2010 Elsevier Ireland Ltd. All rights reserved.
Fan, Xiaowu; Deng, Yu; Chen, Wenshu; Li, Weina; Cai, Yixin; Xu, Qinzi; Fu, Shengling; Fu, Xiangning; Ni, Zhang
2014-10-01
Lung-preserving surgery was proved to be effective and safe to treat patients with benign bronchial strictures. However, this surgical treatment has been rarely reported in patients with complete occlusion in the left main bronchus. The aim of this study was to assess the value of this procedure and report our experience in the treatment of these patients with left atelectasis caused by inflammatory bronchial occlusion. We reviewed and analysed the medical records of 8 patients who had undergone left main bronchus sleeve resection for symptomatic left atelectasis caused by inflammatory bronchial occlusion from May 2007 to April 2011. Eight patients (3 men and 5 women) with a medical history of active pulmonary tuberculosis were involved in this study. The median age was 23 years. Parenchyma-sparing left main bronchus resection was performed in 4 patients, 1 of whom received partial wedge resection in the lingual lobe. Left main bronchus sleeve resection plus superior lobectomy was performed in 2 patients and left main bronchus sleeve resection plus left inferior lobectomy in 2 patients, 1 of whom received additional partial wedge resection of the lingual lobe. The procedure was completed successfully in all 8 patients without postoperative deaths. The mean follow-up time was 49.3 months, ranging from 23 to 69 months. No major complications, including stenosis and atelectasis, were observed during the follow-up period. The symptoms of pulmonary atelectasis disappeared and pulmonary ventilation function improved significantly. In symptomatic patients with left atelectasis caused by inflammatory bronchial occlusion, lung-preserving surgery is an effective and safe surgical treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Debs, Tarek; Petrucciani, Niccolo; Kassir, Radwan; Iannelli, Antonio; Amor, Imed Ben; Gugenheim, Jean
During the past decade, the field of bariatric surgery has changed dramatically. The study aims to summarize and perform a periodic assessment of the current trends in the use of bariatric surgery in France and review findings on the long-term progression of bariatric surgery. The data were extracted from the national registry Programme de Médicalisation des Systèmes d׳Information from 2005 to 2014. National health system and private practice in France. We identified all hospitalizations during which a bariatric procedure was performed for the treatment of morbid obesity from 2005 to 2014 in France. Data were reviewed for patient characteristics and the number and types of bariatric procedures. We also analyzed the setting and the characteristics of the centers and the difference of the activity between the public and private sector. Between 2005 and 2014, the number of bariatric operations increased fourfold. Sleeve gastrectomy became the most performed bariatric intervention, representing 60.7% of bariatric activity in 2014. There was a concomitant steep increase in sleeve gastrectomy, with Roux-en-Y gastric bypass increasing slightly overall and a substantial decrease in adjustable gastric banding. In 2014, 481 centers performed bariatric surgery. Among them, one third performed<30 operations/yr. We observed an overall in-hospital mortality ranging from .038% to .05% during the last 3 years. Bariatric surgery is increasing in France, with a fourfold augmentation of interventions in the last 10 years. The number of sleeve gastrectomies has increased considerably. This activity is performed in numerous centers, one third of them performing<30 interventions/yr. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Banding the Sleeve Improves Weight Loss in Midterm Follow-up.
Fink, Jodok M; Hoffmann, Natalie; Kuesters, Simon; Seifert, Gabriel; Laessle, Claudia; Glatz, Torben; Hopt, Ulrich T; Konrad Karcz, W; Marjanovic, Goran
2017-04-01
Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG. In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years. Forty-two patients who had undergone conventional LSG were selected as matched pairs. Mean preoperative BMI was 54.93 ± 7.42 kg/m 2 for BLSG and 53.46 ± 6.69 kg/m 2 for LSG (Mann-Whitney P = 0.540). Total weight loss (%TWL) was significantly greater in the BLSG group 3 years after surgery (BLSG 38.22% ± 7.26; n = 26 vs. LSG 32.69 ± 9.47; n = 26; P = 0.0154). Ring placement had no relevant impact on new-onset reflux (Fisher's exact test P = 1.0) but a tendency towards reflux improvement when reflux pre-existed (odds ratio 1.96). The major side effect of ring implantation was regurgitation with over 44% of patients presenting with regurgitation >1 per week (Fisher's exact test P = 0.0019, odds ratio 18.07). BLSG is a safe procedure showing similar comorbidity to conventional LSG. However, BLSG leads to a higher rate of postoperative regurgitation. Weight loss is significantly improved 3 years after surgery. Hence, additional ring implantation might be an option for increased restriction in LSG surgery.
Page, Philip Le; Martin, David; Taylor, Craig; Wang, Jennifer; Wadhawan, Himanshu; Falk, Gregory; Gibson, Simon C
2018-05-01
Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a treatment of choice for morbid obesity and associated comorbidities. There has been a concern about new onset or worsening of gastroesophageal reflux (GERD) following LSG. The objective of the study was to evaluate the effect of surgically treating hiatal weakness on GERD symptoms in patients undergoing LSG. Single tertiary referral institution, Sydney, Australia. A prospective observational cohort study was conducted with consecutive patients undergoing LSG. Hiatal findings, patient demographics, medications and reflux score were recorded prospectively. Patients were followed up post-operatively for a minimum of 12 months and assessed using GERD-HRQL score to quantify reflux symptoms. Data from 100 patients with a minimum of 1-year follow-up were analysed. Mean follow-up was 18.9 months. Overall, GERD-HRQL improved from mean 4.5 ± 5.8 pre-operatively to 0.76 ± 1.5 after 18.9 months (p = 0.0001). For those with pre-operative reflux, GERD-HRQL improved from mean (SD) 8.43 ± 6.26 pre-operatively to 0.94 ± 1.55 (p = 0.0001). All the nine patients with troublesome daily reflux significantly improved. For those without pre-operative reflux, GERD-HRQL improved from 0.88 ± 1.37 to 0.47 ± 1.25 (p-ns) post-operatively. On multivariate analysis, higher pre-operative reflux and dysphagia/bloat scores, younger age and lower percentage excess weight loss after 18.9 months were associated with GERD-HRQL improvement. In the medium term, GERD-HRQL improves following sleeve gastrectomy with meticulous hiatal assessment and repair of hiatal laxity and herniation.
Mandeville, Yannick; Van Looveren, Ruth; Vancoillie, Peter-Jan; Verbeke, Xander; Vandendriessche, Katrien; Vuylsteke, Patrick; Pattyn, Paul; Smet, Bart
2017-07-01
Laparoscopic sleeve gastrectomy (LSG) has become a popular one-stage bariatric procedure with a proven efficacy on weight loss. However, the relationship between LSG and gastroesophageal reflux disease (GERD) remains a subject of debate. The objective is to determine the long-term effect of LSG on weight loss and reflux disease. A retrospective analysis of 100 consecutive patients who underwent an LSG between January 2005 and March 2009 was performed. The effect of LSG on weight evolution and the relationship between preoperative and postoperative GERD symptoms and PPI dependency was analyzed. A mean follow-up of 8.48 years (range 6.1-10.3) was achieved. We observed a long-term % excess weight loss (%EWL) of 60%. A significant increase in reflux symptoms and use of PPIs was seen. Seventeen percent suffered from reflux disease preoperatively versus 50% at the end of the postoperative follow-up (RR = 2.5882, 95% CI [1.6161-4.1452], p value = 0.0001). The chance of developing de novo reflux after LSG was 47.8% (32/67). Reflux disease was present in 7 of the 26 patients who underwent a secondary Roux-en-Y gastric bypass (RYGB). In four of these seven patients, reflux disease disappeared completely after the secondary RYGB (57.1%). A satisfactory long-term effect on weight loss was achieved. However, a significant increase in GERD and PPI dependency after LSG was noted. New onset GERD was seen in more than 40% of the study population. Conversion to RYGB is a good option in patients with refractory reflux disease after LSG.
Felsenreich, Daniel Moritz; Kefurt, Ronald; Schermann, Martin; Beckerhinn, Philipp; Kristo, Ivan; Krebs, Michael; Prager, Gerhard; Langer, Felix B
2017-12-01
Laparoscopic sleeve gastrectomy (SG) has become the most frequently performed bariatric procedure worldwide. De novo reflux might impact patients' quality of life, requiring lifelong proton pump inhibitor medication. It also increases the risk of esophagitis and formation of Barrett's metaplasia. Besides weight regain, gastroesophageal reflux disease (GERD) is the most common reason for conversion to Roux-en-Y gastric bypass. We performed 24-h pH metries, manometries, gastroscopies, and questionnaires focusing on reflux (GIQLI, RSI) in SG patients with a follow-up of more than 10 years who did not suffer from symptomatic reflux or hiatal hernia preoperatively. From a total of 53 patients, ten patients after adjustable gastric banding were excluded. From the remaining 43, six patients (14.0%) were converted to RYGB due to intractable reflux over a period of 130 months. Ten out of the remaining non-converted patients (n = 26) also suffered from symptomatic reflux. Gastroscopies revealed de novo hiatal hernias in 45% of the patients and Barrett's metaplasia in 15%. SG patients suffering from symptomatic reflux scored significantly higher in the RSI (p = 0.04) and significantly lower in the GIQLI (p = 0.02) questionnaire. This study shows a high incidence of Barrett's esophagus and hiatal hernias at more than 10 years after SG. Its results therefore suggest maintaining pre-existing large hiatal hernia, GERD, and Barrett's esophagus as relative contraindications to SG. The limitations of this study-its small sample size as well as the fact that it was based on early experience with SG-make drawing any general conclusions about this procedure difficult.
Comparative anatomy of the foramen ovale in the hearts of cetaceans
Macdonald, Alastair A; Carr, Peter A; Currie, Richard J W
2007-01-01
The structure of the cardiac foramen ovale from 17 species representing six cetacean families, the Monodontidae, Phocoenidae, Delphinidae, Ziphiidae, Balaenidae and the Balaenopteridae, was studied using the scanning electron microscope. Eight white whale fetuses (Delphinapterus leucas) and a narwhal fetus (Monodon monoceros) represented the Monodontidae; one fetal and nine neonatal harbour porpoises (Phocoena phocoena) and a finless porpoise fetus (Neophocoena phocoenoides) represented the Phocoenidae; two white-beaked dolphin fetuses (Lagenorhynchus albirostris), four fetal and one neonatal Atlantic white-sided dolphins (Lagenorhynchus acutus), a Risso's dolphin fetus (Grampus griseus), two common bottle-nosed dolphin neonates (Tursiops truncatus), a female short-beaked common dolphin fetus (Delphinus delphis), four killer whale fetuses (Orcinus orca) and two long-finned pilot whale fetuses (Globicephala melas) represented the Delphinidae; two northern bottlenose whale fetuses (Hyperoodon ampullatus) represented the Ziphiidae; one bowhead whale fetus (Balaena mysticetus) represented the Balaenidae and five Common minke whale fetuses (Balaenoptera acutorostrata), one blue whale fetus (Balaenoptera musculus), nine fin whale fetuses (Balaenoptera physalus) and four humpback whale fetuses (Megaptera novaeangliae) represented the Balaenopteridae. The hearts of an additional two incompletely identified toothed and four baleen whale fetuses were also studied. In each species the fold of tissue derived from the cardiac septum primum and subtended by the foramen ovale had the appearance of a short tunnel or sleeve which was fenestrated at its distal end. In the toothed whales the tissue fold was tunnel-shaped with the interatrial septum as the floor whereas in baleen whales it was more sleeve-like. In toothed whales thin threads extended from the fold to insert into the interatrial septum whereas a network of threads covered the distal end of the sleeve in the baleen whales. Similar structures were present in the corresponding cardiac tissues of neonatal Hippopotamidae. PMID:17532800
HYDROCARBON VAPOR DIFFUSION IN INTACT CORE SLEEVES
The diffusion of 2,2,4-trimethylpentane (TMP) and 2,2,5-trimethylhexane (TMH) vapors put of residually contaminated sandy soil from the U.S. Environmental Protection Agency (EPA) field research site at Traverse City, Michigan, was measured and modeled. The headspace of an intact ...
Lindskoug, Stefan
1984-01-01
In a piston rod seal of the type comprising a gland through which the piston rod is passed the piston is provided with a sleeve surrounding the piston rod and extending axially so as to axially partly overlap the gland when the piston is in its bottom dead center position.
Structural Repair of Steel Piping by In-Situ Sleeving of Nanostructured Materials
DOT National Transportation Integrated Search
2009-06-03
The focus of Task 1 is to demonstrate the repair of degraded pipeline steel using patches of high strength nanocrystalline metal. As mentioned in Bi-Monthly Research Progress Report #2, the cracking caused by corrosion damage in the steel pipe sectio...
32 CFR 765.13 - Insignia to be worn on uniform by persons not in the service.
Code of Federal Regulations, 2011 CFR
2011-07-01
... outer clothing on the right sleeve, at the point of the shoulder, the upper tip of the diamond to be one-fourth inch below the shoulder seam. For persons who are participating in United States Marine Corps...
32 CFR 765.13 - Insignia to be worn on uniform by persons not in the service.
Code of Federal Regulations, 2014 CFR
2014-07-01
... outer clothing on the right sleeve, at the point of the shoulder, the upper tip of the diamond to be one-fourth inch below the shoulder seam. For persons who are participating in United States Marine Corps...
32 CFR 765.13 - Insignia to be worn on uniform by persons not in the service.
Code of Federal Regulations, 2010 CFR
2010-07-01
... outer clothing on the right sleeve, at the point of the shoulder, the upper tip of the diamond to be one-fourth inch below the shoulder seam. For persons who are participating in United States Marine Corps...
32 CFR 765.13 - Insignia to be worn on uniform by persons not in the service.
Code of Federal Regulations, 2013 CFR
2013-07-01
... outer clothing on the right sleeve, at the point of the shoulder, the upper tip of the diamond to be one-fourth inch below the shoulder seam. For persons who are participating in United States Marine Corps...
32 CFR 765.13 - Insignia to be worn on uniform by persons not in the service.
Code of Federal Regulations, 2012 CFR
2012-07-01
... outer clothing on the right sleeve, at the point of the shoulder, the upper tip of the diamond to be one-fourth inch below the shoulder seam. For persons who are participating in United States Marine Corps...
76 FR 3128 - Intent to Grant Patent License
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-19
... Displacement Hydraulic Pump/Motor. 7,108,016 Lightweight Low September 19, 2006. Permeation Piston-in- Sleeve..., Large March 16, 2010. Angle, Variable Displacement Hydraulic Pump/Motor (Divisional). Application No. Title Date filed 11/233,822 Independent Displacement September 22, 2005. Opposing Pump/Motors and Method...
Effect of Changing the Center of Gravity on Human Performance in Simulated Lunar Gravity
NASA Technical Reports Server (NTRS)
Chappell, Steven P.; Norcross, Jason R.; Gernhardt, Michael L.
2010-01-01
The presentation slides include: Moving Past Apollo, Testing in Analog Environments, NEEMO/NBL CG (center of gravity) Studies, Center of Gravity Test Design and Methods, CG Suited Locations and Results, CG Individual Considerations, CG Shirt-Sleeve Locations and Results.
2016-06-17
APPLICATIONS [0002] None. BACKGROUND OF THE INVENTION (1) Field of the Invention [0003] The present invention relates to an impulse pump for generating...impulse pump 15. The sleeve bearings 98 are affixed to the head block 90 to ease axial motion while the plunger 72 is under torsional loads. [0041
Vacuum-jacketed transfer line installation technique
NASA Technical Reports Server (NTRS)
Bowers, W. M.
1968-01-01
Rolling-type spacers in the form of steel balls retained in appropriate sleeves affixed at intervals to the exterior of the transfer line facilitate the installation of a vacuum-jacketed line. They act as standoffs to position the transfer line concentrically within the vacuum jacket line.
Eddy Current Sensing of Torque in Rotating Shafts
NASA Astrophysics Data System (ADS)
Varonis, Orestes J.; Ida, Nathan
2013-12-01
The noncontact torque sensing in machine shafts is addressed based on the stress induced in a press-fitted magnetoelastic sleeve on the shaft and eddy current sensing of the changes of electrical conductivity and magnetic permeability due to the presence of stress. The eddy current probe uses dual drive, dual sensing coils whose purpose is increased sensitivity to torque and decreased sensitivity to variations in distance between probe and shaft (liftoff). A mechanism of keeping the distance constant is also employed. Both the probe and the magnetoelastic sleeve are evaluated for performance using a standard eddy current instrument. An eddy current instrument is also used to drive the coils and analyze the torque data. The method and sensor described are general and adaptable to a variety of applications. The sensor is suitable for static and rotating shafts, is independent of shaft diameter and operational over a large range of torques. The torque sensor uses a differential eddy current measurement resulting in cancellation of common mode effects including temperature and vibrations.
Northrup, M. Allen
2003-08-05
A silicon-based sleeve type chemical reaction chamber that combines heaters, such as doped polysilicon for heating, and bulk silicon for convection cooling. The reaction chamber combines a critical ratio of silicon and non-silicon based materials to provide the thermal properties desired. For example, the chamber may combine a critical ratio of silicon and silicon nitride to the volume of material to be heated (e.g., a liquid) in order to provide uniform heating, yet low power requirements. The reaction chamber will also allow the introduction of a secondary tube (e.g., plastic) into the reaction sleeve that contains the reaction mixture thereby alleviating any potential materials incompatibility issues. The reaction chamber may be utilized in any chemical reaction system for synthesis or processing of organic, inorganic, or biochemical reactions, such as the polymerase chain reaction (PCR) and/or other DNA reactions, such as the ligase chain reaction, which are examples of a synthetic, thermal-cycling-based reaction. The reaction chamber may also be used in synthesis instruments, particularly those for DNA amplification and synthesis.
Active-Controlled Fluid Film Based on Wave-Bearing Technology
NASA Technical Reports Server (NTRS)
Dimofte, Florin; Hendricks, Robert C.
2011-01-01
It has been known since 1967 that the steady-state and dynamic performance, including the stability of a wave bearing, are highly dependent on the wave amplitude. A wave-bearing profile can be readily obtained by elastically distorting the stationary bearing sleeve surface. The force that distorts the elastic sleeve surface could be an applied force or pressure. The magnitude and response of the distorting force would be defined by the relation between the bearing surface stiffness and the bearing pressure, or load, in a feedback loop controller. Using such devices as piezoelectric or other electromechanical elements, one could step control or fully control the bearing. The selection between these systems depends on the manner in which the distortion forces are applied, the running speed, and the reaction time of the feedback loop. With these techniques, both liquid- (oil-) or gas- (air-) lubricated wave bearings could be controlled. This report gives some examples of the dependency of the bearing's performance on the wave amplitude. The analysis also was proven experimentally.
Liu, Bingyu; Chen, Jiang; Zhang, Yiping
2016-01-01
In this study, two short precast concrete columns and two cast-in-situ concrete columns were tested under cyclic loads. It was shown that the sleeve grouted connection was equivalent to the cast-in-situ connections for short columns when the axial compression ratio was 0.6. In order to determine the influence of the axial compression ratio and the shear-span ratio on the shear capacity of the horizontal joint, a FE model was established and verified. The analysis showed that the axial compression ratio is advantageous to the joint and the shear capacity of the horizontal joint increases with increase of the shear-span ratio. Based on the results, the methods used to estimate the shear capacity of horizontal joints in the Chinese Specification and the Japanese Guidelines are discussed and it was found that both overestimated the shear capacity of the horizontal joint. In addition, the Chinese Specification failed to consider the influence of the shear-span ratio. PMID:27861493
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bryan, Charles R.; Schindelholz, Eric John
In June 2017, dust and salt samples were collected from the surface of Spent Nuclear Fuel (SNF) dry storage canisters at the Calvert Cliffs Nuclear Power Plant. The samples were delivered to Sandia National laboratories for analysis. Two types of samples were collected: filter-backed Scotch-Brite TM pads were used to collect dry dust samples for characterization of salt and dust morphologies and distributions; and Saltsmart TM test strips were used to collect soluble salts for determining salt surface loadings per unit area. After collection, the samples were sealed into plastic sleeves for shipping. Condensation within the sleeves containing the Scotch-Britemore » TM samples remobilized the salts, rendering them ineffective for the intended purpose, and also led to mold growth, further compromising the samples; for these reasons, the samples were not analyzed. The SaltSmart TM samples were unaffected and were analyzed by ion chromatography for major anions and cations. The results of those analyses are presented here.« less
NASA Technical Reports Server (NTRS)
Wingard, Charles Doug; Munafo, Paul M. (Technical Monitor)
2001-01-01
Neoprene gloves are used in a Space Shuttle Microgravity Glove Box (MGBX) experiment. In 1999, significant corrosion was observed in the work area and on the outer surface of the left glove ring. Analysis of the corrosion products showed that they contained chlorine. The Neoprene gloves used in this glove box were obtained in 1995, with a recommended shelf life of 3 years. After storage of these gloves in a cabinet drawer until 1999, significant signs of corrosion were also observed in the drawer. Mechanical and thermal properties were determined on samples cut from the finger and sleeve areas of the "good" and "bad" gloves. This data showed significant aging of the left-hand glove, particularly in the sleeve area. Thermal analysis data by DSC and TGA was complimentary to tensile data in showing this aging. However, this test data did not pinpoint the cause of the left-hand glove aging, or of the corrosion products.