Retention of polyurethane foam fragments during VAC therapy: a complication to be considered.

PubMed

Dessy, Luca A; Serratore, Francesco; Corrias, Federico; Parisi, Paola; Mazzocchi, Marco; Carlesimo, Bruno

2015-04-01

Vacuum-assisted closure (VAC) therapy is a closed-loop, non-invasive active system, characterised by a controlled and localised negative pressure applied on porous polyurethane absorbent foams. It promotes healing of acute and chronic wounds. Therapeutic effects of VAC therapy have been proved and demonstrated; however, this method can have some disadvantages. Even if it is a quite versatile device, only qualified medical/paramedical personnel should use it in order to avoid possible complications that can occur after an improper application. In this report, 11 cases of foam-fragment retention within the wound are presented. This rare complication did not promote healing, but further hindered it. On the basis of our experience, it is mandatory to define the indications, benefits and limitations of VAC therapy. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Comparative study of abdominal cavity temporary closure techniques for damage control.

PubMed

Ribeiro, Marcelo A F; Barros, Emily Alves; Carvalho, Sabrina Marques DE; Nascimento, Vinicius Pereira; Cruvinel, José; Fonseca, Alexandre Zanchenko

2016-01-01

The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack. We conducted a systematic review of the literature, selecting 28 articles published in the last 20 years. The techniques of the bag Bogotá and Vacuum-pack had the advantage of easy access to the material in most centers and low cost, contrary to VAC, which, besides presenting high cost, is not available in most hospitals. On the other hand, the VAC technique was more effective in reducing stress at the edges of lesions, removing stagnant fluids and waste, in addition to acting at the cellular level by increasing proliferation and cell division rates, and showed the highest rates of primary closure of the abdominal cavity. RESUMO A cirurgia de controle de danos, com ênfase em peritoneostomia, geralmente resulta em retração da aponeurose e perda da capacidade de fechar a parede abdominal, levando à formação de hérnias ventrais incisionais. Atualmente, várias técnicas oferecem maiores chances de fechamento da cavidade abdominal, com menor tensão. Deste modo, este estudo tem por objetivo avaliar três técnicas de fechamento temporário da cavidade abdominal: fechamento a vácuo (Vacuum-Assisted Closure Therapy - VAC), Bolsa de Bogotá e Vacuum-pack. Realizou-se uma revisão sistemática da literatura com seleção de 28 artigos publicados nos últimos 20 anos. As técnicas de Bolsa de Bogotá e Vacuum-pack tiveram como vantagem o acesso fácil ao material, na maioria dos centros, e baixo custo, ao contrário do que se observa na terapia a vácuo, VAC, que além de apresentar

Vacuum-assisted closure as a surgical assistant in life-threatening necrotizing fasciitis in children

PubMed Central

Al-Subhi, FS; Zuker, RM; Cole, WG

2010-01-01

Necrotizing fasciitis is a severe soft tissue infection that can involve skin, subcutaneous fat, fascia and muscle. It can result in devastating sequelae including tissue necrosis, sepsis, toxic shock syndrome, cardiopulmonary collapse and death. To control rapidly spreading necrosis, early diagnosis and aggressive surgical treatment with extensive radical debridement of the affected areas is necessary, as well as systemic administration of broad-spectrum antimicrobials and, very often, intensive care support. The subatmospheric negative pressure dressing has been previously used in acute and complex wounds management. The concept of using vacuum-assisted closure dressing as another management component is presented in the current article. PMID:22131841

Vacuum-Assisted, Constant-Force Exercise Device

NASA Technical Reports Server (NTRS)

Hansen, Christopher P.; Jensen, Scott

2006-01-01

The vacuum-assisted, constant-force exercise device (VAC-FED) has been proposed to fill a need for a safe, reliable exercise machine that would provide constant loads that could range from 20 to 250 lb (0.09 to 1.12 kN) with strokes that could range from 6 to 36 in. (0.15 to 0.91 m). The VAC-FED was originally intended to enable astronauts in microgravity to simulate the lifting of free weights, but it could just as well be used on Earth for simulated weight lifting and other constant-force exercises. Because the VAC-FED would utilize atmospheric/vacuum differential pressure instead of weights to generate force, it could weigh considerably less than either a set of free weights or a typical conventional exercise machine based on weights. Also, the use of atmospheric/ vacuum differential pressure to generate force would render the VAC-FED inherently safer, relative to free weights and to conventional exercise machines that utilize springs to generate forces. The overall function of the VAC-FED would be to generate a constant tensile force in an output cable, which would be attached to a bar, handle, or other exercise interface. The primary force generator in the VAC-FED would be a piston in a cylinder. The piston would separate a volume vented to atmosphere at one end of the cylinder from an evacuated volume at the other end of the cylinder (see figure). Hence, neglecting friction at the piston seals, the force generated would be nearly constant equal to the area of the piston multiplied by the atmospheric/vacuum differential pressure. In the vented volume in the cylinder, a direct-force cable would be looped around a pulley on the piston, doubling the stroke and halving the tension. One end of the direct-force cable would be anchored to a cylinder cap; the other end of the direct-force cable would be wrapped around a variable-ratio pulley that would couple tension to the output cable. As its name suggests, the variable-ratio pulley would contain a mechanism that

Treatment with vacuum-assisted closure and cryo-preserved homologous de-epidermalised dermis of complex traumas to the lower limbs with loss of substance, and bones and tendons exposure.

PubMed

Brandi, C; Grimaldi, L; Nisi, G; Silvestri, A; Brafa, A; Calabrò, M; D'Aniello, C

2008-12-01

Lower-limb injuries with loss of tissue and exposure of bones and tendons are an increasing problem. The condition of the wound locally and the patient in general does not always allow immediate and adequate coverage of the structures exposed by the trauma. Therefore, new therapeutic solutions are needed. A reduction in the time that bones and tendons are exposed is essential to achieve complete healing of bone fractures, with reduced risks of infection and less disabling outcomes. The effectiveness of vacuum-assisted closure (VAC) therapy in supporting wound healing and of cryopreserved homologous de-epidermalised dermis (DED) in providing an effective template for re-epithelialisation has been previously reported. We carried out a study to evaluate the effectiveness of the synergistic and combined use of the two methodologies. Eighteen patients with traumatic loss of tissue in the lower limbs, involving exposure of bone and tendon structures, were enrolled in the study. All participants had local, general contraindications to first-instance reconstructions, or both. All patients received a combination of VAC therapy and DED implants. Granulation tissue was obtained in all wounds, with complete coverage of exposed structures. No infections were detected in the cohort, and all patients were prepared for further necessary reconstructive treatments. In our experience, the combination of VAC therapy and DED could, in selected cases, constitute an effective treatment for complex lower limb traumatic injuries with bone and tendon exposure.

Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

PubMed Central

Noh, Soo Min; Lee, Jeong Hoon; Jung, Hwoon-Yong; AlGhamdi, Zeead; Kim, Hyeong Ryul; Kim, Yong-Hee

2018-01-01

Aim To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. Methods Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. Results All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. Conclusion With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy. PMID:29849581

Terra Vac In Situ Vacuum Extraction System: Applications Analysis Report

EPA Science Inventory

This document is an evaluation of the Terra Vac in situ vacuum extraction system and its applicability as a treatment method for waste site cleanup. This report analyzes the results from the Superfund Innovative Technology Evaluation (SITE) Program’s 56-day demonstration at t...

Options for Closure of the Infected Abdomen

PubMed Central

Campbell, Chris A.; Rosenberger, Laura H.; Politano, Amani D.; Davies, Stephen W.; Riccio, Lin M.; Sawyer, Robert G.

2012-01-01

Abstract Background The infected abdomen poses substantial challenges to surgeons, and often, both temporary and definitive closure techniques are required. We reviewed the options available to close the abdominal wall defect encountered frequently during and after the management of complicated intra-abdominal infections. Methods A comprehensive review was performed of the techniques and literature on abdominal closure in the setting of intra-abdominal infection. Results Temporary abdominal closure options include the Wittmann Patch, Bogota bag, vacuum-assisted closure (VAC), the AbThera™ device, and synthetic or biologic mesh. Definitive reconstruction has been described with mesh, components separation, and autologous tissue transfer. Conclusion Reconstructing the infected abdomen, both temporarily and definitively, can be accomplished with various techniques, each of which is associated with unique advantages and disadvantages. Appropriate judgment is required to optimize surgical outcomes in these complex cases. PMID:23216525

The Use of Vacuum-Assisted Closure and GranuFoam Silver® Dressing in the Management of Diabetic Foot Ulcer.

PubMed

Günal, Özgür; Tuncel, Umut; Turan, Aydin; Barut, Sener; Kostakoglu, Naci

2015-10-01

The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC) and GranuFoam Silver® dressing (KCI, San Antonio, TX) compared with conventional GranuFoam® dressing in the management of diabetic foot ulcers. Twenty-one consecutive patients treated with conventional or silver-coated foam dressing were reviewed retrospectively. The wound duration was 6 mo. Group 1 (n=10) received conventional foam dressing (GranuFoam) and group 2 (n=11) received silver-coated foam dressing (GranuFoam Silver). The wound surface area, duration of treatment, bacteriology, and recurrence were compared between the groups. The mean age of the patients was 61.70±10.52 y in group 1 and 67.27±11.28 y in group 2. In group 1, the average surface area of the wounds was 45.30±46.96 cm2 and 18.40±23.48 cm2 in the pre-treatment and post-treatment periods, respectively. There was a statistically significant difference between two measurements (p=0.005). Average duration of the treatment was 25.50±27.13 d in this group. In group 2, average surface area of the wounds in the pre-treatment and post-treatment periods were 41.55±36.03 cm2 and 7.64±3.91 cm2, respectively. There was a statistically significant difference between two measurements (p=0.003). Average duration of the treatment was 10.09±3.51 d in this group. The patients treated with silver-impregnated polyurethane foam dressing had reduced recurrence (2 vs. 7 wounds, p=0.030) and increased number of the culture-negative cases at the end of the treatment. With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers.

The value of debridement and Vacuum-Assisted Closure (V.A.C.) Therapy in diabetic foot ulcers.

PubMed

Eneroth, Magnus; van Houtum, William H

2008-01-01

Treatment of diabetic foot ulcers includes a number of different regimes such as glycaemic control, re-vascularization, surgical, local wound treatment, offloading and other non-surgical treatments. Although considered the standard of care, the scientific evidence behind the various debridements used is scarce. This presentation will focus on debridement and V.A.C. Therapy, two treatments widely used in patients with diabetes and foot ulcers. A review of existing literature on these treatments in diabetic foot ulcers, with focus on description of the various types of debridements used, the principles behind negative pressure wound therapy (NPWT) using the V.A.C. Therapy system and level of evidence. Five randomized controlled trials (RCT) of debridement were identified; three assessed the effectiveness of a hydrogel as a debridement method, one evaluated surgical debridement and one evaluated larval therapy. Pooling the three hydrogel RCTs suggested that hydrogels are significantly more effective than gauze or standard care in healing diabetic foot ulcers. Surgical debridement and larval therapy showed no significant benefit. Other debridement methods such as enzyme preparations or polysaccharide beads have not been evaluated in RCTs of people with diabetes. More than 300 articles have been published on negative pressure wound therapy, including several small RCTs and a larger multi-centre RCT of diabetic foot ulcers. Negative pressure wound therapy seems to be a safe and effective treatment for complex diabetic foot wounds, and could lead to a higher proportion of healed wounds, faster healing rates, and potentially fewer re-amputations than standard care. Although debridement of the ulcer is considered a prerequisite for healing of diabetic foot ulcers, the grade of evidence is quite low. This may be due to a lack of studies rather than lack of effect. Negative pressure wound therapy seems to be safe and effective in the treatment of some diabetic foot ulcers

Surgical debridement, vacuum therapy and pectoralis plasty in poststernotomy mediastinitis.

PubMed

Ennker, I C; Pietrowski, D; Vöhringer, L; Kojcici, B; Albert, A; Vogt, P M; Ennker, J

2009-11-01

In cardiac surgery poststernotomy mediastinitis continues to be a serious cause of morbidity and mortality. We report our experience with vacuum-assisted closure (VAC) therapy followed by reconstruction with M. pectoralis muscle flaps as treatment for deep sternal wound infections. Our group performed a retrospective analysis of 3630 consecutive cardiac surgical patients using median sternotomy from 11/2004 to 11/2007. After removing sternal wires, necrotic debris and potentially infective material, restabilisation of the sternum was performed and VAC therapy was employed. Wound closure and subsequent reconstruction were performed using a bilateral pectoralis muscle plasty. Of the analysed patients 16 female and 29 male patients suffered from deep sternal wound infections and were treated with VAC. The most common risk factors were diabetes mellitus odds ratio (OR 3.5), chronic obstructive pulmonary disease (COPD) (OR 2.9), use of bilateral mammarian artery (OR 2.0) and obesity (1.8). The median age of patients with deep sternal infections was similar to control patients. Staphylococcus epidermis was the most common pathogen (37.8%) followed by Enterococcus faecilis (22.2%) and Staphylococcus aureus (17.8). In 22.2% no pathogen could be detected. The 30 day mortality was 0%, the in-hospital mortality was 15.6%. The results of our studies demonstrate that vacuum therapy in conjunction with early and aggressive debridement is an effective strategy for treating poststernotomy mediastinitis. We consider pectoralis major muscle flap reconstruction as a safe technique and regard it as the primary choice for wound closure in poststernotomy mediastinitis. (c) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Experience With Wound VAC and Delayed Primary Closure of Contaminated Soft Tissue Injuries in Iraq

DTIC Science & Technology

2006-11-01

wound was definitively closed by delayed primary closure, flap mobilization, or split-thickness skin grafting . The VAC system was also used...postoperatively for 3 to 5 days over skin grafts , then removed at the bedside to assess graft take. Granulation tissue was not a prerequisite for wound closure...hospital until the closed wounds were clean and dry with good skin graft incorporation. All patients were scheduled for follow-up in our outpatient

Abdominal wall integrity after open abdomen: long-term results of vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM).

PubMed

Willms, A; Schaaf, S; Schwab, R; Richardsen, I; Bieler, D; Wagner, B; Güsgen, C

2016-12-01

The open abdomen has become a standard technique in the management of critically ill patients undergoing surgery for severe intra-abdominal conditions. Negative pressure and mesh-mediated fascial traction are commonly used and achieve low fistula rates and high fascial closure rates. In this study, long-term results of a standardised treatment approach are presented. Fifty-five patients who underwent OA management for different indications at our institution from 2006 to 2013 were enrolled. All patients were treated under a standardised algorithm that uses a combination of vacuum-assisted wound closure and mesh-mediated fascial traction. Structured follow-up assessments were offered to patients and included a medical history, a clinical examination and abdominal ultrasonography. The data obtained were statistically analysed. The fascial closure rate was 74 % in an intention-to-treat analysis and 89 % in a per-protocol analysis. The fistula rate was 1.8 %. Thirty-four patients attended follow-up. The median follow-up was 46 months (range 12-88 months). Incisional hernias developed in 35 %. Patients with hernias needed more operative procedures (10.3 vs 3.4, p = 0.03) than patients without hernia formation. A Patient Observer Scar Assessment Scale (POSAS) of 31.1 was calculated. Patients with symptomatic hernias (NAS of 2-10) had a significantly lower mean POSAS score (p = 0.04). Vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) seem to result in low complication rates and high fascial closure rates. Abdominal wall reconstruction, which is a challenging and complex procedure and causes considerable patient discomfort, can thus be avoided in the majority of cases. Available results are based on studies involving only a small number of cases. Multi-centre studies and registry-based data are therefore needed to validate these findings.

Prophylactic Groin Wound Vacuum-assisted Therapy in Vascular Surgery Patients at Enhanced Risk for Postoperative Wound Infection.

PubMed

Pesonen, Luke O; Halloran, Brian G; Aziz, Abdulhameed

2018-01-01

Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified. A single institution, retrospective analysis was conducted from January 2013 to September 2016 utilizing procedure codes to identify patients with wound VACs placed in the operating room. Two distinct groups were identified. The first was a wound complication patient group with 15 limbs (13 patients) with a groin wound VAC placed within 45 days postoperatively for groin wound complications. Eleven of these limbs had the VAC placed at readmission. The second group was a prophylactic patient group that included 8 limbs (7 patients) who received a VAC prophylactically placed in the enhanced risk wounds. These wounds were determined to be enhanced risk based on clinical criteria judged by the operating surgeon such as a large overhanging panniculus and/or one of several ongoing medical issues. We calculated a Wiseman score for all patients, determined total cost of the readmissions, and determined 30-day postsurgical SSI incidence for the prophylactic VAC group. Per the Wiseman scores, 9 limbs with postoperative complications were high risk and 3 limbs were moderate/high risk. Eleven limbs had a VAC placed at readmission with an average readmission cost of $8876.77. For the prophylactic group, 8 limbs were high risk with no observed postdischarge SSI in the first 30 days from surgery. The Wiseman scores showed close correlation between the retrospective high and moderate/high risk groups versus the prophylactic VAC group (31.5 ± 7.3 vs. 32 ± 5.5, P = 0.87). The Wiseman

Long-term outcomes of sandwich ventral hernia repair paired with hybrid vacuum-assisted closure.

PubMed

Hicks, Caitlin W; Poruk, Katherine E; Baltodano, Pablo A; Soares, Kevin C; Azoury, Said C; Cooney, Carisa M; Cornell, Peter; Eckhauser, Frederic E

2016-08-01

Sandwich ventral hernia repair (SVHR) may reduce ventral hernia recurrence rates, although with an increased risk of surgical site occurrences (SSOs) and surgical site infections (SSIs). Previously, we found that a modified negative pressure wound therapy (hybrid vacuum-assisted closure [HVAC]) system reduced SSOs and SSIs after ventral hernia repair. We aimed to describe our outcomes after SVHR paired with HVAC closure. We conducted a 4-y retrospective review of all complex SVHRs (biologic mesh underlay and synthetic mesh overlay) with HVAC closure performed at our institution by a single surgeon. All patients had fascial defects that could not be reapproximated primarily using anterior component separation. Descriptive statistics were used to report the incidence of postoperative complications and hernia recurrence. A total of 60 patients (59.3 ± 11.4 y, 58.3% male, 75% American Society of Anesthesiologists class ≥3) with complex ventral hernias being underwent sandwich repair with HVAC closure. Major postoperative morbidity (Dindo-Clavien class ≥3) occurred in 14 (23.3%) patients, but incidence of SSO (n = 13, 21.7%) and SSI (n = 4, 6.7%) was low compared with historical reports. Median follow-up time for all patients was 12 mo (interquartile range 5.8-26.5 mo). Hernia recurrence occurred in eight patients (13.3%) after a median time of 20.6 months (interquartile range 16.4- 25.4 months). Use of a dual layer sandwich repair for complex abdominal wall reconstruction is associated with low rates of hernia recurrence at 1 year postoperatively. The addition of the HVAC closure system may reduce the risk of SSOs and SSIs previously reported with this technique and deserves consideration in future prospective studies assessing optimization of ventral hernia repair approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

In vitro comparison of intra-abdominal hypertension development after different temporary abdominal closure techniques.

PubMed

Benninger, Emanuel; Labler, Ludwig; Seifert, Burkhardt; Trentz, Otmar; Menger, Michael D; Meier, Christoph

2008-01-01

To compare volume reserve capacity (VRC) and development of intra-abdominal hypertension after different in vitro temporary abdominal closure (TAC) techniques. A model of the abdomen was designed. The abdominal wall was simulated with polychloroprene, a synthetic rubber compound. A lentil-shaped defect of 150 cm(2) was cut into the anterior aspect of the abdominal wall. TAC of this defect was performed by a zipper system (ZS), a bag silo closure (BSC), or a vacuum assisted closure (VAC) with subatmospheric pressures ranging from 0- to 200 mmHg. The model with intact abdominal wall served as reference. The model was filled with water to baseline level. The intra-abdominal pressure was increased in 2 mmHg steps from baseline level (6 mmHg) to 40 mmHg by adding volume to the system according to a standardized protocol. VRC with corresponding intra-abdominal pressure were analyzed and compared for the different TAC techniques. VRC was the highest after BSC at all pressure levels studied (P < 0.05). VAC and ZS resulted in significantly lower VRC compared with BSC and reference (P < 0.05). The magnitude of negative pressure on the VAC did not significantly influence the VRC. In the present in vitro model, BSC demonstrated the highest VRC of all evaluated TAC techniques. Different levels of subatmospheric pressures applied to the VAC did not affect VRC. The results for ZS and VAC indicate that these TAC techniques may increase the risk for recurrent intra-abdominal hypertension and should therefore not be used in high-risk patients during the initial phase after abdominal decompression.

EPA SITE DEMONSTRATION OF THE TERRA VAC IN SITU VACUUM EXTRACTION PROCESS IN GROVELAND, MASSACHUSETTS

EPA Science Inventory

This paper presents an EPA evaluation of the patented Terra Vac, Inc.'s in situ vacuum extraction process that was field-demonstrated on a trichloroethylene (TCE) contaminated soil in Groveland, MA, under the EPA Superfund Innovative Technology Evaluation (SITE) program. he Terra...

Distally based saphenous neurocutaneous perforator flap combined with vac therapy for soft tissue reconstruction and hardware salvage in the lower extremities.

PubMed

Wen, Gen; Wang, Chun-Yang; Chai, Yi-Min; Cheng, Liang; Chen, Ming; Yi-Min, L V

2013-11-01

The complex wound with the exposed hardware and infection is one of the common complications after the internal fixation of the tibia fracture. The salvage of hardware and reconstruction of soft tissue defect remain challenging. In this report, we presented our experience on the use of the distally based saphenous neurocutaneous perforator flap combined with vacuum-assisted closure (VAC) therapy for the coverage of the soft tissue defect and the exposed hardware in the lower extremity with fracture. Between January 2008 and July 2010, seven patients underwent the VAC therapy followed by transferring a reversed saphenous neurocutaneous perforator flap for reconstruction of the wound with exposed hardware around the distal tibia. The sizes of the flaps ranged from 6 × 3 cm to 15 × 6 cm. Six flaps survived completely. Partial necrosis occurred in one patient. There were no other complications of repair and donor sites. Bone healing was achieved in all patients. In conclusion, the reversed saphenous neurocutaneous perfortor flaps combined with the VAC therapy might be one of the options to cover the complex wound with exposed hardware in the lower extremities. © 2013 Wiley Periodicals, Inc.

The use of the M-Vac® wet-vacuum system as a method for DNA recovery.

PubMed

Vickar, Toby; Bache, Katherine; Daniel, Barbara; Frascione, Nunzianda

2018-07-01

Collecting sufficient template DNA from a crime scene sample is often challenging, especially with low quantity samples such as touch DNA (tDNA). Traditional DNA collection methods such as double swabbing have limitations, in particular when used on certain substrates which can be found at crime scenes, thus a better collection method is advantageous. Here, the effectiveness of the M-Vac® Wet-Vacuum System is evaluated as a method for DNA recovery on tiles and bricks. It was found that the M-Vac® recovered 75% more DNA than double swabbing on bricks. However, double swabbing collected significantly more DNA than the M-Vac® on tiles. Additionally, it was found that cell-free DNA is lost in the filtration step of M-Vac® collection. In terms of peak height and number of true alleles detected, no significant difference was found between the DNA profiles obtained through M-Vac® collection versus double swabbing of tDNA depositions from 12 volunteers on bricks. The results demonstrate that the M-Vac® has potential for DNA collection from porous surfaces such as bricks, but that alterations to the filter apparatus would be beneficial to increase the amount of genetic material collected for subsequent DNA profiling. These results are anticipated to be a starting point to validate the M-Vac® as a DNA collection device, providing an alternative method when DNA is present on a difficult substrate, or if traditional DNA collection methods have failed. Copyright © 2018 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

Determination of transformation products of unsymmetrical dimethylhydrazine in water using vacuum-assisted headspace solid-phase microextraction.

PubMed

Orazbayeva, Dina; Kenessov, Bulat; Psillakis, Elefteria; Nassyrova, Dayana; Bektassov, Marat

2018-06-22

A new, sensitive and simple method based on vacuum-assisted headspace solid-phase microextraction (Vac-HSSPME) followed by gas chromatography-mass-spectrometry (GC-MS), is proposed for the quantification of rocket fuel unsymmetrical dimethylhydrazine (UDMH) transformation products in water samples. The target transformation products were: pyrazine, 1-methyl-1H-pyrazole, N-nitrosodimethylamine, N,N-dimethylformamide, 1-methyl-1Н-1,2,4-triazole, 1-methyl-imidazole and 1H-pyrazole. For these analytes and within shorter sampling times, Vac-HSSPME yielded detection limits (0.5-100 ng L -1 ) 3-10 times lower than those reported for regular HSSPME. Vac-HSSPME sampling for 30 min at 50 °C yielded the best combination of analyte responses and their standard deviations (<15%). 1-Formyl-2,2-dimethylhydrazine and formamide were discarded because of the poor precision and accuracy when using Vac-HSSPME. The recoveries for the rest of the analytes ranged between 80 and 119%. The modified Mininert valve and Thermogreen septum could be used for automated extraction as it ensured stable analyte signals even after long waiting times (>24 h). Finally, multiple Vac-HSSME proved to be an efficient tool for controlling the matrix effect and quantifying UDMH transformation products. Copyright © 2018 Elsevier B.V. All rights reserved.

Pilot study of a novel vacuum-assisted method for decellularization of tracheae for clinical tissue engineering applications.

PubMed

Lange, P; Greco, K; Partington, L; Carvalho, C; Oliani, S; Birchall, M A; Sibbons, P D; Lowdell, M W; Ansari, T

2017-03-01

Tissue engineered tracheae have been successfully implanted to treat a small number of patients on compassionate grounds. The treatment has not become mainstream due to the time taken to produce the scaffold and the resultant financial costs. We have developed a method for decellularization (DC) based on vacuum technology, which when combined with an enzyme/detergent protocol significantly reduces the time required to create clinically suitable scaffolds. We have applied this technology to prepare porcine tracheal scaffolds and compared the results to scaffolds produced under normal atmospheric pressures. The principal outcome measures were the reduction in time (9 days to prepare the scaffold) followed by a reduction in residual DNA levels (DC no-vac: 137.8±48.82 ng/mg vs. DC vac 36.83±18.45 ng/mg, p<0.05.). Our approach did not impact on the collagen or glycosaminoglycan content or on the biomechanical properties of the scaffolds. We applied the vacuum technology to human tracheae, which, when implanted in vivo showed no significant adverse immunological response. The addition of a vacuum to a conventional decellularization protocol significantly reduces production time, whilst providing a suitable scaffold. This increases clinical utility and lowers production costs. To our knowledge this is the first time that vacuum assisted decellularization has been explored. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

James Webb Space Telescope (JWST) Integrated Sciene Instrument Module (ISIM) Cryo-Vac 3 (CV3) Thermal Vacuum Test

NASA Technical Reports Server (NTRS)

Packard, Ed

2016-01-01

This presentation describes the test objectives, test summary, test configuration and test performance of the James Webb Space Telescope Integrated Science Instrument Module CryoVac 3 Thermal Vacuum Test. Verify the ISIM System in its final configuration after environmental exposure and provide a post-environmental performance baseline, including critical ground calibrations needed for science data processing in flight.

Remote controlled vacuum joint closure mechanism

DOEpatents

Doll, D.W.; Hager, E.R.

1984-02-22

A remotely operable and maintainable vacuum joint closure mechanism for a noncircular aperture is disclosed. The closure mechanism includes an extendible bellows coupled at one end to a noncircular duct and at its other end to a flange assembly having sealed grooves for establishing a high vacuum seal with the abutting surface of a facing flange which includes an aperture forming part of the system to be evacuated. A plurality of generally linear arrangements of pivotally coupled linkages and piston combinations are mounted around the outer surface of the duct and aligned along the length thereof. Each of the piston/linkage assemblies is adapted to engage the flange assembly by means of a respective piston and is further coupled to a remote controlled piston drive shaft to permit each of the linkages positioned on a respective flat outer surface of the duct to simultaneously and uniformly displace a corresponding piston and the flange assembly with which it is in contact along the length of the duct in extending the bellows to provide a high vacuum seal between the movable flange and the facing flange. A plurality of latch mechanisms are also pivotally mounted on the outside of the duct. A first end of each of the latch mechanisms is coupled to a remotely controlled latch control shaft for displacing the latch mechanism about its pivot point. In response to the pivoting displacement of the latch mechanism, a second end thereof is displaced so as to securely engage the facing flange and maintain the high vacuum seal established by the displacement of the flange assembly and extension of the bellows without displacing the entire duct.

Remote controlled vacuum joint closure mechanism

DOEpatents

Doll, David W.; Hager, E. Randolph

1986-01-01

A remotely operable and maintainable vacuum joint closure mechanism for a noncircular aperture is disclosed. The closure mechanism includes an extendible bellows coupled at one end to a noncircular duct and at its other end to a flange assembly having sealed grooves for establishing a high vacuum seal with the abutting surface of a facing flange which includes an aperture forming part of the system to be evacuated. A plurality of generally linear arrangements of pivotally coupled linkages and piston combinations are mounted around the outer surface of the duct and aligned along the length thereof. Each of the piston/linkage assemblies is adapted to engage the flange assembly by means of a respective piston and is further coupled to a remote controlled piston drive shaft to permit each of the linkages positioned on a respective flat outer surface of the duct to simultaneously and uniformly displace a corresponding piston and the flange assembly with which it is in contact along the length of the duct in extending the bellows to provide a high vacuum seal between the movable flange and the facing flange. A plurality of latch mechanisms are also pivotally mounted on the outside of the duct. A first end of each of the latch mechanisms is coupled to a remotely controlled latch control shaft for displacing the latch mechanism about its pivot point. In response to the pivoting displacement of the latch mechanism, a second end thereof is displaced so as to securely engage the facing flange.

Bio-Engineering tissue and V.A.C. therapy: A new method for the treatment of extensive necrotizing infection in the diabetic foot.

PubMed

Armenio, Andrea; Cutrignelli, Daniela Anna; Nardulli, Maria Luisa; Maggio, Giulio; Memeo, Giuseppe; De Santis, Valerio; Giudice, Giuseppe; Ressa, Cosmo Maurizio

2017-01-01

The aim of the study is to compare the standard care for progressive necrotizing infection in diabetic foot with a treatment protocol based on the association between autologous fibroblast grafts and vacuum-assisted closure therapy (V.A.C.). A retrospective matched Case-Control study was carried out on 20 patients with diabetic foot infection, 10 treated with the standard care and 10 with our new protocol. Inclusion criteria were: acute diabetic foot necrosis (Wagner III and IV), ulcer size (30 to 80 cm2), tendon and bone exposure. Success in the treatment was evaluated as: percentage of healing at the 20th week, time of healing, deambulation, recurrence and major amputation rate. A 90% healing rate was observed after 20 weeks in the study group, compared to a 28.6% in the control group. The recurrence rate in the treated areas was 20% in the study group and 100% in the control group. None of the patients in either group required major amputations. We achieved very promising results by associating autologous fibroblasts grafts and V.A.C. therapy, in comparison with standard care. V.A.C. therapy seems to improve the growth rate of the fibroblasts, probably by sealing the wound and providing a moist environment following the fibroblast graft. The improved neoangiogenesis of the neo-dermis could explain the reduced recurrence rate of the study group. Despite the low number of patients involved and the retrospective nature of the analysis, this study showed a reliable, safe and cost-effective method of treating extensive infection in the diabetic foot. Bio-Engineered Tissue, Diabetic foot, Fibroblast graft, V.A.C.

49 CFR 570.56 - Vacuum brake assist unit and vacuum brake system.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... The following requirements apply to vehicles with vacuum brake assist units and vacuum brake systems. (a) Vacuum brake assist unit integrity. The vacuum brake assist unit shall demonstrate integrity as... maintained on the pedal. (1) Inspection procedure. Stop the engine and apply service brake several times to...

Unloading Farmers’ Stock Warehouses with a Peanut Vac

USDA-ARS?s Scientific Manuscript database

A peanut vacuum has been developed by a company specializing in pneumatic conveying equipment by redesigning their existing grain vacuum (vac) specifically to handle farmers’ stock peanuts accounting for the desire to maintain the integrity of the peanut pod throughout the conveyance process. The pe...

Multichannel Negative Pressure Wound Therapy Vacuum Assisted Closure (V.A.C.)

DTIC Science & Technology

2016-10-01

Concepts, Inc. (KCI) Innovation & Strategic Marketing 12930 W Interstate 10 San Antonio, TX 78249-2248 8. PERFORMING ORGANIZATION REPORT...canisters. It was also designed to have four independently controlled NPWT channels . 15. SUBJECT TERMS Wound therapy, multichannel negative...wound dressings and wound exudate canisters. It was also designed to have four independently controlled NPWT channels . 2.0 INTRODUCTION The

Vacuum-assisted venous return reduces blood usage.

PubMed

Banbury, Michael K; White, Jennifer A; Blackstone, Eugene H; Cosgrove, Delos M

2003-09-01

To determine whether vacuum-assisted venous return has clinical advantages over conventional gravity drainage apart from allowing the use of smaller cannulas and shorter tubing. A total of 150 valve operations were performed at our institution between February and July 1999 using vacuum-assisted venous return with small venous cannulas connected to short tubing. These were compared with (1) 83 valve operations performed between April 1997 and January 1998 using the initial version of vacuum-assisted venous return, and (2) 124 valve operations performed between January and April of 1997 using conventional gravity drainage. Priming volume, hematocrit value, red blood cell usage, and total blood product usage were compared multivariably. These comparisons were covariate and propensity adjusted for dissimilarities between the groups and confirmed by propensity-matched pairs analysis. Priming volume was 1.4 +/- 0.4 L for small-cannula vacuum-assisted venous return, 1.7 +/- 0.4 L for initial vacuum-assisted venous return, and 2.0 +/- 0.4 L for gravity drainage (P <.0001). Smaller priming resulted in higher hematocrit values both at the beginning of cardiopulmonary bypass (27% +/- 5% compared with 26% +/- 4% and 25% +/- 4%, respectively, P <.0001) and at the end (30% +/- 4% compared with 28% +/- 4% and 27% +/- 4%, respectively, P <.0001). Red cell transfusions were used in 17% of the patients having small-cannula vacuum-assisted venous return, 27% of the initial patients having vacuum-assisted venous return, and 37% of the patients having gravity drainage (P =.001); total blood product usage was 19%, 27%, and 39%, respectively (P =.002). Although ministernotomy also was associated with reduced blood product usage (P <.004), propensity matching on type of sternotomy confirmed the association of vacuum-assisted venous return with lowered blood product usage. Vacuum-assisted venous return results in (1) higher hematocrit values during cardiopulmonary bypass and (2) decreased

Open abdomen with vacuum-assisted wound closure and mesh-mediated fascial traction in patients with complicated diffuse secondary peritonitis: A single-center 8-year experience.

PubMed

Tolonen, Matti; Mentula, Panu; Sallinen, Ville; Rasilainen, Suvi; Bäcklund, Minna; Leppäniemi, Ari

2017-06-01

Open abdomen (OA) treatment in patients with peritonitis is increasing worldwide. Various temporary abdominal closure devices are being used. This study included patients with complicated diffuse secondary peritonitis, OA, and vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). The aim of this study was to describe mortality and major morbidity in terms of delayed primary fascial closure and enteroatmospheric fistula rates. This was a single-academic-center retrospective study of consecutive patients with diffuse peritonitis, OA, and VAWCM between years 2008 and 2016. Descriptive and univariate analyses were performed. Forty-one patients were identified and analyzed. Median age was 59 years, preoperative septic shock was diagnosed in 54% (n = 22), and 59% (n = 24) had a postoperative peritonitis. Mortality was 29% (n = 12), and 76% (n = 31) of patients were admitted in the intensive care unit. The median duration of OA was 7 days with a median of two dressing changes. Delayed primary fascial closure rate among survivors was 92% (n = 33), and enteroatmospheric fistulas developed in 7% (n = 3). In a subgroup analysis, patients with OA in the primary laparotomy for peritonitis (n = 27) were compared with patients with OA in the subsequent laparotomies (n = 14). There were no significant differences between groups. The VAWCM technique in patients with complicated secondary diffuse peritonitis and OA yields excellent results in terms of delayed primary fascial closure rate and a low number of enteroatmospheric fistulas. It seems to be safe to close the abdomen at the index laparotomy, if possible, even if there is a risk of a need of OA later. Therapeutic/care management study, level IV.

21 CFR 864.9125 - Vacuum-assisted blood collection system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vacuum-assisted blood collection system. 864.9125... Blood and Blood Products § 864.9125 Vacuum-assisted blood collection system. (a) Identification. A vacuum-assisted blood collection system is a device intended for medical purposes that uses a vacuum to...

21 CFR 864.9125 - Vacuum-assisted blood collection system.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Vacuum-assisted blood collection system. 864.9125... Blood and Blood Products § 864.9125 Vacuum-assisted blood collection system. (a) Identification. A vacuum-assisted blood collection system is a device intended for medical purposes that uses a vacuum to...

21 CFR 864.9125 - Vacuum-assisted blood collection system.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Vacuum-assisted blood collection system. 864.9125... Blood and Blood Products § 864.9125 Vacuum-assisted blood collection system. (a) Identification. A vacuum-assisted blood collection system is a device intended for medical purposes that uses a vacuum to...

21 CFR 864.9125 - Vacuum-assisted blood collection system.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Vacuum-assisted blood collection system. 864.9125... Blood and Blood Products § 864.9125 Vacuum-assisted blood collection system. (a) Identification. A vacuum-assisted blood collection system is a device intended for medical purposes that uses a vacuum to...

21 CFR 864.9125 - Vacuum-assisted blood collection system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vacuum-assisted blood collection system. 864.9125... Blood and Blood Products § 864.9125 Vacuum-assisted blood collection system. (a) Identification. A vacuum-assisted blood collection system is a device intended for medical purposes that uses a vacuum to...

Economic evaluation of Vacuum Assisted Closure® Therapy for the treatment of diabetic foot ulcers in France.

PubMed

Whitehead, Sarah J; Forest-Bendien, Véronique L; Richard, Jean-Louis; Halimi, Serge; Van, Georges Ha; Trueman, Paul

2011-02-01

The objective of the study was to assess the cost-effectiveness of Vacuum Assisted Closure® (V.A.C.®) Therapy compared with advanced wound care (AWC) for the treatment of diabetic foot ulcers (DFUs) in France. A cost-effectiveness model intended to reflect the management of DFUs was updated for the French setting. The Markov model follows the progression of 1000 hypothetical patients over a 1-year period. The model was populated with French-specific data, obtained from published sources and clinical experts. The analysis evaluated costs and health outcomes, in terms of quality-adjusted life-years (QALYs), wounds healed and amputations, from the perspective of the payer. The patients treated with V.A.C.® Therapy experienced more QALYs (0.787 versus 0.784) and improved healing rates (50.2% versus 48.5%) at a lower total cost of care (€24,881 versus €28,855 per patient per year) when compared with AWC. Sensitivity analyses conducted around key model parameters indicated that the results were affected by hospital resource use and costs. DFU treatment using V.A.C.® Therapy in France was associated with lower costs, additional QALYs, more healed ulcers and fewer amputations than treatment with AWC. V.A.C.® Therapy was therefore found to be the dominant treatment option. © 2010 The Authors. © 2010 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Fast MRI-guided vacuum-assisted breast biopsy: initial experience.

PubMed

Liberman, Laura; Morris, Elizabeth A; Dershaw, D David; Thornton, Cynthia M; Van Zee, Kimberly J; Tan, Lee K

2003-11-01

The purpose of this study was to evaluate a new method for performing MRI-guided vacuum-assisted breast biopsy in a study of lesions that had subsequent surgical excision. SUBJECTS AND METHODS. Twenty women scheduled for MRI-guided needle localization and surgical biopsy were prospectively entered in the study. MRI-guided biopsy was performed with a vacuum-assisted probe, followed by placement of a localizing clip, and then needle localization for surgical excision. Vacuum-assisted biopsy and surgical histology were correlated. Vacuum-assisted biopsy was successfully performed in 19 (95%) of the 20 women. The median size of 27 MRI-detected lesions that had biopsy was 1.0 cm (range, 0.4-6.4 cm). Cancer was present in eight (30%) of 27 lesions and in six (32%) of 19 women; among these eight cancers, five were infiltrating and three were ductal carcinoma in situ (DCIS). Among these 27 lesions, histology was benign at vacuum-assisted biopsy and at surgery in 19 (70%), cancer at vacuum-assisted biopsy in six (22%), atypical ductal hyperplasia at vacuum-assisted biopsy and DCIS at surgery in one (4%), and benign at vacuum-assisted biopsy with surgery showing microscopic DCIS that was occult at MRI in one (4%). The median time to perform vacuum-assisted biopsy of a single lesion was 35 min (mean, 35 min; range, 24-48 min). Placement of a localizing clip, attempted in 26 lesions, was successful in 25 (96%) of 26, and the clip was retrieved on specimen radiography in 22 (96%) of 23. One complication occurred: a hematoma that resolved with compression. MRI-guided vacuum-assisted biopsy is a fast, safe, and accurate alternative to surgical biopsy for breast lesions detected on MRI.

Antibacterial potency of V.A.C. GranuFoam Silver(®) Dressing.

PubMed

Sachsenmaier, Saskia; Peschel, Andreas; Ipach, Ingmar; Kluba, Torsten

2013-10-01

V.A.C.(®) GranuFoam™ therapy is regularly used in the surgical therapy of infected wounds and soft tissue injuries. Silver nanoparticles can destroy bacterial cell walls and inhibit enzymes for cell replication. Silver dressings are therefore successfully used for many indications in wound therapy. In this study, we investigated the antimicrobial potency of ionic silver released from the silver-coated V.A.C.(®) GranuFoam™ during vacuum therapy. Silver dressing was exposed to agar plates populated with bacteria to measure silver release. A total of 15 agar plates colonised with either Staphylococcus aureus populations or with Staphylococcus epidermidis, were loaded with V.A.C. GranuFoam Silver(®) Dressing polyurethane foam (KCI, San Antonio, Texas). Each of 13 pieces of silver-coated foam was applied to an agar plate. Two plates were loaded with conventional black foam without any coating. After connecting to a vacuum pump, the vacuum therapy of the 15 plates lasted 5 days. The zone of inhibition of bacterial growth around the foam was measured daily. Silver release was also determined as a function of time. At each time point, there was evidence of silver in the agar independent of bacterial colonisation. The S. aureus agar showed a consecutive increase in silver concentration from baseline upon 48 h after exposure to the negative pressure of V.A.C. therapy. An increasing mean silver level after 48, 72 and 96 h was measured under V.A.C. therapy with a peak value after 120 h. In contrast, the results from the S. epidermidis plates did not follow a linear pattern. At the beginning of vacuum therapy, we documented a rise in silver concentration. After 48-96h, the silver levels fluctuated. A maximum zone of inhibition in both bacterial colonised plates (S. aureus and S. epidermidis) was found 39 h after the start of the V.A.C. GranuFoam Silver(®) therapy. From our results, we confirmed the antimicrobial effect of the silver ions against S. aureus and S

Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages

PubMed Central

de Carvalho Filho, Élio Barreto; Marson, Fernando Augusto de Lima; da Costa, Loredana Nilkenes Gomes; Antunes, Nilson

2014-01-01

Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas. PMID:25140478

Vacuum-assisted drainage in cardiopulmonary bypass: advantages and disadvantages.

PubMed

Carvalho Filho, Elio Barreto de; Marson, Fernando Augusto de Lima; Costa, Loredana Nilkenes Gomes da; Antunes, Nilson

2014-01-01

Systematic review of vacuum assisted drainage in cardiopulmonary bypass, demonstrating its advantages and disadvantages, by case reports and evidence about its effects on microcirculation. We conducted a systematic search on the period 1997-2012, in the databases PubMed, Medline, Lilacs and SciELO. Of the 70 selected articles, 26 were included in the review. Although the vacuum assisted drainage has significant potential for complications and requires appropriate technology and professionalism, prevailed in literature reviewed the concept that vacuum assisted drainage contributed in reducing the rate of transfusions, hemodilutions, better operative field, no significant increase in hemolysis, reduced complications surgical, use of lower prime and of smaller diameter cannulas.

Window-assisted nanosphere lithography for vacuum micro-nano-electronics

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

Li, Nannan; Institute of Electronic Engineering, Chinese Academy of Engineering Physics, Mianyang, 621900; Pang, Shucai

2015-04-15

Development of vacuum micro-nano-electronics is quite important for combining the advantages of vacuum tubes and solid-state devices but limited by the prevailing fabricating techniques which are expensive, time consuming and low-throughput. In this work, window-assisted nanosphere lithography (NSL) technique was proposed and enabled the low-cost and high-efficiency fabrication of nanostructures for vacuum micro-nano-electronic devices, thus allowing potential applications in many areas. As a demonstration, we fabricated high-density field emitter arrays which can be used as cold cathodes in vacuum micro-nano-electronic devices by using the window-assisted NSL technique. The details of the fabricating process have been investigated. This work provided amore » new and feasible idea for fabricating nanostructure arrays for vacuum micro-nano-electronic devices, which would spawn the development of vacuum micro-nano-electronics.« less

Early intervention of negative pressure wound therapy using Vacuum-Assisted Closure in trauma patients: impact on hospital length of stay and cost.

PubMed

Kaplan, Mark; Daly, Darron; Stemkowski, Stephen

2009-03-01

The cost of treating complex traumatic wounds is substantial because of trauma severity, potential for infection, and delayed closure. Negative pressure wound therapy using reticulated open cell foam (NPWT/ROCF) as delivered by Vacuum-Assisted Closure* (KCI Licensing, Inc, San Antonio, Texas) is an established, viable option for treating traumatic wounds. The authors used retrospective data to study the clinical and cost-effective benefits of using NPWT/ROCF early on day 1 or day 2 of treatment for traumatic wounds as compared with using it late (on day 3 or later). Hospital data records from trauma wound patients treated with NPWT/ROCF were retrospectively analyzed. Data were subdivided into 2 groups based on start of treatment. The group of patients treated on day 1 or 2 of their hospital stay was referred to as the early group, and that composed of patients treated on day 3 or later as the late group. Clinical and cost-effective metrics were compared between the 2 groups. For the early group, 518 patient records were included; 1000 records were reviewed for the late group. Early-group patients had fewer hospital inpatient days (10.6 vs 20.6 days; P < .0001), fewer treatment days (5.1 vs 6.0 days; P = .0498), shorter intensive care unit (ICU) stays (5.3 vs 12.4 days; P < .0001), and higher ICU admission rates (51.5 vs 44.5%; P = .0091) than the late group. Compared with late-group patients, early-group patients had lower total and variable costs per patient discharge ($43,956 vs $32,175; P < .0001 and $22,891 vs $15,805; P < .0001, respectively). Acute-care trauma wound patients receiving early NPWT/ROCF demonstrated significant reductions in length of stay, treatment days, and ICU stay, which resulted in significant reduced patient treatment costs. These results indicate that early intervention with NPWT/ROCF has potential clinical and cost-effective benefits for the treatment of traumatic wounds.

The vacuum platform

NASA Astrophysics Data System (ADS)

McNab, A.

2017-10-01

This paper describes GridPP’s Vacuum Platform for managing virtual machines (VMs), which has been used to run production workloads for WLCG and other HEP experiments. The platform provides a uniform interface between VMs and the sites they run at, whether the site is organised as an Infrastructure-as-a-Service cloud system such as OpenStack, or an Infrastructure-as-a-Client system such as Vac. The paper describes our experience in using this platform, in developing and operating VM lifecycle managers Vac and Vcycle, and in interacting with VMs provided by LHCb, ATLAS, ALICE, CMS, and the GridPP DIRAC service to run production workloads.

A clinical study of the LiVac laparoscopic liver retractor system.

PubMed

Gan, Philip; Bingham, Judy

2016-02-01

All retractors for laparoscopic operations on the gallbladder or stomach apply an upward force to the under-surface of the liver or gallbladder, most requiring an additional skin incision. The LiVac laparoscopic liver retractor system (LiVac retractor) comprises a soft silicone ring attached to suction tubing and connected to a regulated source of suction. The suction tubing extends alongside existing ports. When placed between the liver and diaphragm, and suction applied, a vacuum is created within the ring, keeping these in apposition. Following successful proof-of-concept animal testing, a clinical study was conducted to evaluate the performance and safety of the retractor in patients. The study was a dual-centre, single-surgeon, open-label study and recruited ten patients scheduled to undergo routine upper abdominal laparoscopic surgery including cholecystectomy, primary gastric banding surgery or fundoplication. The study was conducted at two sites and was approved by the institutions' ethics committees. The primary objective of the study was to evaluate the performance of the LiVac retractor in patients undergoing upper abdominal single- or multi-port laparoscopic surgery. Performance was measured by the attainment of milestones for the retractor and accessory bevel, where used, and safety outcomes through the recording of adverse events, physical parameters, pain scales, blood tests and a post-operative liver ultrasound. The LiVac retractor achieved both primary and secondary performance and safety objectives in all patients. No serious adverse events and no device-related adverse events or device deficiencies were reported. The LiVac retractor achieved effective liver retraction without clinically significant trauma and has potential application in multi- or single-port laparoscopic upper abdominal surgery. As a separate incision is not required, the use of the LiVac retractor in multi-port surgery therefore reduces the number of incisions.

VAC: Versatile Advection Code

NASA Astrophysics Data System (ADS)

Tóth, Gábor; Keppens, Rony

2012-07-01

The Versatile Advection Code (VAC) is a freely available general hydrodynamic and magnetohydrodynamic simulation software that works in 1, 2 or 3 dimensions on Cartesian and logically Cartesian grids. VAC runs on any Unix/Linux system with a Fortran 90 (or 77) compiler and Perl interpreter. VAC can run on parallel machines using either the Message Passing Interface (MPI) library or a High Performance Fortran (HPF) compiler.

Veterans Aging Cohort Study (VACS)

PubMed Central

Justice, Amy C.; Dombrowski, Elizabeth; Conigliaro, Joseph; Fultz, Shawn L.; Gibson, Deborah; Madenwald, Tamra; Goulet, Joseph; Simberkoff, Michael; Butt, Adeel A.; Rimland, David; Rodriguez-Barradas, Maria C.; Gibert, Cynthia L.; Oursler, Kris Ann K.; Brown, Sheldon; Leaf, David A.; Goetz, Matthew B.; Bryant, Kendall

2010-01-01

Background The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study. Objectives We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample. Research Design We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection. Measures Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA “paperless” electronic medical record system. Results More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age–race–site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control. Conclusions VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions. PMID:16849964

Emergent Embolization of Arterial Bleeding after Vacuum-Assisted Breast Biopsy

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

Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org; Epelboym, Yan, E-mail: yan.epelboym@mssm.edu; Siegelbaum, Robert H., E-mail: rhsiegelbaum@gmail.com

2012-02-15

Vacuum-assisted core breast biopsy has become important in evaluating patients with suspicious breast lesions. It has proven to be a relatively safe procedure that in rare cases can result in vascular complications. These are the first reported cases of transcatheter embolization of uncontrolled breast hemorrhage after vacuum-assisted breast biopsy. With increased use of biopsy and larger-gauge devices, breast imaging groups may consider embolotherapy as a safe alternative for treatment of hemorrhage in a select group of patients.

Vacuum decay container/closure integrity testing technology. Part 2. Comparison to dye ingress tests.

PubMed

Wolf, Heinz; Stauffer, Tony; Chen, Shu-Chen Y; Lee, Yoojin; Forster, Ronald; Ludzinski, Miron; Kamat, Madhav; Mulhall, Brian; Guazzo, Dana Morton

2009-01-01

Part 1 of this series demonstrated that a container closure integrity test performed according to ASTM F2338-09 Standard Test Method for Nondestructive Detection of Leaks in Packages by Vacuum Decay Method using a VeriPac 325/LV vacuum decay leak tester by Packaging Technologies & Inspection, LLC (PTI) is capable of detecting leaks > or = 5.0 microm (nominal diameter) in rigid, nonporous package systems, such as prefilled glass syringes. The current study compared USP, Ph.Eur. and ISO dye ingress integrity test methods to PTI's vacuum decay technology for the detection of these same 5-, 10-, and 15-microm laser-drilled hole defects in 1-mL glass prefilled syringes. The study was performed at three test sites using several inspectors and a variety of inspection conditions. No standard dye ingress method was found to reliably identify all holed syringes. Modifications to these standard dye tests' challenge conditions increased the potential for dye ingress, and adjustments to the visual inspection environment improved dye ingress detection. However, the risk of false positive test results with dye ingress tests remained. In contrast, the nondestructive vacuum decay leak test method reliably identified syringes with holes > or = 5.0 microm.

Durability of central aortic valve closure in patients with continuous flow left ventricular assist devices.

PubMed

McKellar, Stephen H; Deo, Salil; Daly, Richard C; Durham, Lucian A; Joyce, Lyle D; Stulak, John M; Park, Soon J

2014-01-01

A competent aortic valve is essential to providing effective left ventricular assist device support. We have adopted a practice of central aortic valve closure by placing a simple coaptation stitch at left ventricular assist device implantation in patients with significant aortic insufficiency. We conducted a follow-up study to evaluate the efficacy and durability of this procedure. The study included patients who had undergone continuous flow left ventricular assist device implantation. The patients were divided into 2 groups, those who did not require any aortic procedure because the valve was competent and those who underwent central aortic valve closure for mild or greater aortic regurgitation. The clinical endpoints were mortality, progression or recurrence of aortic insufficiency, and reoperation for aortic valve pathologic features. Aortic insufficiency was measured qualitatively from mild to severe on a scale of 0 to 5. A total of 123 patients received continuous flow left ventricular assist devices from February 2007 to August 2011. Of those, 18 (15%) underwent central aortic valve closure at left ventricular assist device implantation because of significant aortic insufficiency (1.8 ± 1.4) and 105 who did not (competent aortic valve, 0.15 ± 0.43; P < .01). At follow-up (median, 312 days; range, 0-1429 days), the mean aortic insufficiency score remained low for the patients with central aortic valve closure (0.27 ± 0.46) in contrast to those without central aortic valve closure who experienced aortic insufficiency progression (0.78 ± 0.89; P = .02). In addition, the proportion of patients with more than mild aortic insufficiency was significantly less in the central aortic valve closure group (0% vs 18%; P = .05). The patients in the central aortic valve closure group were significantly older and had a greater incidence of renal failure at baseline. The 30-day mortality was greater in the central aortic valve closure group, but the late survival

New suturing technique for robotic-assisted vaginal cuff closure during single-site hysterectomy.

PubMed

Shin, So-Jin; Chung, Hyewon; Kwon, Sang-Hoon; Cha, Soon-Do; Cho, Chi-Heum

2017-06-01

To describe a simple and efficient technique for suturing the vaginal cuff in robotic-assisted single-site hysterectomy using barbed suture and a straight needle. Consecutive patients undergoing robotic-assisted single-site hysterectomy from February 2014 to August 2015 at Dong San Hospital, Keimyung University were included. Surgeons used two barbed sutures in a running fashion to close the vaginal cuff. A barbed suture was exclusively used with a straightened needle in upward direction from posterior vaginal cuff to anterior vaginal cuff which played a pivotal role for closure. A total of 100 patients underwent robotic-assisted single-site hysterectomy. The total operation time was 132.5 min and vaginal cuff closure time was 12.0 min. There were no postoperative complications; vaginal cuff dehiscence, vaginal cuff infection, and vaginal bleeding that require surgical intervention or admission. The use of barbed suture with straightened needle to close the vaginal cuff in robotic-assisted single-site hysterectomy is easy to perform and demonstrates safety and efficacy. This technique offers secure, fast, and effective incision closure.

NASA's OSIRIS-REx Spacecraft In Thermal Vacuum Testing

NASA Image and Video Library

2017-12-08

The OSIRIS-REx spacecraft being lifted into the thermal vacuum chamber at Lockheed Martin for environmental testing. Credits: Lockheed Martin Read more: www.nasa.gov/feature/goddard/2016/osiris-rex-in-thermal-vac

First results from the new PVLAS apparatus: A new limit on vacuum magnetic birefringence

NASA Astrophysics Data System (ADS)

Della Valle, F.; Milotti, E.; Ejlli, A.; Messineo, G.; Piemontese, L.; Zavattini, G.; Gastaldi, U.; Pengo, R.; Ruoso, G.

2014-11-01

Several groups are carrying out experiments to observe and measure vacuum magnetic birefringence, predicted by quantum electrodynamics (QED). We have started running the new PVLAS apparatus installed in Ferrara, Italy, and have measured a noise floor value for the unitary field magnetic birefringence of vacuum Δ nu(vac )=(4 ±20 )×1 0-23 T-2 (the error represents a 1 σ deviation). This measurement is compatible with zero and hence represents a new limit on vacuum magnetic birefringence deriving from nonlinear electrodynamics. This result reduces to a factor of 50 the gap to be overcome to measure for the first time the value of Δ nu(vac ,QED ) predicted by QED: Δ nu(vac ,QED )=4 ×10-24 T-2 . These birefringence measurements also yield improved model-independent bounds on the coupling constant of axion-like particles to two photons, for masses greater than 1 meV, along with a factor-2 improvement of the fractional charge limit on millicharged particles (fermions and scalars), including neutrinos.

Risk factors for anal sphincter tears in vacuum-assisted delivery.

PubMed

Ryman, P; Ahlberg, M; Ekéus, C

2015-10-01

The aim of the present study was to describe the prevalence of anal sphincter tears (AST) in relation to obstetric management and technique during vacuum extraction deliveries (VE) (re: indications, the station of the fetal head at application of the cup, number of tractions, the length for the extraction, cup detachments, pain relief, episiotomy, fetal presentation, and experience of the operator) as well as maternal and infant anthropometrics. Descriptive study. Data on six hundred vacuum extraction deliveries were consecutively collected from six different delivery units in Sweden. Each unit contributed with data on 100 deliveries. The final study population included 596 women who delivered by vacuum extraction. There was no correlation between the management of the vacuum extraction and risk for anal sphincter tear. Women from Africa had nearly a fourfold risk for anal sphincter tear during vacuum-assisted delivery compared with Swedish-born women (OR 3.82 CI 1.47-9.89). Compared with infants with birth weight less than 4000 g, birth weight above 4000 g was associated with increased risk of AST (OR 1.87 CI 1.06-3.28). In this study, the obstetric management in VE-assisted deliveries did not impact the risk of AST. Copyright © 2015 Elsevier B.V. All rights reserved.

Non-destructive vacuum decay method for pre-filled syringe closure integrity testing compared with dye ingress testing and high-voltage leak detection.

PubMed

Simonetti, Andrea; Amari, Filippo

2015-01-01

In reaction to the limitations of the traditional sterility test methods, in 2008, the U.S. Food and Drug Administration issued the guidance "Container and Closure System Integrity Testing in Lieu of Sterility Testing as a Component of the Stability Protocol for Sterile Products" encouraging sterile drug manufacturers to use properly validated physical methods, apart from conventional microbial challenge testing, to confirm container closure integrity as part of the stability protocol. The case study presented in this article investigated the capability of four container closure integrity testing methods to detect simulated defects of different sizes and types on glass syringes, prefilled both with drug product intended for parenteral administration and sterile water. The drug product was a flu vaccine (Agrippal, Novartis Vaccines, Siena, Italy). Vacuum decay, pharmacopoeial dye ingress test, Novartis specific dye ingress test, and high-voltage leak detection were, in succession, the methods involved in the comparative studies. The case study execution was preceded by the preparation of two independent sets of reference prefilled syringes, classified, respectively, as examples of conforming to closure integrity requirements (negative controls) and as defective (positive controls). Positive controls were, in turn, split in six groups, three of with holes laser-drilled through the prefilled syringe glass barrel, while the other three with capillary tubes embedded in the prefilled syringe plunger. These reference populations were then investigated by means of validated equipment used for container closure integrity testing of prefilled syringe commercial production; data were collected and analyzed to determine the detection rate and the percentage of false results. Results showed that the vacuum decay method had the highest performance in terms of detection sensitivity and also ensured the best reliability and repeatability of measurements. An innovative technical

The cost effectiveness of vacuum-assisted versus core-needle versus surgical biopsy of breast lesions.

PubMed

Fernández-García, P; Marco-Doménech, S F; Lizán-Tudela, L; Ibáñez-Gual, M V; Navarro-Ballester, A; Casanovas-Feliu, E

To determine the cost effectiveness of breast biopsy by 9G vacuum-assisted guided by vertical stereotaxy or ultrasonography in comparison with breast biopsy by 14G core-needle biopsy and surgical biopsy. We analyzed a total of 997 biopsies (181 vacuum-assisted, 626 core, and 190 surgical biopsies). We calculated the total costs (indirect and direct) of the three types of biopsy. We did not calculate intangible costs. We measured the percentage of correct diagnoses obtained with each technique. To identify the most cost-effective option, we calculated the mean ratios for the three types of biopsies. Total costs were €225.09 for core biopsy, €638.90 for vacuum-assisted biopsy, and €1780.01 for surgical biopsy. The overall percentage of correct diagnoses was 91.81% for core biopsy, 94.03% for vacuum-assisted biopsy, and 100% for surgical biopsy; however, these differences did not reach statistical significance (p=0.3485). For microcalcifications, the percentage of correct diagnoses was 50% for core biopsy and 96.77% for vacuum-assisted biopsy (p<0.0001). For nodules, there were no significant differences among techniques. The mean cost-effectiveness ratio considering all lesions was 2.45 for core biopsy, 6.79 for vacuum-assisted biopsy, and 17.80 for surgical biopsy. Core biopsy was the dominant option for the diagnosis of suspicious breast lesions in general. However, in cases with microcalcifications, the low percentage of correct diagnoses achieved by core biopsy (50%) advises against its use in this context, where vacuum-assisted biopsy would be the technique of choice because it is more cost-effective than surgical biopsy, the other technique indicated for biopsying microcalcifications. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Vacuum-assisted headspace-solid phase microextraction for determining volatile free fatty acids and phenols. Investigations on the effect of pressure on competitive adsorption phenomena in a multicomponent system.

PubMed

Trujillo-Rodríguez, María J; Pino, Verónica; Psillakis, Elefteria; Anderson, Jared L; Ayala, Juan H; Yiantzi, Evangelia; Afonso, Ana M

2017-04-15

This work proposes a new vacuum headspace solid-phase microextraction (Vac-HSSPME) method combined to gas chromatography-flame ionization detection for the determination of free fatty acids (FFAs) and phenols. All target analytes of the multicomponent solution were volatiles but their low Henry's Law constants rendered them amenable to Vac-HSSPME. The ability of a new and easy to construct Vac-HSSPME sampler to maintain low-pressure conditions for extended sampling times was concurrently demonstrated. Vac-HSSPME and regular HSSPME methods were independently optimized and the results were compared at all times. The performances of four commercial SPME fibers and two polymeric ionic liquid (PIL)-based SPME fibers were evaluated and the best overall results were obtained with the adsorbent-type CAR/PDMS fiber. For the concentrations used here, competitive displacement became more intense for the smaller and more volatile analytes of the multi-component solution when lowering the sampling pressure. The extraction time profiles showed that Vac-HSSPME had a dramatic positive effect on extraction kinetics. The local maxima of adsorbed analytes recorded with Vac-HSSPME occurred faster, but were always lower than that with regular HSSPME due to the faster analyte-loading from the multicomponent solution. Increasing the sampling temperature during Vac-HSSPME reduced the extraction efficiency of smaller analytes due to the enhancement in water molecule collisions with the fiber. This effect was not recorded for the larger phenolic compounds. Based on the optimum values selected, Vac-HSSPME required a shorter extraction time and milder sampling conditions than regular HSSPME: 20 min and 35 °C for Vac-HSSPME versus 40 min and 45 °C for regular HSSPME. The performance of the optimized Vac-HSSPME and regular HSSPME procedures were assessed and Vac-HSSPME method proved to be more sensitive, with lower limits of detection (from 0.14 to 13 μg L -1 ), and better intra

21. Engine identified as a 'single cylinder vacuum assist engine ...

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

21. Engine identified as a 'single cylinder vacuum assist engine for Tod tandem compound engine' showing compressor. - Carnegie Steel-Ohio Works, Steam Engines, 912 Salt Springs Road, Youngstown, Mahoning County, OH

20. Engine identified as a 'single cylinder vacuum assist engine ...

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

20. Engine identified as a 'single cylinder vacuum assist engine for the Tod tandem compound engine' showing crank end. - Carnegie Steel-Ohio Works, Steam Engines, 912 Salt Springs Road, Youngstown, Mahoning County, OH

19. Engine identified as a single cylinder vacuum assist engine ...

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

19. Engine identified as a single cylinder vacuum assist engine for the Filer and Stowell 15-inch continuous mill. - Carnegie Steel-Ohio Works, Steam Engines, 912 Salt Springs Road, Youngstown, Mahoning County, OH

DEMONSTRATION BULLETIN: IN-SITU VACUUM EXRACTION: TERRA VAC, INC.

EPA Science Inventory

This in-situ vacuum extraction technology is a process for the removal and venting of volatile organic compounds (VOCs) from the vadose or unsaturated zone of soils. Often, these compounds can be removed from the vadose zone before they have a chance to contaminate groundwater. ...

A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial.

PubMed

Kamamoto, Fabio; Lima, Ana Lucia Munhoz; Rezende, Marcelo Rosa de; Mattar-Junior, Rames; Leonhardt, Marcos de Camargo; Kojima, Kodi Edson; Santos, Carla Chineze Dos

2017-12-01

Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC). This is a randomized, controlled, non-inferiority, unblinded trial. Patients admitted with complex injuries to a trauma center in a public referral hospital who were indicated for orthopedic surgery were randomized to a USP or VAC group. The primary outcome was the time required to achieve a "ready for surgery condition", which was defined as a wound bed with healthy granulation tissue and without necrosis or purulent secretion. Wound bed area contraction, granulation tissue growth and the direct costs of the dressings were secondary outcomes. Variation in area and granulation tissue growth were essentially the same between the systems, and healing time was equal between the groups (p=0.379). In both systems, serial debridement increased wound area (p=0.934), and granulation tissue was also increased (p=0.408). The mean treatment cost was US$ 15.15 in the USP group and US$ 872.59 in the VAC group. For treating complex traumatic injuries, USP was non-inferior to and less expensive than VAC.

EVALUATION OF MASS FLUX TO AND FROM GROUND WATER USING A VERTICAL FLUX MODEL (VFLUX): APPLICATION TO THE SOIL VACUUM EXTRACTION CLOSURE PROBLEM

EPA Science Inventory

Site closure for soil vacuum extraction (SVE) application typically requires attainment of specified soil concentration standards based on the premise that mass flux from the vadose zone to ground water not result in levels exceeding maximum contaminant levels (MCLSs). Unfortuna...

Evaluation of a Prototype Hybrid Vacuum Pump to Provide Vacuum-Assisted Suspension for Above-Knee Prostheses

PubMed Central

Major, Matthew J.; Caldwell, Ryan; Fatone, Stefania

2015-01-01

Vacuum-assisted suspension (VAS) of prosthetic sockets utilizes a pump to evacuate air from between the prosthetic liner and socket, and are available as mechanical or electric systems. This technical note describes a hybrid pump that benefits from the advantages of mechanical and electric systems, and evaluates a prototype as proof-of-concept. Cyclical bench testing of the hybrid pump mechanical system was performed using a materials testing system to assess the relationship between compression cycles and vacuum pressure. Phase 1 in vivo testing of the hybrid pump was performed by an able-bodied individual using prosthesis simulator boots walking on a treadmill, and phase 2 involved an above-knee prosthesis user walking with the hybrid pump and a commercial electric pump for comparison. Bench testing of 300 compression cycles produced a maximum vacuum of 24 in-Hg. In vivo testing demonstrated that the hybrid pump continued to pull vacuum during walking, and as opposed to the commercial electric pump, did not require reactivation of the electric system during phase 2 testing. The novelty of the hybrid pump is that while the electric system provides rapid, initial vacuum suspension, the mechanical system provides continuous air evacuation while walking to maintain suspension without reactivation of the electric system, thereby allowing battery power to be reserved for monitoring vacuum levels. PMID:27462383

An Overview of Helicobacter pylori VacA Toxin Biology

PubMed Central

Foegeding, Nora J.; Caston, Rhonda R.; McClain, Mark S.; Ohi, Melanie D.; Cover, Timothy L.

2016-01-01

The VacA toxin secreted by Helicobacter pylori enhances the ability of the bacteria to colonize the stomach and contributes to the pathogenesis of gastric adenocarcinoma and peptic ulcer disease. The amino acid sequence and structure of VacA are unrelated to corresponding features of other known bacterial toxins. VacA is classified as a pore-forming toxin, and many of its effects on host cells are attributed to formation of channels in intracellular sites. The most extensively studied VacA activity is its capacity to stimulate vacuole formation, but the toxin has many additional effects on host cells. Multiple cell types are susceptible to VacA, including gastric epithelial cells, parietal cells, T cells, and other types of immune cells. This review focuses on the wide range of VacA actions that are detectable in vitro, as well as actions of VacA in vivo that are relevant for H. pylori colonization of the stomach and development of gastric disease. PMID:27271669

[Treatment of septic olecranon and patellar bursitis by excision and vacuum-assisted closure therapy].

PubMed

Walter, G; Kemmerer, M; Hoffmann, R

2013-08-01

Treatment of septic olecranon and patellar bursitis differs considerably and is currently under discussion. We therefore performed a retrospective study of our patients with septic bursitis in the past 5 years. Between March 2007 and February 2012 we treated 79 patients with septic olecranon (n = 43) and patellar (n = 36) bursitis surgically: 61-males, 18 females, age 51 (range: 11-91) years. Four patients had not been treated before, 25 had suffered recurrences after 1-10 previous procedures, and 9 patients had not improved after conservative therapy. 34 patients presented with traumatic rupture or fistula of their bursae. In all cases we performed a radical bursectomy and vacuum-assisted therapy for 4 to 5 days. In addition, patients received systemic antibiotics. We phoned all patients and were successful in 57 cases (72 %). We questioned these patients for range of movement, limitations at work, pain, sensibility disorder, satisfaction with the result and further surgical procedures. In all cases we took tissue specimens for cultures, in 48 preparations histological examination was performed. Microbiological and histological results are discussed in detail. 40 patients were free of complaints, 15 complained of mild pain, 54 of 57 had unlimited range of motion. Minor discomforts at desk work were reported by 5 of 43 patients, 12 out of 36 patient reported discomfort when performing on their knees. There was no recurrence in the period of investigation. We recommend our treatment concept for septic olecranon and patellar bursitis because patient satisfaction is high and recurrences are reliably avoided. The soft tissue is spared, so that plastic covering procedures are seldom necessary. Georg Thieme Verlag KG Stuttgart · New York.

Is adhesive paper-tape closure of video assisted thoracoscopic port-sites safe?

PubMed

Luckraz, Heyman; Rammohan, Kandadai S; Phillips, Mabel; O'Keefe, Peter A

2007-07-01

Video assisted thoracoscopic surgery (VATS) is used in lung surgery for diagnostic, staging, curative and palliative purposes. The port-sites are usually sutured with dissolvable sutures. The use of adhesive paper-tape for port-site closure was assessed by a prospective randomised double-blind control trial comparing sutured to adhesive paper-tape closure. The following outcomes were assessed: incidence of clinically significant pneumothorax, wound healing using the ASEPSIS score, patient's comfort (pain score using a visual analog score), the time difference between the two techniques of wound closure and cost savings. Thirty patients were recruited in each group. No clinically significant pneumothoraces occurred in either group. There were no significant differences between the two groups in terms of immediate post-operative pain scores, wound cosmesis and wound complications. It was quicker to close the wound with adhesive paper-tape with a mean time of closure per unit length of wound of 9.3 and 2.2s/mm for the groups, respectively. The cost for wound closure (per patient) was $0.8 for the adhesive paper-tape group and $4.00 for the sutures.

Diversification of the vacAs1m1 and vacAs2m2 Strains of Helicobacter pylori in Meriones unguiculatus

PubMed Central

Mendoza-Elizalde, Sandra; Arteaga-Resendiz, Nancy K.; Valencia-Mayoral, Pedro; Luna, Raúl C.; Moreno-Espinosa, Sarbelio; Arenas-Huertero, Francisco; Zúñiga, Gerardo; Velázquez-Guadarrama, Norma

2016-01-01

The bacterium Helicobacter pylori exhibits great genetic diversity, and the pathogenic roles of its virulence factors have been widely studied. However, the evolutionary dynamics of H. pylori strains during stomach colonization are not well-characterized. Here, we analyzed the microevolutionary dynamics of the toxigenic strain vacAs1m1, the non-toxigenic strain vacAs2m2, and a combination of both strains in an animal model over time. Meriones unguiculatus were inoculated with the following bacteria: group 1-toxigenic strain vacAs1m1/cagA+/cagE+/babA2+; ST181, group 2-non-toxigenic strain vacAs2m2/cagA+/cagE+/babA2+; ST2901, and group 3-both strains. The gerbils were euthanized at different time points (3, 6, 12, and 18 months). In group 1, genetic alterations were observed at 6 and 12 months. With the combination of both strains, group 3 also exhibited genetic alterations at 3 and 18 months; moreover, a chimera, vacA m1-m2, was detected. Additionally, four new sequence types (STs) were reported in the PubMLST database for H. pylori. Synonymous and non-synonymous mutations were analyzed and associated with alterations in amino acids. Microevolutionary analysis of the STs (PHYLOViZ) identified in each group revealed many mutational changes in the toxigenic (vacAs1m1) and non-toxigenic (vacAs2m2) strains. Phylogenetic assessments (eBURST) did not reveal clonal complexes. Our findings indicate that the toxigenic strain, vacAs1m1, and a combination of toxigenic and non-toxigenic strains acquired genetic material by recombination. The allelic combination, vacAs2m1, displayed the best adaptation in the animal model over time, and a chimera, m1-m2, was also identified, which confirmed previous reports. PMID:27877163

Diversification of the vacAs1m1 and vacAs2m2 Strains of Helicobacter pylori in Meriones unguiculatus.

PubMed

Mendoza-Elizalde, Sandra; Arteaga-Resendiz, Nancy K; Valencia-Mayoral, Pedro; Luna, Raúl C; Moreno-Espinosa, Sarbelio; Arenas-Huertero, Francisco; Zúñiga, Gerardo; Velázquez-Guadarrama, Norma

2016-01-01

The bacterium Helicobacter pylori exhibits great genetic diversity, and the pathogenic roles of its virulence factors have been widely studied. However, the evolutionary dynamics of H. pylori strains during stomach colonization are not well-characterized. Here, we analyzed the microevolutionary dynamics of the toxigenic strain vacAs1m1 , the non-toxigenic strain vacAs2m2 , and a combination of both strains in an animal model over time. Meriones unguiculatus were inoculated with the following bacteria: group 1-toxigenic strain vacAs1m1/cagA+/cagE+/babA2+ ; ST181, group 2-non-toxigenic strain vacAs2m2/cagA+/cagE+/babA2+ ; ST2901, and group 3-both strains. The gerbils were euthanized at different time points (3, 6, 12, and 18 months). In group 1, genetic alterations were observed at 6 and 12 months. With the combination of both strains, group 3 also exhibited genetic alterations at 3 and 18 months; moreover, a chimera, vacA m1-m2 , was detected. Additionally, four new sequence types (STs) were reported in the PubMLST database for H. pylori . Synonymous and non-synonymous mutations were analyzed and associated with alterations in amino acids. Microevolutionary analysis of the STs (PHYLOViZ) identified in each group revealed many mutational changes in the toxigenic ( vacAs1m1 ) and non-toxigenic ( vacAs2m2 ) strains. Phylogenetic assessments (eBURST) did not reveal clonal complexes. Our findings indicate that the toxigenic strain, vacAs1m1 , and a combination of toxigenic and non-toxigenic strains acquired genetic material by recombination. The allelic combination, vacAs2m1 , displayed the best adaptation in the animal model over time, and a chimera, m1-m2 , was also identified, which confirmed previous reports.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region.

PubMed

Ozer, Mete; Akdeniz, Berat Serdar; Sumer, Mahmut

2013-12-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Recommendations of the VAC2VAC workshop on the design of multi-centre validation studies.

PubMed

Halder, Marlies; Depraetere, Hilde; Delannois, Frédérique; Akkermans, Arnoud; Behr-Gross, Marie-Emmanuelle; Bruysters, Martijn; Dierick, Jean-François; Jungbäck, Carmen; Kross, Imke; Metz, Bernard; Pennings, Jeroen; Rigsby, Peter; Riou, Patrice; Balks, Elisabeth; Dobly, Alexandre; Leroy, Odile; Stirling, Catrina

2018-03-01

Within the Innovative Medicines Initiative 2 (IMI 2) project VAC2VAC (Vaccine batch to vaccine batch comparison by consistency testing), a workshop has been organised to discuss ways of improving the design of multi-centre validation studies and use the data generated for product-specific validation purposes. Moreover, aspects of validation within the consistency approach context were addressed. This report summarises the discussions and outlines the conclusions and recommendations agreed on by the workshop participants. Copyright © 2018.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

PubMed Central

Akdeniz, Berat Serdar; Sumer, Mahmut

2013-01-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region. PMID:24396740

Development of Subischial Prosthetic Sockets with Vacuum-Assisted Suspension for Highly Active Persons with Transfemoral Amputations

DTIC Science & Technology

2012-10-01

materials to facilitate dissemination of this technique. 15. SUBJECT TERMS Transfemoral amputation, sub-ischial socket, prosthesis , vacuum-assisted...an appropriate mechanical pump to create suitable vacuum for suspension of the prosthesis ...sockets of highly active prosthesis users

Development of Subischial Prosthetic Sockets with Vacuum-Assisted Suspension for Highly Active Persons with Transfemoral Amputations

DTIC Science & Technology

2014-10-01

Award Number: W81XWH-10-1-0744 TITLE: Development of Subischial Prosthetic Sockets with Vacuum...REPORT TYPE Annual 3. DATES COVERED 15 Sep 2013 – 14 Sep 2014 4. TITLE AND SUBTITLE Development of Subischial Prosthetic Sockets with Vacuum...to develop a highly flexible sub-ischial prosthetic socket with assisted-vacuum suspension for highly active persons with transfemoral amputation. The

Protection of polyphenols in blueberry juice by vacuum-assisted block freeze concentration.

PubMed

Orellana-Palma, Patricio; Petzold, Guillermo; Pierre, Lissage; Pensaben, José Manuel

2017-11-01

Block freeze concentration allows produces high-quality cryoconcentrates with important protection of valuable components from fresh fruit juices. The aim of this study was to investigate the use of vacuum-assisted block freeze concentration under different experimental conditions to protect polyphenols in the elaboration of concentrated blueberry juice. Fresh blueberry juice was radial or unidirectional frozen at -20 and -80 °C for 12 h and vacuum process was performed at 80 kPa during 120 min. Results showed a significant solute increased in the concentrated fraction in all treatments, and the best treatment was - 20 °C/unidirectional with a value of ≈63 °Brix, equivalent to an increase of 3.8 times in the total polyphenol content (76% of retention). The color of concentrated samples was darker than the initial sample, with ΔE* values of >25 CIELab units in all treatments. The vacuum-assisted block freeze concentrations was an effective technology for protecting polyphenols and obtain a concentrated with a higher concentration of solids from blueberry juice, as well as interesting values of process parameters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Goose-neck snare-assisted transcatheter ASD closure: A safety procedure for large and complex ASDs.

PubMed

Butera, Gianfranco; Lovin, Nicusor; Basile, Domenica Paola; Carminati, Mario

2016-04-01

To report on a new technique that increases the safety of percutaneous atrial septal defect (ASD) closure using a goose-neck snare system. ASD transcatheter closure is a widespread procedure. However, in some cases, ASDs may be large and with soft rims. In these situation, a potential risk exists for device malposition or embolization. When transesophageal echocardiography (TEE) evaluation and balloon sizing showed large defects with floppy rims the chosen Amplatzer device was implanted in a standard way. In large defects with floppy rims, before release a 5-mm goose-neck snare with its 4 Fr catheter was placed across the delivery cable and fixed to catch the screwing mechanism of implanted Amplatzer device. The delivery cable was unscrewed and the device reached its final position without any tension. If the position was considered satisfactory the device was released from the goose-neck snare. Thirteen patients had a snare-assisted ASD transcatheter closure. Median device size was 24 mm (range 14-38 mm). Retrieval or repositioning of the device using the goose-neck snare was performed in four cases: in three patients, because of device malposition after delivery cable release and in one patient, because of unsuitability of closure of a second significant defect. Furthermore, in two subjects with multiple ASDs, a second fenestration looked quite significant with the device still attached to the delivery cable while it appeared smaller after release. Snare-assisted Amplatzer ASD device placement is a new method for ASD percutaneous closure and adds safety to the procedure. © 2016 Wiley Periodicals, Inc.

[Assessment of vacuum-assisted vaginal delivery in a frank breech presentation].

PubMed

Bleu, G; Deruelle, P; Demetz, J; Michel, S; Dufour, P; Depret, S; Subtil, D

2015-02-01

After verification of the eligibility criteria and with an obstetrician familiar with the specific maneuvers likely to be needed, vaginal delivery of breech presentations is possible. If problems arise during the active pushing phase of labor, vacuum extraction has been described in the literature for this uncommon condition with limited series. The aim of this study is to assess retrospectively vacuum extraction in frank breech presentation in our center. This retrospective study of trials of vaginal delivery of fetuses in breech presentation at term compares cases according to whether they did or did not use a vacuum extraction. During a two-year period, 83 patients, whom had trials of vaginal delivery in breech presentations, reached the active pushing/bearing down stage after complete cervical dilatation. Vacuum assistance was applied in six of these (7.2 %). The failure rate for vaginal delivery was significantly higher in the group with compared to without vacuum extraction (33.3 % versus 6.5 %, P<0.05). Moreover, the mean pH at birth was significantly lower in the group with vacuum extraction (7.12±0.11 versus 7.20±0.08, P<0.05), and these infants more frequently had deep cutaneous injuries (66.7 % versus 26.0 %, P<0.05). In fetuses in breech presentation, when vaginal delivery failed, it seems to be safer for the fetuses to perform caesarean section rather than attempt vacuum extraction. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Microbial growth, communities and sensory characteristics of vacuum and modified atmosphere packaged lamb shoulders.

PubMed

Kiermeier, Andreas; Tamplin, Mark; May, Damian; Holds, Geoff; Williams, Michelle; Dann, Alison

2013-12-01

Packaging fresh lamb in a vacuum (VAC) versus a 100% CO2 modified atmosphere (MAP) may influence product shelf-life and the bacterial communities. While VAC is a common packing method and 100% CO2 MAP is used in some countries, there is little information about how these different techniques affect the growth of spoilage bacteria and sensory attributes of lamb. The aim of this study was to assess changes in microbiological and organoleptic properties, and determine differences in microbial communities by terminal restriction fragment length polymorphism (TRFLP) and 454 pyrosequencing, in bone-in (BI) and bone-out (BO) MAP- and VAC-packed lamb shoulders stored at -0.3 °C over 12 wk. VAC and MAP lamb shoulders were acceptable in sensory test scores over 12 wk of storage at -0.3 °C, despite total viable count (TVC) and lactic acid bacteria (LAB) levels increasing to 8 log10 CFU/cm(2) for VAC lamb and 4-6 log10 CFU/cm(2) for MAP lamb. Similar to the sensory results, there were no significant differences in microbial communities between BI and BO product. However, types of bacteria were different between VAC and MAP packaging. Specifically, while VAC shoulder became dominated by Carnobacterium spp. in the middle of the storage period, the MAP shoulder microbial population remained similar from the start until later storage times. Copyright © 2013 Elsevier Ltd. All rights reserved.

Vacuum-assisted fluid flow in microchannels to pattern substrates and cells.

PubMed

Shrirao, Anil B; Kung, Frank H; Yip, Derek; Cho, Cheul H; Townes-Anderson, Ellen

2014-09-01

Substrate and cell patterning are widely used techniques in cell biology to study cell-to-cell and cell-substrate interactions. Conventional patterning techniques work well only with simple shapes, small areas and selected bio-materials. This paper describes a method to distribute cell suspensions as well as substrate solutions into complex, long, closed (dead-end) polydimethylsiloxane (PDMS) microchannels using negative pressure. Our method builds upon a previous vacuum-assisted method used for micromolding (Jeon et al 1999 Adv. Mater 11 946) and successfully patterned collagen-I, fibronectin and Sal-1 substrates on glass and polystyrene surfaces, filling microchannels with lengths up to 120 mm and covering areas up to 13 × 10 mm(2). Vacuum-patterned substrates were subsequently used to culture mammalian PC12 and fibroblast cells and amphibian neurons. Cells were also patterned directly by injecting cell suspensions into microchannels using vacuum. Fibroblast and neuronal cells patterned using vacuum showed normal growth and minimal cell death indicating no adverse effects of vacuum on cells. Our method fills reversibly sealed PDMS microchannels. This enables the user to remove the PDMS microchannel cast and access the patterned biomaterial or cells for further experimental purposes. Overall, this is a straightforward technique that has broad applicability for cell biology.

Vacuum-assisted Fluid Flow in Microchannels to Pattern Substrates and Cells

PubMed Central

Shrirao, Anil B.; Kung, Frank H.; Yip, Derek; Cho, Cheul H.; Townes-Anderson, Ellen

2014-01-01

Substrate and cell patterning are widely used techniques in cell biology to study cell-to-cell and cell-to-substrate interactions. Conventional patterning techniques work well only with simple shapes, small areas and selected bio-materials. This paper describes a method to distribute cell suspensions as well as substrate solutions into complex, long, closed (dead-end) polydimethylsiloxane (PDMS) microchannels using negative pressure. Our method builds upon a previous vacuum-assisted method used for micromolding (Jeon, Choi et al. 1999) and successfully patterned collagen-I, fibronectin and Sal-1 substrates on glass and polystyrene surfaces, filling microchannels with lengths up to 120 mm and covering areas up to 13 × 10 mm2. Vacuum-patterned substrates were subsequently used to culture mammalian PC12 and fibroblast cells and amphibian neurons. Cells were also patterned directly by injecting cell suspensions into microchannels using vacuum. Fibroblast and neuronal cells patterned using vacuum showed normal growth and minimal cell death indicating no adverse effects of vacuum on cells. Our method fills reversibly sealed PDMS microchannels. This enables the user to remove the PDMS microchannel cast and access the patterned biomaterial or cells for further experimental purposes. Overall, this is a straightforward technique that has broad applicability for cell biology. PMID:24989641

Development of Sub-Ischial Prosthetic Sockets with Vacuum-Assisted Suspension for Highly Active Persons with Transfemoral Amputations

DTIC Science & Technology

2013-10-01

15. SUBJECT TERMS Transfemoral amputation, sub-ischial socket, prosthesis , vacuum-assisted suspension 16. SECURITY CLASSIFICATION OF: 17...vacuum for suspension of the prosthesis ...14 Task 6 Determine range of volumes to be evacuated from transfemoral sockets of highly active prosthesis users

PlanetVac: Sample Return with a Puff of Gas

NASA Astrophysics Data System (ADS)

Zacny, K.; Mueller, R.; Betts, B. H.

2014-12-01

PlanetVac is a regolith sample acquisition mission concept that uses compressed gas to blow material from the surface up a pneumatic tube and directly into a sample return container. The PlanetVac sampling device is built into the lander legs to eliminate cost and complexity associated with robotic arms and scoops. The pneumatic system can effectively capture fine and coarse regolith, including small pebbles. It is well suited for landed missions to Mars, asteroids, or the Moon. Because of the low pressures on all those bodies, the technique is extremely efficient. If losses are kept to minimum, 1 gram of compressed gas could efficiently lift 6000 grams of soil. To demonstrate this approach, the PlanetVac lander with four legs and two sampling tubes has been designed, integrated, and tested. Vacuum chamber testing was performed using two well-known planetary regolith simulants: Mars Mojave Simulant (MMS) and lunar regolith simulant JSC-1A. One of the two sampling systems was connected to a mockup of an earth return rocket while the second sampling system was connected to a lander deck mounted instrument (clear box for easy viewing). The tests included a drop from a height of approximately 50 cm onto the bed of regolith, deployment of sampling tubes into the regolith, pneumatic acquisition of sample into an instrument (sample container) and the rocket, and the launch of the rocket. The demonstration has been successful and can be viewed here: https://www.youtube.com/watch?v=DjJXvtQk6no. In most of the tests, 20 grams or more of sample was delivered to the 'instrument' and approximately 5 grams of regolith was delivered into a sampling chamber within the rocket. The gas lifting efficiency was calculated to be approximately 1000:1; that is 1 gram of gas lofted 1000 grams of regolith. Efficiencies in lower gravity environments are expected to be much higher. This successful, simple and lightweight sample capture demonstration paves the way to using such sampling system

The benefits of using a vacuum-assisted socket system to improve balance and gait in elderly transtibial amputees.

PubMed

Samitier, C Beatriz; Guirao, Lluis; Costea, Maria; Camós, Josep M; Pleguezuelos, Eulogio

2016-02-01

Lower limb amputation leads to impaired balance, ambulation, and transfers. Proper fit of the prosthesis is a determining factor for successful ambulation. Vacuum-assisted socket systems extract air from the socket, which decreases pistoning and probability of soft-tissue injuries and increases proprioception and socket comfort. To investigate the effect of vacuum-assisted socket system on transtibial amputees' performance-based and perceived balance, transfers, and gait. Quasi-experimental before-and-after study. Subjects were initially assessed using their prosthesis with the regular socket and re-evaluated 4 weeks after fitting including the vacuum-assisted socket system. We evaluated the mobility grade using Medicare Functional Classification Level, Berg Balance Scale, Four Square Step Test, Timed Up and Go Test, the 6-Min Walk Test, the Locomotor Capabilities Index, Satisfaction with Prosthesis (SAT-PRO questionnaire), and Houghton Scale. A total of 16 unilateral transtibial dysvascular amputees, mean age 65.12 (standard deviation = 10.15) years. Using the vacuum-assisted socket system, the patients significantly improved in balance, gait, and transfers: scores of the Berg Balance Scale increased from 45.75 (standard deviation = 6.91) to 49.06 (standard deviation = 5.62) (p < 0.01), Four Square Step Test decreased from 18.18 (standard deviation = 3.84) s to 14.97 (3.9) s (p < 0.01), Timed Up and Go Test decreased from 14.3 (standard deviation = 3.29) s to 11.56 (2.46) s (p < 0.01). The distance walked in the 6-Min Walk Test increased from 288.53 (standard deviation = 59.57) m to 321.38 (standard deviation = 72.81) m (p < 0.01). Vacuum-assisted socket systems are useful for improving balance, gait, and transfers in over-50-year-old dysvascular transtibial amputees. This study gives more insight into the use of vacuum-assisted socket systems to improve elderly transtibial dysvascular amputees

Single Center Experience with the AngioVac Aspiration System

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

Salsamendi, Jason, E-mail: jsalsamendi@med.miami.edu; Doshi, Mehul, E-mail: mdoshi@med.miami.edu; Bhatia, Shivank, E-mail: sbhatia1@med.miami.edu

2015-08-15

PurposeThe AngioVac catheter system is a mechanical suction device designed for removal of intravascular material using extracorporeal veno-venous bypass circuit. The purpose of this study is to present the outcomes in patients treated with the AngioVac aspiration system and to discuss its efficacy in different vascular beds.Materials and MethodsA retrospectively review was performed of seven patients treated with AngioVac between October 2013 and December 2014. In 6/7 cases, the AngioVac cannula was inserted percutaneously and the patient was placed on veno-venous bypass. In one of the cases, the cannula was inserted directly into the Fontan circuit after sternotomy and themore » patient was maintained on cardiopulmonary bypass. Thrombus location included iliocaval (2), SVC (1), pulmonary arteries (1), Fontan circuit and Glenn shunt with pulmonary artery extension (1), right atrium (1), and IVC with renal vein extension (1).ResultsThe majority of thrombus (50–95 %) was removed in 5/7 cases, and partial thrombus removal (<50 %) was confirmed in 2/7 cases. Mean follow-up was 205 days (range 64–403 days). All patients were alive at latest follow-up. Minor complications included three neck hematomas in two total patients. No major complications occurred.ConclusionAngioVac is a useful tool for acute thrombus removal in the large vessels. The setup and substantial cost may limit its application in straightforward cases. More studies are needed to establish the utility of AngioVac in treatment of intravascular and intracardiac material.« less

[Robot-assisted atrial septal defect closure in adults: first experience in Russia].

PubMed

Arkhipov, A N; Bogachev-Prokofiev, A V; Zubritskiy, A V; Khapaev, T S; Gorbatykh, Yu N; Pavlushin, P M; Karaskov, A M

To analyze immediate results of minimally invasive robot-assisted atrial septal defect (ASD) closure in adults. For the period from March 2012 to November 2016 sixty patients with contraindications to endovascular procedure have undergone robot-assisted atrial septal defect closure at Meshalkin Siberian Federal Biomedical Research Center. Mean age was 34.5±11.3 years, body mass index - 24.6±4.0 kg/m 2 . 48 (80%) patients had NYHA class II before surgery. In 37 (61.7%) patients isolated ASD with deficiency or absence of one edge was diagnosed, isolated ASD with primary septum aneurysm - in 16 (26.7%) cases, 7 (11.6%) patients had reticulate ASD. 5 (8.3%) patients had concomitant tricuspid valve insufficiency required surgical repair (suture annuloplasty). All operations were performed under cardiopulmonary bypass with peripheral cannulation. Right-sided anterolateral mini-thoracotomy was used in the first 43 patients. Following 17 patients underwent completely endoscopic procedure. Depending on the shape, size and anatomical features of the defect we performed suturing (14 patients, 23.3%) or repair with xenopericardial patch (46%, 76.6%). Mean CPB and aortic cross-clamping time was 89.1±28.7 and 24.8±9.5 min, respectively. Postoperative variables: mechanical ventilation 3.3±1.5 hours, ICU-stay - 18.2±3.7 hours, postoperative hospital-stay - 13.4±5.7 days. There were no mortality and any life-threatening intra- and postoperative complications. Cases of conversion to thoraco-/sternotomy and postoperative bleeding followed by redo surgery were also absent. 23 patients were followed-up within 1 year, 6 patients - within 2 years, 3 patients - within 3 years. All patients were in NYHA class I-II with 100% freedom from ASD recanalization and redo surgery. According to echocardiography data there were decreased right heart, pulmonary artery pressure and preserved left ventricular function in early postoperative period and 1 year after surgery. In view of favorable

Oral immunisation of laying hens with the live vaccine strains of TAD Salmonella vac E and TAD Salmonella vac T reduces internal egg contamination with Salmonella Enteritidis.

PubMed

Gantois, Inne; Ducatelle, Richard; Timbermont, Leen; Boyen, Filip; Bohez, Lotte; Haesebrouck, Freddy; Pasmans, Frank; van Immerseel, Filip

2006-09-11

Eggs are a major source of human infections with Salmonella. Therefore controlling egg contamination in laying hen flocks is one of the main targets for control programmes. A study was carried out to assess the effect of oral vaccination with TAD Salmonella vac E, TAD Salmonella vac T and with both vaccines TAD Salmonella vac E and TAD Salmonella vac T, on colonization of the reproductive tract and internal egg contamination of laying hens with Salmonella Enteritidis. Three groups of 30 laying hens were vaccinated at 1 day, 6 weeks and 16 weeks of age with either one of the vaccine strains, or a combination of both vaccine strains, while a fourth group was left unvaccinated. At 24 weeks of age, the birds were intravenously challenged with 0.5 ml containing 5 x 10(7)cfu Salmonella Enteritidis PT4 S1400/94. The number of oviducts from which Salmonella was isolated, was significantly lower in the vaccinated than in the non-vaccinated hens at 3 weeks post-challenge. Significantly less egg contents were Salmonella positive in the birds vaccinated with TAD Salmonella vac E or TAD Salmonella vac T (12/105 batches of eggs in both groups) than in the unvaccinated birds (28/105 batches of eggs). Internal egg contamination in the hens vaccinated with both TAD Salmonella vac E and TAD Salmonella vac T was even more reduced, as over the whole experiment, only one batch of eggs was positive. In conclusion, these data indicate that vaccination of laying hens with these live vaccines could be considered as a valuable tool in controlling internal egg contamination.

Automated Road Closure Gate

DOT National Transportation Integrated Search

2000-05-01

This report presents the procedures involved in the research, design, construction, and testing of an Automated Road Closure Gate. The current road closure gates used in South Dakota are often unsafe and difficult to operate. This report will assist ...

Integrated cooling-vacuum-assisted 1540-nm erbium:glass laser is effective in treating mild-to-moderate acne vulgaris.

PubMed

Politi, Y; Levi, A; Enk, C D; Lapidoth, M

2015-12-01

Acne treatment by a mid-infrared laser may be unsatisfactory due to deeply situated acne-affected sebaceous glands which serve as its target. Skin manipulation by vacuum and contact cooling may improve laser-skin interaction, reduce pain sensation, and increase overall safety and efficacy. To evaluate the safety and efficacy of acne treatment using an integrated cooling-vacuum-assisted 1540-nm erbium:glass laser, a prospective interventional study was conducted. It included 12 patients (seven men and five women) suffering from mild-to-moderate acne vulgaris. The device utilizes a mid-infrared 1540-nm laser (Alma Lasers Ltd. Caesarea, Israel), which is integrated with combined cooling-vacuum-assisted technology. An acne lesion is initially manipulated upon contact by a vacuum-cooling-assisted tip, followed by three to four stacked laser pulses (500-600 mJ, 4 mm spot size, and frequency of 2 Hz). Patients underwent four to six treatment sessions with a 2-week interval and were followed-up 1 and 3 months after the last treatment. Clinical photographs were taken by high-resolution digital camera before and after treatment. Clinical evaluation was performed by two independent dermatologists, and results were graded on a scale of 0 (exacerbation) to 4 (76-100 % improvement). Patients' and physicians' satisfaction was also recorded. Pain perception and adverse effects were evaluated as well. All patients demonstrated a moderate to significant improvement (average score of 3.6 and 2.0 within 1 and 3 months, respectively, following last treatment session). No side effects, besides a transient erythema, were observed. Cooling-vacuum-assisted 1540-nm laser is safe and effective for the treatment of acne vulgaris.

A Case of an Aortic Abscess around the Elephant Trunk.

PubMed

Fujii, Takeshiro; Kawasaki, Muneyasu; Katayanagi, Tomoyuki; Okuma, Shinnosuke; Masuhara, Hiroshi; Shiono, Noritsugu; Watanabe, Yoshinori

2015-01-01

A 52-year-old male patient with a history of total arch replacement using the elephant trunk technique for acute aortic dissection 4 years before visited our hospital with the chief complaint of persistent fever. Chest computed tomography (CT) suggested prosthetic vascular graft infection, which was treated surgically after chemotherapy. The first surgery consisted of debridement of an abscess around the vascular graft and in the aorta around the elephant trunk, and thoracic descending aorta replacement and vacuum-assisted closure (VAC) in view of the risk of bleeding from the peripheral region of the elephant trunk. One week later, omental filling was performed as the second step. This is a very rare case of aortic abscess around the elephant trunk that could successfully be managed by graft-conserving treatment.

[Modified gloving technique for vacuum therapy in the hand].

PubMed

Polykandriotis, E; Kneser, U; Kopp, J; Horch, R E

2006-04-01

During the last 10 years sub-atmospheric pressure dressings (Topical Negative Pressure Therapy = TNP) has become a well accepted standard therapeutic modality in the management of acute and chronic wounds. However, in the hand and the fingers TNP treatment is not as an established method as elsewhere in the body. This is mostly due to difficulties in the technique of sealing wounds near the interdigital folds, especially when the interdigital folds are affected themselves. Over a period of 36 months we treated 9 extensive open wounds of the hand with the TNP dressing procedure. To optimize the effective sealing procedure several methods of closure were applied: sterile vinyl gloves, split V.A.C. gel-straps and the "Sandwich"-principle. In all cases we were able to achieve a tight vacuum sealing with the use of our vinyl or latex free surgical glove as an aid to cover the interdigital spaces. There was a rapid and complete remission of the symptoms in terms of edema, redness, tenderness and range of motion. The indication spectrum encompassed infection control, temporary coverage of exposed bone or tendons, intermittent irrigation with local antiseptics as well as wound preconditioning before skin grafting or flap coverage. For the definite closure or coverage a second operation was necessary in all cases. The TNP-dressing can be securely achieved even in wounds encompassing the interdigital folds or adjacent to the in digital spaces with a modified surgical gloving technique to aid the standard sealing foil. It is a suitable principle for the management of severe hand infections with a reduction of clinical symptoms, reduction of the frequency of dressing changes compared to open approaches and a significant amelioration in the quality of life both for patients and health care personnel.

Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries.

PubMed

Wu, Jennifer M; Williams, Kathryn S; Hundley, Andrew F; Connolly, AnnaMarie; Visco, Anthony G

2005-08-01

The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Within the OP group, 41.7% developed a third- or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4-4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7-9.6) more likely to be associated with an anal sphincter injury than OA position. Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.

Managing virtual machines with Vac and Vcycle

NASA Astrophysics Data System (ADS)

McNab, A.; Love, P.; MacMahon, E.

2015-12-01

We compare the Vac and Vcycle virtual machine lifecycle managers and our experiences in providing production job execution services for ATLAS, CMS, LHCb, and the GridPP VO at sites in the UK, France and at CERN. In both the Vac and Vcycle systems, the virtual machines are created outside of the experiment's job submission and pilot framework. In the case of Vac, a daemon runs on each physical host which manages a pool of virtual machines on that host, and a peer-to-peer UDP protocol is used to achieve the desired target shares between experiments across the site. In the case of Vcycle, a daemon manages a pool of virtual machines on an Infrastructure-as-a-Service cloud system such as OpenStack, and has within itself enough information to create the types of virtual machines to achieve the desired target shares. Both systems allow unused shares for one experiment to temporarily taken up by other experiements with work to be done. The virtual machine lifecycle is managed with a minimum of information, gathered from the virtual machine creation mechanism (such as libvirt or OpenStack) and using the proposed Machine/Job Features API from WLCG. We demonstrate that the same virtual machine designs can be used to run production jobs on Vac and Vcycle/OpenStack sites for ATLAS, CMS, LHCb, and GridPP, and that these technologies allow sites to be operated in a reliable and robust way.

A proposed biophysical approach to Visual absorption capability (VAC)

Treesearch

W. C. Yeomans

1979-01-01

In British Columbia, visual analysis is in its formative stages and has only recently been accepted by Government as a resource component, notably within the Resource Analysis Branch, Ministry of Environment. Visual absorption capability (VAC), is an integral factor in visual resource assessment. VAC is examined by the author in the degree to which it relates to...

Flat epithelial atypia in directional vacuum-assisted biopsy of breast microcalcifications: surgical excision may not be necessary.

PubMed

McCroskey, Zulfia; Sneige, Nour; Herman, Carolyn R; Miller, Ross A; Venta, Luz A; Ro, Jae Y; Schwartz, Mary R; Ayala, Alberto G

2018-02-21

The aim of this study was to analyze the clinicopathological features of patients with flat epithelial atypia, diagnosed in directional vacuum-assisted biopsy targeting microcalcifications, to identify upgrade rate to in situ ductal or invasive breast carcinoma, and determine factors predicting carcinoma in the subsequent excision. We retrospectively evaluated the histological, clinical, and mammographic features of 69 cases from 65 women, with directional vacuum-assisted biopsy-diagnosed flat epithelial atypia with or without atypical ductal hyperplasia or atypical lobular hyperplasia, which underwent subsequent surgical excision. The extent and percentage of microcalcifications sampled by directional vacuum-assisted biopsy were evaluated by mammography. All biopsy and surgical excision slides were reviewed. The age of the women ranged from 40 to 85 years (mean 57 years). All patients presented with mammographically detected microcalcifications only, except in one case that had associated architectural distortion. Extent of calcifications ranged from <1 cm (n = 47), 1-3 cm (n = 15) to > 3 cm (n = 6), and no measurement (n = 1). A mean of 11 cores (range 6-25) was obtained from each lesion. Post-biopsy mammogram revealed >90% removal of calcifications in 81% of cases. Pure flat epithelial atypia represented nearly two-thirds of directional vacuum-assisted biopsy specimens (n = 43, 62%), while flat epithelial atypia coexisted with atypical ductal hyperplasia (18 cases, 26%), or atypical lobular hyperplasia (8 cases, 12%). Upon excision, none of the cases were upgraded to in situ ductal or invasive breast cancer. In one case, however, an incidental, tubular carcinoma (4 mm) was found away from biopsy site. Excluding this case, the upgrade rate was 0%. Our study adds to the growing evidence that diagnosis of flat epithelial atypia on directional vacuum-assisted biopsy for microcalcifications as the only imaging finding is not associated

Ultrasound-Guided Core-Needle Versus Vacuum-Assisted Breast Biopsy: A Cost Analysis Based on the American Society of Breast Surgeons' Mastery of Breast Surgery Registry.

PubMed

Grady, Ian; Vasquez, Tony; Tawfik, Sara; Grady, Sean

2017-03-01

To evaluate the cost-efficacy of vacuum-assisted ultrasound-guided breast biopsy instruments compared to ultrasound-guided 14-gauge spring-loaded core-needle biopsy. The American Society of Breast Surgeons' Mastery of Breast Surgery Registry was reviewed. Biopsy findings, any rebiopsy, and the instrument used were abstracted for 31,451 ultrasound-guided biopsy procedures performed between 2001 and July 2014. Rates of cancer diagnosis and rebiopsy were calculated for each instrument. A linear mathematical model was developed to calculate total cost per cancer diagnosis, including procedural costs and the costs of any additional surgical rebiopsy procedures. Mean cost per cancer diagnosis with confidence limits was then determined for 14-gauge spring-loaded core-needle biopsy and 14 different vacuum-assisted instruments. For 14-gauge spring-loaded core-needle biopsy, mean cost per cancer diagnosis was $4346 (4327-$4366). For the vacuum-assisted instruments, mean cost per cancer diagnosis ranged from a low of $3742 ($3732-$3752) to a high of $4779 ($4750-$4809). Vacuum-assisted instruments overall were more cost-effective than core with a mean cost per cancer diagnosis of $4052 ($4038-$4067) (p < 0.05). Tethered vacuum-assisted instruments performed best with a mean cost per cancer diagnosis of $3978 ($3964-$3991) (p < 0.05). Nontethered devices had a mean cost per cancer diagnosis of $4369 ($4350-$4388), a result no better than core (p < 0.05). Ultrasound-guided vacuum-assisted breast biopsy had a lower mean cost per cancer diagnosis than 14-gauge spring-loaded core-needle biopsy. This advantage was only seen in tethered vacuum-assisted instruments. Within device families, larger instruments tended to outperform smaller instruments.

Surface oxidation of GaN(0001): Nitrogen plasma-assisted cleaning for ultrahigh vacuum applications

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

Gangopadhyay, Subhashis; Schmidt, Thomas, E-mail: tschmidt@ifp.uni-bremen.de; Kruse, Carsten

The cleaning of metal-organic vapor-phase epitaxial GaN(0001) template layers grown on sapphire has been investigated. Different procedures, performed under ultrahigh vacuum conditions, including degassing and exposure to active nitrogen from a radio frequency nitrogen plasma source have been compared. For this purpose, x-ray photoelectron spectroscopy, reflection high-energy electron diffraction, and scanning tunneling microscopy have been employed in order to assess chemical as well as structural and morphological surface properties. Initial degassing at 600 °C under ultrahigh vacuum conditions only partially eliminates the surface contaminants. In contrast to plasma assisted nitrogen cleaning at temperatures as low as 300 °C, active-nitrogen exposure at temperaturesmore » as high as 700 °C removes the majority of oxide species from the surface. However, extended high-temperature active-nitrogen cleaning leads to severe surface roughening. Optimum results regarding both the removal of surface oxides as well as the surface structural and morphological quality have been achieved for a combination of initial low-temperature plasma-assisted cleaning, followed by a rapid nitrogen plasma-assisted cleaning at high temperature.« less

Extended negative pressure wound therapy-assisted dermatotraction for the closure of large open fasciotomy wounds in necrotizing fasciitis patients

PubMed Central

2014-01-01

Background Necrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction. Methods A retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure. Results After the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm2 to 29.37 cm2; p = 0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier’s gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on

Diverse vacA allelic types of Helicobacter pylori in Korea and clinical correlation.

PubMed

Choe, Yon Ho; Kim, Pum Soo; Lee, Don Haeng; Kim, Hyung Kil; Kim, Young Soo; Shin, Yong Woon; Hwang, Tae Sook; Kim, Hyeon Joo; Song, Sun Uk; Choi, Mi Sook

2002-06-01

Helicobacter pylori has a diversity of vacA allelic types. The purpose of this study was to correlate the vacA status and the clinical outcome. After constructing specific primers for the vacA signal sequence, H. pylori-positive antral biopsy specimens were examined for the vacA status in 25 gastric ulcers, 31 duodenal ulcers, 22 gastric cancers, 42 chronic gastritis, and 8 gastroduodenal ulcers. The relationship between the vacA allele and the clinical disease was examined. The vacA genotype s1c/m1 is predominant in Korea (71/128, 55.5%). Other strains including s1b or s2 were not found in this study. s1c/m1 was more prominent in duodenal ulcers, than in gastric ulcers (p=0.041) and cancer (p=0.029). Seven out of 8 patients with gastric and coexistent duodenal ulcers had the s1c/m1 allele. No statistical differences in the positive rates of the s1a/m1, s1a/m2, and s1c/m2 alleles among the disease groups were found. In conclusion, s1c/m1 is the main vacA allele in Korea and it is particularly associated with duodenal ulcers.

Prospective cohort study of a new vacuum delivery device to assist with complicated labour in low-resource settings.

PubMed

Khan, Mishal; Hashmani, Farah Naz; Ahmed, Sajjad; Ahmed, Owais; Asim, Shabnam S; Wajahat, Yasmin; Sobani, Shoaib; Syed, Shershah; Qazi, Fahad

2015-02-01

Currently available vacuum devices used to assist women undergoing complicated labour are unsuitable for use in low-resource settings. The objective of this study was to evaluate the safety and feasibility of a new low-cost vacuum device, named Koohi Goth Vacuum Delivery System (KGVDS), designed for use in low-resource settings. A hospital-based, multicentre, prospective cohort study with no control group was conducted in Karachi, Pakistan. After training, KGVDS devices were made available for use by labour room staff at their discretion when instrumental delivery was indicated. Women to whom KGVDS was applied were followed from the start of labour until discharge. Feasibility was assessed in terms of successful expulsion of the foetal head following application of KGVDS and ease of use ratings. Safety was assessed by observing maternal and newborn post-delivery outcomes prior to discharge. Koohi Goth Vacuum Delivery System was applied to 137 women requiring instrumental delivery, of whom 111 (81%; 95% CI = 74-88%) successfully expelled the foetal head assisted by KGVDS and 103 (75%) stated that they would agree to use KGVDS again. There were no serious maternal or neonatal injuries or infections related to KGVDS use. The mean score for 'ease of use' given by doctors and midwives using the device was 8 of 10. Koohi Goth Vacuum Delivery System was feasible and safe to use for assisting complicated deliveries in low-resource hospitals in this initial evaluation. Our results indicate that this new device may have the potential to improve birth outcomes in settings where most mortality occurs and that further evaluations should be conducted. © 2014 John Wiley & Sons Ltd.

Papilloma diagnosed at MRI-guided vacuum-assisted breast biopsy: is surgical excision still warranted?

PubMed

Brennan, Sandra B; Corben, Adriana; Liberman, Laura; Dershaw, D David; Brogi, Edi; Van Zee, Kimberly J; Morris, Elizabeth

2012-10-01

The objective of our study was to determine the frequency of cancer at surgery in breast lesions yielding papilloma at MRI-guided 9-gauge vacuum-assisted biopsy (VAB) and to determine whether any features are associated with cancer upgrade. For this study, 1487 MRI-guided vacuum-assisted biopsies performed from January 2004 to March 2011 were reviewed. Lesions yielding papilloma were identified and classified as papilloma with or without atypia. Surgical findings were reviewed to determine the cancer rate. Statistical analysis was performed and 95% CIs were calculated. Papilloma was identified in 75 of the 1487 MRI-guided vacuum-assisted biopsies (5%). These 75 papillomas occurred in 73 women with a median age of 49 years (age range, 27-70 years). Of the 75 papillomas, 25 (33%) had atypia and 50 (67%) did not on core needle biopsy. Subsequent surgery of 67 of the 75 papillomas (89%) yielded ductal carcinoma in situ (DCIS) in four (6%; 95% CI, 2-15%). Surgery yielded DCIS in two of 23 papillomas with atypia (9%; 95% CI, 1-28%) at MRI-guided VAB and in two of 44 papillomas without atypia (5%; 95% CI, 0.4-16%) at MRI-guided VAB; these cancer rates did not differ significantly (p=0.6). Postmenopausal status (p=0.04) and histologic size of less than 0.2 cm (p=0.04) had a significant association with the cancer upgrade rate. Papilloma with or without atypia was found in 5% of patients who underwent MRI-guided VAB during the study period. Surgery revealed cancer in 6%. DCIS was found at surgery in 9% of lesions yielding papilloma with atypia versus 5% of lesions yielding papilloma without atypia. For lesions yielding papilloma with or without atypia at MRI-guided VAB, surgical excision is warranted.

Matrix Assisted Ionization Vacuum (MAIV), a New Ionization Method for Biological Materials Analysis Using Mass Spectrometry*

PubMed Central

Inutan, Ellen D.; Trimpin, Sarah

2013-01-01

The introduction of electrospray ionization (ESI) and matrix-assisted laser desorption/ionization (MALDI) for the mass spectrometric analysis of peptides and proteins had a dramatic impact on biological science. We now report that a wide variety of compounds, including peptides, proteins, and protein complexes, are transported directly from a solid-state small molecule matrix to gas-phase ions when placed into the vacuum of a mass spectrometer without the use of high voltage, a laser, or added heat. This ionization process produces ions having charge states similar to ESI, making the method applicable for high performance mass spectrometers designed for atmospheric pressure ionization. We demonstrate highly sensitive ionization using intermediate pressure MALDI and modified ESI sources. This matrix and vacuum assisted soft ionization method is suitable for the direct surface analysis of biological materials, including tissue, via mass spectrometry. PMID:23242551

The use of negative pressure wound therapy in the treatment of infected wounds. Case studies.

PubMed

Jones, Daniel de Alcântara; Neves Filho, Wilson Vasconcelos; Guimarães, Janice de Souza; Castro, Daniel de Araújo; Ferracini, Antonio Marcos

2016-01-01

To evaluate the results and benefits obtained from the topical use of negative pressure wound therapy (NPWT) in patients with infected wounds. This was a retrospective study of 20 patients (17 males and three females, mean age 42 years) with infected wounds treated using NPWT. The infected wounds were caused by trauma. The treatment system used was VAC. ® (Vacuum Assisted Closure, KCI, San Antonio, United States) applied to the wound in continuous mode from 100 to 125 mmHg. The parameters related to the wounds (location, number of VAC changes, the size of the defects in the soft parts, and the evolution of the state of the wound), length of hospital stay, length of intravenous antibiotic therapy, and complications related to the use of this therapy were evaluated. The mean length of the hospital stay, use of NPWT, and antibacterial therapy were 41 days, 22.5 days, and 20 days respectively. The use of the VAC led to a mean reduction of 29% in the wound area (95.65-68.1 cm 2 ; p  < 0.05). Only one patient did not show any improvement in the final appearance of the wound with complete eradication of the infection. No complication directly caused by NPWT was observed. NPWT stimulates infection-free scar tissue formation in a short time, and is a quick and comfortable alternative to conventional infected wounds treatment methods.

50 CFR 622.43 - Closures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... following closure restrictions apply (See § 622.49 for closure provisions when an ACL is reached or... quota specified in § 622.42, or the ACL specified in 622.49, being reached and subsequent data indicate that the quota or ACL was not reached, the Assistant Administrator may file a notification to that...

Miniature piezo electric vacuum inlet valve

DOEpatents

Keville, Robert F.; Dietrich, Daniel D.

1998-03-24

A miniature piezo electric vacuum inlet valve having a fast pulse rate and is battery operated with variable flow capability. The low power (<1.6 watts), high pulse rate (<2 milliseconds), variable flow inlet valve is utilized for mass spectroscopic applications or other applications where pulsed or continuous flow conditions are needed. The inlet valve also has a very minimal dead volume of less than 0.01 std/cc. The valve can utilize, for example, a 12 Vdc input/750 Vdc, 3 mA output power supply compared to conventional piezo electric valves which require preloading of the crystal drive mechanism and 120 Vac, thus the valve of the present invention is smaller by a factor of three.

Feasibility and Advantages of Full Thickness Skin Graft from the Anterolateral Thigh.

PubMed

Shin, Seung-Han; Kim, Chulkyu; Lee, Yong-Suk; Kang, Jin-Woo; Chung, Yang-Guk

2017-12-01

Full thickness skin graft (FTSG) gives better outcomes than split thickness skin graft (STSG), but it has the drawback of limited donor sites. Anterolateral thigh (ALT), a popular donor site of STSG, is also a popular donor site of perforator flaps. This area has the advantage of large flap size available with primary closure. Based on this we harvested FTSG instead of STSG from the ALT. We retrospectively reviewed 10 cases of FTSG from the ALT, with the recipient site of foot in 3, ankle in 2, lower leg in 2, forearm in 2, and wrist in 1 patient. In all cases elliptical full thickness skin was harvested from the ALT, and the donor site was closed primarily. The skin was defatted and placed onto the defect with vacuum-assisted closure (VAC). The skin size ranged 7-30 cm in length and 3-12 cm in width. Mean follow up period was 7 months (range, 3-13). FTSG from the ALT provided durable wound coverage, with excellent color and texture matching. Partial (< 20%) graft failure was observed in 1 case, but no additional surgery was necessary. No patient reported donor site pain at postoperative 2 weeks. No donor site complications were encountered. No patient complained a feeling of tension in the thigh at final follow-up. FTSG from the ALT is feasible with the aid of VAC. Considering the skin quality, large skin size available, early pain relief, and little donor site morbidity, the ALT should be revisited as a donor site of FTSG.

Post-Vacuum-Assisted Stereotactic Core Biopsy Clip Displacement: A Comparison Between Commercially Available Clips and Surgical Clip.

PubMed

Yen, Peggy; Dumas, Sandra; Albert, Arianne; Gordon, Paula

2018-02-01

The placement of localization clips following percutaneous biopsy is a standard practice for a variety of situations. Subsequent clip displacement creates challenges for imaging surveillance and surgical planning, and may cause confusion amongst radiologists and between surgeons and radiologists. Many causes have been attributed for this phenomenon including the commonly accepted "accordion effect." Herein, we investigate the performance of a low cost surgical clip system against 4 commercially available clips. We retrospectively reviewed 2112 patients who underwent stereotactic vacuum-assisted core biopsy followed by clip placement between January 2013 and June 2016. The primary performance parameter compared was displacement >10 mm following vacuum-assisted stereotactic core biopsy. Within the group of clips that had displaced, the magnitude of displacement was compared. There was a significant difference in displacement among the clip types (P < .0001) with significant pairwise comparisons between pediatric surgical clips and SecureMark (38% vs 28%; P = .001) and SenoMark (38% vs 27%; P = .0001) in the proportion displaced. The surgical clips showed a significant magnitude of displacement of approximately 25% greater average distance displaced. As a whole, the commercial clips performed better than the surgical clip after stereotactic vacuum-assisted core biopsy suggesting the surrounding outer component acts to anchor the central clip and minimizes clip displacement. The same should apply to tomosynthesis-guided biopsy. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study.

PubMed

Hong, Kyung Sook; Yi, Hee Jung; Lee, Ryung-Ah; Kim, Kwang Ho; Chung, Soon Sup

2017-12-01

Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics. Of 15 patients admitted to an intensive care unit, 11 underwent colostomy, and 4 required skin grafts for wound healing. The wide wounds of two patients were healed using vacuum-assisted closure (VAC ® ) dressing without additional surgery. The mortality rate was 25%, and the patients whose Fournier's gangrene severity index (FGSI) score was higher than 9 points or whose blood urea nitrogen (BUN) level was higher than 50 mg/dl had a poor prognosis. In order to treat Fournier's gangrene, aggressive surgical treatment, including wide debridement and stoma creation, should be considered as soon as possible to improve survival rates. Additionally, VAC dressing is helpful in healing the wide debridement wound without additional reconstructive surgery. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Vacuolating cytotoxin A (VacA), a key toxin for Helicobacter pylori pathogenesis

PubMed Central

Palframan, Samuel L.; Kwok, Terry; Gabriel, Kipros

2012-01-01

More than 50% of the world's population is infected with Helicobacter pylori (H. pylori). Chronic infection with this Gram-negative pathogen is associated with the development of peptic ulcers and is linked to an increased risk of gastric cancer. H. pylori secretes many proteinaceous factors that are important for initial colonization and subsequent persistence in the host stomach. One of the major protein toxins secreted by H. pylori is the Vacuolating cytotoxin A (VacA). After secretion from the bacteria via a type V autotransport secretion system, the 88 kDa VacA toxin (comprised of the p33 and p55 subunits) binds to host cells and is internalized, causing severe “vacuolation” characterized by the accumulation of large vesicles that possess hallmarks of both late endosomes and early lysosomes. The development of “vacuoles” has been attributed to the formation of VacA anion-selective channels in membranes. Apart from its vacuolating effects, it has recently become clear that VacA also directly affects mitochondrial function. Earlier studies suggested that the p33 subunit, but not the p55 subunit of VacA, could enter mitochondria to modulate organelle function. This raised the possibility that a mechanism separate from pore formation may be responsible for the effects of VacA on mitochondria, as crystallography studies and structural modeling predict that both subunits are required for a physiologically stable pore. It has also been suggested that the mitochondrial effects observed are due to indirect effects on pro-apoptotic proteins and direct effects on mitochondrial morphology-related processes. Other studies have shown that both the p55 and p33 subunits can indeed be efficiently imported into mammalian-derived mitochondria raising the possibility that they could re-assemble to form a pore. Our review summarizes and consolidates the recent advances in VacA toxin research, with focus on the outstanding controversies in the field and the key remaining

Matrix Characterization and Development for the Vacuum Assisted Resin Transfer Molding Process

NASA Technical Reports Server (NTRS)

Grimsley, B. W.; Hubert, P.; Hou, T. H.; Cano, R. J.; Loos, A. C.; Pipes, R. B.

2001-01-01

The curing kinetics and viscosity of an epoxy resin system, SI-ZG-5A, have been characterized for application in the vacuum assisted resin transfer molding (VARTM) process. Impregnation of a typical carbon fiber perform provided the test bed for the characterization. Process simulations were carried out using the process model, COMPRO, to examine heat transfer and curing kinetics for a fully impregnated panel, neglecting resin flow. The predicted viscosity profile and final degree of cure were found to be in good agreement with experimental observations.

Cold Shock Exoribonuclease R (VacB) is Involved in Aeromonas hydrophila Pathogenesis

EPA Science Inventory

In this study, we cloned and sequenced a virulence-associated gene (vacB) from a clinical isolate SSU of Aeromonas hydrophila. We identified this gene based on our recently annotated genome sequence of the environmental isolate ATCC 7966T of A. hydrophila and the vacB gene of Shi...

Cold Shock Exoribonuclease R(VacB) is involved in Aeromonas hydrophila Virulence

EPA Science Inventory

In this study, we cloned and sequenced a virulence-associated gene (vacB) from a clinical isolate SSU of Aeromonas hydrophila. We identified this gene based on our recently annotated genome sequence of the environmental isolate ATCC 7966T of A. hydrophila and the vacB gene of Shi...

Assessment of a simple, novel endoluminal method for gastrotomy closure in NOTES.

PubMed

Lee, Sang Soo; Oelschlager, Brant K; Wright, Andrew S; Soares, Renato V; Sinan, Huseyin; Montenovo, Martin I; Hwang, Joo Ha

2011-10-01

A reliable method for gastrotomy closure in NOTES will be essential for NOTES to become viable clinically. However, methods using existing and widely available endoscopic accessories have been ineffective. The objective of this study was to evaluate the feasibility and safety of a new simple method for gastric closure (retracted clip-assisted loop closure) that uses existing endoscopic accessories with minor modifications. The retracted clip-assisted loop closure technique involves deploying 3-4 Resolution(®) clips (modified by attaching a 90-cm length of suture to the end of each clip) along the margin of the gastrotomy with one jaw on the serosal surface and the other jaw on the mucosal surface. The suture strings are threaded through an endoloop. Traction is then applied to the strings causing the gastric wall to tent. The endoloop is secured below the tip of the clips, completing a full-thickness gastrotomy closure. The main outcome measures were feasibility, efficacy, and safety of the new retracted clip-assisted loop closure technique for NOTES gastrotomy closure. An air-tight seal was achieved in 100% (n = 9) of stomachs. The mean leak pressure was 116.3 (±19.4) mmHg. The retracted clip-assisted loop closure technique can be used to perform NOTES gastrotomy closure by using existing endoscopic accessories with minor modifications.

Characterization of Clostridium difficile Spores Lacking Either SpoVAC or Dipicolinic Acid Synthetase

PubMed Central

Donnelly, M. Lauren; Fimlaid, Kelly A.

2016-01-01

ABSTRACT The spore-forming obligate anaerobe Clostridium difficile is a leading cause of antibiotic-associated diarrhea around the world. In order for C. difficile to cause infection, its metabolically dormant spores must germinate in the gastrointestinal tract. During germination, spores degrade their protective cortex peptidoglycan layers, release dipicolinic acid (DPA), and hydrate their cores. In C. difficile, cortex hydrolysis is necessary for DPA release, whereas in Bacillus subtilis, DPA release is necessary for cortex hydrolysis. Given this difference, we tested whether DPA synthesis and/or release was required for C. difficile spore germination by constructing mutations in either spoVAC or dpaAB, which encode an ion channel predicted to transport DPA into the forespore and the enzyme complex predicted to synthesize DPA, respectively. C. difficile spoVAC and dpaAB mutant spores lacked DPA but could be stably purified and were more hydrated than wild-type spores; in contrast, B. subtilis spoVAC and dpaAB mutant spores were unstable. Although C. difficile spoVAC and dpaAB mutant spores exhibited wild-type germination responses, they were more readily killed by wet heat. Cortex hydrolysis was not affected by this treatment, indicating that wet heat inhibits a stage downstream of this event. Interestingly, C. difficile spoVAC mutant spores were significantly more sensitive to heat treatment than dpaAB mutant spores, indicating that SpoVAC plays additional roles in conferring heat resistance. Taken together, our results demonstrate that SpoVAC and DPA synthetase control C. difficile spore resistance and reveal differential requirements for these proteins among the Firmicutes. IMPORTANCE Clostridium difficile is a spore-forming obligate anaerobe that causes ∼500,000 infections per year in the United States. Although spore germination is essential for C. difficile to cause disease, the factors required for this process have been only partially characterized

Outer membrane lipoprotein VacJ is required for the membrane integrity, serum resistance and biofilm formation of Actinobacillus pleuropneumoniae.

PubMed

Xie, Fang; Li, Gang; Zhang, Wanjiang; Zhang, Yanhe; Zhou, Long; Liu, Shuanghong; Liu, Siguo; Wang, Chunlai

2016-02-01

The outer membrane proteins of Actinobacillus pleuropneumoniae are mediators of infection, acting as targets for the host's defense system. The outer membrane lipoprotein VacJ is involved in serum resistance and intercellular spreading in several pathogenic bacteria. To investigate the role of VacJ in the pathogenicity of Actinobacillus pleuropneumoniae, the vacJ gene-deletion mutant MD12 ΔvacJ was constructed. The increased susceptibility to KCl, SDS plus EDTA, and several antibiotics in the MD12ΔvacJ mutant suggested that the stability of the outer membrane was impaired as a result of the mutation in the vacJ gene. The increased NPN fluorescence and significant cellular morphological variation in the MD12ΔvacJ mutant further demonstrated the crucial role of the VacJ lipoprotein in maintaining the outer membrane integrity of A. pleuropneumoniae. In addition, the MD12ΔvacJ mutant exhibited decreased survival from the serum and complement killing compared to the wild-type strain. Interestingly, the MD12ΔvacJ mutant showed reduced biofilm formation compared to the wild-type strain. To our knowledge, this is the first description of the VacJ lipoprotein contributing to bacterial biofilm formation. The data presented in this study illustrate the important role of the VacJ lipoprotein in the maintenance of cellular integrity, serum resistance, and biofilm formation in A. pleuropneumoniae. Copyright © 2015 Elsevier B.V. All rights reserved.

Ultrasound-assisted extraction coupled with under vacuum distillation of flavour compounds from spearmint (carvone-rich) plants: Comparison with conventional hydrodistillation.

PubMed

Da Porto, Carla; Decorti, Deborha

2009-08-01

Ultrasonically assisted extraction of flavour compounds from different varieties of Mentha spicata, using 70% ethanol, have been carried out for 5, 10 and 15min and coupled with under vacuum distillation. The ultrasound distilled extracts have been analysed by GC-MS and compared with essential oils obtained by hydrodistillation. The results have showed that ultrasonically assisted extraction in combination with under vacuum distillation have provided extracts with higher flavouring strength due to the increased concentration of desirable oxygenated compounds (from 5 to 8 times) compared with hydrodistillation. Extraction yields of flavour volatiles have been calculated giving a range 0.04-0.13% by ultrasound and 0.01-0.02% by hydrodistillation.

Inhibitory effects of anthocyanins on secretion of Helicobacter pylori CagA and VacA toxins.

PubMed

Kim, Sa-Hyun; Park, Min; Woo, Hyunjun; Tharmalingam, Nagendran; Lee, Gyusang; Rhee, Ki-Jong; Eom, Yong Bin; Han, Sang Ik; Seo, Woo Duck; Kim, Jong Bae

2012-01-01

Anthocyanins have been studied as potential antimicrobial agents against Helicobacter pylori. We investigated whether the biosynthesis and secretion of cytotoxin-associated protein A (CagA) and vacuolating cytotoxin A (VacA) could be suppressed by anthocyanin treatment in vitro. H. pylori reference strain 60190 (CagA(+)/VacA(+)) was used in this study to investigate the inhibitory effects of anthocyanins; cyanidin 3-O-glucoside (C3G), peonidin 3-O-glucoside (Peo3G), pelargonidin 3-O-glucoside (Pel3G), and malvidin 3-O-glucoside (M3G) on expression and secretion of H. pylori toxins. Anthocyanins were added to bacterial cultures and Western blotting was used to determine secretion of CagA and VacA. Among them, we found that C3G inhibited secretion of CagA and VacA resulting in intracellular accumulation of CagA and VacA. C3G had no effect on cagA and vacA expression but suppressed secA transcription. As SecA is involved in translocation of bacterial proteins, the down-regulation of secA expression by C3G offers a mechanistic explanation for the inhibition of toxin secretion. To our knowledge, this is the first report suggesting that C3G inhibits secretion of the H. pylori toxins CagA and VacA via suppression of secA transcription.

Inhibitory Effects of Anthocyanins on Secretion of Helicobacter pylori CagA and VacA Toxins

PubMed Central

Kim, Sa-Hyun; Park, Min; Woo, Hyunjun; Tharmalingam, Nagendran; Lee, Gyusang; Rhee, Ki-Jong; Eom, Yong Bin; Han, Sang Ik; Seo, Woo Duck; Kim, Jong Bae

2012-01-01

Anthocyanins have been studied as potential antimicrobial agents against Helicobacter pylori. We investigated whether the biosynthesis and secretion of cytotoxin-associated protein A (CagA) and vacuolating cytotoxin A (VacA) could be suppressed by anthocyanin treatment in vitro. H. pylori reference strain 60190 (CagA+/VacA+) was used in this study to investigate the inhibitory effects of anthocyanins; cyanidin 3-O-glucoside (C3G), peonidin 3-O-glucoside (Peo3G), pelargonidin 3-O-glucoside (Pel3G), and malvidin 3-O-glucoside (M3G) on expression and secretion of H. pylori toxins. Anthocyanins were added to bacterial cultures and Western blotting was used to determine secretion of CagA and VacA. Among them, we found that C3G inhibited secretion of CagA and VacA resulting in intracellular accumulation of CagA and VacA. C3G had no effect on cagA and vacA expression but suppressed secA transcription. As SecA is involved in translocation of bacterial proteins, the down-regulation of secA expression by C3G offers a mechanistic explanation for the inhibition of toxin secretion. To our knowledge, this is the first report suggesting that C3G inhibits secretion of the H. pylori toxins CagA and VacA via suppression of secA transcription. PMID:23155357

Relevance of Helicobacter pylori vacA 3'-end Region Polymorphism to Gastric Cancer.

PubMed

Bakhti, Seyedeh Zahra; Latifi-Navid, Saeid; Mohammadi, Shiva; Zahri, Saber; Bakhti, Fatemeh Sadat; Feizi, Farideh; Yazdanbod, Abbas; Siavoshi, Farideh

2016-08-01

Helicobacter pylori vacA genotypes play an important role in the pathogenesis of severe gastrointestinal disease. We identified a novel polymorphic site in the 3'-end region of H. pylori vacA gene, denoted by c1/-c2 (c1: with deletion of 15 bp), and examined associations of this and the previous four sites as well as cagA status with gastroduodenal diseases, in a total of 217 Iranian H. pylori isolates. Histopathologic evaluations were performed and patients with gastric cancer (GC) were further classified based on the anatomic site of tumor, including cardia and noncardia GC, and the histopathologic type of tumor, including intestinal- and diffuse-type GC. The vacA m1, i1, d1, c1, and cagA genotypes were significantly associated with an increased risk of GC, the odds ratio (95% confidence interval) was 4.29 (2.03-9.08), 6.11 (2.63-14.19), 3.18 (1.49-6.76), 15.13 (5.86-39.01), and 2.59 (1.09-6.12), respectively. The vacA c1 genotype had an increased age- and sex-adjusted risk for GC by the multiple logistic regression analysis; the OR was 38.32 (95% CI, 6.60-222.29). This association was independent of and larger than the associations of the m-, i-, and d-type of vacA or cagA status with GC. No significant correlation was found between s1, whether independently or in combination, and the risk of GC or peptic ulcer disease (PUD). The vacA i1 and cagA genotypes were linked to an increased risk of PUD; the OR (95% CI) was 2.80 (1.45-5.40) and 2.62 (1.23-5.61), respectively. The presence of both the vacA i1 and cagA genotypes further increased the risk of PUD; the OR was 5.20 (95% CI, 1.92-14.03). The H. pylori vacA c1 genotype might therefore be one of the strongest risk predictors of GC in male patients aged ≥55 in Iran. © 2015 John Wiley & Sons Ltd.

Traction-assisted Internal Negative Pressure Wound Therapy With Bridging Retention Sutures to Facilitate Staged Closure of High-risk Wounds Under Tension.

PubMed

DeFazio, Michael V; Economides, James M; Anghel, Ersilia L; Mathis, Ryan K; Barbour, John R; Attinger, Christopher E

2017-10-01

Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures. Instillation of antimicrobial solution was reserved for wounds containing infected/exposed hardware or prosthetic devices. Demographic data, wound characteristics, reconstructive outcomes, and complications were reviewed retrospectively. Eighteen wounds were treated with traction-assisted internal NPWT using the conventional (n = 11) or modified instillation (n = 7) technique. Defects involved the lower extremity (n = 14), trunk (n = 3), and proximal upper extremity (n = 1), with positive cultures identified in 12 wounds (67%). Therapy continued for 3 to 8 days (mean, 4.3 days), resulting in an average wound surface area reduction of 78% (149 cm² vs. 33 cm²) at definitive closure. Seventeen wounds (94%) were closed directly, whereas the remaining defect required coverage with a local muscle flap and skin graft. At final follow-up (mean, 12 months), 89% of wounds remained closed. In 2 patients with delayed, recurrent periprosthetic infection (mean, 7.5 weeks), serial debridement/hardware removal mandated free tissue transfer for composite defect reconstruction. Traction-assisted internal NPWT provides a safe and effective alternative to reduce wound burden and facilitate definitive closure in cases where delayed reconstruction of high-tension wounds is planned.

Miniature piezo electric vacuum inlet valve

DOEpatents

Keville, R.F.; Dietrich, D.D.

1998-03-24

A miniature piezo electric vacuum inlet valve having a fast pulse rate and is battery operated with variable flow capability is disclosed. The low power (<1.6 watts), high pulse rate (<2 milliseconds), variable flow inlet valve is utilized for mass spectroscopic applications or other applications where pulsed or continuous flow conditions are needed. The inlet valve also has a very minimal dead volume of less than 0.01 std/cc. The valve can utilize, for example, a 12 Vdc input/750 Vdc, 3 mA output power supply compared to conventional piezo electric valves which require preloading of the crystal drive mechanism and 120 Vac, thus the valve of the present invention is smaller by a factor of three. 6 figs.

Drying based on temperature-detection-assisted control in microwave-assisted pulse-spouted vacuum drying.

PubMed

Cao, Xiaohuang; Zhang, Min; Qian, He; Mujumdar, Arun S

2017-06-01

An online temperature-detection-assisted control system of microwave-assisted pulse-spouted vacuum drying was newly developed. By using this system, temperature control can be automatically and continuously adjusted based on the detection of drying temperature and preset temperature. Various strategies for constant temperature control, linear temperature control and three-step temperature control were applied to drying carrot cubes. Drying kinetics and the quality of various temperature-controlled strategies online are evaluated for the new drying technology as well as its suitability as an alternative drying method. Drying time in 70 °C mode 1 had the shortest drying time and lowest energy consumption in all modes. A suitable colour, highest re-hydration ratio and fracture-hardness, and longest drying time occurred in 30-40-50 °C mode 3. The number of hot spots was reduced in 40-50-60 °C mode 3. Acceptable carrot snacks were obtained in 50-60-70 °C mode 3 and 70 °C mode 2. All temperature curves showed that the actual temperatures followed the preset temperatures appropriately. With this system, a linear temperature-controlled strategy and a three-step temperature-controlled strategy can improve product quality and heating non-uniformity compared to constant temperature control, but need greater energy consumption and longer drying time. A temperature-detection-assisted control system was developed for providing various drying strategies as a suitable alternative in making a snack product. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Strengthening national decision-making on immunization by building capacity for economic evaluation: Implementing ProVac in Europe.

PubMed

Blau, Julia; Hoestlandt, Céline; D Clark, Andrew; Baxter, Louise; Felix Garcia, Ana Gabriela; Mounaud, Bérénice; Mosina, Liudmila

2015-05-07

For many years, low- and middle-income countries have made efforts to strengthen national decision-making on immunization. The Pan American Health Organization (PAHO) ProVac Initiative was established to help expedite the use of evidence-based decision-making around new vaccine introduction. This initiative provides training in user-friendly cost-effectiveness models and supports the development of country-led economic evaluations. Due to the success of the ProVac Initiative in the Americas, and following requests from countries from outside the Americas, the Bill & Melinda Gates Foundation funded a two-year pilot effort to expand the initiative to other world regions. Called the ProVac International Working Group (IWG), this endeavor took place in 2012 and 2013. It was coordinated by PAHO and carried out in collaboration with several international partners, including the Agence de Médecine Préventive (AMP), London School of Hygiene & Tropical Medicine (LSHTM), Program for Appropriate Technology in Health, Sabin Vaccine Institute, United States Centers for Disease Control and Prevention, and the World Health Organization (WHO). In the WHO European Region, technical support was provided by AMP, in close collaboration with the WHO Regional Office for Europe and other ProVac IWG partners. In 2012, AMP, the WHO Regional Office for Europe, and other partners held a training workshop in Dubrovnik, Croatia, for 31 participants from four countries of the WHO European Region. The aim was to train health professionals in standard methods of economic evaluation and to assess regional demand for economic studies to support decision-making on immunization. AMP and the other organizations also supported four national cost-effectiveness studies in the WHO European Region. The assistance included country visits and support over a period of six months, the establishment of multidisciplinary teams of experts, ongoing training on the TRIVAC decision-support model for new

Comparison of the antimicrobial efficacy of irrigation using the EndoVac to endodontic needle delivery.

PubMed

Miller, Todd A; Baumgartner, J Craig

2010-03-01

The purpose of this investigation was to compare the antimicrobial efficacy of root canal irrigation with the EndoVac (Discus Dental, Culver City, CA) to endodontic needle irrigation in the apical 5 mm of root canals infected with Enterococcus faecalis. Bilaterally matched, extracted human teeth were sterilized and inoculated with E. faecalis. Specimens in the EndoVac group were irrigated using the EndoVac system, whereas those in the needle group were irrigated with a 30-G side-vented needle. After chemomechanical preparation, the apical 5 mm of the roots were removed, frozen in liquid nitrogen, and pulverized to expose E. faecalis in dentinal tubules or other morphologic irregularities. The number of colony forming units (cfus) of E. faecalis per mg dentin was determined. The EndoVac Group had a mean of 31.6 cfu/mg, whereas the needle group had a mean of 157 cfu/mg. This represents a bacterial reduction of 99.7% in group A and 98.8% in group B when compared with positive controls. Although there were fewer cfu/mg when using the EndoVac, there was not a statistically significant difference between the EndoVac and needle groups. Copyright (c) 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Polyimide Composites Properties of RTM370 Fabricated by Vacuum Assisted Resins Transfer Molding (VARTM)

NASA Technical Reports Server (NTRS)

Chuang, Kathy C.; Criss, Jim M.; Mintz, Eric A.

2011-01-01

RTM370 imide resin based on 2,3,3 ,4 -biphenyl dianhydride ( a-BPDA), 3,4 -oxydianinline (3,4 -ODA) with 4-phenylethynylphthalic (PEPA) endcap has shown to exhibit high Tg (370 C) and low melt viscosity (10-30 poise) at 280 C with a pot-life of 1-2 h. Previously, RTM370 resin has been fabricated into composites with T650-35 carbon fabrics by resin transfer molding (RTM) successfully. RTM370 composites exhibit excellent mechanical properties up to 327 C (620 F), and outstanding property retention after aging at 288 C (550 F) for 1000 hrs. In this presentation, RTM 370 composites will be fabricated by vacuum assisted resins transfer molding (VARTM), using vacuum bags without mold. The mechanical properties of RTM370 composites fabricated by VARTM will be compared to those of RTM370 made by RTM.

Comparison of the EndoVac system to needle irrigation of root canals.

PubMed

Nielsen, Benjamin A; Craig Baumgartner, J

2007-05-01

Past studies have shown that current irrigation methods are effective at cleaning root canals coronally but less effective apically. To be effective, endodontic irrigants should ideally be delivered near working length. The purpose of this study was to compare the efficacy of the EndoVac irrigation system and needle irrigation to debride root canals at 1 and 3 mm from working length. One tooth of each matched pair was instrumented and irrigated by using the EndoVac, which uses negative pressure to deliver irrigating solutions to working length. The other tooth of the matched pair was instrumented and irrigated with a 30-gauge ProRinse irrigating needle. All teeth were irrigated with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) for a predetermined amount of time, and total volume of irrigant used was recorded. After instrumentation and irrigation, the teeth were fixed, decalcified, and sectioned at 1 mm and 3 mm from working length. Serial sections were made and digitally photographed. The amount of remaining debris was determined as a percentage of the area of the canal lumen. Remaining debris and total irrigant were analyzed by using the Wilcoxon signed rank test at the 5% confidence level. At the 1-mm level, significantly less debris was found in the EndoVac group (p=0.0347). At the 3-mm level, there was no significant difference between groups. Significantly more irrigant was delivered with the EndoVac (p<0001). This study showed significantly better debridement at 1 mm from working length by using the EndoVac compared with needle irrigation.

Flow and Compaction During the Vacuum Assisted Resin Transfer Molding Process

NASA Technical Reports Server (NTRS)

Grimsley, Brian W.; Hubert, Pascal; Song, Xiao-Lan; Cano, Roberto J.; Loos, Alfred C.; Pipes, R. Byron

2001-01-01

The flow of an epoxy resin and compaction behavior of carbon fiber preform during vacuum- assisted resin transfer molding (VARTM) infiltration was measured using an instrumented tool. Composite panels were fabricated by the VARTM process using SAERTEX(R)2 multi-axial non- crimp carbon fiber fabric and the A.T.A.R.D. SI-ZG-5A epoxy resin. Resin pressure and preform thickness variation was measured during infiltration. The effects of the resin on the compaction behavior of the preform were measured. The local preform compaction during the infiltration is a combination of wetting and spring-back deformations. Flow front position computed by the 3DINFIL model was compared with the experimental data.

Sternoclavicular Osteomyelitis in an Immunosuppressed Patient: A Case Report and Review of the Literature.

PubMed

Khan, Kamran; Wozniak, Susan E; Mehrabi, Erfan; Giannone, Anna Lucia; Dave, Mitul

2015-12-28

BACKGROUND Sternoclavicular osteomyelitis is a rare disease, with less than 250 cases identified in the past 50 years. We present a rare case of sternoclavicular osteomyelitis in an immunosuppressed patient that developed from a conservatively treated dislocation. CASE REPORT A 62-year-old white man with a history of metastatic renal cell carcinoma presented to the emergency department (ED) with a dislocated left sternoclavicular joint. He was managed conservatively and subsequently discharged. However, over subsequent days he began to experience pain, fever, chills, and night sweats. He presented to the ED again and imaging revealed osteomyelitis. In the operating room, the wound was aggressively debrided and a wound vac (vacuum-assisted closure) was placed. He was diagnosed with sternoclavicular osteomyelitis and placed on a 6-week course of intravenous Nafcillin. CONCLUSIONS Chemotherapy patients who sustain joint trauma normally associated with a low risk of infection should be monitored thoroughly, and the option to discontinue immunosuppressive therapy should be considered if signs of infection develop.

Serum VacA antibody is associated with risks of peptic ulcer and gastric cancer: A meta-analysis.

PubMed

Li, Qiuping; Liu, Jingwei; Gong, Yuehua; Yuan, Yuan

2016-10-01

Increasing studies have investigated the relationship between the status of H. pylori vacA antibody and risks of peptic ulcer disease (PUD) and gastric cancer (GC). However, the results were controversial. The aim of this meta-analysis is to clarify whether serum vacA antibody is associated with risks of PUD and GC. Databases including PubMed, Embase, Web of knowledge, Wanfang, Chinese National Knowledge Infrastructure (CNKI), OVID, Karger and Scopus were systematically searched for potentially eligible literature. Odds ratios (OR) and their 95% confidence interval (CI) were adopted to assess the strength of association. Serum VacA antibody was associated with increased risk of PUD compared with gastritis/functional dyspepsia (FD) (OR = 1.96, 95%CI = 1.56-2.46, P < 0.001). Serum VacA antibody was significantly associated with increased risk of gastric ulcer (GU) and duodenal ulcer (DU) compared with gastritis/FD (GU: OR = 1.64, 95%CI = 1.02-2.62, P = 0.042; DU: OR = 2.06, 95%CI = 1.50-2.84, P < 0.001, respectively). Significant increased risk of GC was found in serum VacA antibody positive subjects compared with serum VacA antibody negative individuals (OR = 2.78, 95%CI = 1.98-3.89, P < 0.001). There was no significant publication bias in all of the comparisons. Serum VacA antibody was significantly associated with increased risks of peptic ulcer disease, gastric ulcer and duodenal ulcer compared with gastritis and functional dyspepsia controls. Significant association was also found between serum VacA antibody and gastric cancer risk. Serum VacA antibody might be a potential biomarker for the prediction of risks of PUD and GC. Copyright © 2016 Elsevier Ltd. All rights reserved.

Composite Properties of RTM370 Polyimide Fabricated by Vacuum Assisted Resin Transfer Molding (VARTM)

NASA Technical Reports Server (NTRS)

Chuang, Kathy C.; Criss, James M.; Mintz, Eric A.; Shonkwiler, Brian; McCorkle, Linda S.

2011-01-01

RTM370 imide resin based on 2,3,3?,4?-biphenyl dianhydride (a-BPDA), 3,4'-oxydianinline (3,4'-ODA) with the 4-phenylethynylphthalic (PEPA) endcap has been shown to exhibit a high cured T(sub g) (370 C) and low melt viscosity (10-30 poise) at 280 C with a pot-life of 1-2 h. Previously, RTM370 resin has been successfully fabricated into composites reinforced with T650-35 carbon fabrics by resin transfer molding (RTM). RTM370 composites exhibit excellent mechanical properties up to 327?C (620?F), and outstanding property retention after aging at 288?C (550?F) for 1000 h. In this work, RTM370 composites were fabricated by vacuum assisted resin transfer molding (VARTM), using vacuum bags on a steel plate. The mechanical properties of RTM370 composites fabricated by VARTM are compared to those prepared by RTM.

[The evolution of vacuum extraction in obstetrics].

PubMed

Nikolov, A

2010-01-01

Vacuum extraction is one of the methods for assisted vaginal delivery. In this article the evolution of vacuum extraction in obstetrics is been discussed. Historical facts and data from the invention up to state-of-the-art vacuum systems in modern obstetrics are presented.

Temporary Abdominal Closure Combined With an Irrigating System Utilizing Hypochlorous Acid Solution to Decrease Abdominal Mucopurulence

PubMed Central

Matthews, Marc R.; Quan, Asia N.; Weir, Alexandra S.; Foster, Kevin N.; Caruso, Daniel M.

2018-01-01

Introduction: Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds. There is no literature regarding the infusion of hypochlorous solution into the abdominal cavity for intra-abdominal sepsis or mucopurulent abscesses or biofilm. Objectives: A 47-year-old man with granulomatosis polyangiitis was started on weekly rituximab. After 4 infusions, skin sloughing, ultimately diagnosed as toxic epidermal necrolysis, developed. During the hospital course, he developed sepsis and bowel perforation necessitating an exploratory laparotomy. The abdomen was left open with a temporary abdominal closure using the Abthera open abdomen negative wound therapy device; however, the abdomen remained infected with visually diffuse, thickening mucopurulence despite multiple washouts. Therefore, a VAC Vera-Flo irrigation device was combined with the Abthera open abdomen negative wound therapy device and cyclical irrigation of hypochlorous acid. After 72 hours, the purulence visually was improved and no adverse events were recorded with the placement of intra-abdominal hypochlorous acid. Conclusions: The combination of two medical devices for the intra-abdominal instillation of irrigation is considered “off-label use” from the manufacturer's recommendations. In addition, the repeated instillation of hypochlorous acid solution has not been described but was noted to have visually decreased the contaminated effluent within the intra-abdominal fluid. PMID:29527250

Homogenate-assisted Vacuum-powered Bubble Extraction of Moso Bamboo Flavonoids for On-line Scavenging Free Radical Capacity Analysis.

PubMed

Sun, Yinnan; Yang, Kui; Cao, Qin; Sun, Jinde; Xia, Yu; Wang, Yinhang; Li, Wei; Ma, Chunhui; Liu, Shouxin

2017-07-11

A homogenate-assisted vacuum-powered bubble extraction (HVBE) method using ethanol was applied for extraction of flavonoids from Phyllostachys pubescens (P. pubescens) leaves. The mechanisms of homogenate-assisted extraction and vacuum-powered bubble generation were discussed in detail. Furthermore, a method for the rapid determination of flavonoids by HPLC was established. HVBE followed by HPLC was successfully applied for the extraction and quantification of four flavonoids in P. pubescens , including orientin, isoorientin, vitexin, and isovitexin. This method provides a fast and effective means for the preparation and determination of plant active components. Moreover, the on-line antioxidant capacity, including scavenging positive ion and negative ion free radical capacity of different fractions from the bamboo flavonoid extract was evaluated. Results showed that the scavenging DPPH ˙ free radical capacity of vitexin and isovitexin was larger than that of isoorientin and orientin. On the contrary, the scavenging ABTS⁺ ˙ free radical capacity of isoorientin and orientin was larger than that of vitexin and isovitexin.

Resection of giant right atrial lymphoma using vacuum-assisted cardiopulmonary bypass without snaring the inferior vena cava.

PubMed

Shin, Hankei; Mori, Mitsuharu; Matayoshi, Toru; Suzuki, Ryo; Yozu, Ryohei

2004-08-01

A 53-year-old man sustained hemodynamic collapse due to a huge right atrial tumor and was transferred to our hospital and underwent a life-saving emergency operation. The tumor arose from the inferolateral wall of the right atrium, occupying almost the whole right atrial cavity and obstructing not only the inflow of the right ventricle but also the orifice of the inferior vena cava. Venous cannulation via the right atrial wall and placing a snare around the inferior vena cava were impossible. With a cardiopulmonary bypass using vacuum-assisted venous drainage, the tumor was successfully resected and the tricuspid valve was replaced with a bioprosthetic valve without snaring the inferior vena cava. Postoperative histological examination demonstrated the tumor to be a large B-cell non-Hodgkin type malignant lymphoma. When the tumor is large and it is difficult to establish total cardiopulmonary bypass, the vacuum-assisted cardiopulmonary bypass is a useful option. This can achieve a bloodless operative field and is not blocked by the incoming air, due to the venous drainage being continually pressure-regulated.

Genomic and bioinformatics analyses of HAdV-4vac and HAdV-7vac, two human adenovirus (HAdV) strains that constituted original prophylaxis against HAdV-related acute respiratory disease, a reemerging epidemic disease.

PubMed

Purkayastha, Anjan; Su, Jing; McGraw, John; Ditty, Susan E; Hadfield, Ted L; Seto, Jason; Russell, Kevin L; Tibbetts, Clark; Seto, Donald

2005-07-01

Vaccine strains of human adenovirus serotypes 4 and 7 (HAdV-4vac and HAdV-7vac) have been used successfully to prevent adenovirus-related acute respiratory disease outbreaks. The genomes of these two vaccine strains have been sequenced, annotated, and compared with their prototype equivalents with the goals of understanding their genomes for molecular diagnostics applications, vaccine redevelopment, and HAdV pathoepidemiology. These reference genomes are archived in GenBank as HAdV-4vac (35,994 bp; AY594254) and HAdV-7vac (35,240 bp; AY594256). Bioinformatics and comparative whole-genome analyses with their recently reported and archived prototype genomes reveal six mismatches and four insertions-deletions (indels) between the HAdV-4 prototype and vaccine strains, in contrast to the 611 mismatches and 130 indels between the HAdV-7 prototype and vaccine strains. Annotation reveals that the HAdV-4vac and HAdV-7vac genomes contain 51 and 50 coding units, respectively. Neither vaccine strain appears to be attenuated for virulence based on bioinformatics analyses. There is evidence of genome recombination, as the inverted terminal repeat of HAdV-4vac is initially identical to that of species C whereas the prototype is identical to species B1. These vaccine reference sequences yield unique genome signatures for molecular diagnostics. As a molecular forensics application, these references identify the circulating and problematic 1950s era field strains as the original HAdV-4 prototype and the Greider prototype, from which the vaccines are derived. Thus, they are useful for genomic comparisons to current epidemic and reemerging field strains, as well as leading to an understanding of pathoepidemiology among the human adenoviruses.

Genomic and Bioinformatics Analyses of HAdV-4vac and HAdV-7vac, Two Human Adenovirus (HAdV) Strains That Constituted Original Prophylaxis against HAdV-Related Acute Respiratory Disease, a Reemerging Epidemic Disease

PubMed Central

Purkayastha, Anjan; Su, Jing; McGraw, John; Ditty, Susan E.; Hadfield, Ted L.; Seto, Jason; Russell, Kevin L.; Tibbetts, Clark; Seto, Donald

2005-01-01

Vaccine strains of human adenovirus serotypes 4 and 7 (HAdV-4vac and HAdV-7vac) have been used successfully to prevent adenovirus-related acute respiratory disease outbreaks. The genomes of these two vaccine strains have been sequenced, annotated, and compared with their prototype equivalents with the goals of understanding their genomes for molecular diagnostics applications, vaccine redevelopment, and HAdV pathoepidemiology. These reference genomes are archived in GenBank as HAdV-4vac (35,994 bp; AY594254) and HAdV-7vac (35,240 bp; AY594256). Bioinformatics and comparative whole-genome analyses with their recently reported and archived prototype genomes reveal six mismatches and four insertions-deletions (indels) between the HAdV-4 prototype and vaccine strains, in contrast to the 611 mismatches and 130 indels between the HAdV-7 prototype and vaccine strains. Annotation reveals that the HAdV-4vac and HAdV-7vac genomes contain 51 and 50 coding units, respectively. Neither vaccine strain appears to be attenuated for virulence based on bioinformatics analyses. There is evidence of genome recombination, as the inverted terminal repeat of HAdV-4vac is initially identical to that of species C whereas the prototype is identical to species B1. These vaccine reference sequences yield unique genome signatures for molecular diagnostics. As a molecular forensics application, these references identify the circulating and problematic 1950s era field strains as the original HAdV-4 prototype and the Greider prototype, from which the vaccines are derived. Thus, they are useful for genomic comparisons to current epidemic and reemerging field strains, as well as leading to an understanding of pathoepidemiology among the human adenoviruses. PMID:16000418

RETENTION OF POLYURETHANE FOAM FRAGMENTS DURING VAC-THERAPY, A COMPLICATION TO BE CONSIDERED

PubMed Central

Dessy, L.A.; Serratore, F.; Corrias, F.; Parisi, P.; Mazzocchi, M.; Carlesimo, B.

2013-01-01

VAC-therapy is a closed-loop, non-invasive active system, characterised by a controlled and localized negative pressure applied on porous polyurethane absorbent foams. It promotes healing of acute and chronic wounds. Therapeutic effects of VAC-therapy have been proved and demonstrated, however this method can have some disadvantages. Even if it is a quite versatile device, only qualified medical/paramedical personnel should use it in order to avoid possible complications that can occur after an improper application. In this report, 11 cases of foam fragment retention within the wound are presented. This rare complication did not promote healing, but further hindered it. On the basis of our experience, it is mandatory to define indications, benefits and limitations of the VAC-therapy. PMID:23590296

Violence Against Children Surveys (VACS): towards a global surveillance system.

PubMed

Chiang, Laura F; Kress, Howard; Sumner, Steven A; Gleckel, Jessie; Kawemama, Philbert; Gordon, Rebecca N

2016-04-01

To describe the Violence Against Children Surveys (VACS). The survey is a national, household survey that systematically measures the prevalence, nature and consequences of sexual, physical and emotional violence against children. This report provides information about the history, implementation, ethical protections, utility, results, limitations, and future directions of the VACS work. The study has been implemented in 11 countries in Africa, Asia and the Caribbean, providing each of these countries with baseline data and momentum to address violence against children as a public health and human rights priority. These data are novel in each country, and VACS is well poised to contribute to an existing surveillance system or be used as the basis of a periodic surveillance system. Without ongoing surveillance to assess prevalence and the impact of policy, prevention and response programming, violence will likely continue to be overlooked as the linchpin public health crisis that it is, globally and in individual countries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Enterocutaneous fistula: a review of 82 cases.

PubMed

Njeze, G E; Achebe, U J

2013-01-01

Enterocutaneous fistula is an unpleasant and troublesome complication of abdominal operations. The objective was to review the outcome of treatment of patients treated for enterocutaneous fistula. This is a retrospective study of 82 teenage and adult patients, who suffered from enterocutaneous fistula, seen over an 11 year period, in the University of Nigeria Teaching Hospital, Enugu. Patients' charts were reviewed for biodata, etiology of the fistula, volume of the fistula output, and result of treatment. Majority of the fistulas occurred after abdominal operations; many by general practitioners. After treatment for correction of fluid and electrolyte deficits, they were all tried on conservative therapy with enteral nutritional support as the main stay of management. Those, whose fistulas did not close, underwent surgical treatment. Total parenteral nutrition, octreotide, fibrin glue, and wound vacuum assisted closure (VAC) were not used for treating these patients. Spontaneous healing of fistulas occurred in 26 patients (31.7%), whereas 42 patients out of 50 (84%) healed after definitive operation. Fourteen patients (17%) in this study, died. Proper management of fluid and electrolyte imbalances, enteral nutritional support, control of sepsis and correctly timed surgical therapy, resulted in this good healing rate and acceptable mortality, without the use of parenteral nutrition, biologic fibrin glue injection or VAC. Suggestions are offered about steps that may help in eradicating some of these enterocutaneous fistulas.

Propeller flap for treatment of a poststernotomy sternal fistula: a case report.

PubMed

Corradino, Bartolo; Di Lorenzo, Sara; Hubova, Martina; Cordova, Adriana

2014-11-01

The treatment of post-operative deep sternal wound infections is a real challenge for surgeons. Conservative treatment with debridement and vacuum-assisted closure (VAC) therapy is not always successful. In the most severe and chronic cases, a surgical debridement and reconstruction of the defect is mandatory. In this report, the authors present a case of a 61-year-old female patient with a chronic cutaneous fistula in the sternal region following a median sternotomy after coronary artery bypass. The patient had already undergone treatment with antibiotics, drainage of an abscess and local debridement, but the infection continued to relapse periodically. The authors decided to treat the fistula with debridement and reconstruction with a local freestyle propeller flap mobilised from the right parasternal region. The fistula healed without any complications. There has been no relapse, and the aesthetic result is satisfactory. The scar at the donor site is acceptable with a minimum alteration to the mammary region. Sternal fistulas after medial sternotomy are difficult to treat. The treatment method of debridement followed, in certain cases, by VAC therapy is quite controversial. A surgical procedure is sometimes necessary to speed healing. Mobilisation of a freestyle propeller flap represents a less invasive surgical approach to the treatment of sternal fistulas in cases of conservative treatment failure. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Cotton roll isolation versus Vac-Ejector isolation.

PubMed

Wood, A J; Saravia, M E; Farrington, F H

1989-01-01

A visible-light-cured, white pit-and-fissure sealant was applied to 523 teeth in school children using either cotton rolls or a VacEjector for isolation. After a minimum of six months, the patients were recalled and the retention of the sealants was evaluated. No significant difference in sealant retention was found between the two isolation methods.

Effectiveness of bridge V.A.C. dressings in the treatment of diabetic foot ulcers

PubMed Central

Nather, Aziz; Hong, Ng Yau; Lin, Wong Keng; Sakharam, Joshi Abhijit

2011-01-01

Objectives This is a prospective study of the clinical efficacy of the V.A.C. Granufoam Bridge Dressing for the treatment of diabetic foot ulcers. Materials and methods Five consecutive patients with diabetic foot ulcers were treated with V.A.C. Granufoam Bridge Dressings and studied over a period of 22–48 days. The indications for treatment included diabetic patients with open ray amputation wounds and wounds post-drainage for abscess with exposed deep structures. Clinical outcome was measured in terms of reduction in wound dimensions, presence of wound granulation, microbial clearance, and development of wound complications. Results Our results showed that with V.A.C. therapy, wound healing occurred in all patients. The number of dressings required ranged from 8 to 10. The baseline average wound size was 23.1 cm2. Wound areas shrunk by 18.4–41.7%. All subjects achieved 100% wound bed granulation with an average length of treatment of 33 days. Microbial clearance was achieved in all cases. All wounds healed by secondary intention in one case and four cases required split-thickness skin grafting. Conclusion The V.A.C. Granufoam Bridge Dressing is effective in the treatment of diabetic foot ulcers. It promotes reduction of wound area, wound bed granulation, and microbial clearance. By allowing placement of the suction pad outside the foot, it allowed patients to wear protective shoes and to walk non-weight bearing with crutches during V.A.C. therapy. PMID:22396825

An effective vacuum assisted extraction method for the optimization of labdane diterpenoids from Andrographis paniculata by response surface methodology.

PubMed

Wang, Ya-Qi; Wu, Zhen-Feng; Ke, Gang; Yang, Ming

2014-12-31

An effective vacuum assisted extraction (VAE) technique was proposed for the first time and applied to extract bioactive components from Andrographis paniculata. The process was carefully optimized by response surface methodology (RSM). Under the optimized experimental conditions, the best results were obtained using a boiling temperature of 65 °C, 50% ethanol concentration, 16 min of extraction time, one extraction cycles and a 12:1 liquid-solid ratio. Compared with conventional ultrasonic assisted extraction and heat reflux extraction, the VAE technique gave shorter extraction times and remarkable higher extraction efficiency, which indicated that a certain degree of vacuum gave the solvent a better penetration of the solvent into the pores and between the matrix particles, and enhanced the process of mass transfer. The present results demonstrated that VAE is an efficient, simple and fast method for extracting bioactive components from A. paniculata, which shows great potential for becoming an alternative technique for industrial scale-up applications.

VAC protocol for treatment of dogs with stage III hemangiosarcoma.

PubMed

Alvarez, Francisco J; Hosoya, Kenji; Lara-Garcia, Ana; Kisseberth, William; Couto, Guillermo

2013-01-01

Hemangiosarcomas (HSAs) are aggressive tumors with a high rate of metastasis. Clinical stage has been considered a negative prognostic factor for survival. The study authors hypothesized that the median survival time (MST) of dogs with metastatic (stage III) HSA treated with a vincristine, doxorubicin, and cyclophosphamide (VAC) chemotherapy protocol would not be different than those with stage I/II HSA. Sixty-seven dogs with HSA in different anatomic locations were evaluated retrospectively. All dogs received the VAC protocol as an adjuvant to surgery (n = 50), neoadjuvant (n = 3), or as the sole treatment modality (n = 14). There was no significant difference (P = 0.97) between the MST of dogs with stage III and stage I/II HSA. For dogs presenting with splenic HSA alone, there was no significant difference between the MST of dogs with stage III and stage I/II disease (P = 0.12). The overall response rate (complete response [CR] and partial response [PR]) was 86%). No unacceptable toxicities were observed. Dogs with stage III HSA treated with the VAC protocol have a similar prognosis to dogs with stage I/II HSA. Dogs with HSA and evidence of metastases at the time of diagnosis should not be denied treatment.

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure.

PubMed

Cheng, Li-Fu; Lee, Jiunn-Tat; Hsu, Honda; Wu, Meng-Si

2017-03-01

Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique after a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful.

Simple skin-stretching device in assisted tension-free wound closure

PubMed Central

Cheng, Li-Fu; Lee, Jiunn-Tat; Hsu, Honda; Wu, Meng-Si

2017-01-01

Background Numerous conventional wound reconstruction methods such as wound undermining with direct suture, skin graft, and flap surgery can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. Materials and Methods This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique following a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. Results All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. Conclusion The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful. PMID:28195891

Helicobacter pylori vacA genotype is a predominant determinant of immune response to Helicobacter pylori CagA

PubMed Central

Link, Alexander; Langner, Cosima; Schirrmeister, Wiebke; Habendorf, Wiebke; Weigt, Jochen; Venerito, Marino; Tammer, Ina; Schlüter, Dirk; Schlaermann, Philipp; Meyer, Thomas F; Wex, Thomas; Malfertheiner, Peter

2017-01-01

AIM To evaluate the frequency of Helicobacter pylori (H. pylori) CagA antibodies in H. pylori infected subjects and to identify potential histopathological and bacterial factors related to H. pylori CagA-immune response. METHODS Systematic data to H. pylori isolates, blood samples, gastric biopsies for histological and molecular analyses were available from 99 prospectively recruited subjects. Serological profile (anti-H. pylori, anti-CagA) was correlated with H. pylori isolates (cagA, EPIYA, vacA s/m genotype), histology (Sydney classification) and mucosal interleukin-8 (IL-8) mRNA and protein expression. Selected H. pylori strains were assessed for H. pylori CagA protein expression and IL-8 induction in co-cultivation model with AGS cells. RESULTS Thirty point three percent of microbiologically confirmed H. pylori infected patients were seropositive for CagA. Majority of H. pylori isolates were cagA gene positive (93.9%) with following vacA polymorphisms: 42.4% vacA s1m1, 23.2% s1m2 and 34.3% s2m2. Anti-CagA-IgG seropositivity was strongly associated with atrophic gastritis, increased mucosal inflammation according to the Sydney score, IL-8 and cagA mRNA expression. VacA s and m polymorphisms were the major determinants for positive (vacA s1m1) or negative (vacA s2m2) anti-CagA serological immune response, which also correlated with the in vitro inflammatory potential in AGS cells. In vitro co-cultivation of representative H. pylori strains with AGS cells confirmed functional CagA translocation, which showed only partial correlation with CagA seropositivity in patients, supporting vacA as major co-determinant of the immune response. CONCLUSION Serological immune response to H. pylori cagA+ strain in H. pylori infected patients is strongly associated with vacA polymorphism, suggesting the crucial role of bacterial factors in immune and clinical phenotype of the infection. PMID:28765692

Vacuum decay container closure integrity leak test method development and validation for a lyophilized product-package system.

PubMed

Patel, Jayshree; Mulhall, Brian; Wolf, Heinz; Klohr, Steven; Guazzo, Dana Morton

2011-01-01

A leak test performed according to ASTM F2338-09 Standard Test Method for Nondestructive Detection of Leaks in Packages by Vacuum Decay Method was developed and validated for container-closure integrity verification of a lyophilized product in a parenteral vial package system. This nondestructive leak test method is intended for use in manufacturing as an in-process package integrity check, and for testing product stored on stability in lieu of sterility tests. Method development and optimization challenge studies incorporated artificially defective packages representing a range of glass vial wall and sealing surface defects, as well as various elastomeric stopper defects. Method validation required 3 days of random-order replicate testing of a test sample population of negative-control, no-defect packages and positive-control, with-defect packages. Positive-control packages were prepared using vials each with a single hole laser-drilled through the glass vial wall. Hole creation and hole size certification was performed by Lenox Laser. Validation study results successfully demonstrated the vacuum decay leak test method's ability to accurately and reliably detect those packages with laser-drilled holes greater than or equal to approximately 5 μm in nominal diameter. All development and validation studies were performed at Whitehouse Analytical Laboratories in Whitehouse, NJ, under the direction of consultant Dana Guazzo of RxPax, LLC, using a VeriPac 455 Micro Leak Test System by Packaging Technologies & Inspection (Tuckahoe, NY). Bristol Myers Squibb (New Brunswick, NJ) fully subsidized all work. A leak test performed according to ASTM F2338-09 Standard Test Method for Nondestructive Detection of Leaks in Packages by Vacuum Decay Method was developed and validated to detect defects in stoppered vial packages containing lyophilized product for injection. This nondestructive leak test method is intended for use in manufacturing as an in-process package integrity

Integrated Cooling-Vacuum-Assisted Non-Fractional 1540 nm Erbium:Glass Laser is Effective in Treating Acne Scars.

PubMed

Politi, Yael; Levi, Assi; Lapidoth, Moshe

2016-11-01

Acne scars are a common result of in ammatory acne, affecting many patients worldwide. Among which, atrophic scars are the most prevalent form, presenting as dermal depressions caused by inflammatory degeneration of dermal collagen. Mid-infrared laser skin interaction is characterized by its modest absorption in water and nite penetration to the mid-dermis. Since collagen is a desirable laser target, 1540-nm wavelength is amenable for collagen remodeling within the depressed area of atrophic scars. To evaluate the safety and efficacy of acne scars treatment using an integrated cooling-vacuum-assisted 1540 nm Erbium: Glass Laser. This interventional prospective study included 25 volunteers (10 men, 15 women) with post acne atrophic scars. Patients were treated with a mid-infrared non-fractional 1540 nm Er:Glass laser (Alma Lasers Ltd. Caesarea, Israel) with integrat- ed cooling- vacuum assisted technology. Acne scars were exposed to 3 stacked laser pulses (400-600 mJ/pulse, 4 mm spot size, frequency of 3 Hz). Patients underwent 3-6 treatment sessions with a 2-3 week interval and were followed-up 1 month and 3 months after the last treatment. Clinical photographs were taken by high resolution digital camera before and after treatment. Clinical evaluation was performed by two independent dermatologists and results were graded on a scale of 0 (exacerbation) to 4 (76%-100% improvement). Patients' and physicians' satisfaction were also recorded (on a 1-5 scale). Pain perception and adverse effects were evaluated as well. Almost all patients (24/25) demonstrated a moderate to significant improvement. Average improvement was 3.9 and 4.1 points on the quartile scale used for outcome assessment 1 and 3 months following the last session, respectively. Patient satisfaction rate was 4.2. Side effects were minimal and transient: erythema, mild transient vesicles, and mild pain or inconvenience. CONCLUSION Cooling-Vacuum-Assisted mid-infrared non-fractional Er:Glass 1540 nm laser

PREFACE: International Symposium on `Vacuum Science and Technology' (IVS 2007)

NASA Astrophysics Data System (ADS)

Mittal, K. C.; Gupta, S. K.

2008-03-01

equipments, accessories, products etc by different manufacturers and suppliers has been organized at the venue of the symposium hall for the benefit of the participants. The interest shown by the exhibitors reveals that the industry has come of age and the advances that have taken place over the years is quite significant. During the symposium, the Indian Vacuum Society felicitated two distinguished personalities who have contributed significantly for the development of vacuum science and technology in the country. The C AMBASANKARAN memorial and Smt SHAKUNTALABAI VYAWAHARE memorial Awards were also conferred on the two best contributed papers. A committee constituted by the Symposium Organizing Committee evaluated the relevance, scientific content, and clarity of presentation to decide the award winning papers. It is hoped that the discussion generated by the delegates at the symposium will help in a better understanding vacuum science and technology. K C Mittal Convener S K Gupta Co Convener International Advisory Committee Kakodkar, Anil DAE/India, Chairman Badve, Cdr A.V.(IN Retd.) Pfeiffer Vac India Banerjee, S. BARC/India Bhandari, R.K. BRNS/India Chander, Shekhar CEERI/India Chopra, K.L. IIT Delhi/India Day, Chris ITER Grover, R.B DAE,BARC/India Jakub, Szajman VSA/ Australia Jayaraj, R.N. NFC/India Kamath, H.S. BARC/India Kaw, P.K. IPR/India Kobayashi, M. VSJ/Japan Kumar, Lalit MTRDC, India Kumar, Vikram NPL., India Langley, Robert AVS, USA Larour, Jean Ecole/France Mendonsa, R.H. Lawrence and Mayo Myneni, Ganapatirao Jlab/USA Narsaiah, S.V. HHV Padamsee, Hasan Cornell/USA Pillay, R.G. TIFR Raj, Baldev IGCAR/India Raju, P.T. IVS/India Ramasami, T. DST/India Ray, A.K. BARC/India Reid, RJ IUVSTA/UK Roy, Amit IUAC/india Sahni, V.C. RRCAT, BARC/India Schamiloglu, E. UNM/USA Shankara, K.N. VSSC,ISRO/India Sinha, Bikash VEC,SINP/India Strubin, P. CERN/Switzerland Local Organizing Committee Ray, A.K. BARC (Chairman) Kailas, S. BARC, (Co Chairman) Chakravarty, D.P. BARC

Immune Protection against Trypanosoma cruzi Induced by TcVac4 in a Canine Model

PubMed Central

Aparicio-Burgos, José E.; Zepeda-Escobar, José A.; de Oca-Jimenez, Roberto Montes; Estrada-Franco, José G.; Barbabosa-Pliego, Alberto; Ochoa-García, Laucel; Alejandre-Aguilar, Ricardo; Rivas, Nancy; Peñuelas-Rivas, Giovanna; Val-Arreola, Margarita; Gupta, Shivali; Salazar-García, Felix; Garg, Nisha J.; Vázquez-Chagoyán, Juan C.

2015-01-01

Chagas disease, caused by Trypanosoma cruzi, is endemic in southern parts of the American continent. Herein, we have tested the protective efficacy of a DNA-prime/T. rangeli-boost (TcVac4) vaccine in a dog (Canis familiaris) model. Dogs were immunized with two-doses of DNA vaccine (pcDNA3.1 encoding TcG1, TcG2, and TcG4 antigens plus IL-12- and GM-CSF-encoding plasmids) followed by two doses of glutaraldehyde-inactivated T. rangeli epimastigotes (TrIE); and challenged with highly pathogenic T. cruzi (SylvioX10/4) isolate. Dogs given TrIE or empty pcDNA3.1 were used as controls. We monitored post-vaccination and post-challenge infection antibody response by an ELISA, parasitemia by blood analysis and xenodiagnosis, and heart function by electrocardiography. Post-mortem anatomic and pathologic evaluation of the heart was conducted. TcVac4 induced a strong IgG response (IgG2>IgG1) that was significantly expanded post-infection, and moved to a nearly balanced IgG2/IgG1 response in chronic phase. In comparison, dogs given TrIE or empty plasmid DNA only developed high IgG titers with IgG2 predominance in response to T. cruzi infection. Blood parasitemia, tissue parasite foci, parasite transmission to triatomines, electrocardiographic abnormalities were significantly lower in TcVac4-vaccinated dogs than was observed in dogs given TrIE or empty plasmid DNA only. Macroscopic and microscopic alterations, the hallmarks of chronic Chagas disease, were significantly decreased in the myocardium of TcVac4-vaccinated dogs. We conclude that TcVac4 induced immunity was beneficial in providing resistance to T. cruzi infection, evidenced by control of chronic pathology of the heart and preservation of cardiac function in dogs. Additionally, TcVac4 vaccination decreased the transmission of parasites from vaccinated/infected animals to triatomines. PMID:25853654

Immune protection against Trypanosoma cruzi induced by TcVac4 in a canine model.

PubMed

Aparicio-Burgos, José E; Zepeda-Escobar, José A; de Oca-Jimenez, Roberto Montes; Estrada-Franco, José G; Barbabosa-Pliego, Alberto; Ochoa-García, Laucel; Alejandre-Aguilar, Ricardo; Rivas, Nancy; Peñuelas-Rivas, Giovanna; Val-Arreola, Margarita; Gupta, Shivali; Salazar-García, Felix; Garg, Nisha J; Vázquez-Chagoyán, Juan C

2015-04-01

Chagas disease, caused by Trypanosoma cruzi, is endemic in southern parts of the American continent. Herein, we have tested the protective efficacy of a DNA-prime/T. rangeli-boost (TcVac4) vaccine in a dog (Canis familiaris) model. Dogs were immunized with two-doses of DNA vaccine (pcDNA3.1 encoding TcG1, TcG2, and TcG4 antigens plus IL-12- and GM-CSF-encoding plasmids) followed by two doses of glutaraldehyde-inactivated T. rangeli epimastigotes (TrIE); and challenged with highly pathogenic T. cruzi (SylvioX10/4) isolate. Dogs given TrIE or empty pcDNA3.1 were used as controls. We monitored post-vaccination and post-challenge infection antibody response by an ELISA, parasitemia by blood analysis and xenodiagnosis, and heart function by electrocardiography. Post-mortem anatomic and pathologic evaluation of the heart was conducted. TcVac4 induced a strong IgG response (IgG2>IgG1) that was significantly expanded post-infection, and moved to a nearly balanced IgG2/IgG1 response in chronic phase. In comparison, dogs given TrIE or empty plasmid DNA only developed high IgG titers with IgG2 predominance in response to T. cruzi infection. Blood parasitemia, tissue parasite foci, parasite transmission to triatomines, electrocardiographic abnormalities were significantly lower in TcVac4-vaccinated dogs than was observed in dogs given TrIE or empty plasmid DNA only. Macroscopic and microscopic alterations, the hallmarks of chronic Chagas disease, were significantly decreased in the myocardium of TcVac4-vaccinated dogs. We conclude that TcVac4 induced immunity was beneficial in providing resistance to T. cruzi infection, evidenced by control of chronic pathology of the heart and preservation of cardiac function in dogs. Additionally, TcVac4 vaccination decreased the transmission of parasites from vaccinated/infected animals to triatomines.

Histology after lumpectomy in women with epithelial atypia on stereotactic vacuum-assisted breast biopsy.

PubMed

Graesslin, O; Antoine, M; Chopier, J; Seror, J Y; Flahault, A; Callard, P; Daraï, E; Uzan, S

2010-02-01

Large-core needle biopsy of the breast (LCNB) and vacuum-assisted breast biopsy (VABB) are widely used as alternatives to open surgical biopsy (OSB) for initial diagnosis of mammographic abnormalities. Between 18% and 80% of cases in which such specimens show atypical lobular hyperplasia (ALH) or atypical ductal hyperplasia (ADH) are found to be malignant at surgery. From 1999 to 2005, 68 women with mammographic abnormalities were sampled by stereotactic VABB and presented atypical epithelial hyperplasia. Immunohistochemical staining with anti-cytokeratin 5/6 and anti-E-cadherin antibodies was performed. All women underwent a lumpectomy. Clinical, radiological or histological factors predictive of the risk of finding malignancy at surgery were sought. VABB initially showed 28 cases of ADH, 32 cases of ALH, one case of flat epithelial atypia, five cases of mixed atypia, and two cases of Lobular Carcinoma In Situ (LCIS). After slide review with immunohistochemical staining, two cases of ADH were reclassified as simple hyperplasia and two cases of ALH were reclassified as mixed atypia. Seven lesions (10.3%) that appeared to be benign on VABB were found to be malignant on OSB (Ductal Carcinoma In Situ (DCIS) in six cases and invasive ductal carcinoma in one case). ADH was the only predictive factor of malignancy on OSB (p=0.04 versus ALH). ADH diagnosed by vacuum-assisted breast biopsy frequently corresponds to cancer on open surgical biopsy. Surgical excision of all breast lesions containing atypical hyperplasia on percutaneous biopsy can be recommended. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Magnet Assisted Composite Manufacturing: A Flexible New Technique for Achieving High Consolidation Pressure in Vacuum Bag/Lay-Up Processes.

PubMed

Pishvar, Maya; Amirkhosravi, Mehrad; Altan, M Cengiz

2018-05-17

This work demonstrates a protocol to improve the quality of composite laminates fabricated by wet lay-up vacuum bag processes using the recently developed magnet assisted composite manufacturing (MACM) technique. In this technique, permanent magnets are utilized to apply a sufficiently high consolidation pressure during the curing stage. To enhance the intensity of the magnetic field, and thus, to increase the magnetic compaction pressure, the magnets are placed on a magnetic top plate. First, the entire procedure of preparing the composite lay-up on a magnetic bottom steel plate using the conventional wet lay-up vacuum bag process is described. Second, placement of a set of Neodymium-Iron-Boron permanent magnets, arranged in alternating polarity, on the vacuum bag is illustrated. Next, the experimental procedures to measure the magnetic compaction pressure and volume fractions of the composite constituents are presented. Finally, methods used to characterize microstructure and mechanical properties of composite laminates are discussed in detail. The results prove the effectiveness of the MACM method in improving the quality of wet lay-up vacuum bag laminates. This method does not require large capital investment for tooling or equipment and can also be used to consolidate geometrically complex composite parts by placing the magnets on a matching top mold positioned on the vacuum bag.

Association between cagA, vacAi, and dupA genes of Helicobacter pylori and gastroduodenal pathologies in Chilean patients.

PubMed

Paredes-Osses, Esteban; Sáez, Katia; Sanhueza, Enrique; Hebel, Sonja; González, Carlos; Briceño, Carlos; García Cancino, Apolinaria

2017-09-01

In addition to the already known cagA gene, novel genetic markers have been associated with Helicobacter pylori (H. pylori) virulence: the dupA and vacAi genes. These genes might play an important role as specific markers to determine the clinical outcome of the disease, especially the vacAi gene, which has been expected to be a good marker of severe pathologies like gastric adenocarcinoma. In the present study, the association of cagA, dupA, and vacAi genes with gastroduodenal pathologies in Chilean patients was studied. One hundred and thirty-two patients positive for H. pylori were divided into two groups-non-severe and severe gastric pathologies-and investigated for the presence of cagA, dupA, and vacAi H. pylori virulence genes by PCR. The cagA gene was detected in 20/132 patients (15.2%), the vacAi1 gene was detected in 54/132 patients (40.9%), the vacAi2 gene was detected in 26/132 patients (19.7%), and the dupA gene was detected in 50/132 (37.9%) patients. Logistic regression model analysis showed that the vacAi1 isoform gene in the infected strains and the severity of the diseases outcome were highly associated, causing severe gastric damage that may lead to gastric cancer (p < 0.0001; OR = 8.75; 95% CI 3.54-21.64). Conversely, cagA (p = 0.3507; OR = 1.62; 95% CI 0.59-4.45) and vacAi2 (p = 0.0114; OR = 3.09; 95% CI 1.26-7.60) genes were not associated with damage, while the dupA gene was associated significantly with non-severe clinical outcome (p = 0.0032; OR = 0.25; 95% CI 0.09-0.65). In addition, dupA gene exerts protection against severe gastric pathologies induced by vacAi1 by delaying the outcome of the disease by approximately 20 years.

Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma

PubMed Central

Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

2016-01-01

Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy. PMID:27570778

Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

PubMed

Galvez, Carlos; Sesma, Julio; Bolufer, Sergio; Lirio, Francisco; Navarro-Martinez, Jose; Galiana, Maria; Baschwitz, Benno; Rivera, Maria Jesus

2016-08-01

Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy.

ProVac Global Initiative: a vision shaped by ten years of supporting evidence-based policy decisions.

PubMed

Jauregui, Barbara; Janusz, Cara Bess; Clark, Andrew D; Sinha, Anushua; Garcia, Ana Gabriela Felix; Resch, Stephen; Toscano, Cristiana M; Sanderson, Colin; Andrus, Jon Kim

2015-05-07

The Pan American Health Organization (PAHO) created the ProVac Initiative in 2004 with the goal of strengthening national technical capacity to make evidence-based decisions on new vaccine introduction, focusing on economic evaluations. In view of the 10th anniversary of the ProVac Initiative, this article describes its progress and reflects on lessons learned to guide the next phase. We quantified the output of the Initiative's capacity-building efforts and critically assess its progress toward achieving the milestones originally proposed in 2004. Additionally, we reviewed how country studies supported by ProVac have directly informed and strengthened the deliberations around new vaccine introduction. Since 2004, ProVac has conducted four regional workshops and supported 24 health economic analyses in 15 Latin American and Caribbean countries. Five Regional Centers of Excellence were funded, resulting in six operational research projects and nine publications. Twenty four decisions on new vaccine introductions were supported with ProVac studies. Enduring products include the TRIVAC and CERVIVAC cost-effectiveness models, the COSTVAC program costing model, methodological guides, workshop training materials and the OLIVES on-line data repository. Ten NITAGs were strengthened through ProVac activities. The evidence accumulated suggests that initiatives with emphasis on sustainable training and direct support for countries to generate evidence themselves, can help accelerate the introduction of the most valuable new vaccines. International and Regional Networks of Collaborators are necessary to provide technical support and tools to national teams conducting analyses. Timeliness, integration, quality and country ownership of the process are four necessary guiding principles for national economic evaluations to have an impact on policymaking. It would be an asset to have a model that offers different levels of complexity to choose from depending on the vaccine being

Can Vacuum Assisted Venous Drainage be Achieved using a Roller Pump in an Emergency? A Pilot Study using Neonatal Circuitry

PubMed Central

Hill, S. L.; Holt, D. W.

2007-01-01

Abstract: There has been much advancement in perfusion technology over its 50 years of progression. One of these techniques is vacuum-assisted venous drainage (VAVD). Many perfusionists augment venous drainage using VAVD, typically from a wall vacuum source. This study explores alternates to providing VAVD if the wall vacuum fails. In two porcine laboratories, ∼36 in. of 3/16-in. tubing was connected to a sucker return port and placed into the roller head next to the arterial pump. The vacuum was monitored with a DLP pressure monitoring system (Medtronic). This system was connected to small-bore tubing and attached to a stopcock on top of the reservoir. The vacuum was regulated using another stopcock connected to a non-filtered luer lock port on top of the reservoir or by a segment of 3 × 0.25-in.-diameter tubing attached to the vent port with a c-clamp. Vacuum drainage was achieved, ranging from −18 mmHg to −71 mmHg by manipulating the stopcock or c-clamp. Changes in venous drainage were seen by volume fluctuations in the venous reservoir. The vacuum was adjusted to account for dramatic changes. Augmented venous drainage using a roller pump can be achieved successfully during cardiopulmonary bypass (CPB). This method of active drainage can be used in lieu of wall suction or during times of emergency if wall suction fails. PMID:18293812

Deep inferior epigastric artery perforator flap donor-site closure with cannula-assisted, limited undermining, and progressive high-tension sutures versus standard abdominoplasty: complications, sensitivity, and cosmetic outcomes.

PubMed

Visconti, Giuseppe; Tomaselli, Federica; Monda, Anna; Barone-Adesi, Liliana; Salgarello, Marzia

2015-01-01

In deep inferior epigastric artery perforator (DIEP) flap breast reconstruction, abdominal donor-site cosmetic and sensibility outcomes and the closure technique have drawn little attention in the literature, with many surgeons still following the principles of standard abdominoplasty. In this article, the authors report their experience with the cannula-assisted, limited undermining, and progressive high-tension suture ("CALP") technique of DIEP donor-site closure compared with standard abdominoplasty. Between December of 2008 and January of 2013, 137 consecutive women underwent DIEP flap breast reconstruction. Of these, 82 patients (between December of 2008 and November of 2011) underwent DIEP flap donor-site closure by means of standard abdominoplasty (control group) and 55 patients (from December of 2011 to January of 2013) by means of cannula-assisted, limited undermining, and progressive high-tension suture (study group). The abdominal drainage daily output, donor-site complications, abdominal skin sensitivity at 1-year follow-up, cosmetic outcomes, and patient satisfaction were recorded and analyzed statistically. Daily drainage output was significantly lower in the study group. Donor-site complications were significantly higher in the control group (37.8 percent versus 9 percent). Seroma and wound healing problems were experienced in the control group. Abdominal skin sensibility was better preserved in the study group. Overall, abdominal wall aesthetic outcomes were similar in both groups, except for scar quality (better in the study group). According to the authors' experience, cannula-assisted, limited undermining, and progressive high-tension suture should be always preferred to standard abdominoplasty for DIEP donor-site closure to reduce the complication rate to improve abdominal skin sensitivity and scar quality. Therapeutic, II.

Complementary DNA display selection of high-affinity peptides binding the vacuolating toxin (VacA) of Helicobacter pylori.

PubMed

Hayakawa, Yumiko; Matsuno, Mitsuhiro; Tanaka, Makoto; Wada, Akihiro; Kitamura, Koichiro; Takei, Osamu; Sasaki, Ryuzo; Mizukami, Tamio; Hasegawa, Makoto

2015-09-01

Artificial peptides designed for molecular recognition of a bacterial toxin have been developed. Vacuolating cytotoxin A protein (VacA) is a major virulence factor of Helicobacter pylori, a gram-negative microaerophilic bacterium inhabiting the upper gastrointestinal tract, particularly the stomach. This study attempted to identify specific peptide sequences with high affinity for VacA using systematic directed evolution in vitro, a cDNA display method. A surface plasmon resonance-based biosensor and fluorescence correlation spectroscopy to examine binding of peptides with VacA identified a peptide (GRVNQRL) with high affinity. Cyclization of the peptide by attaching cysteine residues to both termini improved its binding affinity to VacA, with a dissociation constant (Kd ) of 58 nm. This study describes a new strategy for the development of artificial functional peptides, which are promising materials in biochemical analyses and medical applications. Copyright © 2015 European Peptide Society and John Wiley & Sons, Ltd.

vacA Genotype Status of Helicobacter pylori Isolated from Foods with Animal Origin

PubMed Central

Saeidi, Elnaz

2016-01-01

According to controversial theories and results of studies, foods with animal origins play an important role in the transmission of H. pylori to human. The aim of this study was to determine the distribution of vacA genotypes of H. pylori, isolated from milk and meat samples of cow, sheep, goat, camel, and buffalo. Eight hundred and twenty raw milk and meat samples were collected from various parts of Iran. Samples were cultured and those found positive for H. pylori were analyzed for the presence of various genotypes of vacA gene. Out of 420 milk and 400 meat samples, 92 (21.90%) and 105 (26.25%) were positive for H. pylori, respectively. The most commonly detected genotypes in the vacA gene were s1a (86.80%), m1a (79.18%), s1b (69.54%), and m1b (63.45%) and detected combined genotypes were mostly m1as1a (68.52%), m1as1b (60.40%), m1bs1b (55.83%), and m1bs1a (53.29%). High presence of bacteria in the milk and meat samples of sheep represents that sheep may be the natural host of H. pylori. High presence of H. pylori strains in milk and meat samples similar to vacA genotypes in human being suggests that milk and meat samples could be the sources of bacteria for human. PMID:27088092

vacA Genotype Status of Helicobacter pylori Isolated from Foods with Animal Origin.

PubMed

Saeidi, Elnaz; Sheikhshahrokh, Amirhossein

2016-01-01

According to controversial theories and results of studies, foods with animal origins play an important role in the transmission of H. pylori to human. The aim of this study was to determine the distribution of vacA genotypes of H. pylori, isolated from milk and meat samples of cow, sheep, goat, camel, and buffalo. Eight hundred and twenty raw milk and meat samples were collected from various parts of Iran. Samples were cultured and those found positive for H. pylori were analyzed for the presence of various genotypes of vacA gene. Out of 420 milk and 400 meat samples, 92 (21.90%) and 105 (26.25%) were positive for H. pylori, respectively. The most commonly detected genotypes in the vacA gene were s1a (86.80%), m1a (79.18%), s1b (69.54%), and m1b (63.45%) and detected combined genotypes were mostly m1as1a (68.52%), m1as1b (60.40%), m1bs1b (55.83%), and m1bs1a (53.29%). High presence of bacteria in the milk and meat samples of sheep represents that sheep may be the natural host of H. pylori. High presence of H. pylori strains in milk and meat samples similar to vacA genotypes in human being suggests that milk and meat samples could be the sources of bacteria for human.

Abdominal Subcutaneous Mass After Laser-Assisted Lipolysis and Immediate Multiple Treatments with a Dual-Wavelength Laser, Vacuum and Massage Device.

PubMed

Gentileschi, Stefano; Servillo, Maria; D'Ettorre, Marco; Salgarello, Marzia

2016-04-01

Body contouring by means of minimally invasive procedures is a growing trend. Current approaches to body contouring often involve a combination of surgical techniques (eg, laser-assisted liposuction) and a series of noninvasive device-based treatments aimed at accelerating recovery and improving aesthetic outcomes. In this case study, we describe a 38-year-old woman who presented with an abdominal-wall mass that resembled a tumor when assessed with magnetic resonance imaging. Twenty-six months before presenting to our office, the patient had undergone laser lipolysis and a series of treatments with a device that delivered dual-wavelength laser energy and vacuum-assisted massage. To address the patient's concerns, we removed the mass and performed abdominal dermolipectomy. No postoperative complications occurred, and the patient was highly satisfied with the aesthetic outcome. The results of histologic studies indicated that the mass was pseudocystic and fluid-filled, surrounded by a fibrous capsule, and characterized as a foreign-body granuloma. Further analysis is warranted regarding the safety of laser lipolysis without aspiration combined with a device delivering dual-wavelength laser energy and vacuum-assisted massage. 5 Risk. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Predictions of vacuum loss of evacuated vials from initial air leak rates.

PubMed

Prisco, Michael R; Ochoa, Jorge A; Yardimci, Atif M

2013-08-01

Container closure integrity is a critical factor for maintaining product sterility and stability. Therefore, closure systems (found in vials, syringes, and cartridges) are designed to provide a seal between rubber stoppers and glass containers. To ensure that the contained product has maintained its sterility and stability at the time of deployment, the seal must remain intact within acceptable limits. To this end, a mathematical model has been developed to describe vacuum loss in evacuated drug vials. The model computes equivalent leak diameter corresponding to initial air leak rate as well as vacuum loss as a function of time and vial size. The theory accounts for three flow regimes that may be encountered. Initial leak rates from 10(-8) to 10(3) sccm (standard cubic centimeters per minute) were investigated for vials ranging from 1 to 100 mL. Corresponding leak diameters of 0.25-173 μm were predicted. The time for a vial to lose half of its vacuum, the T50 value, ranged from many years at the lowest leak rates and largest vials, to fractions of a second at the highest leak rates and smallest vials. These results may be used to determine what level of initial vacuum leak is acceptable for a given product. Copyright © 2013 Wiley Periodicals, Inc.

Constrained optimization framework for interface-aware sub-scale dynamics models for voids closure in Lagrangian hydrodynamics

DOE PAGES

Barlow, Andrew; Klima, Matej; Shashkov, Mikhail

2018-04-02

In hydrocodes, voids are used to represent vacuum and model free boundaries between vacuum and real materials. We give a systematic description of a new treatment of void closure in the framework of the multimaterial arbitrary Lagrangian–Eulerian (ALE) methods. This includes a new formulation of the interface-aware sub-scale-dynamics (IA-SSD) closure model for multimaterial cells with voids, which is used in the Lagrangian stage of our indirect ALE scheme. The results of the comprehensive testing of the new model are presented for one- and two-dimensional multimaterial calculations in the presence of voids. Finally, we also present a sneak peek of amore » realistic shaped charge calculation in the presence of voids and solids.« less

Constrained optimization framework for interface-aware sub-scale dynamics models for voids closure in Lagrangian hydrodynamics

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

Barlow, Andrew; Klima, Matej; Shashkov, Mikhail

In hydrocodes, voids are used to represent vacuum and model free boundaries between vacuum and real materials. We give a systematic description of a new treatment of void closure in the framework of the multimaterial arbitrary Lagrangian–Eulerian (ALE) methods. This includes a new formulation of the interface-aware sub-scale-dynamics (IA-SSD) closure model for multimaterial cells with voids, which is used in the Lagrangian stage of our indirect ALE scheme. The results of the comprehensive testing of the new model are presented for one- and two-dimensional multimaterial calculations in the presence of voids. Finally, we also present a sneak peek of amore » realistic shaped charge calculation in the presence of voids and solids.« less

Lawn mower injuries in pediatric patients.

PubMed

Horn, Pamela L; Beebe, Allan C

2009-01-01

Lawn mower injuries are painful, devastating, and life-altering. Pediatric patients who sustain these injuries suffer various forms of physical trauma. Some are minor, but many others are disfiguring or even fatal. The psychological and social impact is far-reaching as well. These injuries have high rates of morbidity, include many days lost from school, and can cause financial loss for the parents due to the hospitalization and missed work. The primary objective with regards to lawn mower injuries is prevention that is accomplished by education. However, once the patient has been injured and admitted to the hospital, then immediate treatment with timely discharge is the main objective. Excellent wound care, acceptable cosmetic appearance, and infection prevention are the ultimate goals. Use of the Vacuum Assisted Closure (VAC) device has helped facilitate the end results. Psychological adjustment with regards to this traumatic event is also addressed immediately for both the patient and the caregivers. Inpatient and outpatient counseling and follow-up all play a role in this stressful time.

Grand Junction projects office mixed-waste treatment program, VAC*TRAX mobile treatment unit process hazards analysis

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

Bloom, R.R.

1996-04-01

The objective of this report is to demonstrate that a thorough assessment of the risks associated with the operation of the Rust Geotech patented VAC*TRAX mobile treatment unit (MTU) has been performed and documented. The MTU was developed to treat mixed wastes at the US Department of Energy (DOE) Albuquerque Operations Office sites. The MTU uses an indirectly heated, batch vacuum dryer to thermally desorb organic compounds from mixed wastes. This process hazards analysis evaluated 102 potential hazards. The three significant hazards identified involved the inclusion of oxygen in a process that also included an ignition source and fuel. Changesmore » to the design of the MTU were made concurrent with the hazard identification and analysis; all hazards with initial risk rankings of 1 or 2 were reduced to acceptable risk rankings of 3 or 4. The overall risk to any population group from operation of the MTU was determined to be very low; the MTU is classified as a Radiological Facility with low hazards.« less

Evidence-based decision-making for vaccine introductions: Overview of the ProVac International Working Group's experience.

PubMed

Jauregui, Barbara; Garcia, Ana Gabriela Felix; Bess Janusz, Cara; Blau, Julia; Munier, Aline; Atherly, Deborah; Mvundura, Mercy; Hajjeh, Rana; Lopman, Benjamin; Clark, Andrew David; Baxter, Louise; Hutubessy, Raymond; de Quadros, Ciro; Andrus, Jon Kim

2015-05-07

Pan American Health Organization's (PAHO) ProVac Initiative aims to strengthen countries' technical capacity to make evidence-based immunization policy. With financial support from the Bill and Melinda Gates Foundation, PAHO established the ProVac International Working Group (IWG), a platform created for two years to transfer the ProVac Initiative's tools and methods to support decisions in non-PAHO regions. In 2011, WHO Regional Offices and partner agencies established the IWG to transfer the ProVac framework for new vaccine decision support, including tools and trainings to other regions of the world. During the two year period, PAHO served as the coordinating secretariat and partner agencies played implementing or advisory roles. Fifty nine national professionals from 17 countries received training on the use of economic evaluations to aid vaccine policy making through regional workshops. The IWG provided direct technical support to nine countries to develop cost-effectiveness analyses to inform decisions. All nine countries introduced the new vaccine evaluated or their NITAGs have made a recommendation to the Ministry of Health to introduce the new vaccine. Developing countries around the world are increasingly interested in weighing the potential health impact due to new vaccine introduction against the investments required. During the two years, the ProVac approach proved valuable and timely to aid the national decision making processes, even despite the different challenges and idiosyncrasies encountered in each region. The results of this work suggest that: (1) there is great need and demand for technical support and for capacity building around economic evaluations; and (2) the ProVac method of supporting country-owned analyses is as effective in other regions as it has been in the PAHO region. Decision support for new vaccine introduction in low- and middle-income countries is critical to guiding the efficient use of resources and prioritizing high impact

Technical specification for vacuum systems

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

Khaw, J.

The vacuum systems at the Stanford Linear Accelerator Center (SLAC) are primarily of all-metal construction and operate at pressures from 10/sup -5/ to 10/sup -11/ Torr. The primary gas loads during operation result from thermal desorption and beam-induced desorption from the vacuum chamber walls. These desorption rates can be extremely high in the case of hydrocarbons and other contaminants. These specifications place a major emphasis on eliminating contamination sources. The specifications and procedures have been written to insure the cleanliness and vacuum integrity of all SLAC vacuum systems, and to assist personnel involved with SLAC vacuum systems in choosing andmore » designing components that are compatible with existing systems and meet the quality and reliability of SLAC vacuum standards. The specification includes requirements on design, procurement, fabrication, chemical cleaning, clean room practices, welding and brazing, helium leak testing, residual gas analyzer testing, bakeout, venting, and pumpdown. Also appended are specifications regarding acceptable vendors, isopropyl alcohol, bakeable valve cleaning procedure, mechanical engineering safety inspection, notes on synchrotron radiation, and specifications of numerous individual components. (LEW)« less

An innovative intermittent-vacuum assisted thermophilic anaerobic digestion process for effective animal manure utilization and treatment.

PubMed

Zhang, Renchuan; Anderson, Erik; Addy, Min; Deng, Xiangyuan; Kabir, Fayal; Lu, Qian; Ma, Yiwei; Cheng, Yanling; Liu, Yuhuan; Chen, Paul; Ruan, Roger

2017-11-01

Intermittent-vacuum stripping (IVS) was developed as a pretreatment for thermophilic anaerobic digestion (TAD) to improve methanogenesis and hydrolysis activity through preventing free ammonia and hydrogen sulfide (H 2 S) inhibition from liquid swine manure (LSM). Over 98% of ammonia and 38% organic nitrogen were removed in 60min from 55°C to 85°C with vacuum pressure (from 100.63±3.79mmHg to 360.91±7.39mmHg) at initial pH 10.0 by IVS. Thermophilic methanogenesis and hydrolysis activity of pretreated LSM increased 52.25% (from 11.56±1.75% to 17.60±0.49%) in 25days and 40% (from 10days to 6days) in bio-methane potential assay. Over 80% H 2 S and total nitrogen were removed by IVS assistance, while around 70% nitrogen was recycled as ammonium sulfate. Therefore, IVS-TAD combination could be an effective strategy to improve TAD efficiency, whose elution is more easily utilized in algae cultivation and/or hydroponic system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vacuum assisted birth and risk for cerebral complications in term newborn infants: a population-based cohort study.

PubMed

Ekéus, Cecilia; Högberg, Ulf; Norman, Mikael

2014-01-20

Few studies have focused on cerebral complications among newborn infants delivered by vacuum extraction (VE). The aim of this study was to determine the risk for intracranial haemorrhage and/or cerebral dysfunction in newborn infants delivered by VE and to compare this risk with that after cesarean section in labour (CS) and spontaneous vaginal delivery, respectively. Data was obtained from Swedish national registers. In a population-based cohort from 1999 to 2010 including all singleton newborn infants delivered at term after onset of labour by VE (n = 87,150), CS (75,216) or spontaneous vaginal delivery (n = 851,347), we compared the odds for neonatal intracranial haemorrhage, traumatic or non-traumatic, convulsions or encephalopathy. Logistic regressions were used to calculate adjusted (for major risk factors and indication) odds ratios (AOR), using spontaneous vaginal delivery as reference group. The rates of traumatic and non-traumatic intracranial hemorrhages were 0.8/10,000 and 3.8/1,000. VE deliveries provided 58% and 31.5% of the traumatic and non-traumatic cases, giving a ten-fold risk [AOR 10.05 (4.67-21.65)] and double risk [AOR 2.23 (1.57-3.16)], respectively. High birth weight and short mother were associated with the highest risks. Infants delivered by CS had no increased risk for intracranial hemorrhages. The risks for convulsions or encephalopathy were similar among infants delivered by VE and CS, exceeding the OR after non-assisted spontaneous vaginal delivery by two-to-three times. Vacuum assisted delivery is associated with increased risk for neonatal intracranial hemorrhages. Although causality could not be established in this observational study, it is important to be aware of the increased risk of intracranial hemorrhages in VE deliveries, particularly in short women and large infants. The results warrant further studies in decision making and conduct of assisted vaginal delivery.

Helicobacter pylori oipA, vacA and dupA genetic diversity in individual hosts.

PubMed

Matteo, Mario José; Armitano, Rita Inés; Granados, Gabriela; Wonaga, Andrés Dario; Sánches, Christian; Olmos, Martín; Catalano, Mariana

2010-01-01

Helicobacter pylori putative virulence factors can undergo a continuously evolving mechanism as an approach to bacterial adaptation to the host changing environment during chronic infection. oipA, vacA and dupA genetic diversity among isolates from multiple biopsies (niches) from the antrum and corpus of 40 patients was investigated. A set of 229 isolates was examined. Direct DNA sequence analysis of amplified fragments was used to study oipA 'on/off' expression status as well as the presence of C or T insertion in jhp0917 that originates a continuous (jhp0917-jhp0918) dupA gene. vacA alleles were identified by multiplex PCR. Different inter-niches oipA CT repeat patterns were observed in nine patients; in six of these, 'on' and 'off' mixed patterns were found. In three of these nine patients, different vacA alleles were also observed in a single host. Inter-niche dupA differences involved the absence and presence of jhp0917 and/or jhp0918 or mutations in dupA, including those that may originate a non-functional gene, and they were also present in two patients with mixed oipA CT patterns and in another seven patients. Evidence of mixed infection was observed in two patients only. In conclusion, oipA and dupA genes showed similar inter-niche variability, occurring in approximately 1/4 patients. Conversely, vacA allele microevolution seemed to be a less common event, occurring in approximately 1/10 patients, probably due to the mechanism that this gene evolves 'in vivo'.

Comparison of intraocular pressure during the application of a liquid patient interface (FEMTO LDV Z8) for femtosecond laser-assisted cataract surgery using two different vacuum levels.

PubMed

Ebner, Martina; Mariacher, Siegfried; Januschowski, Kai; Boden, Katrin; Seuthe, Anna-Maria; Szurman, Peter; Boden, Karl Thomas

2017-08-01

To evaluate intraocular pressure (IOP) using the application of a novel liquid patient interface for femtosecond laser-assisted cataract surgery with the FEMTO LDV Z8. IOP was evaluated in enucleated porcine eyes prior, during and after the application of the Femto LDV Z8 liquid patient interface (Ziemer Ophthalmic Systems, Switzerland) using intracameral cannulation (n=20), intravitreal cannulation (n=20), rebound tonometry (n=20) and indentation tonometry (n=20). Pressure was assessed prior vacuum, during vacuum (30 s, 1 min, 2 min, 3 min) and after releasing the vacuum (1 min and 2 min). Two groups with different predefined vacuum levels (350 mbar, 420 mbar) were investigated. Mean intracameral pressure (±SD) increased during vacuum application from 20 mm Hg to 52.00 mm Hg (±6.35mm Hg; p=0.005) and 45.18 mmHg (±4.34 mm Hg; p=0.005) for the 420 mbar and the 350 mbar vacuum levels, respectively. Mean intravitreal pressure increased from 20 mm Hg to 25.60 mm Hg (±9.85 mm Hg; p=0.058) and 28.10 mm Hg (±2.54 mm Hg; p=0.059) for the 420 mbar and the 350 mbar vacuum levels, respectively. Pressure values from indentation and rebound tonometry were in between intracameral and intravitreal values. Mean intracameral IOP was 18.1% higher (p=0.019) in the 420 mbar group compared with the 350 mbar group. During vacuum application of the liquid patient interface of the Femto LDV Z8 for femtosecond laser-assisted cataract surgery, IOP values were higher in the anterior chamber compared with the intravitreal pressure measurements. The higher predefined vacuum level (350 mbar vs 420 mbar) resulted in significant higher intracameral IOP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Biological constraints do not entail cognitive closure.

PubMed

Vlerick, Michael

2014-12-01

From the premise that our biology imposes cognitive constraints on our epistemic activities, a series of prominent authors--most notably Fodor, Chomsky and McGinn--have argued that we are cognitively closed to certain aspects and properties of the world. Cognitive constraints, they argue, entail cognitive closure. I argue that this is not the case. More precisely, I detect two unwarranted conflations at the core of arguments deriving closure from constraints. The first is a conflation of what I will refer to as 'representation' and 'object of representation'. The second confuses the cognitive scope of the assisted mind for that of the unassisted mind. Cognitive closure, I conclude, cannot be established from pointing out the (uncontroversial) existence of cognitive constraints. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evidence-based decision-making for vaccine introductions: Overview of the ProVac International Working Group’s experience

PubMed Central

Jauregui, Barbara; Garcia, Ana Gabriela Felix; Janusz, Cara Bess; Blau, Julia; Munier, Aline; Atherly, Deborah; Mvundura, Mercy; Hajjeh, Rana; Lopman, Benjamin; Clark, Andrew David; Baxter, Louise; Hutubessy, Raymond; de Quadros, Ciro; Andrus, Jon Kim

2015-01-01

Introduction Pan American Health Organization’s (PAHO) ProVac Initiative aims to strengthen countries’ technical capacity to make evidence-based immunization policy. With financial support from the Bill and Melinda Gates Foundation, PAHO established the ProVac International Working Group (IWG), a platform created for two years to transfer the ProVac Initiative’s tools and methods to support decisions in non-PAHO regions. Methods In 2011, WHO Regional Offices and partner agencies established the IWG to transfer the ProVac framework for new vaccine decision support, including tools and trainings to other regions of the world. During the two year period, PAHO served as the coordinating secretariat and partner agencies played implementing or advisory roles. Results Fifty nine national professionals from 17 countries received training on the use of economic evaluations to aid vaccine policy making through regional workshops. The IWG provided direct technical support to nine countries to develop cost-effectiveness analyses to inform decisions. All nine countries introduced the new vaccine evaluated or their NITAGs have made a recommendation to the Ministry of Health to introduce the new vaccine. Discussion Developing countries around the world are increasingly interested in weighing the potential health impact due to new vaccine introduction against the investments required. During the two years, the ProVac approach proved valuable and timely to aid the national decision making processes, even despite the different challenges and idiosyncrasies encountered in each region. The results of this work suggest that: (1) there is great need and demand for technical support and for capacity building around economic evaluations; and (2) the ProVac method of supporting country-owned analyses is as effective in other regions as it has been in the PAHO region. Conclusion Decision support for new vaccine introduction in low- and middle-income countries is critical to guiding

Computer assisted thermal-vacuum testing

NASA Technical Reports Server (NTRS)

Petrie, W.; Mikk, G.

1977-01-01

In testing complex systems and components under dynamic thermal-vacuum environments, it is desirable to optimize the environment control sequence in order to reduce test duration and cost. This paper describes an approach where a computer is utilized as part of the test control operation. Real time test data is made available to the computer through time-sharing terminals at appropriate time intervals. A mathematical model of the test article and environmental control equipment is then operated on using the real time data to yield current thermal status, temperature analysis, trend prediction and recommended thermal control setting changes to arrive at the required thermal condition. The data acquisition interface and the time-sharing hook-up to an IBM-370 computer is described along with a typical control program and data demonstrating its use.

Comparison of sealer penetration using the EndoVac irrigation system and conventional needle root canal irrigation.

PubMed

Kara Tuncer, Aysun; Unal, Bayram

2014-05-01

The aim of this study was to compare the effect of the EndoVac irrigation system (SybronEndo, Orange, CA) and conventional endodontic needle irrigation on sealer penetration into dentinal tubules. Forty single-rooted, recently extracted human maxillary central incisors were randomly divided into 2 groups according to the irrigation technique used: conventional endodontic needle irrigation and EndoVac irrigation. All teeth were instrumented using the ProFile rotary system (Dentsply Maillefer, Ballaigues, Switzerland) and obturated with gutta-percha and AH Plus sealer (Dentsply DeTrey, Konstanz, Germany) labeled with fluorescent dye. Transverse sections at 1, 3, and 5 mm from the root apex were examined using confocal laser scanning microscopy. The total percentage and maximum depth of sealer penetration were then measured. Mann-Whitney test results showed that EndoVac irrigation resulted in a significantly higher percentage of sealer penetration than conventional irrigation at both the 1- and 3-mm levels (P < .05). However, no difference was found at the 5-mm level. The 5-mm sections in each group showed a significantly higher percentage and maximum depth of sealer penetration than did the 1- and 3-mm sections (P < .05). The EndoVac irrigation system significantly improved the sealer penetration at the 1- to 3-mm level over that of conventional endodontic needle irrigation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Frequency of vacA, cagA and babA2 virulence markers in Helicobacter pylori strains isolated from Mexican patients with chronic gastritis

PubMed Central

Paniagua, Gloria Luz; Monroy, Eric; Rodríguez, Raymundo; Arroniz, Salvador; Rodríguez, Cristina; Cortés, José Luis; Camacho, Ausencio; Negrete, Erasmo; Vaca, Sergio

2009-01-01

Background Helicobacter pylori has been strongly associated with chronic gastritis, peptic and duodenal ulcers, and it is a risk factor for gastric cancer. Three major virulence factors of H. pylori have been described: the vacuolating toxin (VacA), the cytotoxin-associated gene product (CagA) and the adhesion protein BabA2. Since considerable geographic diversity in the prevalence of H. pylori virulence factors has been reported, the aim of this work was to establish the H. pylori and vacA, cagA and babA2 gene status in 238 adult patients, from a marginal urban area of Mexico, with chronic gastritis. Methods H. pylori was identified in cultures of gastric biopsies by nested PCR. vacA and cagA genes were detected by multiplex PCR, whereas babA2 gene was identified by conventional PCR. Results H. pylori-positive biopsies were 143 (60.1%). All H. pylori strains were vacA+; 39.2% were cagA+; 13.3% were cagA+ babA2+ and 8.4% were babA2+. Mexican strains examined possessed the vacA s1, m1 (43.4%), s1, m2 (24.5%), s2, m1 (20.3%) and s2, m2 (11.9%) genotypes. Conclusion These results show that the Mexican patients suffering chronic gastritis we have studied had a high incidence of infection by H. pylori. Forty four percent (63/143) of the H. pylori strains analyzed in this work may be considered as highly virulent since they possessed two or three of the virulence markers analyzed: vacA s1 cagA babA2 (9.8%, 14/143), vacA s1 babA2 (4.9%, 7/143), and vacA s1 cagA (29.4%, 42/143). However, a statistically significant correlation was not observed between vacAs1, cagA and babA2 virulence markers (χ2 test; P > 0.05). PMID:19405980

VacA and cagA genotypes of Helicobacter pylori isolated from raw meat in Isfahan province, Iran

PubMed Central

Gilani, Ali; Razavilar, Vadood; Rokni, Nordahr; Rahimi, Ebrahim

2017-01-01

Foods with animal origins play a substantial role in the transmission of Helicobacter pylori. The present investigation was carried out to study the vacA and cagA genotypes status of H. pylori isolated from various types of meat samples. Two hundred and twenty meat samples were collected and cultured. H. pylori-positive strains were analyzed for the presence of vacA and cagA genotypes. Eleven out of 220 (5.00%) samples were positive for H. pylori. Findings were confirmed by nested PCR. Prevalence of H. pylori in the meat samples of slaughterhouses and butcheries were 72.20% and 27.70%, respectively. The most commonly detected genotypes in the meat samples of slaughterhouses and butcheries were vacA m1a (66.66%) and vacA s1a (37.50%), respectively. The S1am1a was the most commonly detected genotype. Meat sampled from butcheries had the higher prevalence of H. pylori and its genotypes than those of slaughterhouses (p < 0.05). Results showed that meat samples could be the potential sources of virulent strains of H. pylori. Application of sanitary measures in the storage, transportation and sale of meat is essential for reducing the levels of H. pylori cross contamination. PMID:28473901

VacA and cagA genotypes of Helicobacter pylori isolated from raw meat in Isfahan province, Iran.

PubMed

Gilani, Ali; Razavilar, Vadood; Rokni, Nordahr; Rahimi, Ebrahim

2017-01-01

Foods with animal origins play a substantial role in the transmission of Helicobacter pylori . The present investigation was carried out to study the vacA and cagA genotypes status of H. pylori isolated from various types of meat samples. Two hundred and twenty meat samples were collected and cultured. H. pylori -positive strains were analyzed for the presence of vacA and cagA genotypes. Eleven out of 220 (5.00%) samples were positive for H. pylori . Findings were confirmed by nested PCR. Prevalence of H. pylori in the meat samples of slaughterhouses and butcheries were 72.20% and 27.70%, respectively. The most commonly detected genotypes in the meat samples of slaughterhouses and butcheries were vacA m1a (66.66%) and vacA s1a (37.50%), respectively. The S1am1a was the most commonly detected genotype. Meat sampled from butcheries had the higher prevalence of H. pylori and its genotypes than those of slaughterhouses ( p < 0.05). Results showed that meat samples could be the potential sources of virulent strains of H. pylori . Application of sanitary measures in the storage, transportation and sale of meat is essential for reducing the levels of H. pylori cross contamination.

Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion

PubMed Central

Inui, Keiko; Hanafusa, Takaaki; Namiki, Takeshi; Ueno, Makiko; Igawa, Ken; Yokozeki, Hiroo

2016-01-01

A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The results of her blood test were normal, except for the hemoglobin level. Histology of the skin biopsy specimen from the ulcer did not show any specific findings. The previous surgeon who had performed the laparoscopic cholecystectomy revealed that surgical wound dehiscence had occurred during her admission. After a body restraint had been applied, the ulcer improved. Medical records indicated that she had been admitted to the department of plastic surgery at our hospital for skin grafting of a leg ulcer. During that admission, she refused to consult with the department of psychiatry, al-though the staff suspected mental disorders. Therefore, we diagnosed her with cutaneous Munchausen syndrome. After vacuum-assisted closure (VAC) therapy had been performed to prevent her from traumatizing the ulcer again, it rapidly became granulated and reepithelialized. Munchausen syndrome is characterized by feigning physical symptoms to seek attention. Patients self-inflict numerous lesions, keep getting admitted to different hospitals, and feign acute illness, usually spectacular diseases. VAC therapy may be effective for preventing patients with cutaneous Munchausen syndrome from traumatizing their wounds. PMID:27194978

Human genetic variation in VAC14 regulates Salmonella invasion and typhoid fever through modulation of cholesterol.

PubMed

Alvarez, Monica I; Glover, Luke C; Luo, Peter; Wang, Liuyang; Theusch, Elizabeth; Oehlers, Stefan H; Walton, Eric M; Tram, Trinh Thi Bich; Kuang, Yu-Lin; Rotter, Jerome I; McClean, Colleen M; Chinh, Nguyen Tran; Medina, Marisa W; Tobin, David M; Dunstan, Sarah J; Ko, Dennis C

2017-09-12

Risk, severity, and outcome of infection depend on the interplay of pathogen virulence and host susceptibility. Systematic identification of genetic susceptibility to infection is being undertaken through genome-wide association studies, but how to expeditiously move from genetic differences to functional mechanisms is unclear. Here, we use genetic association of molecular, cellular, and human disease traits and experimental validation to demonstrate that genetic variation affects expression of VAC14, a phosphoinositide-regulating protein, to influence susceptibility to Salmonella enterica serovar Typhi ( S Typhi) infection. Decreased VAC14 expression increased plasma membrane cholesterol, facilitating Salmonella docking and invasion. This increased susceptibility at the cellular level manifests as increased susceptibility to typhoid fever in a Vietnamese population. Furthermore, treating zebrafish with a cholesterol-lowering agent, ezetimibe, reduced susceptibility to S Typhi. Thus, coupling multiple genetic association studies with mechanistic dissection revealed how VAC14 regulates Salmonella invasion and typhoid fever susceptibility and may open doors to new prophylactic/therapeutic approaches.

Human genetic variation in VAC14 regulates Salmonella invasion and typhoid fever through modulation of cholesterol

PubMed Central

Alvarez, Monica I.; Glover, Luke C.; Luo, Peter; Wang, Liuyang; Theusch, Elizabeth; Oehlers, Stefan H.; Walton, Eric M.; Tram, Trinh Thi Bich; Kuang, Yu-Lin; Rotter, Jerome I.; McClean, Colleen M.; Chinh, Nguyen Tran; Medina, Marisa W.; Dunstan, Sarah J.

2017-01-01

Risk, severity, and outcome of infection depend on the interplay of pathogen virulence and host susceptibility. Systematic identification of genetic susceptibility to infection is being undertaken through genome-wide association studies, but how to expeditiously move from genetic differences to functional mechanisms is unclear. Here, we use genetic association of molecular, cellular, and human disease traits and experimental validation to demonstrate that genetic variation affects expression of VAC14, a phosphoinositide-regulating protein, to influence susceptibility to Salmonella enterica serovar Typhi (S. Typhi) infection. Decreased VAC14 expression increased plasma membrane cholesterol, facilitating Salmonella docking and invasion. This increased susceptibility at the cellular level manifests as increased susceptibility to typhoid fever in a Vietnamese population. Furthermore, treating zebrafish with a cholesterol-lowering agent, ezetimibe, reduced susceptibility to S. Typhi. Thus, coupling multiple genetic association studies with mechanistic dissection revealed how VAC14 regulates Salmonella invasion and typhoid fever susceptibility and may open doors to new prophylactic/therapeutic approaches. PMID:28827342

Distribution of Helicobacter pylori cagA, cagE and vacA in different ethnic groups in Kuala Lumpur, Malaysia.

PubMed

Tan, Huck Joo; Rizal, Abdul Manaf; Rosmadi, Mohamed-Yusoff; Goh, Khean-Lee

2005-04-01

There is a geographic variation in Helicobacter pylori (HP) genotypes and virulence factors. Cytotoxin associated genes A (cagA) and E (cagE), and certain vacuolating cytotoxin (vacA) genotypes are associated with peptic ulcer disease (PUD). There is also a different prevalence of PUD among different ethnic groups in Malaysia. The present study compared the distribution of vacA alleles and cagA and cagE status in three ethnic groups residing in Kuala Lumpur, Malaysia, and their association with clinical outcome. All patients with cultured positive HP were recruited prospectively. DNA was extracted and polymerase chain reaction was carried out to determine the cagA and cagE status and vacA alleles. The results of 127 patients (72 men and 55 women) were included. The mean age was 55.53 +/- 12.52 years. The ethnic distribution was 59 Chinese, 38 Indian and 30 Malay patients. The predominant genotype was s1a among the Malay (76.6%) and Indian patients (71.0%), and s1c among the Chinese patients (66.1%). The vacA middle region sequence m1 was detected in 66.7% of Malay, 54.2% of Chinese and 76.3% of Indian patients. Of the Malay, Chinese and Indian patients, 76.6%, 86.4% and 86.8%, respectively, were cagA positive, and 70.0%, 39.0% and 81.6%, respectively, were cagE positve. HP cagA, cagE and vacA were not associated with PUD. There is a distinctive difference in the HP strains among the three ethnic groups in Malaysia. There was no association between cagA, cagE or vacA genotypes and clinical outcome in the patients. None of these markers are helpful in predicting the clinical presentation of a HP infection.

40 CFR 265.310 - Closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

40 CFR 265.310 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

40 CFR 265.310 - Closure and post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure and post-closure care. 265.310... DISPOSAL FACILITIES Landfills § 265.310 Closure and post-closure care. (a) At final closure of the landfill... subsoils present. (b) After final closure, the owner or operator must comply with all post-closure...

40 CFR 264.228 - Closure and post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

40 CFR 264.228 - Closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

40 CFR 264.228 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

40 CFR 264.228 - Closure and post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

40 CFR 264.228 - Closure and post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Closure and post-closure care. 264.228... Surface Impoundments § 264.228 Closure and post-closure care. (a) At closure, the owner or operator must... materials are left in place at final closure, the owner or operator must comply with all post-closure...

Intrapartum translabial ultrasound with pushing used to predict the difficulty in vacuum-assisted delivery of fetuses in non-occiput posterior position.

PubMed

Antonio Sainz, José; Borrero, Carlota; Aquise, Adriana; García-Mejido, José Antonio; Gutierrez, Laura; Fernández-Palacín, Ana

2016-10-01

Our aim is to evaluate the capacity of intrapartum translabial ultrasound (ITU) with pushing in the prediction of difficulty of fetal extraction in vacuum assisted deliveries. Prospective, observational study performed (2/2015-8/2015) on 75 nulliparous women, ≥37 weeks with singleton pregnancies at full dilatation who had ITU-with-pushing performed, previous to vacuum-placement for fetal extraction. Working on the translabial sagittal-plane, we assessed: Angle-Progression (AoP), Progression-Distance (PD) and Head-Direction (HD); in the axial plane we evaluated: Midline-Angle (MLA) and Head-Perineum-Distance (HPD). Vacuum extractions were classified as easy-difficulty (ED) (≤3 vacuum-pulls), difficult-unsuccessful (DD) (>3 vacuum-pulls). We did not assess occipito-posterior-presentations. Seventy nulliparous were studied (44-ED,26-DD). We observed no differences in obstetric, neonatal or intrapartum characteristics between the two study groups, with the following exceptions: newborn weight (3272 ± 438 g versus 3540 ± 372 g; p = 0.011) and number of vacuum-pulls (1.4-ED-vs-4.4-DD; p < 0.0005). AoP-pushing was 143.9° ± 14.6° in ED and 115.1°± 12.9° in DD (p < 0.0005); Head-Up was 79.5% versus 38.4% (p < 0.0005); PD-Pushing was 42.7 ± 11.3 mm versus 30.4 ± 9.8 mm (p < 0.0005); MLA-Pushing was 27.6°± 26.6° versus 57.5°±26.5°(p=0.025); HPD-Pushing was 40.8 ± 10.0 mm versus 47.4 ± 10.9 mm (p = 0.039). We identified that the presence of an AoP-Pushing > 128° predicts an Easy-Vacuum-Delivery (≤3 Vacuum-Pulls) in  >85% of cases (Sen 80%-FPR 9.3%).

Subcostal closure technique for prevention of postthoracotomy pain syndrome.

PubMed

Hong, Kipyo; Bae, Mikyung; Han, Sora

2016-09-01

The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome. From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group). The duration of oral opioid consumption was evaluated from medical records, and postoperative pain was evaluated by telephone interview conducted by a trained nurse practitioner who was unaware of the patient's group. Pain scores were higher in the thoracoscopy group compared to the subcostal closure group, reaching statistical significance (Numeric Rating Scale 0.55 ± 0.948 in the subcostal closure group vs. 1.84 ± 1.614 in the thoracoscopy group; p < 0.001, Clinical Pain Scale 0.24 ± 0.435 in the subcostal closure group vs. 0.81 ± 0.703 in the thoracoscopy group; p < 0.001). The number of patients who consumed oral opioids for longer than 2 months after the operation was significantly greater in the thoracoscopy group than the subcostal closure group (6.9% in the subcostal closure group vs. 32.3% in the thoracoscopy group; p = 0.022). The subcostal closure technique is useful to prevent postthoracotomy pain syndrome. © The Author(s) 2016.

[Caesarean section with vacuum extraction of the head].

PubMed

Dimitrov, A; Pavlova, E; Krŭsteva, K; Nikolov, A

2008-01-01

The aim of the study is to investigate the benefits and the limits in using the soft cup vacuum extractor on the fetal scalp during the caesarean section. The prospective study includes 19 cases of caesarean sections (group A), with vacuum assisted delivery using the soft cup vacuum extractor on the fetal scalp (diameter 6 cm) and 25 cases (group B) of caesarean sections with usual, manual extraction of the head assisted by fundal compression. All of the patients had undergone a planned caesarean section on term in absence of uterine activity and preserved amniotic membranes. Our results doesn't show differences in the Apgar score on the first and 5-th minute in the newborns of the two groups. The duration of the scalp traction was significantly shorter (30 +/- 4 sec) in comparison to the classical manual extraction (53 +/- 21 sec). The mean duration for applying the vacuum cup was 10 sec and 25 sec for tractions. The total blood loose and total duration of the caesarean sections were shorter than in the control group. The applied traction with the vacuum cup was sufficient for head extraction and there was no need for additional fundal compression. In conclusion we consider that the extraction of the fetal head in high position in caesarean section with vacuum extractor is an easy, non traumatic and rapid method which can put away the need of rough and prolonged fundal compression and its consequences.

Apical Extrusion of Irrigants in Immature Permanent Teeth by Using EndoVac and Needle Irrigation: An In Vitro Study

PubMed Central

Velmurugan, N; Sooriaprakas, C; Jain, Preetham

2014-01-01

Objective: Immature teeth have a large apical opening and thin divergent or parallel dentinal walls; hence, with conventional needle irrigation there is a very high possibility of extrusion. This study was done to compare the apical extrusion of NaOCl in an immature root delivered using EndoVac and needle irrigation. Materials and Methods: Eighty freshly extracted maxillary central incisors were decoronated followed by access cavity preparation. Modified organotypic protocol was performed to create an open apex; then, the samples were divided into four groups (n=20): EndoVac Microcannula (group I), EndoVac Macrocannula (group II), NaviTip irrigation needle (group III) and Max-i-Probe Irrigating needle (group IV); 9.0 ml of 3% sodium hypochlorite was delivered slowly over a period of 60 seconds. Extruded irrigants were collected in a vial and analysed statistically. Results: Group I, group III and group IV showed 100% extrusion (20/20) but group II showed only 40% extrusion (8/20). The difference in this respect between group II and other groups was statistically significant (P<0.001). With regards to the volume of extrusion, group II had only 0.23 ml of extruded irrigant. Group I extruded 7.53ml of the irrigant. Group III and group IV extruded the entire volume of irrigant delivered. Conclusion: EndoVac Macrocannula resulted in the least extrusion of irrigant in immature teeth when compared to EndoVac Microcannula and conventional needle irrigation. PMID:25584055

Long-term clinical evaluation of a 800-nm long-pulsed diode laser with a large spot size and vacuum-assisted suction for hair removal.

PubMed

Ibrahimi, Omar A; Kilmer, Suzanne L

2012-06-01

The long-pulsed diode (800-810-nm) laser is one of the most commonly used and effective lasers for hair removal. Limitations of currently available devices include a small treatment spot size, treatment-associated pain, and the need for skin cooling. To evaluate the long-term hair reduction capabilities of a long-pulsed diode laser with a large spot size and vacuum assisted suction. Thirty-five subjects were enrolled in a prospective, self-controlled, single-center study of axillary hair removal. The study consisted of three treatments using a long-pulsed diode laser with a large spot size and vacuum-assisted suction at 4- to 6-week intervals with follow-up visits 6 and 15 months after the last treatment. Hair clearance was quantified using macro hair-count photographs taken at baseline and at 6- and 15-month follow-up visits. Changes in hair thickness and color, levels of treatment-associated pain, and adverse events were additional study endpoints. There was statistically significant hair clearance at the 6 (54%) and 15-month (42%) follow-up visits. Remaining hairs were thinner and lighter at the 15-month follow-up visit, and the majority of subjects reported feeling up to mild to moderate pain during treatment without the use of pretreatment anesthesia or skin cooling. A long-pulsed diode laser with a large spot size and vacuum-assisted suction is safe and effective for long-term hair removal. This is the largest prospective study to evaluate long-term hair removal and the first to quantify decreases in hair thickness and darkness with treatment. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Sternoclavicular Osteomyelitis in an Immunosuppressed Patient: A Case Report and Review of the Literature

PubMed Central

Khan, Kamran; Wozniak, Susan E.; Mehrabi, Erfan; Giannone, Anna Lucia; Dave, Mitul

2015-01-01

Patient: Male, 62 Final Diagnosis: Sternoclavicular osteomyelitis Symptoms: — Medication: — Clinical Procedure: Debridement Specialty: Infectious Diseases Objective: Rare disease Background: Sternoclavicular osteomyelitis is a rare disease, with less than 250 cases identified in the past 50 years. We present a rare case of sternoclavicular osteomyelitis in an immunosuppressed patient that developed from a conservatively treated dislocation. Case Report: A 62-year-old white man with a history of metastatic renal cell carcinoma presented to the emergency department (ED) with a dislocated left sternoclavicular joint. He was managed conservatively and subsequently discharged. However, over subsequent days he began to experience pain, fever, chills, and night sweats. He presented to the ED again and imaging revealed osteomyelitis. In the operating room, the wound was aggressively debrided and a wound vac (vacuum-assisted closure) was placed. He was diagnosed with sternoclavicular osteomyelitis and placed on a 6-week course of intravenous Nafcillin. Conclusions: Chemotherapy patients who sustain joint trauma normally associated with a low risk of infection should be monitored thoroughly, and the option to discontinue immunosuppressive therapy should be considered if signs of infection develop. PMID:26708708

Comparative evaluation of canal isthmus debridement efficacy of modified EndoVac technique with different irrigation systems.

PubMed

Thomas, Anchu Rachel; Velmurugan, Natanasabapathy; Smita, Surendran; Jothilatha, Sundaramurthy

2014-10-01

The purpose of this study was to evaluate the canal isthmus debridement efficacy of a new modified EndoVac (Discus Dental, Culver City, CA) irrigation protocol in comparison with EndoVac, passive ultrasonic irrigation (PUI), and conventional needle irrigation in mesial roots of mandibular molars. The mesial roots of 64 extracted mandibular molars mounted in resin using Kuttler's endodontic cube, sectioned at 2 and 4 mm from the working length, were randomly divided into 4 groups (n = 16): group 1: Max-I-Probe (Dentsply Tulsa Dental, York, PA), group 2: EndoVac (EVI), group 3: modified EndoVac, and group 4: PUI. The specimens were reassembled and instrumented. A standard irrigation protocol was used during cleaning and shaping and final irrigation with the 4 irrigation/agitation techniques. Images of the isthmus region were taken before and after cleaning and shaping and after final irrigation. The percentage reduction of debris in the isthmus region was calculated by using the software program Image J (v1.43; National Institutes of Health, Bethesda, MD). Intergroup analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Intragroup analysis was performed using Friedman and Wilcoxon signed rank tests. The level of significance was set at P < .05. Intragroup analysis revealed a statistically significant difference in the percentage reduction of debris after cleaning and shaping and after final irrigation protocol in all the groups (P < .001). The final irrigation protocol produced significantly cleaner canal isthmuses in all the groups (P < .001). On intergroup analysis, the modified EVI group performed significantly better than the other groups. The EVI and PUI groups performed better than the Max-I-Probe group. There was no statistical significance between the EVI and PUI groups. Canal isthmuses were significantly cleaner with the modified EndoVac irrigation technique when compared with the cleanliness seen with the other irrigation systems

Laser-assisted skin closure at 1.32 microns: the use of a software-driven medical laser system

NASA Astrophysics Data System (ADS)

Dew, Douglas K.; Hsu, Tung M.; Hsu, Long S.; Halpern, Steven J.; Michaels, Charles E.

1991-06-01

This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal approximated wound edges in pig skin. The medical laser system used was the DLS Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG laser in a large animal model. Effectiveness was judged on the basis of wound dehiscence, infection, unusual healing result and consistency of results. Comparative cosmetic result was also evaluated. In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness wounds. The pig model was chosen for its many integumentary similarities to man. Controls included scalpel-induced wounds closed using suture, staple and some with norepair. After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75- 100 pounds) each was clipped with animal hair clippers from the shoulder area to the hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or abrasions of the skin. The dorsum was divided into four rows of four parallel incisions made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the dorsum of the pigs and then closed either with one loosely approximating Prolene" suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs. Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart along the 9 cm incision. The no-repair incisions were grossly approximated using a single 2-0 Prolene full thickness, simple, interrupted suture located at the

A vacuum flash-assisted solution process for high-efficiency large-area perovskite solar cells

NASA Astrophysics Data System (ADS)

Li, Xiong; Bi, Dongqin; Yi, Chenyi; Décoppet, Jean-David; Luo, Jingshan; Zakeeruddin, Shaik Mohammed; Hagfeldt, Anders; Grätzel, Michael

2016-07-01

Metal halide perovskite solar cells (PSCs) currently attract enormous research interest because of their high solar-to-electric power conversion efficiency (PCE) and low fabrication costs, but their practical development is hampered by difficulties in achieving high performance with large-size devices. We devised a simple vacuum flash-assisted solution processing method to obtain shiny, smooth, crystalline perovskite films of high electronic quality over large areas. This enabled us to fabricate solar cells with an aperture area exceeding 1 square centimeter, a maximum efficiency of 20.5%, and a certified PCE of 19.6%. By contrast, the best certified PCE to date is 15.6% for PSCs of similar size. We demonstrate that the reproducibility of the method is excellent and that the cells show virtually no hysteresis. Our approach enables the realization of highly efficient large-area PSCs for practical deployment.

40 CFR 265.228 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Closure and post-closure care. 265.228... DISPOSAL FACILITIES Surface Impoundments § 265.228 Closure and post-closure care. (a) At closure, the owner... impoundment and provide post-closure care for a landfill under subpart G and § 265.310, including the...

40 CFR 265.228 - Closure and post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Closure and post-closure care. 265.228... DISPOSAL FACILITIES Surface Impoundments § 265.228 Closure and post-closure care. (a) At closure, the owner... impoundment and provide post-closure care for a landfill under subpart G and § 265.310, including the...

Comparison of the Antimicrobial Efficacy of the EndoVac System and Conventional Needle Irrigation in Primary Molar Root Canals.

PubMed

Buldur, Burak; Kapdan, Arife

The purpose of this study was to compare the antimicrobial efficacy of the EndoVac system and conventional needle irrigation to eliminate E faecalis in primary molar root canals. 60 extracted human primary second molar roots were instrumented up to an apical size .04/35 and randomly divided into two groups; Group 1: conventional needle (n=30) and Group 2: EndoVac (n=30), and four subgroups (two experimental subgroups; (a) 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA) (n=20), (b) ozonated water (OW) + EDTA (n=20), and control groups (c) 5.25% NaOCl (n=10) and (d) saline (n=10). All roots were sterilized and then inoculated with E.faecalis. Before and after final irrigation procedures, root canals were sampled and the grown colony forming units (CFUs) were counted. Data were analyzed by Kruskall-Wallis and Mann-Whitney U tests using a 0.05 significance level. The EndoVac reduced more bacteria than the conventional needle did but it was not statistically significant (p>0.05). NaOCl alone or followed by EDTA totally eliminated bacteria. OW + EDTA showed higher reduction of bacteria but could not totally eliminate bacterias. In the context of bacterial elimination, the EndoVac was not significantly better than the conventional needle. Although, there were fewer CFU/mg when using EndoVac, there was not any statistically significant superiority to conventional needle irrigation. An OW+EDTA regimen showed antibacterial effect in the primary molar root canals but it was significantly less effective than NaOCl+EDTA.

Quantum vacuum polarization, nanotechnology and a robotic mission to Proxima Centauri

NASA Astrophysics Data System (ADS)

de Morais Mendonca Teles, Antonio

inertial mass of the mini-spacecraft has a relativistic increase factor of 0.005, fifty years of mission is a feasible one. A way of achieving this is by using altogether the possible available spacecraft acceleration: gravity assistance, ionic propulsion, and using characteristics of the medium through which any spacecrafts travel by -vacuum. Vacuum has intrinsic quantum properties such as quantum tunneling, latent quantum residual energy, and the quantum vac-uum polarization phenomenon. I also propose the use of such quantum vacuum polarization (QVP) for the propulsion assistance for possible future Solar System and interstellar missions. QVP is a natural phenomenon arisen as a second-order correction for perturbation of quantum vacuum fluctuations, within the quantum field physics arena. It is related experimentally to the Casimir effect (the appearance of a negative potential barrier between very close and par-allel metallic plates in vacuum). Using a laser beam with a minimum of 1.22 MeV energy it is possible to create inside those plates in vacuum 1 real pair of electron-positron (anti-electron), and associated with this there is the creation of 1 virtual pair of electron-positron, through the geometrodynamical arrangement of the quantum vacuum fluctuations states, with a very small interval of time (δt). With much greater energies (GeV, TeV) it is possible to create virtual pairs with much longer δt, with the appearance of a repulsive force between the real and asso-ciated virtual pairs, caused by forced alignment of the spins of the real and virtual pairs. This could be attained by the use of a magnetic field. A powerful laser put in the extremity of the mini-spacecraft (together with the ionic mini-motor) in the middle of Casimir plates, could use that repulsive force to get much more momentum to the mini-spacecraft, for a possible speed in the order of 0.1 c. Telecommunication aspect can be arranged through the use of a tracking and data relay mini

Analysis of the temperature sensitivity of Japanese rubella vaccine strain TO-336.vac and its effect on immunogenicity in the guinea pig.

PubMed

Okamoto, Kiyoko; Ami, Yasushi; Suzaki, Yuriko; Otsuki, Noriyuki; Sakata, Masafumi; Takeda, Makoto; Mori, Yoshio

2016-04-01

The marker of Japanese domestic rubella vaccines is their lack of immunogenicity in guinea pigs. This has long been thought to be related to the temperature sensitivity of the viruses, but supporting evidence has not been described. In this study, we generated infectious clones of TO-336.vac, a Japanese domestic vaccine, TO-336.GMK5, the parental virus of TO-336.vac, and their mutants, and determined the molecular bases of their temperature sensitivity and immunogenicity in guinea pigs. The results revealed that Ser(1159) in the non-structural protein-coding region was responsible for the temperature sensitivity of TO-336.vac dominantly, while the structural protein-coding region affected the temperature sensitivity subordinately. The findings further suggested that the temperature sensitivity of TO-336.vac affected the antibody induction in guinea pigs after subcutaneous inoculation. Copyright © 2016 Elsevier Inc. All rights reserved.

Transcatheter closure of Patent Ductus Arteriosus through only venous route.

PubMed

Sheikh, Abdul Malik; Duke, Abdul Karim; Sattar, Hina

2018-03-01

Patent ductus arteriosus is a common congenital cardiac defect comprising 5-10% of all these defects in term neonates. Although open chest and video-assisted interruption are still in use, transcatheter occlusion has rapidly become the first choice for patent ductus arteriosus closure in the appropriate patient. Percutaneous closure of patent ductus arteriosus is widely done by transvenous approach guided by aortic access. We present the case of a 2 year old girl who underwent patent ductus arteriosus device occlusion with transvenous access only.

Negative pressure wound therapy-assisted dermatotraction for the closure of large open wounds in a patient with non-clostridial gas gangrene.

PubMed

Ishida, Kenichiro; Noborio, Mitsuhiro; Nishimura, Tetsuro; Ieki, Yohei; Shimahara, Yumiko; Sogabe, Taku; Ehara, Naoki; Saoyama, Yuki; Sadamitsu, Daikai

2016-04-01

A 53-year-old woman developed septic shock associated with non-clostridial gas gangrene. She presented to the emergency department with two large open wounds on both thighs and in her sacral region. Non-enhanced computed tomography showed air density in contact with the right iliopsoas, which extended to the posterior compartment of the thigh. We made repeated efforts at surgical debridement of the wound with resection of necrotic tissues. Using negative pressure wound therapy-assisted dermatotraction, the pus pockets and the wound dehiscence decreased in size. Using this method we were successful in achieving delayed closure without skin grafts. Negative pressure wound therapy can be an effective treatment for large and infected open contoured wounds. Negative pressure wound therapy-assisted dermatotraction might be beneficial for poorly healing, large, open wounds in patients in poor condition and with insufficient reserve to tolerate reconstructive surgery.

Negative pressure wound therapy‐assisted dermatotraction for the closure of large open wounds in a patient with non‐clostridial gas gangrene

PubMed Central

Noborio, Mitsuhiro; Nishimura, Tetsuro; Ieki, Yohei; Shimahara, Yumiko; Sogabe, Taku; Ehara, Naoki; Saoyama, Yuki; Sadamitsu, Daikai

2015-01-01

Case A 53‐year‐old woman developed septic shock associated with non‐clostridial gas gangrene. She presented to the emergency department with two large open wounds on both thighs and in her sacral region. Non‐enhanced computed tomography showed air density in contact with the right iliopsoas, which extended to the posterior compartment of the thigh. We made repeated efforts at surgical debridement of the wound with resection of necrotic tissues. Outcome Using negative pressure wound therapy‐assisted dermatotraction, the pus pockets and the wound dehiscence decreased in size. Using this method we were successful in achieving delayed closure without skin grafts. Conclusion Negative pressure wound therapy can be an effective treatment for large and infected open contoured wounds. Negative pressure wound therapy‐assisted dermatotraction might be beneficial for poorly healing, large, open wounds in patients in poor condition and with insufficient reserve to tolerate reconstructive surgery. PMID:29123764

Recovery of phosphonate surface contaminants from glass using a simple vacuum extractor with a solid-phase microextraction fiber.

PubMed

Groenewold, Gary S; Scott, Jill R; Rae, Catherine

2011-07-04

Recovery of chemical contaminants from fixed surfaces for analysis can be challenging, particularly if it is not possible to acquire a solid sample to be taken to the laboratory. A simple device is described that collects semi-volatile organic compounds from fixed surfaces by creating an enclosed volume over the surface, then generating a modest vacuum. A solid-phase microextraction (SPME) fiber is then inserted into the evacuated volume where it functions to sorb volatilized organic contaminants. The device is based on a syringe modified with a seal that is used to create the vacuum, with a perforable plunger through which the SPME fiber is inserted. The reduced pressure speeds partitioning of the semi-volatile compounds into the gas phase and reduces the boundary layer around the SPME fiber, which enables a fraction of the volatilized organics to partition into the SPME fiber. After sample collection, the SPME fiber is analyzed using conventional gas chromatography/mass spectrometry. The methodology has been used to collect organophosphorus compounds from glass surfaces, to provide a simple test for the functionality of the devices. Thirty minute sampling times (ΔT(vac)) resulted in fractional recovery efficiencies that ranged from 10(-3) to >10(-2), and in absolute terms, collection of low nanograms was demonstrated. Fractional recovery values were positively correlated to the vapor pressure of the compounds being sampled. Fractional recovery also increased with increasing ΔT(vac) and displayed a roughly logarithmic profile, indicating that an operational equilibrium is being approached. Fractional recovery decreased with increasing time between exposure and sampling; however, recordable quantities of the phosphonates could be collected three weeks after exposure. Copyright © 2011 Elsevier B.V. All rights reserved.

Method and apparatus for performing in-situ vacuum-assisted metal to glass sealing

DOEpatents

Kramer, D.P.; Massey, R.T.

1985-07-18

A method and apparatus for assembling and fusing glass to metal in a glass-metal electrical component is disclosed. The component includes a metallic shell formed with upper and lower cylindrical recesses connected together by longitudinal passages, a pair of metal rings and plural metal pins assembled to define electrical feed-throughs. The component parts are assembled on a fixture having a sleeve-like projection and a central mounting projection establishing concentric nesting surfaces to which the metal rings are slip-fitted in concentric alignment with each other spaced from sidewalls of the lower recess. The pins are in electrical contact with the metal rings. A glass pre-form is seated within the upper recess. The assembled structure is heated to a temperature sufficient to melt the glass pre-form which flows under gravity through the passages into the lower recess to provide an insulative seal between the metal parts. The gravity flow of glass is assisted by applying vacuum to the lower recess, ensuring that all spaces between the metal parts are filled with sealing glass without formation of bubbles.

Method and apparatus for performing in-situ vacuum-assisted metal to glass sealing

DOEpatents

Kramer, Daniel P.; Massey, Richard T.

1986-01-01

A method and apparatus for assembling and fusing glass to metal in a glass-metal electrical component is disclosed. The component includes a metallic shell formed with upper and lower cylindrical recesses connected together by longitudinal passages, a pair of metal rings and plural metal pins assembled to define electrical feed-throughs. The component parts are assembled on a fixture having a sleeve-like projection and a central mounting projection establishing concentric nesting surfaces to which the metal rings are slip-fitted in concentric alignment with each other spaced from sidewalls of the lower recess. The pins are in electrical contact with the metal rings. A glass pre-form is seated within the upper recess. The assembled structure is heated to a temperature sufficient to melt the glass pre-form which flows under gravity through the passages into the lower recess to provide an insulative seal between the metal parts. The gravity flow of glass is assisted by applying vacuum to the lower recess, ensuring that all spaces between the metal parts are filled with sealing glass without formation of bubbles.

Contemporary Approach to the Diagnosis and Management of Primary Angle-Closure Disease.

PubMed

Razeghinejad, M Reza; Myers, Jonathan S

2018-05-16

Primary angle closure disease spectrum varies from a narrow angle to advanced glaucoma. A variety of imaging technologies may assist the clinician in determining the pathophysiology and diagnosis of primary angle closure, but gonioscopy remains a mainstay of clinical evaluation. Laser iridotomy effectively eliminates the pupillary block component of angle closure; however, studies show that in many patients the iridocorneal angle remains narrow from underlying anatomic issues, and increasing lens size often leads to further narrowing over time. Recent studies have further characterized the role of the lens in angle closure disease, and cataract or clear lens extraction is increasingly used earlier in its management. As a first surgical step in angle closure glaucoma, lens extraction alone often effectively controls the pressure with less risk of complications than concurrent or stand alone glaucoma surgery, but may not be sufficient in more advanced or severe disease. We provide a comprehensive review on the primary angle-closure disease nomenclature, imaging, and current laser and surgical management. Copyright © 2018. Published by Elsevier Inc.

Relationship between VacA Toxin and Host Cell Autophagy in Helicobacter pylori Infection of the Human Stomach: A Few Answers, Many Questions.

PubMed

Ricci, Vittorio

2016-07-01

Helicobacter pylori is a Gram-negative bacterium that colonizes the stomach of about half the global population and represents the greatest risk factor for gastric malignancy. The relevance of H. pylori for gastric cancer development is equivalent to that of tobacco smoking for lung cancer. VacA toxin seems to play a pivotal role in the overall strategy of H. pylori towards achieving persistent gastric colonization. This strategy appears to involve the modulation of host cell autophagy. After an overview of autophagy and its role in infection and carcinogenesis, I critically review current knowledge about the action of VacA on host cell autophagy during H. pylori infection of the human stomach. Although VacA is a key player in modulation of H. pylori-induced autophagy, a few discrepancies in the data are also evident and many questions remain to be answered. We are thus still far from a definitive understanding of the molecular mechanisms through which VacA affects autophagy and the consequences of this toxin action on the overall pathogenic activity of H. pylori.

Helicobacter pylori VacA Toxin Promotes Bacterial Intracellular Survival in Gastric Epithelial Cells▿ †

PubMed Central

Terebiznik, M. R.; Vazquez, C. L.; Torbicki, K.; Banks, D.; Wang, T.; Hong, W.; Blanke, S. R.; Colombo, M. I.; Jones, N. L.

2006-01-01

Helicobacter pylori colonizes the gastric epithelium of at least 50% of the world's human population, playing a causative role in the development of chronic gastritis, peptic ulcers, and gastric adenocarcinoma. Current evidence indicates that H. pylori can invade epithelial cells in the gastric mucosa. However, relatively little is known about the biology of H. pylori invasion and survival in host cells. Here, we analyze both the nature of and the mechanisms responsible for the formation of H. pylori's intracellular niche. We show that in AGS cells infected with H. pylori, bacterium-containing vacuoles originate through the fusion of late endocytic organelles. This process is mediated by the VacA-dependent retention of the small GTPase Rab7. In addition, functional interactions between Rab7 and its downstream effector, Rab-interacting lysosomal protein (RILP), are necessary for the formation of the bacterial compartment since expression of mutant forms of RILP or Rab7 that fail to bind each other impaired the formation of this unique bacterial niche. Moreover, the VacA-mediated sequestration of active Rab7 disrupts the full maturation of vacuoles as assessed by the lack of both colocalization with cathepsin D and degradation of internalized cargo in the H. pylori-containing vacuole. Based on these findings, we propose that the VacA-dependent isolation of the H. pylori-containing vacuole from bactericidal components of the lysosomal pathway promotes bacterial survival and contributes to the persistence of infection. PMID:17000720

Helicobacter pylori vacA and cagA genotype diversity and interferon gamma expression in patients with chronic gastritis and patients with gastric cancer.

PubMed

Martínez-Carrillo, D N; Atrisco-Morales, J; Hernández-Pando, R; Reyes-Navarrete, S; Betancourt-Linares, R; Cruz-del Carmen, I; Illades Aguiar, B; Román-Román, A; Fernández-Tilapa, G

2014-01-01

Helicobacter pylori (H. pylori) is the main risk factor for the development of chronic gastritis, gastric ulcer, and gastric cancer. In H. pylori-infected individuals, the clinical result is dependent on various factors, among which are bacterial components, the immune response, and environmental influence. To compare IFN-γ expression with the H. pylori vacA and cagA genotypes in patients with chronic gastritis and patients with gastric cancer. Ninety-five patients diagnosed with chronic gastritis and 20 with gastric cancer were included in the study. Three gastric biopsies were taken; one was used for the molecular detection and genotyping of H. pylori; another was fixed in absolute alcohol and histologic sections were made for determining IFN-γ expression through immunohistochemistry. No differences were found in the cells that expressed IFN-γ between the patients with chronic gastritis (median percentage of positive cells: 82.6% in patients without H. pylori and 82% in infected persons) and those with gastric cancer (70.5% in H. pylori-negative patients and 78.5% in infected persons). IFN-γ expression was 69% in chronic gastritis patients infected with H. pylori vacAs2m2/cagA⁻ it was 86.5% in patients infected with H. pylori vacAs1m2/cagA⁻, 86.5% in vacAs1m1/cagA⁻, and 82% in vacAs1m1/cagA⁺. Similar data were found in the patients with gastric cancer. IFN-γ expression varied depending on the H. pylori vacA and cagA genotype, but not in accordance with the presence of chronic gastritis or gastric cancer.

Polymorphism in the Helicobacter pylori CagA and VacA toxins and disease

PubMed Central

Bridge, Dacie R.; Merrell, D. Scott

2013-01-01

Half of the world’s population is infected with Helicobacter pylori and approximately 20% of infected individuals develop overt clinical disease such as ulcers and stomach cancer. Paradoxically, despite its classification as a class I carcinogen, H. pylori has been shown to be protective against development of asthma, allergy, and esophageal disease. Given these conflicting roles for H. pylori, researchers are attempting to define the environmental, host, and pathogen interactions that ultimately result in severe disease in some individuals. From the bacterial perspective, the toxins, CagA and VacA, have each been shown to be polymorphic and to contribute to disease in an allele-dependent manner. Based on the notable advances that have recently been made in the CagA field, herein we review recent studies that have begun to shed light on the role of CagA polymorphism in H. pylori disease. Moreover, we discuss the potential interaction of CagA and VacA as a mediator of gastric disease. PMID:23380646

Application of ionic liquids in vacuum microwave-assisted extraction followed by macroporous resin isolation of three flavonoids rutin, hyperoside and hesperidin from Sorbus tianschanica leaves.

PubMed

Gu, Huiyan; Chen, Fengli; Zhang, Qiang; Zang, Jing

2016-03-01

Rutin, hyperoside and hesperidin were effectively extracted from Sorbus tianschanica leaves by an ionic liquid vacuum microwave-assisted method. A series of ionic liquids with various anions and alkyl chain length of the cations were studied and the extraction was performed in [C6mim][BF4] aqueous solution. After optimization by a factorial design and response surface methodology, total extraction yield of 2.37mg/g with an error of 0.12mg/g (0.71±0.04mg/g, 1.18±0.06mg/g and 0.48±0.02 for rutin, hyperoside and hesperidin, respectively) was achieved under -0.08MPa for vacuum, 19min and 420W for microwave irradiation time and power, and 15mL/g for liquid-solid ratio. The proposed method here is more efficient and needs a shorter extraction time for rutin, hyperoside and hesperidin from S. tianschanica leaves than reference extraction techniques. In stability studies performed with standard rutin, hyperoside and hesperidin, the target analytes were stable under the optimum conditions. The proposed method had a high reproducibility and precision. In addition, separation of rutin, hyperoside and hesperidin from [C6mim][BF4] extraction solution was completed effectively by AB-8 macroporous resin adsorption and desorption process. Ionic liquid vacuum microwave-assisted extraction is a simple, rapid and efficient sample extraction technique. Copyright © 2016 Elsevier B.V. All rights reserved.

The VACS index accurately predicts mortality and treatment response among multi-drug resistant HIV infected patients participating in the options in management with antiretrovirals (OPTIMA) study.

PubMed

Brown, Sheldon T; Tate, Janet P; Kyriakides, Tassos C; Kirkwood, Katherine A; Holodniy, Mark; Goulet, Joseph L; Angus, Brian J; Cameron, D William; Justice, Amy C

2014-01-01

The VACS Index is highly predictive of all-cause mortality among HIV infected individuals within the first few years of combination antiretroviral therapy (cART). However, its accuracy among highly treatment experienced individuals and its responsiveness to treatment interventions have yet to be evaluated. We compared the accuracy and responsiveness of the VACS Index with a Restricted Index of age and traditional HIV biomarkers among patients enrolled in the OPTIMA study. Using data from 324/339 (96%) patients in OPTIMA, we evaluated associations between indices and mortality using Kaplan-Meier estimates, proportional hazards models, Harrel's C-statistic and net reclassification improvement (NRI). We also determined the association between study interventions and risk scores over time, and change in score and mortality. Both the Restricted Index (c = 0.70) and VACS Index (c = 0.74) predicted mortality from baseline, but discrimination was improved with the VACS Index (NRI = 23%). Change in score from baseline to 48 weeks was more strongly associated with survival for the VACS Index than the Restricted Index with respective hazard ratios of 0.26 (95% CI 0.14-0.49) and 0.39(95% CI 0.22-0.70) among the 25% most improved scores, and 2.08 (95% CI 1.27-3.38) and 1.51 (95%CI 0.90-2.53) for the 25% least improved scores. The VACS Index predicts all-cause mortality more accurately among multi-drug resistant, treatment experienced individuals and is more responsive to changes in risk associated with treatment intervention than an index restricted to age and HIV biomarkers. The VACS Index holds promise as an intermediate outcome for intervention research.

A systematic review on the association between the Helicobacter pylori vacA i genotype and gastric disease.

PubMed

Liu, Xian; He, Bangshun; Cho, William C; Pan, Yuqin; Chen, Jie; Ying, Houqun; Wang, Feng; Lin, Kang; Peng, Hongxin; Wang, Shukui

2016-05-01

Helicobacter pylori (H. pylori) has been recognized as a cause of gastrointestinal diseases and progress of the pathology of gastrointestinal diseases is related to the genotype of H. pylori. Published studies have indicated that the H. pylori vacuolating cytotoxin gene A (vacA) i1/i2 genotype is associated with peptic ulcer disease (PUD) and gastric cancer (GC), but their conclusions are inconsistent. This study aimed to further assess the risk of vacA i gene for PUD and/or GC. A systematic search was conducted across three main electronic databases (PubMed, Web of Science, and CNKI). A meta-analysis was then performed on the pooled data of the published articles to estimate the overall influence of vacA i polymorphisms on PUD and/or GC by crude odds ratio (OR) with 95% confidence intervals (CI). The reliability of the results were confirmed by publication bias and sensitivity analysis of included studies. A total of 14 studies were selected according to the specific inclusion and exclusion criteria. The pooled results revealed that patients with GC were more vulnerable to infection by H. pylori i1 genotype (OR = 5.12; 95% CI: 2.66-9.85; P < 0.001) than those with chronic gastritis or nonulcer disease. Moreover, the results of subgroup analysis indicated that the i1 genotype of H. pylori was associated with an increased GC risk (OR = 10.89; 95% CI: 4.11-20.88; P < 0.001) in the Middle Asian population. The H. pylori vacA i1 genotype is associated with an increased GC risk, especially in the Middle Asian population.

vacA s1m1 genotype and cagA EPIYA-ABC pattern are predominant among Helicobacter pylori strains isolated from Mexican patients with chronic gastritis.

PubMed

Atrisco-Morales, Josefina; Martínez-Santos, Verónica I; Román-Román, Adolfo; Alarcón-Millán, Judit; De Sampedro-Reyes, José; Cruz-Del Carmen, Iván; Martínez-Carrillo, Dinorah N; Fernández-Tilapa, Gloria

2018-03-01

Virulent genotypes of Helicobacter pylori vacA s1m1/cagA + /babA2 + have been associated with severe gastric diseases. VacA, CagA and BabA are polymorphic proteins, and their association with the disease is allele-dependent. The aims of this work were: (i) to determine the prevalence of H. pylori by type of chronic gastritis; (ii) to describe the frequency of cagA, babA2 and vacA genotypes in strains from patients with different types of chronic gastritis; (iii) to characterize the variable region of cagA alleles. A total of 164 patients with chronic gastritis were studied. Altogether, 50 H. pylori strains were isolated, and the status of cagA, babA2 and vacA genotypes was examined by PCR. cagA EPIYA segment identification was performed using PCR and sequencing of cagA fragments of six randomly selected strains.Results/Key findings. The overall prevalence of H. pylori was 30.5 %. Eighty percent of the isolated strains were vacA s1m1, and the cagA and babA2 genes were detected in 74 and 32 % of the strains, respectively. The most frequent genotypes were vacA s1m1/cagA + /babA2 - and vacA s1m1/cagA + /babA2 + , with 40 % (20/50) and 28 % (14/50), respectively. In cagA + , the most frequent EPIYA motif was -ABC (78.4 %), and EPIYA-ABCC and -ABCCC motifs were found in 10.8 % of the strains. A modified EPIYT-B motif was found in 66.6 % of the sequenced strains. H. pylori strains carrying vacA s1m1, cagA + and babA2 - genotypes were the most prevalent in patients with chronic gastritis from the south of Mexico. In the cagA + strains, the EPIYA-ABC motif was the most common.

vacA s1m1 genotype and cagA EPIYA-ABC pattern are predominant among Helicobacter pylori strains isolated from Mexican patients with chronic gastritis

PubMed Central

Atrisco-Morales, Josefina; Martínez-Santos, Verónica I.; Román-Román, Adolfo; Alarcón-Millán, Judit; De Sampedro-Reyes, José; Cruz-del Carmen, Iván; Martínez-Carrillo, Dinorah N.; Fernández-Tilapa, Gloria

2018-01-01

Purpose Virulent genotypes of Helicobacter pylori vacA s1m1/cagA+/babA2+ have been associated with severe gastric diseases. VacA, CagA and BabA are polymorphic proteins, and their association with the disease is allele-dependent. The aims of this work were: (i) to determine the prevalence of H. pylori by type of chronic gastritis; (ii) to describe the frequency of cagA, babA2 and vacA genotypes in strains from patients with different types of chronic gastritis; (iii) to characterize the variable region of cagA alleles. Methodology A total of 164 patients with chronic gastritis were studied. Altogether, 50 H. pylori strains were isolated, and the status of cagA, babA2 and vacA genotypes was examined by PCR. cagA EPIYA segment identification was performed using PCR and sequencing of cagA fragments of six randomly selected strains. Results/Key findings The overall prevalence of H. pylori was 30.5 %. Eighty percent of the isolated strains were vacA s1m1, and the cagA and babA2 genes were detected in 74 and 32 % of the strains, respectively. The most frequent genotypes were vacA s1m1/cagA+/babA2- and vacA s1m1/cagA+/babA2+, with 40 % (20/50) and 28 % (14/50), respectively. In cagA+, the most frequent EPIYA motif was -ABC (78.4 %), and EPIYA-ABCC and -ABCCC motifs were found in 10.8 % of the strains. A modified EPIYT-B motif was found in 66.6 % of the sequenced strains. Conclusion H. pylori strains carrying vacA s1m1, cagA+ and babA2- genotypes were the most prevalent in patients with chronic gastritis from the south of Mexico. In the cagA+ strains, the EPIYA-ABC motif was the most common. PMID:29458667

Moles: Tool-Assisted Environment Isolation with Closures

NASA Astrophysics Data System (ADS)

de Halleux, Jonathan; Tillmann, Nikolai

Isolating test cases from environment dependencies is often desirable, as it increases test reliability and reduces test execution time. However, code that calls non-virtual methods or consumes sealed classes is often impossible to test in isolation. Moles is a new lightweight framework which addresses this problem. For any .NET method, Moles allows test-code to provide alternative implementations, given as .NET delegates, for which C# provides very concise syntax while capturing local variables in a closure object. Using code instrumentation, the Moles framework will redirect calls to provided delegates instead of the original methods. The Moles framework is designed to work together with the dynamic symbolic execution tool Pex to enable automated test generation. In a case study, testing code programmed against the Microsoft SharePoint Foundation API, we achieved full code coverage while running tests in isolation without an actual SharePoint server. The Moles framework integrates with .NET and Visual Studio.

40 CFR 264.258 - Closure and post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Waste Piles § 264.258 Closure and post-closure care. (a) At closure, the owner or operator must remove... that apply to landfills (§ 264.310). (c)(1) The owner or operator of a waste pile that does not comply...(c) or § 264.251(b), must: (i) Include in the closure plan for the pile under § 264.112 both a plan...

Transition and closeout of the Fernald Closure Project

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

Bilson, H.E.; Terry, T.; Reising, J.

The U.S. Department of Energy (DOE) and Fluor Fernald have completed the majority of the cleanup of the Fernald Site. The over 1,000 acre complex for processing uranium has been demolished and soil contamination has been remediated. With acres of wetlands and prairies replacing the buildings and waste pits. At the end of the project the focus shifted to developing demonstrating the completion of the project and the contract, as well as ensuring a smooth transition of the facility from the DOE's Environmental Management (EM) Program to the DOE's Legacy Management (LM) Program. Working with the DOE, each portion ofmore » the closure contract was examined for specific closure definition. From this negotiation effort the Comprehensive Exit and Transition Plan (CE/T Plan) was written. The CE/T Plan is intended to assist DOE in the analysis that the site is ready for transfer into long-term stewardship (LTS) (also referred to as legacy management) and that Fluor Fernald, Inc. has satisfactorily completed the closure contract statement of work elements. Following the Lessons Learned from the closure of the Rocky Flats Site, the DOE's Legacy Management Program created a matrix of Transition Elements required to ensure adequate information was in place to allow the new prime contractor to perform the Legacy Management scope of work. The transition plan included over 1,000 elements broken down into functional areas and relied on specific Fernald Responsibility Transition Packages (RTPs) for detailed transition actions. The template for Closure and Transition Planning used at the Fernald Site was developed using the best Lessons Learned from across the DOE Complex. The template could be used for other sites, and lessons learned from this closure and transition will be appropriate for all closure projects. (authors)« less

Comparison of the EndoVac system and conventional needle irrigation on removal of the smear layer in primary molar root canals.

PubMed

Buldur, B; Kapdan, A

2017-09-01

This study aimed to compare the EndoVac system and conventional needle irrigation in removing smear layer (SR) from primary molar root canals. Fifty extracted human primary second molar roots were instrumented up to an apical size of 0.04/35 and randomly divided into two main groups; Group 1: EndoVac system (n = 25) and Group 2: Conventional needle irrigation (n = 25) and three subgroups (a) NaOCl + ethylenediaminetetraacetic acid (EDTA) (n = 20) (b) ozonated water (OW) + EDTA (n = 20) and (c) saline (control, n = 10). After a standardized final irrigation protocol performed for all teeth, scanning electron microscope images were taken at ×1000 magnification for each thirds of each root canal. Data were analyzed by the weighted kappa, Kruskal-Wallis, and Wilcoxon signed rank tests. EndoVac was more effective than conventional needle in the removal of SR from the apical third of the root canal system (P < 0.05). The OW + EDTA regimen provided similar SR removal compared with NaOCl + EDTA. EndoVac has better performance than conventional needle irrigation in the removal of the SR in the apical thirds of the primary molar root canals. As a final irrigation regimen, the OW + EDTA regimen is as effective as the NaOCl + EDTA regimen.

What is the effectiveness of the negative pressure wound therapy (NPWT) in patients treated with open abdomen technique? A systematic review and meta-analysis.

PubMed

Cirocchi, Roberto; Birindelli, Arianna; Biffl, Walter L; Mutafchiyski, Ventsislav; Popivanov, Georgi; Chiara, Osvaldo; Tugnoli, Gregorio; Di Saverio, Salomone

2016-09-01

The open abdomen technique may be used in critically ill patients to manage abdominal injury, reduce the septic complications, and prevent the abdominal compartment syndrome. Many different techniques have been proposed and multiple studies have been conducted, but the best method of temporary abdominal closure has not been determined yet. Recently, new randomized and nonrandomized controlled trials have been published on this topic. We aimed to perform an up-to-date systematic review on the management of open abdomen, including the most recent published randomized and nonrandomized controlled trials, to compare negative pressure wound therapy (NPWT) with no NPWT and define if one technique has better outcomes than the other with regard to primary fascial closure, postoperative 30-day mortality and morbidity, enteroatmospheric fistulae, abdominal abscess, bleeding, and length of stay. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions, an online literature research (until July 1, 2015) was performed on MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, and Cochrane Library databases. The MeSH terms and free words used "vacuum assisted closure" "vac;", "open abdomen", "damage control surgery", and "temporary abdominal closure". No language restriction was made. The initial systematic literature search yielded 452 studies. After a careful assessment of the titles and of the full text was obtained, eight articles fulfilled inclusion criteria. We analyzed 1,225 patients, of whom 723 (59%) underwent NPWT and 502 (41%) did not undergo NPWT, and performed four subgroups: VAC versus Bogota bag technique (two studies, 106 participants), VAC versus mesh-foil laparostomy (two studies, 159 participants), VAC versus laparostomy (adhesive impermeable with midline zip) (one study, 106 participants), and NPWT versus no NPWT techniques (three studies, 854

Overall Quality of Fruits and Vegetables Products Affected by the Drying Processes with the Assistance of Vacuum-Microwaves.

PubMed

Figiel, Adam; Michalska, Anna

2016-12-30

The seasonality of fruits and vegetables makes it impossible to consume and use them throughout the year, thus numerous processing efforts have been made to offer an alternative to their fresh consumption and application. To prolong their availability on the market, drying has received special attention as currently this method is considered one of the most common ways for obtaining food and pharmaceutical products from natural sources. This paper demonstrates the weakness of common drying methods applied for fruits and vegetables and the possible ways to improve the quality using different drying techniques or their combination with an emphasis on the microwave energy. Particular attention has been drawn to the combined drying with the assistance of vacuum-microwaves. The quality of the dried products was ascribed by chemical properties including the content of polyphenols, antioxidant capacity and volatiles as well as physical parameters such as color, shrinkage, porosity and texture. Both these fields of quality classification were considered taking into account sensory attributes and energy aspects in the perspective of possible industrial applications. In conclusion, the most promising way for improving the quality of dried fruit and vegetable products is hybrid drying consisting of osmotic dehydration in concentrated fruit juices followed by heat pump drying and vacuum-microwave finish drying.

Overall Quality of Fruits and Vegetables Products Affected by the Drying Processes with the Assistance of Vacuum-Microwaves

PubMed Central

Figiel, Adam; Michalska, Anna

2016-01-01

The seasonality of fruits and vegetables makes it impossible to consume and use them throughout the year, thus numerous processing efforts have been made to offer an alternative to their fresh consumption and application. To prolong their availability on the market, drying has received special attention as currently this method is considered one of the most common ways for obtaining food and pharmaceutical products from natural sources. This paper demonstrates the weakness of common drying methods applied for fruits and vegetables and the possible ways to improve the quality using different drying techniques or their combination with an emphasis on the microwave energy. Particular attention has been drawn to the combined drying with the assistance of vacuum-microwaves. The quality of the dried products was ascribed by chemical properties including the content of polyphenols, antioxidant capacity and volatiles as well as physical parameters such as color, shrinkage, porosity and texture. Both these fields of quality classification were considered taking into account sensory attributes and energy aspects in the perspective of possible industrial applications. In conclusion, the most promising way for improving the quality of dried fruit and vegetable products is hybrid drying consisting of osmotic dehydration in concentrated fruit juices followed by heat pump drying and vacuum-microwave finish drying. PMID:28042845

Imprint cytology on microcalcifications excised by vacuum-assisted breast biopsy: a rapid preliminary diagnosis.

PubMed

Fotou, Maria; Oikonomou, Vassiliki; Zagouri, Flora; Sergentanis, Theodoros N; Nonni, Afroditi; Athanassiadou, Pauline; Drouveli, Theodora; Atsouris, Efstratios; Kotzia, Evagelia; Zografos, George C

2007-04-03

To evaluate imprint cytology in the context of specimens with microcalcifications derived from Vacuum-Assisted Breast Biopsy (VABB). A total of 93 women with microcalcifications BI-RADS 3 and 4 underwent VABB and imprint samples were examined. VABB was performed on Fischer's table using 11-gauge Mammotome vacuum probes. A mammogram of the cores after the procedure confirmed the excision of microcalcifications. For the application of imprint cytology, the cores with microcalcifications confirmed by mammogram were gently rolled against glass microscope slides and thus imprint smears were made. For rapid preliminary diagnosis Diff-Quick stain, modified Papanicolaou stain and May Grunwald Giemsa were used. Afterwards, the core was dipped into a CytoRich Red Collection fluid for a few seconds in order to obtain samples with the use of the specimen wash. After the completion of cytological procedures, the core was prepared for routine histological study. The pathologist was blind to the preliminary cytological results. The cytological and pathological diagnoses were comparatively evaluated. According to the pathological examination, 73 lesions were benign, 15 lesions were carcinomas (12 ductal carcinomas in situ, 3 invasive ductal carcinomas), and 5 lesions were precursor: 3 cases of atypical ductal hyperplasia (ADH) and 2 cases of lobular neoplasia (LN). The observed sensitivity and specificity of the cytological imprints for cancer were 100% (one-sided, 97.5% CI: 78.2%-100%). Only one case of ADH could be detected by imprint cytology. Neither of the two LN cases was detected by the imprints. The imprints were uninformative in 11 out of 93 cases (11.8%). There was no uninformative case among women with malignancy. Imprint cytology provides a rapid, accurate preliminary diagnosis in a few minutes. This method might contribute to the diagnosis of early breast cancer and possibly attenuates patients' anxiety.

An ultrahigh vacuum, low-energy ion-assisted deposition system for III-V semiconductor film growth

NASA Astrophysics Data System (ADS)

Rohde, S.; Barnett, S. A.; Choi, C.-H.

1989-06-01

A novel ion-assisted deposition system is described in which the substrate and growing film can be bombarded with high current densities (greater than 1 mA/sq cm) of very low energy (10-200 eV) ions. The system design philosophy is similar to that used in III-V semiconductor molecular-beam epitaxy systems: the chamber is an all-metal ultrahigh vacuum system with liquid-nitrogen-cooled shrouds, Knudsen-cell evaporation sources, a sample insertion load-lock, and a 30-kV reflection high-energy electron diffraction system. III-V semiconductor film growth is achieved using evaporated group-V fluxes and group-III elemental fluxes sputtered from high-purity targets using ions extracted from a triode glow discharge. Using an In target and an As effusion cell, InAs deposition rates R of 2 microns/h have been obtained. Epitaxial growth of InAs was observed on both GaSb(100) and Si(100) substrates.

Fournier's Gangrene: A Summary of 10 Years of Clinical Experience

PubMed Central

Oguz, Abdullah; Gümüş, Metehan; Turkoglu, Ahmet; Bozdağ, Zübeyir; Ülger, Burak Veli; Agaçayak, Elif; Böyük, Abdullah

2015-01-01

We aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 ± 1.86 and 10.00 ± 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary. PMID:25859652

Establishing a regional network of academic centers to support decision making for new vaccine introduction in Latin America and the Caribbean: the ProVac experience.

PubMed

Toscano, C M; Jauregui, B; Janusz, C B; Sinha, A; Clark, A D; Sanderson, C; Resch, S; Ruiz Matus, C; Andrus, J K

2013-07-02

The Pan American Health Organization's ProVac Initiative, designed to strengthen national decision making regarding the introduction of new vaccines, was initiated in 2004. Central to realizing ProVac's vision of regional capacity building, the ProVac Network of Centers of Excellence (CoEs) was established in 2010 to provide research support to the ProVac Initiative, leveraging existing capacity at Latin American and Caribbean (LAC) universities. We describe the process of establishing the ProVac Network of CoEs and its initial outcomes and challenges. A survey was sent to academic, not-for-profit institutions in LAC that had recently published work in the areas of clinical decision sciences and health economic analysis. Centers invited to join the Network were selected by an international committee on the basis of the survey results. Selection criteria included academic productivity in immunization-related work, team size and expertise, successful collaboration with governmental agencies and international organizations, and experience in training and education. The Network currently includes five academic institutions across LAC. Through open dialog and negotiation, specific projects were assigned to centers according to their areas of expertise. Collaboration among centers was highly encouraged. Faculty from ProVac's technical partners were assigned as focal points for each project. The resulting work led to the development and piloting of tools, methodological guides, and training materials that support countries in assessing existing evidence and generating new evidence on vaccine introduction. The evidence generated is shared with country-level decision makers and the scientific community. As the ProVac Initiative expands to other regions of the world with support from immunization and public health partners, the establishment of other regional and global networks of CoEs will be critical. The experience of LAC in creating the current network could benefit the

Aerosol Vacuum-Assisted Plasma Ionization (Aero-VaPI) Coupled to Ion Mobility-Mass Spectrometry

NASA Astrophysics Data System (ADS)

Blair, Sandra L.; Ng, Nga L.; Zambrzycki, Stephen C.; Li, Anyin; Fernández, Facundo M.

2018-02-01

In this communication, we report on the real-time analysis of organic aerosol particles by Vacuum-assisted Plasma Ionization-Mass Spectrometry (Aero-VaPI-MS) using a home-built VaPI ion source coupled to a Synapt G2-S HDMS ion mobility-mass spectrometry (IM-MS) system. Standards of organic molecules of interest in prebiotic chemistry were used to generate aerosols. Monocaprin and decanoic acid aerosol particles were successfully detected in both the positive and negative ion modes, respectively. A complex aerosol mixture of different sizes of polymers of L-malic acid was also examined through ion mobility (IM) separations, resulting in the detection of polymers of up to eight monomeric units. This noncommercial plasma ion source is proposed as a low cost alternative to other plasma ionization platforms used for aerosol analysis, and a higher-performance alternative to more traditional aerosol mass spectrometers. VaPI provides robust online ionization of organics in aerosols without extensive ion activation, with the coupling to IM-MS providing higher peak capacity and excellent mass accuracy. [Figure not available: see fulltext.

40 CFR 264.280 - Closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

40 CFR 264.280 - Closure and post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

40 CFR 264.280 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

40 CFR 264.280 - Closure and post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Land Treatment § 264.280 Closure and post-closure care. (a) During the closure period the owner or...

AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

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

Al-Hakim, Ramsey, E-mail: ralhakim@mednet.ucla.edu; Patel, Komal, E-mail: kdpatel@mednet.ucla.edu; Moriarty, John M., E-mail: jmoriarty@mednet.ucla.edu

2015-06-15

This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use ofmore » the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.« less

AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation.

PubMed

Al-Hakim, Ramsey; Patel, Komal; Moriarty, John M

2015-06-01

This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.

Resin Flow Behavior Simulation of Grooved Foam Sandwich Composites with the Vacuum Assisted Resin Infusion (VARI) Molding Process

PubMed Central

Zhao, Chenhui; Zhang, Guangcheng; Wu, Yibo

2012-01-01

The resin flow behavior in the vacuum assisted resin infusion molding process (VARI) of foam sandwich composites was studied by both visualization flow experiments and computer simulation. Both experimental and simulation results show that: the distribution medium (DM) leads to a shorter molding filling time in grooved foam sandwich composites via the VARI process, and the mold filling time is linearly reduced with the increase of the ratio of DM/Preform. Patterns of the resin sources have a significant influence on the resin filling time. The filling time of center source is shorter than that of edge pattern. Point pattern results in longer filling time than of linear source. Short edge/center patterns need a longer time to fill the mould compared with Long edge/center sources.

Values of pathological analysis of lost tissue fragments in the vacuum canister during a vacuum-assisted stereotactic biopsy of the breast.

PubMed

El Khoury, M; Mesurolle, B; Omeroglu, A; Aldis, A; Kao, E

2013-05-01

Determine values of pathological analysis of the canister content during a vacuum-assisted breast biopsy (VABB). Approval was obtained from the ethical committee. Prospective radiological and pathological analyses of the canister content collected during 231 VABBs performed on 231 patients were carried out. χ(2) test was used to determine predictors on canister pathology. The canister pathology was reported separately in 212 cases. It showed only blood in 78/212 (37%) cases and benign (including high-risk lesions) and malignant results in, respectively, 113/212 (53%) and 21/212 (10%) cases. Respective specimen analysis was benign, including high-risk lesions in 162/212 cases (76%) and malignant in 50/212 (24%) cases. Microcalcifications were documented on canister X-ray in 70/231 (30%) cases. There was significant association between the canister and the specimen pathology (p<0.0001). In none of the cases was microcalcifications seen exclusively in the canister content or pathological upgrading found in the canister content compared with the specimen. Small tissue fragments and microcalcifications may be lost in the canister during a VABB. Nevertheless, our results did not show any significant value for systematic analysis of the canister content. There is no added diagnostic value to retrieval and analysis of tissue lost in the canister during a VABB.

40 CFR 265.1202 - Closure and post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... post-closure care. (a) At closure of a magazine or unit which stored hazardous waste under this subpart... estimates for closure, and financial responsibility for magazines or units must meet all of the requirements... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

Effect of additional heat treatment of 2024-T3 on the growth of fatigue crack in air and in vacuum

NASA Technical Reports Server (NTRS)

Louwaard, E. P.

1986-01-01

In order to determine the influence of ductility on the fatigue crack growth rate of aluminum alloys, fatigue tests were carried out on central notched specimens of 2024-T3 and 2024-T8 sheet material. The 2024-T8 material was obtained by an additional heat treatment applied on 2024-T3 (18 hours at 192 C), which increased the static yield strength from 43.6 to 48.9 kgf/sq mm. A change in the ultimate strength was not observed. Fatigue tests were carried out on both materials in humid air and in high vacuum. According to a new crack propagation model, crack extension is supported to be caused by a slip-related process and debonding triggered by the environment. This model predicts an effect of the ductility on the crack growth rate which should be smaller in vacuum than in humid air; however, this was not confirmed. In humid air the crack-growth rate in 2024-T8 was about 2 times faster than in 2024-T3, while in vacuum the ratio was about 2.5. Crack closure measurements gave no indications that crack closure played a significant role in both materials. Some speculative explanations are briefly discussed.

Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review.

PubMed

Aires, Felipe T; Dedivitis, Rogério A; Castro, Mario Augusto F; Bernardo, Wanderley Marques; Cernea, Claudio Roberto; Brandão, Lenine Garcia

2014-05-01

Some primary studies compare manual and mechanical pharyngeal closures after total laryngectomy. The purpose of this study was to evaluate the advantages of the mechanical suture in pharyngeal closure. The literature survey included research in MEDLINE, EMBASE, and LILACS. The intervention analyzed was stapler-assisted pharyngeal closure, whereas the control group was manual suture pharyngeal closure. The survey resulted in 319 studies. However, 4 studies were selected (417 patients). In the group of patients in whom the stapler was used, the incidence of pharyngocutaneous fistula was 8.7%, whereas in the other, it was 22.9%, with an absolute risk reduction of 15% (95% confidence interval [CI], 0.02-0.28; p = .02; I(2) = 66%). Regarding the surgical time, the average difference was 80 minutes in favor of the stapler group (95% CI, 23.16-136.58 minutes; p < .006). The difference for starting oral feeding was 8 days in favor of the mechanical suture (95% CI, 4.01-11.73 days; p < .001). Patients who underwent mechanical suture had a shorter hospitalization period. Copyright © 2013 Wiley Periodicals, Inc.

Evaluation of rapid readout biological indicators for 132 degrees C gravity and 132 degrees C vacuum-assisted steam sterilization cycles using a new automated fluorescent reader.

PubMed

Alfa, Michelle J; Olson, Nancy; DeGagne, Pat; Jackson, Michele

2002-07-01

The primary objective of this study was to evaluate fluorescent readout results of Attest 1291 Biological Indicators (BIs) (3M Health Care, St. Paul, MN) and Attest 1296 BI test packs (containing Attest 1292 BIs) using full and fractional cycles compared with the growth data when prolonged incubation (7 days) was included. Gravity displacement and vacuum-assisted steam sterilization cycles were evaluated. A secondary objective of this study was to evaluate the new automated rapid fluorescent reader (Attest 290 Auto Reader). The rapid readout BIs for gravity displacement and vacuum-assisted steam autoclave cycles at 132 degrees C were processed using full (4 minutes) and four fractional cycles that provided 30% to 80% positive results for growth after 24 hours of incubation (48 hours of incubation for Attest 1292 BIs from the Attest 1296 test packs). Sixty of each type of BI were tested for each cycle (300 of each BI type in total). For all full steam sterilization cycles, results of the rapid fluorescent readout and the 24-hour, 48-hour, and 7-day growth tests were negative for all Attest 1291 and 1292 BIs tested. For all fractional cycles, the 24- and 48-hour growth results for the Attest 1291 and 1292 BIs, respectively, were the same as the 7-day growth results. The fractional cycle data indicated that fluorescent rapid readout was a more sensitive indicator than growth. There were rare (0.9%) false-negative results for BIs under fractional cycle conditions and these all correlated with short fractional cycle exposure times. The fluorescent rapid readout results of the 1291 BIs and 1296 BI test packs reliably predict both 24- and 48-hour and 7-day growth. These data support the value of rapid readout BIs for sterilizer monitoring for both the vacuum-assisted and the gravity displacement steam sterilization cycles. The new automated reader requires less manipulation of the BI and makes monitoring user friendly and less prone to user errors.

Traction-compression-closure for exomphalos major.

PubMed

Morabito, Antonino; Owen, Anthony; Bianchi, Adrian

2006-11-01

We present our experience with traction-compression-closure (TCC) for exomphalos major (EM) to achieve a safe and embryologically correct midline supraumbilical aesthetic closure with preservation of the umbilicus. Nineteen neonates with EM were paralyzed and ventilated. The abdominal domain was increased by upward cord traction to assist liver-bowel reduction by gravity and sac ligation, followed by circumferential elastic body binder compression. The supraumbilical abdominal wall anomaly cicatrized spontaneously or was closed surgically as a midline scar, with preservation of the umbilicus. Over 7 years (1998-2004), 19 patients with EM were treated by TCC, 18 of whom survived. The patients' median gestational age was 36 weeks (range, 24-40 weeks); their median birth weight was 2312 g (range, 890-3000 g). The median time to reduction was 4 days (range, 3-5 days), whereas that to full enteral feeds was 6 days (range, 4-6 days). Mechanical ventilation for 7 days (range, 6-8 days) was not associated with any morbidity, and the time to home discharge was 11 days (range, 8-12 days). Five patients did not require any surgery. There was no episode of sac rupture or infection. Abdominal expansion by vertical cord traction followed by compression reduction (TCC) under muscle relaxation and ventilation is time well spent toward a safe and aesthetic midline abdominal wall closure without tension for EM.

Processing and Properties of Vacuum Assisted Resin Transfer Molded Phenylethynyl Terminated Imide Composites

NASA Technical Reports Server (NTRS)

Cano, Roberto J.; Ghose, Sayata; Watson, Kent A.; Chunchu, Prasad B.; Jensen, Brian J.; Connell, John W.

2012-01-01

Polyimide composites are very attractive for applications that require a high strength to weight ratio and thermal stability. Recent work at NASA Langley Research Center (LaRC) has concentrated on developing new polyimide resin systems that can be processed without the use of an autoclave for advanced aerospace applications. Due to their low melt viscosities and long melt stability, certain phenylethynyl terminated imides (PETI) can be processed into composites using high temperature vacuum assisted resin transfer molding (HT-VARTM). VARTM has shown the potential to reduce the manufacturing cost of composite structures. In the current study, two PETI resins, LARC(Trademark) PETI-330 and LARC(Trademark) PETI-9, were infused into carbon fiber preforms at 260 C and cured at temperatures up to 371 C. Photomicrographs of polished cross sections were taken and void contents, determined by acid digestion, were below 4.5%. Mechanical properties including short block compression (SBC), compression after impact (CAI), and open hole compression (OHC) were determined at room temperature, 177 C, and 288 C. Both PETI-9 and PETI-330 composites demonstrated very good retention of mechanical properties at elevated temperatures. SBC and OHC properties after aging for 1000 hours at temperatures up to 288 C were also determined.

Modulation of Haemophilus influenzae interaction with hydrophobic molecules by the VacJ/MlaA lipoprotein impacts strongly on its interplay with the airways.

PubMed

Fernández-Calvet, Ariadna; Rodríguez-Arce, Irene; Almagro, Goizeder; Moleres, Javier; Euba, Begoña; Caballero, Lucía; Martí, Sara; Ramos-Vivas, José; Bartholomew, Toby Leigh; Morales, Xabier; Ortíz-de-Solórzano, Carlos; Yuste, José Enrique; Bengoechea, José Antonio; Conde-Álvarez, Raquel; Garmendia, Junkal

2018-05-02

Airway infection by nontypeable Haemophilus influenzae (NTHi) associates to chronic obstructive pulmonary disease (COPD) exacerbation and asthma neutrophilic airway inflammation. Lipids are key inflammatory mediators in these disease conditions and consequently, NTHi may encounter free fatty acids during airway persistence. However, molecular information on the interplay NTHi-free fatty acids is limited, and we lack evidence on the importance of such interaction to infection. Maintenance of the outer membrane lipid asymmetry may play an essential role in NTHi barrier function and interaction with hydrophobic molecules. VacJ/MlaA-MlaBCDEF prevents phospholipid accumulation at the bacterial surface, being the only system involved in maintaining membrane asymmetry identified in NTHi. We assessed the relationship among the NTHi VacJ/MlaA outer membrane lipoprotein, bacterial and exogenous fatty acids, and respiratory infection. The vacJ/mlaA gene inactivation increased NTHi fatty acid and phospholipid global content and fatty acyl specific species, which in turn increased bacterial susceptibility to hydrophobic antimicrobials, decreased NTHi epithelial infection, and increased clearance during pulmonary infection in mice with both normal lung function and emphysema, maybe related to their shared lung fatty acid profiles. Altogether, we provide evidence for VacJ/MlaA as a key bacterial factor modulating NTHi survival at the human airway upon exposure to hydrophobic molecules.

Closure of colostomy.

PubMed Central

Beck, P H; Conklin, H B

1975-01-01

We analyzed the records of 77 cases of loop colostomy closure in Vietnam War Casualties. All records were complete from the date of injury to discharge following colostomy closure. Simple of the loop colostomy was performed in 44 patients and resection of the stoma and reanastomosis of bowel segments was performed in 33 patients. Average operating time for simple closure of the loop was 70 minutes compared to 115 minutes for resection and anastomosis. Nasogastric suction was used less frequently and for a shorter time with simple loop closure. The total postoperative complication rate was 9% with simple loop closure as compared to 24% for resection and anastomosis. Simple closure of the loop described in this report is technically easier and as safe as resection of the stoma and reanastomosis. Images Fig. 1. PMID:1094967

Serum TNF-α levels and Helicobacter pylori cagA and vacA genes

NASA Astrophysics Data System (ADS)

Siregar, G. A.; Halim, S.; Sitepu, R. R.; Darmadi

2018-03-01

Helicobacter pylori is associated with higher virulence. TNF-α has an important role in host defense against H. pylori infection. The aim of this study was to investigate the relationship between TNF-α serum levels with cagA and vacA genes in H. pylori infection. This was a cross-sectional study involving 80 patients that consecutively admitted to endoscopy unit. Diagnosis of H. pylori infection was based on rapid urease test. Serum samples werecollected to determine circulating TNF-α level. Polymerase chain reaction was done to examine H. pylori vacA and cagA genes. Data analysis was carriedout using SPSS version 22 with 95%CI and p<0.05 was considered statistically significant. About 45 (56.3%) patients infected with Helicobacter pylori. There were 33 (73.3%) patients with H. pylori cagA positive. Serum TNF-α levels in patients with the H. pylori positive were significantly higher compared to H. pylori negative. Serum level of TNF-α was significantly higher in cagA positive than negative. Subjects with H. pylori cagA gene positive were more likely to have ahigher level of serum TNF-α than H. pylori cagA gene negative.

Cup detachment during vacuum-assisted vaginal delivery and birth outcome.

PubMed

Krispin, Eyal; Aviram, Amir; Salman, Lina; Chen, Rony; Wiznitzer, Arnon; Gabbay-Benziv, Rinat

2017-11-01

To determine the perinatal outcome associated with cup detachment during vacuum-assisted vaginal delivery (VAVD). A retrospective cohort study of all women attempting VAVD in a tertiary hospital (2012-2014). Singleton-term pregnancies were included. Antepartum fetal death and major fetal structural or chromosomal abnormalities were excluded. Primary outcome was neonatal birth trauma (subgaleal hematoma, subarachnoid hematoma, subdural hematoma, skull fracture, and/or erb's palsy). Secondary outcomes were maternal complications or other neonatal morbidities. Outcomes were compared between women after ≥1 cup detachment (study group) and the rest (control group). Logistic regression analysis was utilized to adjust results to potential confounders. Overall, 1779 women attempted VAVD during study period. Of them, in 146 (8.2%), the cup detached prior to delivery; 130/146 (89%) had a single detachment. After detachment, 4 (2.7%) delivered by cesarean section, 77 (52.7%) delivered after cup reapplication, and 65 (44.6%) delivered spontaneously. Women in the study group were more likely to undergo VAVD due to prolonged second stage, and were characterized by lower rates of metal cup use. Neonates in the detachment group had higher rates of subarachnoid hematoma and composite neonatal birth trauma (2.7 vs. 0.1% and 4.8 vs. 1.8%, respectively, p < 0.05). This remained significant after adjustment to potential confounders (subarachnoid hematoma aOR = 45.44, 95% CI 6.42-321.62 and neonatal birth trauma aOR = 2.62, 95% CI 1.1-6.22, p < 0.05 for all). Other neonatal and maternal morbidities were similar between groups. Cup detachment is associated with a higher rate of adverse neonatal outcome. Cup reapplication should be considered carefully.

Vacuum force

NASA Astrophysics Data System (ADS)

Han, Yongquan

2015-03-01

To study on vacuum force, we must clear what is vacuum, vacuum is a space do not have any air and also ray. There is not exist an absolute the vacuum of space. The vacuum of space is relative, so that the vacuum force is relative. There is a certain that vacuum vacuum space exists. In fact, the vacuum space is relative, if the two spaces compared to the existence of relative vacuum, there must exist a vacuum force, and the direction of the vacuum force point to the vacuum region. Any object rotates and radiates. Rotate bend radiate- centripetal, gravity produced, relative gravity; non gravity is the vacuum force. Gravity is centripetal, is a trend that the objects who attracted wants to Centripetal, or have been do Centripetal movement. Any object moves, so gravity makes the object curve movement, that is to say, the radiation range curve movement must be in the gravitational objects, gravity must be existed in non vacuum region, and make the object who is in the region of do curve movement (for example: The earth moves around the sun), or final attracted in the form gravitational objects, and keep relatively static with attract object. (for example: objects on the earth moves but can't reach the first cosmic speed).

USER'S GUIDE TO CLOSURE EVALUATION SYSTEM: CES BETA-TEST VERSION 1.0

EPA Science Inventory

The Closure Evaluation System (CES) is a decision support tool, developed by the U.S. EPA's Risk Reduction Engineering Laboratory, to assist reviewers and preparers of Resource Conservation and Recovery Act (RCRA) Part B permit applications. CES is designed to serve as a checklis...

Ambient Profiling of Phenolic Content in Tea Infusions by Matrix-Assisted Ionization in Vacuum

NASA Astrophysics Data System (ADS)

Cody, Robert B.

2018-05-01

Matrix-assisted ionization in vacuum (MAIV) was used to analyze the polyphenol content of ten different tea infusions. Nine different Camellia sinensis infusions were analyzed including three green teas, two black teas, two oolong teas, jasmine tea, and white tea. An infusion of rooibos (Aspalathus linearis) tea was also analyzed. Each freshly brewed tea was diluted 1:1 with methanol, and 100 ppm of phenolphthalein was added as an internal standard. An excess of 3-nitrobenzonitrile (NBN) was added to each vial, and the solution containing NBN crystals was analyzed by aspiration directly into the mass spectrometer sampling orifice. A working curve constructed for dilutions of catechin with phenolphthalein internal standard showed good linearity for five replicates of each concentration. The measured relative abundances of flavonoid polyphenols in each tea were in good agreement with previously reported values. Polyphenol content in tea infusions varied from 19.2 to 108.6 mg 100 mL-1. In addition to the expected catechin flavonoids, abundant quinic acid and gallic acid was detected in the C. sinensis infusions. Characteristic A. linearis flavonoids were detected in the rooibos tea.

Experimental Verification of Steel Pipe Collapse under Vacuum Pressure Conditions

NASA Astrophysics Data System (ADS)

Autrique, R.; Rodal, E.

2016-11-01

Steel pipes are used widely in hydroelectric systems and in pumping systems. Both systems are subject to hydraulic transient effects caused by changes in boundary conditions, such as sudden valve closures, pump failures, or accidents. Water column separation, and its associated vaporization pressure inside the pipe, can cause the collapse of thin walled steel pipes subject to atmospheric pressure, as happened during the well known Oigawa Power Plant accident in Japan, in 1950. The conditions under which thin walled pipes subject to external pressure can collapse have been studied mathematically since the second half of the XIX century, with classical authors Southwell and Von Mises obtaining definitive equations for long and short pipes in the second decade of the XX century, in which the fundamental variables are the diameter to thickness ratio D/t and the length to diameter ratio L/D. In this paper, the predicted critical D/t ratio for steel pipe collapse is verified experimentally, in a physical model able to reproduce hydraulic transients, generating vacuum pressures through rapid upstream valve closures.

Can post-sternotomy mediastinitis be prevented by a closed incision management system?

PubMed Central

Dohmen, Pascal M.; Markou, Thanasie; Ingemansson, Richard; Rotering, Heinrich; Hartman, Jean M.; van Valen, René; Brunott, Maaike; Kramer, Axel; Segers, Patrique

2014-01-01

Post-sternotomy mediastinitis is a serious complication after cardiothoracic surgery and contribute significantly to post-operative morbidity, mortality, and healthcare costs. Negative pressure wound therapy is today’s golden standard for post-sternotomy mediastinitis treatment. A systematic literature search was conducted at PubMed until October 2012 to analyse whether vacuum-assisted closure technique prevents mediastinitis after clean surgical incisions closure. Today’s studies showed reduction of post-sternotomy mediastinitis including a beneficial socio-economic impact. Current studies, however included only high-risk patients, hence furthermore, larger randomised controlled trials are warranted to clarify the benefit for using surgical incision vacuum management systems in the general patient population undergoing sternotomy and clarify risk factor interaction. PMID:25285263

TNP-assisted fascial closure in a patient with acute abdomen and abdominal compartment syndrome.

PubMed

Gourgiotis, S; Villias, C; Benetatos, C; Tsakiris, A; Parisis, C; Aloizos, S; Salemis, N S

2009-02-01

Topical negative pressure was applied to prevent abdominal compartment syndrome in a patient following surgery for an acute abdomen. It delayed fascial closure, protected the underlying bowel and facilitated abdominal re-entry.

Interferometric Imaging Directly with Closure Phases and Closure Amplitudes

NASA Astrophysics Data System (ADS)

Chael, Andrew A.; Johnson, Michael D.; Bouman, Katherine L.; Blackburn, Lindy L.; Akiyama, Kazunori; Narayan, Ramesh

2018-04-01

Interferometric imaging now achieves angular resolutions as fine as ∼10 μas, probing scales that are inaccessible to single telescopes. Traditional synthesis imaging methods require calibrated visibilities; however, interferometric calibration is challenging, especially at high frequencies. Nevertheless, most studies present only a single image of their data after a process of “self-calibration,” an iterative procedure where the initial image and calibration assumptions can significantly influence the final image. We present a method for efficient interferometric imaging directly using only closure amplitudes and closure phases, which are immune to station-based calibration errors. Closure-only imaging provides results that are as noncommittal as possible and allows for reconstructing an image independently from separate amplitude and phase self-calibration. While closure-only imaging eliminates some image information (e.g., the total image flux density and the image centroid), this information can be recovered through a small number of additional constraints. We demonstrate that closure-only imaging can produce high-fidelity results, even for sparse arrays such as the Event Horizon Telescope, and that the resulting images are independent of the level of systematic amplitude error. We apply closure imaging to VLBA and ALMA data and show that it is capable of matching or exceeding the performance of traditional self-calibration and CLEAN for these data sets.

40 CFR 264.1202 - Closure and post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

40 CFR 264.1202 - Closure and post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

40 CFR 264.1202 - Closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

40 CFR 264.1202 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES Hazardous Waste Munitions and Explosives Storage § 264.1202 Closure and post-closure care. (a) At... it remains in service as a munitions or explosives magazine or storage unit. (b) If, after removing...

Immunogenicity of Sci-B-Vac (a Third-Generation Hepatitis B Vaccine) in HIV-Positive Adults.

PubMed

Alon, Danny; Stein, Gideon Y; Hadas-Golan, Vered; Tau, Luba; Brosh, Tal; Turner, Dan

2017-03-01

Guidelines recommend hepatitis B virus (HBV) vaccination of all adults positive for human immunodeficiency virus (HIV). Immune responses to single-antigen HBV vaccine among HIV-positive patients are low when compared with HIV-negative adults. Sci-B-Vac™ is a recombinant third-generation HBV that may be advantageous in this population. To examine the immune responses to Sci-B-Vac among HIV-positive adults. We conducted a prospective cohort study involving HIV-positive adults who had negative HBV serology (HBSAg, HBSAb, HBcoreAb). Sci-B-Vac at 10 µg/dose was administered intramuscularly upon recruitment and after 1 and 6 months. HBSAb levels were checked 1 month after each dose; a level > 10 mlU/ml was considered protective. Data regarding age, gender, CD4 level, and viral load were collected. The study group comprised 31 patients. Average CD4 count was 503 ± 281 cells/ml, and average viral load was 44 copies/ml. Median interquartile range (IQR) HBVAb titers after the first, second and third immunizations were 0 (0, 3.5), 30 (6, 126) and 253 (81, 408) mlU/ml. Significant titer elevations were found between the second and third immunizations (P = 0.0003). The rate of patients considered protected was 16% after the first, 65% after the second (P < 0.0001), and 84% after the third dose (P = 0.045). No adverse events were reported. More patients under the age of 40 years responded to the first immunization (28% vs. 0%, P = 0.038). CD4 level had no influence on immunization rates. Sci-B-Vac might achieve better immunization rates among HIV-positive adults compared to the single-antigen vaccine and thus deserves further evaluation in a randomized, double-blind study in this population.

[Application research of presacral space drainage tube combined with subcutaneous vacuum pressure suction in the laparoscopic-assisted abdominoperineal resection].

PubMed

Chen, Liqi; Zeng, Changqing; Chi, Liangjie; Huang, Liangxiang; Li, Jiandang

2017-08-25

To study the management for the perineal incision after laparoscopic-assisted abdominoperineal resection for rectal cancer. Clinical data of 87 patients undergoing laparoscopic Miles operation for lower rectal cancer from June 2009 to February 2014 were collected and studied. Presacral space drainage group: presacral space drainage tube was applied in 42 patients. Combined drainage group: presacral space drainage tube combined with subcutaneous vacuum pressure suction was applied in 45 cases. In combined drainage group, except the presacral drainage tube, another drainage tube was placed subcutaneously and connected to a negative pressure ball, which was fixed on the lateral anterior of perineal wound by the further incision and drainage. After subcutaneous tube was placed for 2 weeks, as drainage fluid was limpid and <15 ml/d for 3 days, meanwhile no obvious pelvic fluid was detected by ultrasound, and the wound healed quite well without redness and edema, then the subcutaneous tube with the negative pressure ball could be removed. There were 51 males and 36 females with the mean age of 26-78(56.9±10.8) years old. The laparoscopic Miles operation was successfully completed in all the cases without death and complications. The drainage tube was placed for 4-13(8.0±2.5) days in presacral space drainage group, and for 4-14(6.7±2.4) days in combined drainage group. The subcutaneous tube was placed for 14-24(15.8±3.0) days. The primary healing rate of perineal wound in presacral space drainage group and combined drainage group was 66.7%(28/42) and 91.1%(41/45) respectively, while the perineal wound infection rate was 21.4%(9/42) and 4.4%(2/45) respectively, whose differences between two groups were both significant (χ 2 =7.911, P=0.005 and χ 2 =5.674, P=0.017). Presacral space drainage tube combined with subcutaneous vacuum pressure suction in laparoscopic-assisted abdominoperineal resection for rectal cancer has better efficacy and lower infection rate for

Quick actuating closure

NASA Technical Reports Server (NTRS)

White, III, Dorsey E. (Inventor); Updike, deceased, Benjamin T. (Inventor); Allred, Johnny W. (Inventor)

1989-01-01

A quick actuating closure for a pressure vessel 80 in which a wedge ring 30 with a conical outer surface 31 is moved forward to force shear blocks 40, with conical inner surfaces 41, radially outward to lock an end closure plug 70 within an opening 81 in the pressure vessel 80. A seal ring 60 and a preload ramp 50 sit between the shear blocks 40 and the end closure plug 70 to provide a backup sealing capability. Conical surfaces 44 and 55 of the preload ramp 50 and the shear blocks 40 interact to force the seal ring 60 into shoulders 73 and 85 in the end closure plug 70 and opening 81 to form a tight seal. The end closure plug 70 is unlocked by moving the wedge ring 30 rearward, which causes T-bars 32 of the wedge ring 30 riding within T -slots 42 of the shear blocks 40 to force them radially inward. The end closure plug 70 is then removed, allowing access to the interior of the pressure vessel 80.

Sonographically-guided vacuum-assisted biopsy with digital mammography-guided skin marking of suspicious breast microcalcifications: comparison of outcomes with stereotactic biopsy in Asian women.

PubMed

Hahn, Soo Yeon; Shin, Jung Hee; Han, Boo-Kyung; Ko, Eun Young

2011-02-01

Management of suspicious microcalcifications in very thin breasts is problematic. To evaluate whether sonographically-guided vacuum-assisted biopsy (USVAB) with digital mammography-guided skin marking (DM) for the diagnosis of breast microcalcifications is comparable to stereotactic-guided vacuum-assisted biopsy (SVAB) in Asian women with thin breasts. Retrospective review was performed for 263 consecutive suspicious microcalcification lesions in 261 women who underwent USVAB with DM or SVAB using a prone table between January 2004 and December 2007. SVAB was performed for 190 lesions and USVAB for 73 lesions. Biopsy results were correlated with surgical pathology or followed up for at least 12 months. The diagnostic outcomes of SVAB and USVAB to diagnose microcalcifications were compared. Of 263 lesions, 104 (40%) underwent surgery and 159 (60%) were followed up. SVAB and USVAB groups showed similar final categories or the extent of microcalcifications. US visible lesions were 57 (78%) of 73 at USVAB and 14 (10%) of 140 at SVAB. Of 57 US visible lesions at USVAB, 29 (51%) were not found in initial US but were detectable with the help of DM. Specimen radiographs were negative in 2.1% of lesions at SVAB and in 4.1% at USVAB (p=0.4008). The under-estimation rate and false-negative rate were similar in SVAB and USVAB. US with DM facilitates US visibility of microcalcifications. USVAB with DM can produce acceptable biopsy results, as can SVAB, to diagnose breast microcalcifications in patients with thin breasts.

Gestalt concept of closure: a construct without closure.

PubMed

Wasserstein, Jeanette

2002-12-01

This comment reviews the original Gestalt literature which introduced the concept of 'closure'. It is argued that the meaning of 'closure' was confounded in the source literature and, thus, the term connotes more than it denotes. Research based on different measures of this ambiguous construct inevitably may not always converge.

Port closure techniques.

PubMed

Shaher, Z

2007-08-01

Laparoscopic trocars do create wounds. This article aims to review and list different techniques used for closure of the fascia incision at trocar sites. A literature search was performed for articles dealing with closure techniques. The author searched this subject in English on Medline by combining the words "trocar" and "hernia," as well as "Deschamps" and "Reverdin." All articles reporting techniques with their references were reviewed. The articles described many techniques in addition to classical closure using curved needles, including Grice needle, Maciol needles, Endoclose device, Carter-Thomason device, Tahoe ligature device, Endo-Judge device, eXit puncture closure device, Lowsley retractor, spinal cord needles, dual hemostat, suture carrier, Riverdin and Deschamps needles, and Gore-Tex closure device. Three main groups of techniques were found with favor of extracorporeal manipulations under direct visualization. Old methods are sufficient and cost-effective.

A vacuum microgripping tool with integrated vibration releasing capability

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

Rong, Weibin; Fan, Zenghua, E-mail: zenghua-fan@163.com; Wang, Lefeng

2014-08-01

Pick-and-place of micro-objects is a basic task in various micromanipulation demands. Reliable releasing of micro-objects is usually disturbed due to strong scale effects. This paper focuses on a vacuum micro-gripper with vibration releasing functionality, which was designed and assembled for reliable micromanipulation tasks. Accordingly, a vibration releasing strategy of implementing a piezoelectric actuator on the vacuum microgripping tool is presented to address the releasing problem. The releasing mechanism was illustrated using a dynamic micro contact model. This model was developed via theoretical analysis, simulations and pull-off force measurement using atomic force microscopy. Micromanipulation experiments were conducted to verify the performancemore » of the vacuum micro-gripper. The results show that, with the assistance of the vibration releasing, the vacuum microgripping tool can achieve reliable release of micro-objects. A releasing location accuracy of 4.5±0.5 μm and a successful releasing rate of around 100% (which is based on 110 trials) were achieved for manipulating polystyrene microspheres with radius of 35–100 μm.« less

vacA genotypes of Helicobacter pylori in the oral cavity and stomach of patients with chronic gastritis and gastric ulcer.

PubMed

Román-Román, Adolfo; Giono-Cerezo, Silvia; Camorlinga-Ponce, Margarita; Martínez-Carrillo, Dinorah Nashely; Loaiza-Loeza, Salome; Fernández-Tilapa, Gloria

2013-03-01

Helicobacter pylori adheres to various components of the human saliva. Therefore, the objective of this research was to simultaneously detect H. pylori in saliva and in gastric biopsy, and to determine the agreement between the vacA genotypes in both saliva and gastric biopsy. A total of 162 patients with chronic gastritis and 34 with gastric ulcer were studied, and saliva and biopsy samples were collected from each patient. H. pylori DNA was detected by conventional PCR and nested PCR was used for vacA genotyping. In 24% of the patients (47/196) H. pylori DNA was found in saliva and in biopsy; 52.5% (103/196) were saliva(negative)/biopsy(positive) and 6.6% (13/196) were saliva(positive)/biopsy(negative). In either or both H. pylori vacAs1m1 or s1m2 genotypes were detected in saliva in 41.5% of the patients with chronic gastritis. Forty-seven percent had >1 genotype, and the s1m1/s1m2 combination was found in 36% of them. H. pylori vacAs1m1 and s1m2 were also found in the saliva and biopsy of patients with gastric ulcer. The genotypes found in saliva and biopsy of the same patient had 51.1% agreement. In 27.6% of the 47 patients saliva(positive)/biopsy(positive) two genotypes were found in saliva, and one or both in the stomach. The s1m1/s1m2 genotypes, alone or together, are found simultaneously in saliva and gastric biopsy of the same patient. These results suggest that H. pylori reaches the oral cavity by various ways, and that saliva can be the transmitting and re-infecting vector. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Predictive Accuracy of the Veterans Aging Cohort Study (VACS) Index for Mortality with HIV Infection: A North American Cross Cohort Analysis

PubMed Central

Justice, AC; Modur, S; Tate, JP; Althoff, KN; Jacobson, LP; Gebo, K; Kitahata, M; Horberg, M; Brooks, J; Buchacz, K; Rourke, SB; Rachlis, A; Napravnik, S; Eron, J; Willig, H; Moore, R; Kirk, GD; Bosch, R; Rodriguez, B; Hogg, RS; Thorne, J; Goedert, JJ; Klein, M; Gill, MJ; Deeks, S; Sterling, TR; Anastos, K; Gange, SJ

2013-01-01

Background By supplementing an index composed of HIV biomarkers and age (Restricted Index) with measures of organ injury, the Veterans Aging Cohort Study (VACS) Index more completely reflects risk of mortality. We compare the accuracy of the VACS and Restricted Indices 1) among subjects outside the Veterans Healthcare System (VA), 2) over 1–5 years of prior exposure to antiretroviral therapy (ART), and 3) within important patient subgroups. Methods We used data from 13 cohorts in the North American AIDS Cohort Collaboration (NA-ACCORD, n=10, 835) limiting analyses to HIV-infected subjects with at least 12 months exposure to ART. Variables included demographic, laboratory (CD4 count, HIV-1 RNA, hemoglobin, platelets, aspartate and alanine transaminase, creatinine and hepatitis C status), and survival. We used C statistic and net reclassification improvement (NRI) to test discrimination varying prior ART exposure from 1–5 years. We then combined VA (n=5,066) and NA-ACCORD data, fit a parametric survival model, and compared predicted to observed mortality by cohort, gender, age, race, and HIV-1 RNA level. Results Mean follow-up was 3.3 years (655 deaths). Compared with the Restricted Index, the VACS Index showed greater discrimination (C statistic: 0.77 vs. 0.74; NRI 12%; p<0.0001). NRI was highest among those with HIV-1 RNA<500 copies/ml (25%) and age ≥50 years (20%). Predictions were similar to observed mortality among all subgroups. Conclusion VACS Index scores discriminate risk and translate into accurate mortality estimates over 1–5 years of exposures to ART and for diverse patient subgroups from North American PMID:23187941

Distribution of Helicobacter pylori cagA, cagE, oipA and vacA in different major ethnic groups in Tehran, Iran.

PubMed

Dabiri, Hossein; Maleknejad, Parviz; Yamaoka, Yoshio; Feizabadi, Mohammad M; Jafari, Fereshteh; Rezadehbashi, Maryam; Nakhjavani, Farrokh A; Mirsalehian, Akbar; Zali, Mohammad R

2009-08-01

There are geographical variations in Helicobacter pylori virulence genes; cagA, cagE, vacA and oipA. The present study compared the distribution of these genotypes in major ethnic groups residing in Tehran, Iran and their association with clinical outcomes. A total of 124 H. pylori-positive patients living in Tehran were enrolled in this study. The ethnic distribution was 74 Persians, 33 Turks and 17 other ethnics including Kurds, Lurs, Afghanis and Arabs. The presence of the cagA, cagE and oipA genes and vacA alleles (signal [s] and middle [m] region) were determined by polymerase chain reaction (PCR) from H. pylori DNA. The cagA-positive status was predominant in all three ethnic groups (e.g. 65% in Persians and 73% in Turks). In contrast, the cagE-positive status was less than half in Persians (47%) and Turks (30%), whereas it was 77% in other ethnicities (P = 0.008). The predominant vacA genotypes were s1 and m1 in all three ethnic groups (e.g. 68% in Persians and 70% in Turks were s1). There was no significant association between cagA and cagE status or vacA genotypes and clinical outcomes. The oipA-positive strains were more common in non-ulcer dyspepsia (NUD) (63%) than in peptic ulcer patients (15%) (P = 0.001) in Persians, but the association was not observed in other ethnic groups. There are some differences in the H. pylori genotypes among the ethnic groups in Iran. However, none of these markers seemed to be clinically helpful in predicting the clinical presentation of a H. pylori infection in Iran.

Enterocutaneous fistula: are treatments improving?

PubMed

Draus, John M; Huss, Sara A; Harty, Niall J; Cheadle, William G; Larson, Gerald M

2006-10-01

We studied the etiology, treatment, and outcome of enterocutaneous fistulas in 106 patients to evaluate our current practice and the impact of newer therapies-octreotide, wound vacuum-assisted closure (VAC), and fibrin glue-on clinical outcomes. Review of the literature and our own 1990 study indicate a mortality rate of 5% to 20% for enterocutaneous fistula, and a healing rate of 75% to 85% after definitive surgery. We reviewed all cases of gastrointestinal-cutaneous fistula from 1997 to 2005 at 2 large teaching hospitals. We identified 106 patients with enterocutaneous fistula; patients with irritable bowel disease and anorectal fistulas were excluded. The origin of the fistula was the small bowel in 67 patients, colon in 26, stomach in 8, and duodenum in 5. The etiology of the fistula was previous operation in 81 patients, trauma in 15, hernia mesh erosion in 6, diverticulitis in 2, and radiation in 2. Of the 106 patients in the study, 31 had a high output fistula (greater than 200 mL/day), 44 had a low output fistula, and, in 31 patients, the fistula output was low but there was no record of volume. Initial treatment was nonoperative except for patients with an abscess who needed urgent drainage. In 24 patients, the effect of octreotide was monitored: in 8 patients, fistula output declined; in 16 patients, octreotide was of no benefit. Fibrin glue was used in 8 patients and was of benefit to 1. The wound VAC was used in 13 patients: 12 patients still required operative repair of the fistula, whereas the fistula was healed in 1 patient. The main benefit of the VAC system was improved wound care in all patients before definitive surgery. Total parenteral nutrition was used in most patients to provide nutritional support. Operative repair was performed in 77 patients and was successful in 69 (89%), failing in 6 patients with persistent cancer or infection. Nonoperative treatment was used in 29 patients and resulted in healing in 60%. Of 106 patients, 7 (7%) died

Chemical changes exhibited by latent fingerprints after exposure to vacuum conditions.

PubMed

Bright, Nicholas J; Willson, Terry R; Driscoll, Daniel J; Reddy, Subrayal M; Webb, Roger P; Bleay, Stephen; Ward, Neil I; Kirkby, Karen J; Bailey, Melanie J

2013-07-10

The effect of vacuum exposure on latent fingerprint chemistry has been evaluated. Fingerprints were analysed using a quartz crystal microbalance to measure changes in mass, gas chromatography mass spectrometry to measure changes in lipid composition and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) to determine changes in the content of water, fatty acids and their esters after exposure to vacuum. The results are compared with samples aged under ambient conditions. It was found that fingerprints lose around 26% of their mass when exposed to vacuum conditions, equivalent to around 5 weeks ageing under ambient conditions. Further exposure to vacuum causes a significant reduction in the lipid composition of a fingerprint, in particular with the loss of tetradecanoic and pentadecanoic acid, that was not observed in ambient aged samples. There are therefore implications for sequence in which fingerprint development procedures (for example vacuum metal deposition) are carried out, as well as the use of vacuum based methods such as secondary ion mass spectrometry (SIMS) and matrix-assisted laser desorption ionisation (MALDI) in the study of fingerprint chemistry. Copyright © 2013. Published by Elsevier Ireland Ltd.

Initial Experience with a Wireless Ultrasound-Guided Vacuum-Assisted Breast Biopsy Device

PubMed Central

Choi, E-Ryung; Han, Boo-Kyung; Ko, Eun Sook; Ko, Eun Young; Choi, Ji Soo; Cho, Eun Yoon; Nam, Seok Jin

2015-01-01

Objective To determine the imaging characteristic of frequent target lesions of wireless ultrasound (US)-guided, vacuum-assisted breast biopsy (Wi-UVAB) and to evaluate diagnostic yield, accuracy and complication of the device in indeterminate breast lesions. Materials and Methods From March 2013 to October 2014, 114 women (age range, 29–76 years; mean age, 50.0 years) underwent Wi-UVAB using a 13-gauge needle (Mammotome Elite®; Devicor Medical Products, Cincinnati, OH, USA). In 103 lesions of 96 women with surgical (n = 81) or follow-up (n = 22) data, complications, biopsy procedure, imaging findings of biopsy targets and histologic results were reviewed. Results Mean number of biopsy cores was 10 (range 4–25). Nine patients developed moderate bleeding. All lesions were suspicious on US, and included non-mass lesions (67.0%) and mass lesions (33.0%). Visible calcifications on US were evident in 57.3% of the target lesions. Most of the lesions (93.2%) were nonpalpable. Sixty-six (64.1%) were malignant [ductal carcinoma in situ (DCIS) rate, 61%] and 12 were high-risk lesions (11.7%). Histologic underestimation was identified in 11 of 40 (27.5%). DCIS cases and in 3 of 9 (33.3%) high-risk lesions necessitating surgery. There was no false-negative case. Conclusion Wi-UVAB is very handy and advantageous for US-unapparent non-mass lesions to diagnose DCIS, especially for calcification cases. Histologic underestimation is unavoidable; still, Wi-UVAB is safe and accurate to diagnose a malignancy. PMID:26630136

Prevalence of Helicobacter pylori vacA Genotypes and cagA Gene in Dental Plaque of Asymptomatic Mexican Children.

PubMed

Mendoza-Cantú, Alejandra; Urrutia-Baca, Víctor Hugo; Urbina-Ríos, Cynthia Sofía; De la Garza-Ramos, Myriam Angélica; García-Martínez, Martha Elena; Torre-Martínez, Hilda H H

2017-01-01

The variability in Helicobacter pylori vacA and cagA genes has been related to the progression of the gastrointestinal disease; also the presence of H. pylori in the oral cavity has been associated with periodontal disease in adults, but, in children without dyspeptic symptoms, little is known about this. We evaluated the prevalence of H. pylori and the presence of vacA / cagA genotypes in the oral cavity of Mexican children without dyspeptic symptoms. The gingival status was measured, and dental plaque samples ( n = 100) were taken. 38% of children were positive for H. pylori 16S rRNA gene by qPCR. A significant association between H. pylori oral infection and gingival status was observed ( P < 0.001). In 34.6% (9/26) of mild gingivitis cases, s1m2 genotype was found, while s1m1 was typed in 50% (3/6) of moderate gingivitis. The cagA prevalence among H. pylori -positive children was 80.8% (21/26), 83.3% (5/6), and 16.7% (1/6) of cases of mild gingivitis, moderate gingivitis, and nongingivitis, respectively ( P < 0.001). The s1m1/cagA + combinational genotype was the most detected in children with gingivitis. Our results suggest that the prevalence of H. pylori and detection of vacA/cagA genotypes-associated gastrointestinal disease in the oral cavity could be related to the progression of gingivitis in asymptomatic children.

Prevalence of Helicobacter pylori vacA Genotypes and cagA Gene in Dental Plaque of Asymptomatic Mexican Children

PubMed Central

Mendoza-Cantú, Alejandra; Urbina-Ríos, Cynthia Sofía; García-Martínez, Martha Elena; Torre-Martínez, Hilda H. H.

2017-01-01

The variability in Helicobacter pylori vacA and cagA genes has been related to the progression of the gastrointestinal disease; also the presence of H. pylori in the oral cavity has been associated with periodontal disease in adults, but, in children without dyspeptic symptoms, little is known about this. We evaluated the prevalence of H. pylori and the presence of vacA/cagA genotypes in the oral cavity of Mexican children without dyspeptic symptoms. The gingival status was measured, and dental plaque samples (n = 100) were taken. 38% of children were positive for H. pylori 16S rRNA gene by qPCR. A significant association between H. pylori oral infection and gingival status was observed (P < 0.001). In 34.6% (9/26) of mild gingivitis cases, s1m2 genotype was found, while s1m1 was typed in 50% (3/6) of moderate gingivitis. The cagA prevalence among H. pylori-positive children was 80.8% (21/26), 83.3% (5/6), and 16.7% (1/6) of cases of mild gingivitis, moderate gingivitis, and nongingivitis, respectively (P < 0.001). The s1m1/cagA+ combinational genotype was the most detected in children with gingivitis. Our results suggest that the prevalence of H. pylori and detection of vacA/cagA genotypes-associated gastrointestinal disease in the oral cavity could be related to the progression of gingivitis in asymptomatic children. PMID:29226140

40 CFR 264.197 - Closure and post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 264.197 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES... as hazardous waste, unless § 261.3(d) of this chapter applies. The closure plan, closure activities...

Augmented Method to Improve Thermal Data for the Figure Drift Thermal Distortion Predictions of the JWST OTIS Cryogenic Vacuum Test

NASA Technical Reports Server (NTRS)

Park, Sang C.; Carnahan, Timothy M.; Cohen, Lester M.; Congedo, Cherie B.; Eisenhower, Michael J.; Ousley, Wes; Weaver, Andrew; Yang, Kan

2017-01-01

The JWST Optical Telescope Element (OTE) assembly is the largest optically stable infrared-optimized telescope currently being manufactured and assembled, and is scheduled for launch in 2018. The JWST OTE, including the 18 segment primary mirror, secondary mirror, and the Aft Optics Subsystem (AOS) are designed to be passively cooled and operate near 45K. These optical elements are supported by a complex composite backplane structure. As a part of the structural distortion model validation efforts, a series of tests are planned during the cryogenic vacuum test of the fully integrated flight hardware at NASA JSC Chamber A. The successful ends to the thermal-distortion phases are heavily dependent on the accurate temperature knowledge of the OTE structural members. However, the current temperature sensor allocations during the cryo-vac test may not have sufficient fidelity to provide accurate knowledge of the temperature distributions within the composite structure. A method based on an inverse distance relationship among the sensors and thermal model nodes was developed to improve the thermal data provided for the nanometer scale WaveFront Error (WFE) predictions. The Linear Distance Weighted Interpolation (LDWI) method was developed to augment the thermal model predictions based on the sparse sensor information. This paper will encompass the development of the LDWI method using the test data from the earlier pathfinder cryo-vac tests, and the results of the notional and as tested WFE predictions from the structural finite element model cases to characterize the accuracies of this LDWI method.

A novel vacuum assisted closure therapy model for use with percutaneous devices.

PubMed

Cook, Saranne J; Nichols, Francesca R; Brunker, Lucille B; Bachus, Kent N

2014-06-01

Long-term maintenance of a dermal barrier around a percutaneous prosthetic device remains a common clinical problem. A technique known as Negative Pressure Wound Therapy (NPWT) uses negative pressure to facilitate healing of impaired and complex soft tissue wounds. However, the combination of using negative pressure with percutaneous prosthetic devices has not been investigated. The goal of this study was to develop a methodology to apply negative pressure to the tissues surrounding a percutaneous device in an animal model; no tissue healing outcomes are presented. Specifically, four hairless rats received percutaneous porous coated titanium devices implanted on the dorsum and were bandaged with a semi occlusive film dressing. Two of these animals received NPWT; two animals received no NPWT and served as baseline controls. Over a 28-day period, both the number of dressing changes required between the two groups as well as the pressures were monitored. Negative pressures were successfully applied to the periprosthetic tissues in a clinically relevant range with a manageable number of dressing changes. This study provides a method for establishing, maintaining, and quantifying controlled negative pressures to the tissues surrounding percutaneous devices using a small animal model. Published by Elsevier Ltd.

Helicobacter pylori vacA s1a and s1b alleles from clinical isolates from different regions of Chile show a distinct geographic distribution

PubMed Central

Díaz, MI; Valdivia, A; Martínez, P; Palacios, JL; Harris, P; Novales, J; Garrido, E; Valderrama, D; Shilling, C; Kirberg, A; Hebel, E; Fierro, J; Bravo, R; Siegel, F; Leon, G; Klapp, G; Venegas, A

2005-01-01

AIM: To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers. METHODS: Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing. RESULTS: The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India. CONCLUSION: Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal. PMID:16419167

Impact of Different Standard Type A7A Drum Closure-Ring Practices on Gasket Contraction and Bolt Closure Distance– 15621

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

Ketusky, Edward; Blanton, Paul; Bobbitt, John H.

The Department of Energy, the Savannah River National Laboratory, several manufacturers of specification drums, and the United States Department of Transportation (DOT) are collaborating in the development of a guidance document for DOE contractors and vendors who wish to qualify containers to DOT 7A Type A requirements. Currently, the effort is focused on DOT 7A Type A 208-liter (55-gallons) drums with a standard 12-gauge bolted closure ring. The U.S. requirements, contained in Title 49, Part 178.350 “Specification 7A; general packaging, Type A specifies a competent authority review of the packaging is not required for the transport of (Class 7) radioactivemore » material containing less than Type A quantities of radioactive material. For Type AF drums, a 4 ft. regulatory free drop must be performed, such that the drum “suffers maximum damage.” Although the actual orientation is not defined by the specification, recent studies suggest that maximum damage would result from a shallow angle top impact, where kinetic energy is transferred to the lid, ultimately causing heavy damage to the lid, or even worse, causing the lid to come off. Since each vendor develops closure recommendations/procedures for the drums they manufacture, key parameters applied to drums during closing vary based on vendor. As part of the initial phase of the collaboration, the impact of the closure variants on the ability of the drum to suffer maximum damage is investigated. Specifically, closure testing is performed varying: 1) the amount of torque applied to the closure ring bolt; and, 2) stress relief protocol, including: a) weight of hammer; and, b) orientation that the hammer hits the closure ring. After closure, the amount of drum lid gasket contraction and the distance that the closure bolt moves through the closure ring is measured.« less

Molecular Weight Cut-Off and Structural Analysis of Vacuum-Assisted Titania Membranes for Water Processing

PubMed Central

Abd Jalil, Siti Nurehan; Wang, David K.; Yacou, Christelle; Motuzas, Julius; Smart, Simon; Diniz da Costa, João C.

2016-01-01

This work investigates the structural formation and analyses of titania membranes (TM) prepared using different vacuum exposure times for molecular weight (MW) cut-off performance and oil/water separation. Titania membranes were synthesized via a sol-gel method and coated on macroporous alumina tubes followed by exposure to a vacuum between 30 and 1200 s and then calcined at 400 °C. X-ray diffraction and nitrogen adsorption analyses showed that the crystallite size and particle size of titania increased as a function of vacuum time. All the TM membranes were mesoporous with an average pore diameter of ~3.6 nm with an anatase crystal morphology. Water, glucose, sucrose, and polyvinylpyrrolidone with 40 and 360 kDa (PVP-40 kDa and PVP-360 kDa) were used as feed solutions for MW cut-off and hexadecane solution for oil filtration investigation. The TM membranes were not able to separate glucose and sucrose, thus indicating the membrane pore sizes are larger than the kinetic diameter of sucrose of 0.9 nm, irrespective of vacuum exposure time. They also showed only moderate rejection (20%) of the smaller PVP-40 kDa, however, all the membranes were able to obtain an excellent rejection of near 100% for the larger PVP-360 kDa molecule. Furthermore, the TM membranes were tested for the separation of oil emulsions with a high concentration of oil (3000 ppm), reaching high oil rejections of more than 90% of oil. In general, the water fluxes increased with the vacuum exposure time indicating a pore structural tailoring effect. It is therefore proposed that a mechanism of pore size tailoring was formed by an interconnected network of Ti–O–Ti nanoparticles with inter-particle voids, which increased as TiO2 nanoparticle size increased as a function of vacuum exposure time, and thus reduced the water transport resistance through the TM membranes. PMID:28774057

Indian Vacuum Society: The Indian Vacuum Society

NASA Astrophysics Data System (ADS)

Saha, T. K.

2008-03-01

The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of

40 CFR 264.280 - Closure and post-closure care.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Closure and post-closure care. 264.280 Section 264.280 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES... § 264.278, except that soil-pore liquid monitoring may be terminated 90 days after the last application...

Vacuum-assisted decellularization: an accelerated protocol to generate tissue-engineered human tracheal scaffolds.

PubMed

Butler, Colin R; Hynds, Robert E; Crowley, Claire; Gowers, Kate H C; Partington, Leanne; Hamilton, Nicholas J; Carvalho, Carla; Platé, Manuela; Samuel, Edward R; Burns, Alan J; Urbani, Luca; Birchall, Martin A; Lowdell, Mark W; De Coppi, Paolo; Janes, Sam M

2017-04-01

Patients with large tracheal lesions unsuitable for conventional endoscopic or open operations may require a tracheal replacement but there is no present consensus of how this may be achieved. Tissue engineering using decellularized or synthetic tracheal scaffolds offers a new avenue for airway reconstruction. Decellularized human donor tracheal scaffolds have been applied in compassionate-use clinical cases but naturally derived extracellular matrix (ECM) scaffolds demand lengthy preparation times. Here, we compare a clinically applied detergent-enzymatic method (DEM) with an accelerated vacuum-assisted decellularization (VAD) protocol. We examined the histological appearance, DNA content and extracellular matrix composition of human donor tracheae decellularized using these techniques. Further, we performed scanning electron microscopy (SEM) and biomechanical testing to analyze decellularization performance. To assess the biocompatibility of scaffolds generated using VAD, we seeded scaffolds with primary human airway epithelial cells in vitro and performed in vivo chick chorioallantoic membrane (CAM) and subcutaneous implantation assays. Both DEM and VAD protocols produced well-decellularized tracheal scaffolds with no adverse mechanical effects and scaffolds retained the capacity for in vitro and in vivo cellular integration. We conclude that the substantial reduction in time required to produce scaffolds using VAD compared to DEM (approximately 9 days vs. 3-8 weeks) does not compromise the quality of human tracheal scaffold generated. These findings might inform clinical decellularization techniques as VAD offers accelerated scaffold production and reduces the associated costs. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Stump closure of a thick pancreas using stapler closure increases pancreatic fistula after distal pancreatectomy.

PubMed

Kawai, Manabu; Tani, Masaji; Okada, Ken-ichi; Hirono, Seiko; Miyazawa, Motoki; Shimizu, Astusi; Kitahata, Yuji; Yamaue, Hiroki

2013-09-01

The appropriate surgical stump closure after distal pancreatectomy (DP) is still controversial. This study investigated the benefits and risks of stapler closure during DP. The risk factors of pancreatic fistulas were investigated in 122 DPs among 3 types of stump closure: hand-sewn suture (n = 32), bipolar scissors (n = 45), and stapler closure (n = 45). There was no significant difference in the incidence of pancreatic fistula between the 3 types of stump closure (hand-sewn suture [44%] vs bipolar scissors [37.7%] vs stapler closure [35.5%]). By using receiver operating characteristics curves, 12 mm was the best cutoff value of the thickness of the pancreas for pancreatic fistulas after DP using stapler closure. Three factors (ie, male sex, body mass index >25 kg/m(2), and stapler closure) were independent risk factors of pancreatic fistulas after DP with a pancreas thicker than 12 mm. A pancreas thicker than 12 mm significantly increased the incidence of pancreatic fistulas after DP using stapler closure. Copyright © 2013 Elsevier Inc. All rights reserved.

Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury.

PubMed

Eliya-Masamba, Martha C; Banda, Grace W

2013-10-22

Acute traumatic wounds are one of the common reasons why people present to the emergency department. Primary closure has traditionally been reserved for traumatic wounds presenting within six hours of injury and considered 'clean' by the attending surgeon, with the rest undergoing delayed primary closure as a means of controlling wound infection. Primary closure has the potential benefit of rapid wound healing but poses the potential threat of increased wound infection. There is currently no evidence to guide clinical decision-making on the best timing for closure of traumatic wounds. To determine the effect on time to healing of primary closure versus delayed closure for non bite traumatic wounds presenting within 24 hours post injury. To explore the adverse effects of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours post injury. In May 2013, for this first update we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. There were no restrictions with respect to language, date of publication or study setting. Randomised controlled trials comparing primary closure with delayed closure of non bite traumatic wounds. Two review authors independently evaluated the results of the searches against the inclusion criteria. No studies met the inclusion criteria for this review. Since no studies met the inclusion criteria, neither a meta-analysis nor a narrative description of studies was possible. There is currently no systematic evidence to guide clinical decision-making regarding the timing for closure of traumatic wounds. There is a need for robust research to investigate the effect of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours of injury.

Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipo-lymphedema.

PubMed

Wollina, Uwe; Heinig, Birgit; Schönlebe, Jaqueline; Nowak, Andreas

2014-01-01

Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas.

Vacuum decay container/closure integrity testing technology. Part 1. ASTM F2338-09 precision and bias studies.

PubMed

Wolf, Heinz; Stauffer, Tony; Chen, Shu-Chen Y; Lee, Yoojin; Forster, Ronald; Ludzinski, Miron; Kamat, Madhav; Godorov, Phillip; Guazzo, Dana Morton

2009-01-01

ASTM F2338-09 Standard Test Method for Nondestructive Detection of Leaks in Packages by Vacuum Decay Method is applicable for leak-testing rigid and semi-rigid non-lidded trays; trays or cups sealed with porous barrier lidding materials; rigid, nonporous packages; and flexible, nonporous packages. Part 1 of this series describes the precision and bias studies performed in 2008 to expand this method's scope to include rigid, nonporous packages completely or partially filled with liquid. Round robin tests using three VeriPac 325/LV vacuum decay leak testers (Packaging Technologies & Inspection, LLC, Tuckahoe, NY) were performed at three test sites. Test packages were 1-mL glass syringes. Positive controls had laser-drilled holes in the barrel ranging from about 5 to 15 microm in nominal diameter. Two different leak tests methods were performed at each site: a "gas leak test" performed at 250 mbar (absolute) and a "liquid leak test" performed at about 1 mbar (absolute). The gas leak test was used to test empty, air-filled syringes. All defects with holes > or = 5.0 microm and all no-defect controls were correctly identified. The only false negative result was attributed to a single syringe with a < 5.0-microm hole. Tests performed using a calibrated air leak supported a 0.10-cm3 x min(-1) (ccm) sensitivity limit (99/99 lower tolerance limit). The liquid leak test was used to test both empty, air-filled syringes and water-filled syringes. Test results were 100% accurate for all empty and water-filled syringes, both without holes and with holes (5, 10, and 15 microm). Tests performed using calibrated air flow leaks of 0, 0.05, and 0.10 ccm were also 100% accurate; data supported a 0.10-ccm sensitivity limit (99/99 lower tolerance limit). Quantitative differential pressure results strongly correlated to hole size using either liquid or gas vacuum decay leak tests. The higher vacuum liquid leak test gave noticeably higher pressure readings when water was present in the

Effects of quadratic coupling and squeezed vacuum injection in an optomechanical cavity assisted with a Bose-Einstein condensate

NASA Astrophysics Data System (ADS)

Dalafi, A.; Naderi, M. H.; Motazedifard, Ali

2018-04-01

We investigate theoretically a hybrid system consisting of a Bose-Einstein condensate (BEC) trapped inside a laser-driven membrane-in-the-middle optomechanical cavity assisted with squeezed vacuum injection whose moving membrane interacts both linearly and quadratically with the radiation pressure of the cavity. It is shown that such a hybrid system is very suitable for generating strong quadrature squeezing in the mechanical mode of the membrane and the Bogoliubov mode of the BEC in the unresolved sideband regime. More interestingly, by choosing a suitable sign for the quadratic optomechanical coupling (QOC), one can achieve a very high degree of squeezing in the mechanical mode and a strong entanglement between the mechanical and atomic modes without the necessity of using squeezed light injection. Furthermore, the QOC changes the effective oscillation frequencies of both the mechanical and the atomic modes and affects their relaxation times. It can also make the system switch from optical bistability to tristability.

Primary closure after carotid endarterectomy is not inferior to other closure techniques.

PubMed

Avgerinos, Efthymios D; Chaer, Rabih A; Naddaf, Abdallah; El-Shazly, Omar M; Marone, Luke; Makaroun, Michel S

2016-09-01

Primary closure after carotid endarterectomy (CEA) has been much maligned as an inferior technique with worse outcomes than in patch closure. Our purpose was to compare perioperative and long-term results of different CEA closure techniques in a large institutional experience. A consecutive cohort of CEAs between January 1, 2000, and December 31, 2010, was retrospectively analyzed. Closure technique was used to divide patients into three groups: primary longitudinal arteriotomy closure (PRC), patch closure (PAC), and eversion closure (EVC). End points were perioperative events, long-term strokes, and restenosis ≥70%. Multivariate regression models were used to assess the effect of baseline predictors. There were 1737 CEA cases (bilateral, 143; mean age, 71.4 ± 9.3 years; 56.2% men; 35.3% symptomatic) performed during the study period with a mean clinical follow-up of 49.8 ± 36.4 months (range, 0-155 months). More men had primary closure, but other demographic and baseline symptoms were similar between groups. Half the patients had PAC, with the rest evenly distributed between PRC and EVC. The rate of nerve injury was 2.7%, the rate of reintervention for hematoma was 1.5%, and the length of hospital stay was 2.4 ± 3.0 days, with no significant differences among groups. The combined stroke and death rate was 2.5% overall and 3.9% and 1.7% in the symptomatic and asymptomatic cohort, respectively. Stroke and death rates were similar between groups: PRC, 11 (2.7%); PAC, 19 (2.2%); EVC, 13 (2.9%). Multivariate analysis showed baseline symptomatic disease (odds ratio, 2.4; P = .007) and heart failure (odds ratio, 3.1; P = .003) as predictors of perioperative stroke and death, but not the type of closure. Cox regression analysis demonstrated, among other risk factors, no statin use (hazard ratio, 2.1; P = .008) as a predictor of ipsilateral stroke and severe (glomerular filtration rate <30 mL/min/1.73 m(2)) renal insufficiency (hazard ratio, 2.6; P�

Neglected ends: clinical ethics consultation and the prospects for closure.

PubMed

Fiester, Autumn

2015-01-01

Clinical ethics consultations (CECs) are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering sequelae: moral distress or negative moral emotions. The problem, succinctly named, is that such consults have insufficient "closure" for patients, families, and providers. To promote closure, and avoid the ills of moral distress and the moral emotions, I argue that CECs need to prioritize assisted conversation between the different stakeholders in these conflicts, what is often referred to as "bioethics mediation."

Summary Report on the Audit of Defense Base Closure and Realignment Budget Data for Fiscal Year 1992 and 1993

DTIC Science & Technology

1993-05-25

OFFICE OF THE INSPECTOR GENERAL SUMMARY REPORT ON THE AUDIT OF DEFENSE BASE CLOSURE AND REALIGNMENT BUDGET DATA FOR FISCAL YEARS 1992 AND 1993...ASSISTANT SECRETARY OF DEFENSE (INSTALLATIONS) SUBJECT: Summary Report on the Audit of Defense Base Closure and Realignment Budget Data for Fiscal Years...1992 and 1993 (Report No. 93-100) We are providing this final summary report for your information and use. The audit was required by Public Law

[Learning curve of vacuum extraction in residency: a preliminary study].

PubMed

Velemir, L; Vendittelli, F; Bonnefoy, C; Accoceberry, M; Savary, D; Gallot, D

2009-09-01

The aim of this study was to assess the lurning curve of young residents for vacuum extraction. All vacuum extractions performed in our department by five residents (< or =5th semester) during a study period of nine months were systematically supervised by a senior who fulfilled an assessment questionnaire from which was calculated a score reflecting the quality of the extraction. Fifty-four vacuum extractions were assessed with a mean of 10.8+/-2.9 (range, 10-13) procedures by resident. We compared the group including the six first procedures performed by each resident (group 1, n = 30) with the group including the following procedures (group 2, n = 24). We observed in the group 2 compared to the group 1, a significant improvement of the scores mean (12.3+/-5.4 vs 8.4+/-6.2, p = 0.016) and a significant reduction of the need for manual assistance by the senior (12.5% vs 40%, p = 0.034). We report a method for the learning and assessment of vacuum extraction feasible at "the bed" of the patient. This approach allows to observe a significant progression of the resident for the technique of vacuum extraction on a dozen of procedures.

Occupational closure in nursing work reconsidered: UK health care support workers and assistant practitioners: A focus group study.

PubMed

Traynor, Michael; Nissen, Nina; Lincoln, Carol; Buus, Niels

2015-07-01

In healthcare, occupational groups have adopted tactics to maintain autonomy and control over their areas of work. Witz described a credentialist approach to occupational closure adopted by nursing in the United Kingdom during the 19th and early 20th centuries. However, the recent advancement of assistant, 'non-qualified' workers by governments and managers forms part of a reconfiguration of traditional professional work. This research used focus groups with three cohorts of healthcare support workers undertaking assistant practitioner training at a London university from 2011 to 13 (6 groups, n = 59). The aim was to examine how these workers positioned themselves as professionals and accounted for professional boundaries. A thematic analysis revealed a complex situation in which participants were divided between articulating an acceptance of a subordinate role within traditional occupational boundaries and a usurpatory stance towards these boundaries. Participants had usually been handpicked by managers and some were ambitious and confident in their abilities. Many aspired to train to be nurses claiming that they will gain recognition that they do not currently get but which they deserve. Their scope of practice is based upon their managers' or supervisors' perception of their individual aptitude rather than on a credentialist claim. They 'usurp' nurses claim to be the healthcare worker with privileged access to patients, saying they have taken over what nursing has considered its core work, while nurses abandon it for largely administrative roles. We conclude that the participants are the not unwilling agents of a managerially led project to reshape the workforce that cuts across existing occupational boundaries. Copyright © 2015 Elsevier Ltd. All rights reserved.

The TopClosure® 3S System, for skin stretching and a secure wound closure.

PubMed

Topaz, Moris; Carmel, Narin-Nard; Silberman, Adi; Li, Ming Sen; Li, Yong Zhong

2012-07-01

The principle of stretching wound margins for primary wound closure is commonly practiced and used for various skin defects, leading at times to excessive tension and complications during wound closure. Different surgical techniques, skin stretching devices and tissue expanders have been utilized to address this issue. Previously designed skin stretching devices resulted in considerable morbidity. They were invasive by nature and associated with relatively high localized tissue pressure, frequently leading to necrosis, damage and tearing of skin at the wound margins. To assess the clinical effectiveness and performance and, to determine the safety of TopClosure® for gradual, controlled, temporary, noninvasive and invasive applications for skin stretching and secure wound closing, the TopClosure® device was applied to 20 patients for preoperative skin lesion removal and to secure closure of a variety of wound sizes. TopClosure® was reinforced with adhesives, staples and/or surgical sutures, depending on the circumstances of the wound and the surgeon's judgment. TopClosure® was used prior to, during and/or after surgery to reduce tension across wound edges. No significant complications or adverse events were associated with its use. TopClosure® was effectively used for preoperative skin expansion in preparation for dermal resection (e.g., congenital nevi). It aided closure of large wounds involving significant loss of skin and soft tissue by mobilizing skin and subcutaneous tissue, thus avoiding the need for skin grafts or flaps. Following surgery, it was used to secure closure of wounds under tension, thus improving wound aesthetics. A sample case study will be presented. We designed TopClosure®, an innovative device, to modify the currently practiced concept of wound closure by applying minimal stress to the skin, away from damaged wound edges, with flexible force vectors and versatile methods of attachment to the skin, in a noninvasive or invasive manner.

40 CFR 264.146 - Use of a mechanism for financial assurance of both closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... assurance of both closure and post-closure care. 264.146 Section 264.146 Protection of Environment... mechanism for financial assurance of both closure and post-closure care. An owner or operator may satisfy the requirements for financial assurance for both closure and post-closure care for one or more...

Identification of Selected Child-Resistant Closures (Continuous Thread, Lug-Bayonet, and Snap Closures).

ERIC Educational Resources Information Center

Gross, Rosalind L.; White, Harry E.

This publication describes a selected group of child-resistant closures used in packaging five categories of medicine and household products. The material in the document was collected to train survey personnel to identify closures for a planned household study of the effectiveness of child-resistant packaging. The 39 closures described are of…

Ultrasonic Spray Drying vs High Vacuum and Microwaves Technology for Blueberries

NASA Astrophysics Data System (ADS)

Candia-Muñoz, N.; Ramirez-Bunster, M.; Vargas-Hernández, Y.; Gaete-Garretón, L.

Interest in high quality foods: good taste and a high content of nutrients with healthy beneficial effects are increasing. Fruits have good properties but, they are lost because the oxidation process, additionally, for different reasons a 40% of harvested fruit are lost. To conserve the fruit properties an ultrasonic assisted spray dryer was developed and tested, comparing its results with microwave-vacuum drying technology. Results did shown taste, color, smell, particle shape and size distribution better than the conventional one. The antioxidants conservation were quite good except in the anthocyanins, in which the microwave and vacuum technology shown best results.

40 CFR 265.146 - Use of a mechanism for financial assurance of both closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

... assurance of both closure and post-closure care. 265.146 Section 265.146 Protection of Environment... Use of a mechanism for financial assurance of both closure and post-closure care. An owner or operator may satisfy the requirements for financial assurance for both closure and post-closure care for one or...

Optimizing Vacuum Assisted Resin Transfer Moulding (VARTM) Processing Parameters to Improve Part Quality

NASA Astrophysics Data System (ADS)

Polowick, Christopher

The Low Cost Composites (LCC) group at Carleton University is studying out-of-autoclave composite manufacturing processes such as Vacuum Assisted Resin Transfer Moulding (VARTM) and Closed Cavity Bag Moulding (CCBM). These processes are used to produce inexpensive and high performance components for the GeoSurv II, an Unmanned Aerial Vehicle (UAV) being developed at Carleton University. This research has focused on optimizing VARTM processing parameters to reduce the weight and improve the strength and surface finish of GeoSurv II composite components. A simulation was developed to model resin flow through in VARTM infusions and was used to simulate mould filling and resin emptying of the GeoSurv II inverted V-empennage and mission avionics hatch. The resin infusion schemes of these parts were designed to ensure full preform resin saturation, and minimize thickness variations. An experimental study of the effects of the presence of a corner on composite thickness, void content, and strength was conducted. It was found that inside corners result in local increases in thickness and void content due to poor preform compaction. A novel bagging technique was developed to improve corner compaction, and this technique was shown to reduce thickness variability and void content. The strength, void content, and thickness variation were found to be heavily dependent on corner radius, with corner radii greater than 6.4 mm displaying the greatest improvement in performance for the layups considered. The design of the empennage and hatch mould incorporated the results of this study to improve the quality of these components.

Vacuum mechatronics

NASA Technical Reports Server (NTRS)

Hackwood, Susan; Belinski, Steven E.; Beni, Gerardo

1989-01-01

The discipline of vacuum mechatronics is defined as the design and development of vacuum-compatible computer-controlled mechanisms for manipulating, sensing and testing in a vacuum environment. The importance of vacuum mechatronics is growing with an increased application of vacuum in space studies and in manufacturing for material processing, medicine, microelectronics, emission studies, lyophylisation, freeze drying and packaging. The quickly developing field of vacuum mechatronics will also be the driving force for the realization of an advanced era of totally enclosed clean manufacturing cells. High technology manufacturing has increasingly demanding requirements for precision manipulation, in situ process monitoring and contamination-free environments. To remove the contamination problems associated with human workers, the tendency in many manufacturing processes is to move towards total automation. This will become a requirement in the near future for e.g., microelectronics manufacturing. Automation in ultra-clean manufacturing environments is evolving into the concept of self-contained and fully enclosed manufacturing. A Self Contained Automated Robotic Factory (SCARF) is being developed as a flexible research facility for totally enclosed manufacturing. The construction and successful operation of a SCARF will provide a novel, flexible, self-contained, clean, vacuum manufacturing environment. SCARF also requires very high reliability and intelligent control. The trends in vacuum mechatronics and some of the key research issues are reviewed.

Membrane Assisted Palatal Fistula Closure in a Cleft Palate Patient: A Novel Technique.

PubMed

Reddy, G Siva Prasad; Reddy, G Venkateshwara; Sree, P Karuna; Reddy, K Sravan Kumar; Reddy, P Amarnath

2016-03-01

Palatal fistula following cleft palate repair, is one of the considerable complications and remains a challenging problem to the surgeons. The reported recurrence rate of the fistula is between 33% to 37%. Due to fibrosis and poor vascularity of adjacent tissues, high recurrence rates are typical. Closure of palatal fistulas can be achieved by different surgical techniques like local, regional and distant flaps, local turnover flaps, pedicled flaps from oral mucosa, buccal fat pad flaps, inter-positional cartilage grafts can be utilized for management of small fistulas. For larger fistualas, tongue flaps, temporalis muscle flaps, musculomucosal flaps, nasal septal flaps and free flaps can be used. These procedures are often cumbersome and leave a raw nasal or oral surface, which may increase the incidence of postoperative problems or some flaps can be bulky and may require a second-stage procedure. Different synthetic materials such as alloderm, Poly-D and L-Lactic Acid or "PdLLA" and collagen membrane are used in multilayer repair represented by the nasal mucosa, the inter-positional graft and oral mucosa. These interpositional grafts provide a scaffold for in growth of tissues, revascularization and mucosal epithelialization. We present a case of closure of an oronasal fistula, using resorbable collagen membrane in three layered repair to avoid recurrence.

Natural vacuum electronics

NASA Technical Reports Server (NTRS)

Leggett, Nickolaus

1990-01-01

The ambient natural vacuum of space is proposed as a basis for electron valves. Each valve is an electron controlling structure similiar to a vacuum tube that is operated without a vacuum sustaining envelope. The natural vacuum electron valves discussed offer a viable substitute for solid state devices. The natural vacuum valve is highly resistant to ionizing radiation, system generated electromagnetic pulse, current transients, and direct exposure to space conditions.

VACUUM TRAP

DOEpatents

Gordon, H.S.

1959-09-15

An improved adsorption vacuum trap for use in vacuum systems was designed. The distinguishing feature is the placement of a plurality of torsionally deformed metallic fins within a vacuum jacket extending from the walls to the central axis so that substantially all gas molecules pass through the jacket will impinge upon the fin surfaces. T fins are heated by direct metallic conduction, thereby ol taining a uniform temperature at the adeorbing surfaces so that essentially all of the condensible impurities from the evacuating gas are removed from the vacuum system.

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients.

PubMed

Pereira, Weendelly Nayara; Ferraz, Mariane Avante; Zabaglia, Luanna Munhoz; de Labio, Roger William; Orcini, Wilson Aparecido; Bianchi Ximenez, João Paulo; Neto, Agostinho Caleman; Payão, Spencer Luiz Marques; Rasmussen, Lucas Trevizani

2014-01-23

Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method. Patients with gastritis tested positive for H. pylori more frequently. The dupA gene was detected in 41.5% of them (85/205); cagA gene was found in 98 isolates (47.8%) and vacA genotype s1/m1 in 50.2%, s1/m2 in 8.3%, s2/m2 in 36.6%, s2/m1 in 0.5% and s1/s2/m1/m2 in 4.4%. We also verified a significant association between cagA and dupA genes [p = 0.0003, relative risk (RR) 1.73 and confidence interval [CI] = 1.3-2.3]. The genotypes s1/m1 were also associated with dupA gene (p = 0.0001, RR: 1.72 and CI: 1.3-2.2). The same associations were found when analyzing pediatric and adult groups of patients individually. Ours results suggest that dupA is highly frequent in Brazilian patients and is associated with cagA gene and vacA s1/m1 genotype, and it may be considered an important virulence factor in the development of gastric diseases in adults or children.

Association among H. pylori virulence markers dupA, cagA and vacA in Brazilian patients

PubMed Central

2014-01-01

Background Only a few Helicobacter pylori-infected individuals develop severe gastric diseases and virulence factors of H. pylori appear to be involved in such clinical outcomes. Duodenal ulcer promoting gene A (dupA) is a novel virulence factor of Helicobacter pylori that is associated with duodenal ulcer development and reduced risk for gastric carcinoma in some populations. The aims of the present study were to determine the presence of dupA gene and evaluate the association among dupA and other virulence factors including cagA and vacA in Brazilian patients. Gastric biopsies were obtained from 205 dyspeptic patients (100 children and 105 adults). DNA was extracted and analyzed for the presence of H. pylori and its virulence factors using the polymerase chain reaction method. Results Patients with gastritis tested positive for H. pylori more frequently. The dupA gene was detected in 41.5% of them (85/205); cagA gene was found in 98 isolates (47.8%) and vacA genotype s1/m1 in 50.2%, s1/m2 in 8.3%, s2/m2 in 36.6%, s2/m1 in 0.5% and s1/s2/m1/m2 in 4.4%. We also verified a significant association between cagA and dupA genes [p = 0.0003, relative risk (RR) 1.73 and confidence interval [CI] = 1.3–2.3]. The genotypes s1/m1 were also associated with dupA gene (p = 0.0001, RR: 1.72 and CI: 1.3–2.2). The same associations were found when analyzing pediatric and adult groups of patients individually. Conclusion Ours results suggest that dupA is highly frequent in Brazilian patients and is associated with cagA gene and vacA s1/m1 genotype, and it may be considered an important virulence factor in the development of gastric diseases in adults or children. PMID:24456629

A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor.

PubMed

Perone, Nicola

2018-04-25

To describe an innovative electronically-controlled vacuum extractor (VE) in detail and to illustrate its performance characteristics, as observed in a laboratory study. Thirty simulated, vacuum-assisted deliveries. (1) The ability to measure in real-time of the pull applied and to sound an alert, when the traction approaches the negative pressure under the cup, to prevent its detachment. (2) The recording and printing of a graphic representation of the pull applied (vacuum delivery graph). (3) The emission of a warning signal when the 15-min time limit of continuous cup application on the fetal scalp, is reached. No cup detachment occurred in any of the 15 vacuum-assisted deliveries, in which traction was kept below the adhesive force of the cup [44 lb (20 kg)], except in three cases, due to loss of negative pressure. In the remaining 15 tests, in which traction was greater than the adhesive force of the cup, "pull-offs" inevitably occurred. Furthermore, upon reaching the 15-min time limit of continuous cup application on the fetal cephalic model, a warning signal was emitted, as programmed. Conclusions We demonstrated that the electronically-controlled VE, with its distinctive pull-sensing handle, performs suitably for its intended purposes. The ability of the modernized device to decrease the incidence of cup detachment, secondary to the inadvertent application of excessive traction, may result in considerable safety, medico-legal and didactic advantages.

ZnO synthesis by high vacuum plasma-assisted chemical vapor deposition using dimethylzinc and atomic oxygen

NASA Astrophysics Data System (ADS)

Barnes, Teresa M.; Hand, Steve; Leaf, Jackie; Wolden, Colin A.

2004-09-01

Zinc oxide thin films were produced by high vacuum plasma-assisted chemical vapor deposition (HVP-CVD) from dimethylzinc (DMZn) and atomic oxygen. HVP-CVD is differentiated from conventional remote plasma-enhanced CVD in that the operating pressures of the inductively coupled plasma (ICP) source and the deposition chamber are decoupled. Both DMZn and atomic oxygen effuse into the deposition chamber under near collisionless conditions. The deposition rate was measured as a function of DMZn and atomic oxygen flux on glass and silicon substrates. Optical emission spectroscopy and quadrupole mass spectrometry (QMS) were used to provide real time analysis of the ICP source and the deposition chamber. The deposition rate was found to be first order in DMZn pressure and zero order in atomic oxygen density. All films demonstrated excellent transparency and were preferentially orientated along the c-axis. The deposition chemistry occurs exclusively through surface-mediated reactions, since the collisionless transport environment eliminates gas-phase chemistry. QMS analysis revealed that DMZn was almost completely consumed, and desorption of unreacted methyl radicals was greatly accelerated in the presence of atomic oxygen. Negligible zinc was detected in the gas phase, suggesting that Zn was efficiently consumed on the substrate and walls of the reactor.

Vacuum-assisted stereotactic breast biopsy in the diagnosis and management of suspicious microcalcifications

PubMed Central

Esen, Gül; Tutar, Burçin; Uras, Cihan; Calay, Zerrin; İnce, Ümit; Tutar, Onur

2016-01-01

PURPOSE We aimed to present our biopsy method and retrospectively evaluate the results, upgrade rate, and follow-up findings of stereotactic vacuum-assisted breast biopsy (VABB) procedures performed in our clinic. METHODS Two hundred thirty-four patients with mammographically detected nonpalpable breast lesions underwent VABB using a 9 gauge biopsy probe and prone biopsy table. A total of 195 patients (median age 53 years, range 32–80 years) with 198 microcalcification-only lesions with a follow-up of at least one year were included in the study. The location of the lesion relative to the needle was determined from the postfire images, and unlike the conventional technique, tissue retrieval was predominantly performed from that location, followed by a complete 360° rotation, if needed. RESULTS The median core number was 8.5. Biopsy results revealed 135 benign, 24 atypical, and 39 malignant lesions. The total upgrade rate at surgery was 7.7% (6.1% for ductal carcinomas in situ and 10.5% for atypical lesions). Patients with benign lesions were followed up for a median period of 27.5 months, with no interval change. At the follow-up, scar formation was seen in 23 patients (17%); three of the scars were remarkable for resembling a malignancy. CONCLUSION Our biposy method is fast and practical, and it is easily tolerated by patients without compromising accuracy. Patients with a diagnosis of atypia still need to undergo a diagnostic surgical procedure and those with a malignancy need to undergo curative surgery, even if the lesion is totally excised at biopsy. VABB may leave a scar in the breast tissue, which may resemble a malignancy, albeit rarely. PMID:27306660

Infrared Laser Ablation with Vacuum Capture for Fingermark Sampling

NASA Astrophysics Data System (ADS)

Donnarumma, Fabrizio; Camp, Eden E.; Cao, Fan; Murray, Kermit K.

2017-09-01

Infrared laser ablation coupled to vacuum capture was employed to collect material from fingermarks deposited on surfaces of different porosity and roughness. Laser ablation at 3 μm was performed in reflection mode with subsequent capture of the ejecta with a filter connected to vacuum. Ablation and capture of standards from fingermarks was demonstrated on glass, plastic, aluminum, and cardboard surfaces. Using matrix assisted laser desorption ionization (MALDI), it was possible to detect caffeine after spiking with amounts as low as 1 ng. MALDI detection of condom lubricants and detection of antibacterial peptides from an antiseptic cream was demonstrated. Detection of explosives from fingermarks left on plastic surfaces as well as from direct deposition on the same surface using gas chromatography mass spectrometry (GC-MS) was shown. [Figure not available: see fulltext.

Infrared Laser Ablation with Vacuum Capture for Fingermark Sampling.

PubMed

Donnarumma, Fabrizio; Camp, Eden E; Cao, Fan; Murray, Kermit K

2017-09-01

Infrared laser ablation coupled to vacuum capture was employed to collect material from fingermarks deposited on surfaces of different porosity and roughness. Laser ablation at 3 μm was performed in reflection mode with subsequent capture of the ejecta with a filter connected to vacuum. Ablation and capture of standards from fingermarks was demonstrated on glass, plastic, aluminum, and cardboard surfaces. Using matrix assisted laser desorption ionization (MALDI), it was possible to detect caffeine after spiking with amounts as low as 1 ng. MALDI detection of condom lubricants and detection of antibacterial peptides from an antiseptic cream was demonstrated. Detection of explosives from fingermarks left on plastic surfaces as well as from direct deposition on the same surface using gas chromatography mass spectrometry (GC-MS) was shown. Graphical Abstract ᅟ.

Observations on early and delayed colostomy closure.

PubMed

Tade, A O; Salami, B A; Ayoade, B A

2011-06-01

Traditional treatment of a variety of colorectal pathologies had included a diverting colostomy that was closed eight or more weeks later during a readmission. The aim of this retrospective study was to determine the outcomes of early colostomy closure and delayed colostomy closure in patients with temporary colostomies following traumatic and non-traumatic colorectal pathologies. In this study early colostomy closure was the closure of a colostomy within three weeks of its construction, while delayed colostomy closure referred to closure after 3 weeks. Complete records of the 37 adult patients who had temporary colostomy constructed and closed between Jan. 1997 December 2003 for various colorectal pathologies were studied. Fourteen patients had early colostomy closure while 23 had delayed closure. In the early colostomy closure group there were 10 men and 4 women. The mean age of the patients was 28yr with a range of 18-65yr. Colostomies were closed 9-18 days after initial colostomy construction. There was no mortality. Morbidity rate 28.6% (4 out of 14). There were two faecal fistulas (14.3%). Twenty-three patients had delayed colostomy closure 8 weeks to 18 months after initial colostomy construction. These were patients unfit for early surgery after initial colostomy construction because of carcinoma, significant weight loss, or sepsis. There was no mortality. Morbidity rate was 26.1%. There were 3 faecal fistulas (13.2%). Outcomes following early colostomy closure and delayed closure were comparable. Patients fit for surgery should have early closure whilst patients who may have compromised health should have delayed closure.

RCRA, superfund and EPCRA hotline training module. Introduction to: Closure/post-closure (40 cfr parts 264/265, subpart g) updated July 1996

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

NONE

1996-07-01

The module explains the difference between closure and post-closure. It lists the types of facilities that are subject to closure/post-closures and defines the difference between partial and final closure. It specifies who submits a closure plan and when a closure plan must be submitted, lists the steps in the process, and states the time frame for submittal. It identifies when and how a closure must be amended. It explains the time frame for notification of closure and the deadlines for beginning and completing closure. It specifies which facilities need contingent post-closure plans and lists and the elements of post-closure andmore » cites the requirements. It specifies the conditions and timing for amending a post-closure plan and states who must certify closure/post-closure.« less

Comparison of vacuum and non-vacuum urine tubes for urinary sediment analysis.

PubMed

Topcuoglu, Canan; Sezer, Sevilay; Kosem, Arzu; Ercan, Mujgan; Turhan, Turan

2017-12-01

Urine collection systems with aspiration system for vacuum tubes are becoming increasingly common for urinalysis, especially for microscopic examination of the urine. In this study, we aimed to examine whether vacuum aspiration of the urine sample has any adverse effect on sediment analysis by comparing results from vacuum and non-vacuum urine tubes. The study included totally 213 urine samples obtained from inpatients and outpatients in our hospital. Urine samples were collected to containers with aspiration system for vacuum tubes. Each sample was aliquoted to both vacuum and non-vacuum urine tubes. Urinary sediment analysis was performed using manual microscope. Results were evaluated using chi-square test. Comparison of the sediment analysis results from vacuum and non-vacuum urine tubes showed that results were highly concordant for erythrocyte, leukocyte and epithelial cells (gamma values 1, 0.997, and 0.994, respectively; p < .001). Results were also concordant for urinary casts, crystals and yeast (kappa values 0.815, 0.945 and 1, respectively; p < .001). The results show that in urinary sediment analysis, vacuum aspiration has no adverse effect on the cellular components except on casts.

Debulking Surgery for Elephantiasis Nostras With Large Ectatic Podoplanin-Negative Lymphatic Vessels in Patients With Lipo-Lymphedema

PubMed Central

Wollina, Uwe; Heinig, Birgit; Schönlebe, Jaqueline; Nowak, Andreas

2014-01-01

Objective: Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. Methods: We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. Results: The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. Conclusions: Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas. PMID:24741382

Efficacy of vitrectomy with triamcinolone assistance versus internal limiting membrane peeling for highly myopic macular hole retinal detachment.

PubMed

Wei, Yong; Wang, Ningli; Zu, Zhongqiao; Bi, Chuncao; Wang, Huaizhou; Chen, Fenghua; Yang, Xingguang

2013-06-01

To compare the outcomes of pars plana vitrectomy (PPV) with or without the adjuvant surgical procedures: triamcinolone acetonide (TA) assistance and/or internal limiting membrane (ILM) peeling for the treatment of highly myopic macular hole retinal detachment (MHRD). Case-control study. Pars plana vitrectomy combined with 2 kinds of adjuvant surgical procedures were used on 96 highly myopic eyes with MHRD. These eyes were assigned to 4 groups randomly: Group 1, non-TA-assisted PPV and without ILM peeling; Group 2, non-TA-assisted PPV with ILM peeling; Group 3, TA-assisted PPV and without ILM peeling; Group 4, TA-assisted PPV with ILM peeling. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity were measured. The rates of both retinal reattachment and macular hole closure were higher in Group 2 (84.0 and 44.0%) and Group 3 (80.8 and 46.2%) than Group 1 (73.9 and 17.4%); however, there were no differences between Group 2 and Group 3 (P > 0.05). The rates of macular hole closure were extremely low in Group 1 and also in eyes with extreme long axial lengths (≥29.0 mm), "severe" chorioretinal atrophy, and posterior staphyloma. Pars plana vitrectomy with either TA assistance or ILM peeling was effective for the treatment of highly myopic MHRD. If you peel the ILM, adding TA does not affect closure rates; and if TA is used to visualize the vitreous, ILM peeling may not be necessary in MHRD. There was a lower anatomical success rate in MHRD with extreme long axial lengths, severe chorioretinal atrophy, and posterior staphyloma.

Full closure strategic analysis.

DOT National Transportation Integrated Search

2014-07-01

The full closure strategic analysis was conducted to create a decision process whereby full roadway : closures for construction and maintenance activities can be evaluated and approved or denied by CDOT : Traffic personnel. The study reviewed current...

Economic Development Assistance for Communities Affected by Employment Changes Due to Military Base Closures

DTIC Science & Technology

2008-10-16

project. Among the factors used to assess loan risk are the following: (1) the length of the proposed repayment period; (2) the ratio of expected...Closures: DOD’s 2005 Internal Selection Process, by Daniel Else and David Lockwood. For environmental remediation issues, see CRS Report RS21822...still under environmental review and remediation . 2 Prior to the 1988 BRAC round, military installations were closed, or their missions were altered

Crack closure, a literature study

NASA Astrophysics Data System (ADS)

Holmgren, M.

1993-08-01

In this report crack closure is treated. The state of the art is reviewed. Different empirical formulas for determining the crack closure are compared with each other, and their benefits are discussed. Experimental techniques for determining the crack closure stress are discussed, and some results from fatigue tests are also reported. Experimental data from the literature are reported.

40 CFR 146.71 - Closure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Waste Injection Wells § 146.71 Closure. (a) Closure Plan. The owner or operator of a Class I hazardous waste injection well shall prepare, maintain, and comply with a plan for closure of the well that meets... of material to be used in plugging; (iv) The method of placement of the plugs; (v) Any proposed test...

Linearly exact parallel closures for slab geometry

NASA Astrophysics Data System (ADS)

Ji, Jeong-Young; Held, Eric D.; Jhang, Hogun

2013-08-01

Parallel closures are obtained by solving a linearized kinetic equation with a model collision operator using the Fourier transform method. The closures expressed in wave number space are exact for time-dependent linear problems to within the limits of the model collision operator. In the adiabatic, collisionless limit, an inverse Fourier transform is performed to obtain integral (nonlocal) parallel closures in real space; parallel heat flow and viscosity closures for density, temperature, and flow velocity equations replace Braginskii's parallel closure relations, and parallel flow velocity and heat flow closures for density and temperature equations replace Spitzer's parallel transport relations. It is verified that the closures reproduce the exact linear response function of Hammett and Perkins [Phys. Rev. Lett. 64, 3019 (1990)] for Landau damping given a temperature gradient. In contrast to their approximate closures where the vanishing viscosity coefficient numerically gives an exact response, our closures relate the heat flow and nonvanishing viscosity to temperature and flow velocity (gradients).

27 CFR 26.136 - Affixing closures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

27 CFR 26.136 - Affixing closures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

27 CFR 26.136 - Affixing closures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

27 CFR 26.136 - Affixing closures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... OF THE TREASURY ALCOHOL LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

27 CFR 26.136 - Affixing closures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... OF THE TREASURY LIQUORS LIQUORS AND ARTICLES FROM PUERTO RICO AND THE VIRGIN ISLANDS Closures for Distilled Spirits From Puerto Rico § 26.136 Affixing closures. Closures or other devices shall be securely...

System for closure of a physical anomaly

DOEpatents

Bearinger, Jane P; Maitland, Duncan J; Schumann, Daniel L; Wilson, Thomas S

2014-11-11

Systems for closure of a physical anomaly. Closure is accomplished by a closure body with an exterior surface. The exterior surface contacts the opening of the anomaly and closes the anomaly. The closure body has a primary shape for closing the anomaly and a secondary shape for being positioned in the physical anomaly. The closure body preferably comprises a shape memory polymer.

Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure.

PubMed

Ramesh, S; Ajik, S

2012-12-01

Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

Ultrasound-guided cable-free 13-gauge vacuum-assisted biopsy of non-mass breast lesions

PubMed Central

Seo, Jiwoon; Jang, Mijung; Yun, Bo La; Lee, Soo Hyun; Kim, Eun-Kyu; Kang, Eunyoung; Park, So Yeon; Moon, Woo Kyung; Choi, Hye Young; Kim, Bohyoung

2017-01-01

Purpose To compare the outcomes of ultrasound-guided core biopsy for non-mass breast lesions by the novel 13-gauge cable-free vacuum-assisted biopsy (VAB) and by the conventional 14-gauge semi-automated core needle biopsy (CCNB). Materials and methods Our institutional review board approved this prospective study, and all patients provided written informed consent. Among 1840 ultrasound-guided percutaneous biopsies performed from August 2013 to December 2014, 145 non-mass breast lesions with suspicious microcalcifications on mammography or corresponding magnetic resonance imaging finding were subjected to 13-gauge VAB or 14-gauge CCNB. We evaluated the technical success rates, average specimen numbers, and tissue sampling time. We also compared the results of percutaneous biopsy and final surgical pathologic diagnosis to analyze the rates of diagnostic upgrade or downgrade. Results Ultrasound-guided VAB successfully targeted and sampled all lesions, whereas CCNB failed to demonstrate calcification in four (10.3%) breast lesions with microcalcification on specimen mammography. The mean sampling time were 238.6 and 170.6 seconds for VAB and CCNB, respectively. No major complications were observed with either method. Ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) lesions were more frequently upgraded after CCNB (8/23 and 3/5, respectively) than after VAB (2/26 and 0/4, respectively P = 0.028). Conclusion Non-mass breast lesions were successfully and accurately biopsied using cable-free VAB. The underestimation rate of ultrasound-detected non-mass lesion was significantly lower with VAB than with CCNB. Trial registration CRiS KCT0002267. PMID:28628656

Demonstrations with a Vacuum: Old Demonstrations for New Vacuum Pumps.

ERIC Educational Resources Information Center

Greenslade, Thomas B., Jr.

1989-01-01

Explains mechanisms of 19th-century vacuum pumps. Describes demonstrations using the pump including guinea and feather tube, aurora tube, electric egg, Gassiots cascade, air mill, bell in vacuum, density and buoyancy of air, fountain in vacuum, mercury shower, palm and bladder glasses, Bacchus demonstration, pneumatic man-lifter, and Magdeburg…

Note: A simple sample transfer alignment for ultra-high vacuum systems.

PubMed

Tamtögl, A; Carter, E A; Ward, D J; Avidor, N; Kole, P R; Jardine, A P; Allison, W

2016-06-01

The alignment of ultra-high-vacuum sample transfer systems can be problematic when there is no direct line of sight to assist the user. We present the design of a simple and cheap system which greatly simplifies the alignment of sample transfer devices. Our method is based on the adaptation of a commercial digital camera which provides live views from within the vacuum chamber. The images of the camera are further processed using an image recognition and processing code which determines any misalignments and reports them to the user. Installation has proven to be extremely useful in order to align the sample with respect to the transfer mechanism. Furthermore, the alignment software can be easily adapted for other systems.

Exocytosis of vacuolar apical compartment (VAC): a cell-cell contact controlled mechanism for the establishment of the apical plasma membrane domain in epithelial cells

PubMed Central

1988-01-01

The vacuolar apical compartment (VAC) is an organelle found in Madin- Darby canine kidney (MDCK) cells with incomplete intercellular contacts by incubation in 5 microM Ca++ and in cells without contacts (single cells in subconfluent culture); characteristically, it displays apical biochemical markers and microvilli and excludes basolateral markers (Vega-Salas, D. E., P. J. I. Salas, and E. Rodriguez-Boulan. 1987. J. Cell Biol. 104:1249-1259). The apical surface of cells kept under these culture conditions is immature, with reduced numbers of microvilli and decreased levels of an apical biochemical marker (184 kD), which is, however, still highly polarized (Vega-Salas, D. E., P. J. I. Salas, D. Gundersen, and E. Rodriguez-Boulan. 1987. J. Cell Biol. 104:905-916). We describe here the morphological stages of VAC exocytosis which ultimately lead to the establishment of a differentiated apical domain. Addition of 1.8 mM Ca++ to monolayers developed in 5 microM Ca++ causes the rapid (20-40 min) fusion of VACs with the plasma membrane and their accessibility to external antibodies, as demonstrated by immunofluorescence, immunoperoxidase EM, and RIA with antibodies against the 184-kD apical plasma membrane marker. Exocytosis occurs towards areas of cell-cell contact in the developing lateral surface where they form intercellular pockets; fusion images are always observed immediately adjacent to the incomplete junctional bands detected by the ZO-1 antibody (Stevenson, B. R., J. D. Siliciano, M. S. Mooseker, and D. A. Goodenough. 1986. J. Cell Biol. 103:755-766). Blocks of newly incorporated VAC microvilli and 184-kD protein progressively move from intercellular ("primitive" lateral) spaces towards the microvilli-poor free cell surface. The definitive lateral domain is sealed behind these blocks by the growing tight junctional fence. These results demonstrate a fundamental role of cell-cell contact-mediated VAC exocytosis in the establishment of epithelial surface polarity

ROCKET PORT CLOSURE

DOEpatents

Mattingly, J.T.

1963-02-12

This invention provides a simple pressure-actuated closure whereby windowless observation ports are opened to the atmosphere at preselected altitudes. The closure comprises a disk which seals a windowless observation port in rocket hull. An evacuated instrument compartment is affixed to the rocket hull adjacent the inner surface of the disk, while the outer disk surface is exposed to the atmosphere through which the rocket is traveling. The pressure differential between the evacuated instrument compartment and the relatively high pressure external atmosphere forces the disk against the edge of the observation port, thereby effecting a tight seai. The instrument compartment is evacuated to a pressure equal to the atmospheric pressure existing at the altitude at which it is desiretl that the closure should open. When the rocket reaches this preselected altitude, the inwardly directed atmospheric force on the disk is just equaled by the residual air pressure force within the instrument compartment. Consequently, the closure disk falls away and uncovers the open observation port. The separation of the disk from the rocket hull actuates a switch which energizes the mechanism of a detecting instrument disposed within the instrument compartment. (AE C)

Suitability of Exoseal Vascular Closure Device for Antegrade Femoral Artery Puncture Site Closure

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

Schmelter, Christopher, E-mail: christopher.schmelter@klinikum-ingolstadt.de; Liebl, Andrea; Poullos, Nektarios

Purpose. To assess the efficacy and safety of the Exoseal vascular closure device for antegrade puncture of the femoral artery. Methods. In a prospective study from February 2011 to January 2012, a total of 93 consecutive patients received a total of 100 interventional procedures via an antegrade puncture of the femoral artery. An Exoseal vascular closure device (6F) was used for closure in all cases. Puncture technique, duration of manual compression, and use of compression bandages were documented. All patients were monitored by vascular ultrasound and color-coded duplex sonography of their respective femoral artery puncture site within 12 to 36more » h after angiography to check for vascular complications. Results. In 100 antegrade interventional procedures, the Exoseal vascular closure device was applied successfully for closure of the femoral artery puncture site in 96 cases (96 of 100, 96.0 %). The vascular closure device could not be deployed in one case as a result of kinking of the vascular sheath introducer and in three cases because the bioabsorbable plug was not properly delivered to the extravascular space adjacent to the arterial puncture site, but instead fully removed with the delivery system (4.0 %). Twelve to 36 h after the procedure, vascular ultrasound revealed no complications at the femoral artery puncture site in 93 cases (93.0 %). Minor vascular complications were found in seven cases (7.0 %), with four cases (4.0 %) of pseudoaneurysm and three cases (3.0 %) of significant late bleeding, none of which required surgery. Conclusion. The Exoseal vascular closure device was safely used for antegrade puncture of the femoral artery, with a high rate of procedural success (96.0 %), a low rate of minor vascular complications (7.0 %), and no major adverse events.« less

Improved Vacuum Bazooka

NASA Astrophysics Data System (ADS)

Cockman, John

2003-04-01

This apparatus is a modification to the well-known "vacuum bazooka" (PIRA 2B30.70). My vacuum bazooka is easy to construct and demonstrate, requires no precise fittings, foil, or vacuum grease, and propels ping-pong balls at a tremendous velocity!

Breast 3 T-MR imaging: indication for stereotactic vacuum-assisted breast biopsy.

PubMed

Yamamoto, Nobuko; Yoshizako, Takeshi; Yoshikawa, Kazuaki; Itakura, Masayuki; Maruyama, Riruke; Kitagaki, Hajime

2014-01-01

The purpose of this study was to assess indications for stereotactic vacuum-assisted breast biopsy (SVAB) evaluated by breast 3 T-magnetic resonance (3 T-MR) imaging in patients showing suspicious microcalcifications on mammography and negative ultrasound (US) findings. Fifty-five patients with 55 breast lesions showing suspicious microcalcifications on mammography and negative US findings underwent preoperative 3 T-MR examination including dynamic MR imaging. All patients underwent SVAB within 1 month of MR imaging. The pathological diagnosis of each breast lesion was made by examining tissues obtained by SVAB or radical/partial mastectomy. 3 T-MR imaging findings were evaluated by using the American College of Radiology Breast Imaging Reporting and Data System Atlas (BI-RADS-MRI) and then were correlated with the histopathological findings. When BI-RADS 4 and 5 MR imaging lesions were assumed to be malignant, the usefulness of 3 T-MR imaging was evaluated for diagnosis of impalpable breast lesions by SVAB among lesions with microcalcification detected by mammography and negative US findings. There were 21 malignant lesions, including 5 invasive ductal carcinomas, 16 lesions of ductal carcinoma in situ (DCIS). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 3 T-MR imaging for deciding the indications for SVAB was 90.5%, 97.1%, 95.0%, 94.3%, and 94.5%, respectively. The one-false negative case was a DCIS with small enhancing lesions (0.5 mm). The one false-positive case was ductal adenoma with a linear ductal pattern of enhancement. 3 T-MR imaging may be useful for deciding the indications for SVAB in patients who have breast lesions with microcalcification that are impalpable and are detected by mammography and negative US findings. However, our findings should be considered preliminary and further prospective investigation is required.

Impact of stereotactic 11-g vacuum-assisted breast biopsy on cost of diagnosis in Austria.

PubMed

Gruber, R; Walter, E; Helbich, T H

2011-01-01

To determine the frequency with which stereotactic 11-g vacuum-assisted breast biopsy (11-g SVAB) obviates an open surgical biopsy (OSB), to compare the costs of these two biopsy methods, and to estimate the potential cost savings attributable to 11-g SVAB in the diagnosis of suspicious breast lesions in patients in Austria. We retrospectively reviewed 318 consecutive breast lesions of BI-RADS categories IV and V (microcalcifications n=166; masses n=152) on which 11-g SVAB and OSB were performed. Cost savings were calculated using nationally allowed flat rates and patient charges. Costs were measured from a hospital and a socioeconomic perspective. Common clinical scenarios and sensitivity analyses assessed the extent of achievable cost savings. 11-g SVAB obviated the need for an OSB in 93 (29%) of 318 women. Overall cost savings per 11-g SVAB over OSB were € 242 per case from a hospital perspective, and € 422 per case from a socioeconomic perspective. The use of 11-g SVAB decreased the cost of diagnosis by 7% from a hospital perspective, and by 10% from a socioeconomic perspective. In Austria, annual national savings of over 5 million Euro could be realized with the use of 11-g SVAB for the diagnosis of suspicious breast lesions. Although savings per case are modest, the national health care system realizes significant cost reduction as women benefit from a faster and less invasive approach to diagnosis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Prevalence of cagA and vacA among Helicobacter pylori-infected patients in Iran: a systematic review and meta-analysis.

PubMed

Sayehmiri, Fatemeh; Kiani, Faezeh; Sayehmiri, Kourosh; Soroush, Setareh; Asadollahi, Khairollah; Alikhani, Mohammad Yousef; Delpisheh, Ali; Emaneini, Mohammad; Bogdanović, Lidija; Varzi, Ali Mohammad; Zarrilli, Raffaele; Taherikalani, Morovat

2015-07-30

The varieties of infections caused by Helicobacter pylori may be due to differences in bacterial genotypes and virulence factors as well as environmental and host-related factors. This study aimed to investigate the prevalence of cagA and vacA genes among H. pylori-infected patients in Iran and analyze their relevance to the disease status between two clinical groups via a meta-analysis method. Different databases including PubMed, ISI, Scopus, SID, Magiran, Science Direct, and Medlib were investigated, and 23 relevant articles from the period between 2001 and 2012 were finally analyzed. The relevant data obtained from these papers were analyzed by a random-effects model. Data were analyzed using R software and STATA. The prevalence of cagA and vacA genes among H. pylori-infected patients was 70% (95% CI, 64-75) and 41% (95% CI, 24.3-57.7), respectively. The prevalence of duodenal ulcers, peptic ulcers, and gastritis among cagA+ individuals was 53% (95% CI, 20-86), 65% (95% CI, 34-97), and 71% (95% CI, 59-84), respectively. Odds ratio (OR) between cagA-positive compared with cagA-negative patients showed a 1.89 (95% CI, 1.38-2.57) risk of ulcers. In conclusion, the frequency of cagA gene among H. pylori strains is elevated in Iran and it seems to be more frequently associated with gastritis. Therefore, any information about cagA and vacA prevalence among different H. pylori-infected clinical groups in the country can help public health authorities to plan preventive policies to reduce the prevalence of diseases associated with H. pylori infection.

Angle closure in younger patients.

PubMed Central

Chang, Brian M; Liebmann, Jeffrey M; Ritch, Robert

2002-01-01

PURPOSE: Angle-closure glaucoma is rare in children and young adults. Only scattered cases associated with specific clinical entities have been reported. We evaluated the findings in patients in our database aged 40 or younger with angle closure. METHODS: Our database was searched for patients with angle closure who were 40 years old or younger. Data recorded included age at initial consultation; age at the time of diagnosis; gender; results of slit-lamp examination, gonioscopy, and ultrasound biomicroscopy (from 1993 onward); clinical diagnosis; and therapy. Patients with previous incisional surgery were excluded, as were patients with anterior chamber proliferative mechanisms leading to angle closure. RESULTS: Sixty-seven patients (49 females, 18 males) met entry criteria. Mean age (+/- SD) at the time of consultation was 34.4 +/- 9.4 years (range, 3-68 years). Diagnoses included plateau iris syndrome (35 patients), iridociliary cysts (8 patients), retinopathy of prematurity (7 patients), uveitis (5 patients), isolated nanophthalmos (3 patients), relative pupillary block (2 patients), Weill-Marchesani syndrome (3 patients), and 1 patient each with Marfan syndrome, miotic-induced angle closure, persistent hyperplastic primary vitreous, and idiopathic lens subluxation. CONCLUSION: The etiology of angle closure in young persons is different from that in the older population and is typically associated with structural or developmental ocular anomalies rather than relative pupillary block. Following laser iridotomy, these eyes should be monitored for recurrent angle closure and the need for additional laser or incisional surgical intervention. PMID:12545694

Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives.

PubMed

Zempsky, William T; Zehrer, Cindy L; Lyle, Christopher T; Hedbloom, Edwin C

2005-09-01

Our objective was to review and assess the treatment of low-tension wounds and evaluate the cost-effectiveness of wound closure methods. We used a health economic model to estimate cost/closure of adhesive wound closure strips, tissue adhesives and sutures. The model incorporated cost-driving variables: application time, costs and the likelihood and costs of dehiscence and infection. The model was populated with variable estimates derived from the literature. Cost estimates and cosmetic results were compared. Parameter values were estimated using national healthcare and labour statistics. Sensitivity analyses were used to verify the results. Our analysis suggests that adhesive wound closure strips had the lowest average cost per laceration ($7.54), the lowest cost per infected laceration ($53.40) and the lowest cost per laceration with dehiscence ($25.40). The costs for sutures were $24.11, $69.91 and $41.91, respectively; the costs for tissue adhesives were $28.77, $74.68 and $46.68, respectively. The cosmetic outcome for all three treatments was equivalent. We conclude adhesive wound closure strips were both a cost-saving and a cost-effective alternative to sutures and tissue adhesives in the closure of low-tension lacerations.

Occupancy estimation and the closure assumption

USGS Publications Warehouse

Rota, Christopher T.; Fletcher, Robert J.; Dorazio, Robert M.; Betts, Matthew G.

2009-01-01

1. Recent advances in occupancy estimation that adjust for imperfect detection have provided substantial improvements over traditional approaches and are receiving considerable use in applied ecology. To estimate and adjust for detectability, occupancy modelling requires multiple surveys at a site and requires the assumption of 'closure' between surveys, i.e. no changes in occupancy between surveys. Violations of this assumption could bias parameter estimates; however, little work has assessed model sensitivity to violations of this assumption or how commonly such violations occur in nature. 2. We apply a modelling procedure that can test for closure to two avian point-count data sets in Montana and New Hampshire, USA, that exemplify time-scales at which closure is often assumed. These data sets illustrate different sampling designs that allow testing for closure but are currently rarely employed in field investigations. Using a simulation study, we then evaluate the sensitivity of parameter estimates to changes in site occupancy and evaluate a power analysis developed for sampling designs that is aimed at limiting the likelihood of closure. 3. Application of our approach to point-count data indicates that habitats may frequently be open to changes in site occupancy at time-scales typical of many occupancy investigations, with 71% and 100% of species investigated in Montana and New Hampshire respectively, showing violation of closure across time periods of 3 weeks and 8 days respectively. 4. Simulations suggest that models assuming closure are sensitive to changes in occupancy. Power analyses further suggest that the modelling procedure we apply can effectively test for closure. 5. Synthesis and applications. Our demonstration that sites may be open to changes in site occupancy over time-scales typical of many occupancy investigations, combined with the sensitivity of models to violations of the closure assumption, highlights the importance of properly addressing

Closedure - Mine Closure Technologies Resource

NASA Astrophysics Data System (ADS)

Kauppila, Päivi; Kauppila, Tommi; Pasanen, Antti; Backnäs, Soile; Liisa Räisänen, Marja; Turunen, Kaisa; Karlsson, Teemu; Solismaa, Lauri; Hentinen, Kimmo

2015-04-01

Closure of mining operations is an essential part of the development of eco-efficient mining and the Green Mining concept in Finland to reduce the environmental footprint of mining. Closedure is a 2-year joint research project between Geological Survey of Finland and Technical Research Centre of Finland that aims at developing accessible tools and resources for planning, executing and monitoring mine closure. The main outcome of the Closedure project is an updatable wiki technology-based internet platform (http://mineclosure.gtk.fi) in which comprehensive guidance on the mine closure is provided and main methods and technologies related to mine closure are evaluated. Closedure also provides new data on the key issues of mine closure, such as performance of passive water treatment in Finland, applicability of test methods for evaluating cover structures for mining wastes, prediction of water effluents from mine wastes, and isotopic and geophysical methods to recognize contaminant transport paths in crystalline bedrock.

The Classical Vacuum.

ERIC Educational Resources Information Center

Boyer, Timothy H.

1985-01-01

The classical vacuum of physics is not empty, but contains a distinctive pattern of electromagnetic fields. Discovery of the vacuum, thermal spectrum, classical electron theory, zero-point spectrum, and effects of acceleration are discussed. Connection between thermal radiation and the classical vacuum reveals unexpected unity in the laws of…

Electroweak vacuum instability and renormalized Higgs field vacuum fluctuations in the inflationary universe

NASA Astrophysics Data System (ADS)

Kohri, Kazunori; Matsui, Hiroki

2017-08-01

In this work, we investigated the electroweak vacuum instability during or after inflation. In the inflationary Universe, i.e., de Sitter space, the vacuum field fluctuations < δ phi 2 > enlarge in proportion to the Hubble scale H2. Therefore, the large inflationary vacuum fluctuations of the Higgs field < δ phi 2 > are potentially catastrophic to trigger the vacuum transition to the negative-energy Planck-scale vacuum state and cause an immediate collapse of the Universe. However, the vacuum field fluctuations < δ phi 2 >, i.e., the vacuum expectation values have an ultraviolet divergence, and therefore a renormalization is necessary to estimate the physical effects of the vacuum transition. Thus, in this paper, we revisit the electroweak vacuum instability from the perspective of quantum field theory (QFT) in curved space-time, and discuss the dynamical behavior of the homogeneous Higgs field phi determined by the effective potential V eff( phi ) in curved space-time and the renormalized vacuum fluctuations < δ phi 2 >ren via adiabatic regularization and point-splitting regularization. We simply suppose that the Higgs field only couples the gravity via the non-minimal Higgs-gravity coupling ξ(μ). In this scenario, the electroweak vacuum stability is inevitably threatened by the dynamical behavior of the homogeneous Higgs field phi, or the formations of AdS domains or bubbles unless the Hubble scale is small enough H< ΛI .

Germanium detector vacuum encapsulation

NASA Technical Reports Server (NTRS)

Madden, N. W.; Malone, D. F.; Pehl, R. H.; Cork, C. P.; Luke, P. N.; Landis, D. A.; Pollard, M. J.

1991-01-01

This paper describes an encapsulation technology that should significantly improve the viability of germanium gamma-ray detectors for a number of important applications. A specialized vacuum chamber has been constructed in which the detector and the encapsulating module are processed in high vacuum. Very high vacuum conductance is achieved within the valveless encapsulating module. The detector module is then sealed without breaking the chamber vacuum. The details of the vacuum chamber, valveless module, processing, and sealing method are presented.

Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect.

PubMed

Liang, Fei; Hongxin, Li; Zhang, Hai-Zhou; Wenbin, Guo; Zou, Cheng-Wei; Farhaj, Zeeshan

2017-04-17

Device closure of a wide-spaced multi-hole PmVSD is difficult to succeed in percutaneous approach. This study is to evaluate the feasibility, safety and efficacy of perventricular device closure of wide-spaced multi-hole PmVSD using a double-device implanting technique. Sixteen patients with wide-spaced multi-hole PmVSD underwent perventricular closure with two devices through an inferior median sternotomy approach under transesophageal echocardiographic guidance. The largest hole and its adjacent small holes were occluded with an optimal-sized device. The far-away residual hole was occluded with the other device using a probe-assisted delivery system. All patients were followed up for a period of 1 to 4 years to determine the residual shunt, atrioventricular block and the adjacent valvular function. The number of the holes of the PmVSD was 2 to 4. The maximum distance between the holes was 5.0 to 10.0 mm (median, 6.4 mm). The diameter of the largest hole was 2.5 to 7.0 mm (median, 3.6 mm). The success rate of double-device closure was 100%. Immediate residual shunts were found in 6 patients (38%), and incomplete right bundle branch block at discharge occurred in 3 cases (19%). Both complications decreased to 6% at 1-year follow-up. Neither of them had a severe device-related complication. Perventricular closure of a wide-spaced multi-hole PmVSD using a double-device implanting technique is feasible, safe, and efficacious. In multi-hole PmVSDs with the distance between the holes of more than 5 mm, double-device implantation may achieve a complete occlusion.

Euclidean mirrors: enhanced vacuum decay from reflected instantons

NASA Astrophysics Data System (ADS)

Akal, Ibrahim; Moortgat-Pick, Gudrid

2018-05-01

We study the tunnelling of virtual matter–antimatter pairs from the quantum vacuum in the presence of a spatially uniform, time-dependent electric background composed of a strong, slow field superimposed with a weak, rapid field. After analytic continuation to Euclidean spacetime, we obtain from the instanton equations two critical points. While one of them is the closing point of the instanton path, the other serves as an Euclidean mirror which reflects and squeezes the instanton. It is this reflection and shrinking which is responsible for an enormous enhancement of the vacuum pair production rate. We discuss how important features of two different mechanisms can be analysed and understood via such a rotation in the complex plane. (a) Consistent with previous studies, we first discuss the standard assisted mechanism with a static strong field and certain weak fields with a distinct pole structure in order to show that the reflection takes place exactly at the poles. We also discuss the effect of possible sub-cycle structures. We extend this reflection picture then to weak fields which have no poles present and illustrate the effective reflections with explicit examples. An additional field strength dependence for the rate occurs in such cases. We analytically compute the characteristic threshold for the assisted mechanism given by the critical combined Keldysh parameter. We discuss significant differences between these two types of fields. For various backgrounds, we present the contributing instantons and perform analytical computations for the corresponding rates treating both fields nonperturbatively. (b) In addition, we also study the case with a nonstatic strong field which gives rise to the assisted dynamical mechanism. For different strong field profiles we investigate the impact on the critical combined Keldysh parameter. As an explicit example, we analytically compute the rate by employing the exact reflection points. The validity of the predictions

Development of High Interruption Capability Vacuum Circuit Breaker -Technology of Vacuum Arc Control-

NASA Astrophysics Data System (ADS)

Niwa, Yoshimitsu; Kaneko, Eiji

Vacuum circuit breakers (VCB) have been widely used for power distribution systems. Vacuum Interrupters, which are the current interruption unit, have been increased its interruption capability with the development of vacuum arc control technology by magnetic field. There are three major type electrodes: disk shaped electrodes, radial magnetic field electrodes, axial magnetic field (AMF) electrodes. In the disk shaped electrode, the vacuum arc between the electrodes is not controlled. In the AMF electrode, the vacuum arc is diffused and stabilized by an axial magnetic field, which is parallel to the arc current. In the last type of electrodes, the vacuum arc column is rotated by magnetic force generated by the current flowing in the electrodes. The interruption current and the voltage of one break VCB is increased to 100 kA, 144 kV respectively. This paper describes basic configurations and functions of VCB, vacuum arc control technology in vacuum interrupters, recent researches and applications of VCB.

Electroweak vacuum instability and renormalized Higgs field vacuum fluctuations in the inflationary universe

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

Kohri, Kazunori; Matsui, Hiroki, E-mail: kohri@post.kek.jp, E-mail: matshiro@post.kek.jp

In this work, we investigated the electroweak vacuum instability during or after inflation. In the inflationary Universe, i.e., de Sitter space, the vacuum field fluctuations < δ φ {sup 2} > enlarge in proportion to the Hubble scale H {sup 2}. Therefore, the large inflationary vacuum fluctuations of the Higgs field < δ φ {sup 2} > are potentially catastrophic to trigger the vacuum transition to the negative-energy Planck-scale vacuum state and cause an immediate collapse of the Universe. However, the vacuum field fluctuations < δ φ {sup 2} >, i.e., the vacuum expectation values have an ultraviolet divergence, andmore » therefore a renormalization is necessary to estimate the physical effects of the vacuum transition. Thus, in this paper, we revisit the electroweak vacuum instability from the perspective of quantum field theory (QFT) in curved space-time, and discuss the dynamical behavior of the homogeneous Higgs field φ determined by the effective potential V {sub eff}( φ ) in curved space-time and the renormalized vacuum fluctuations < δ φ {sup 2} >{sub ren} via adiabatic regularization and point-splitting regularization. We simply suppose that the Higgs field only couples the gravity via the non-minimal Higgs-gravity coupling ξ(μ). In this scenario, the electroweak vacuum stability is inevitably threatened by the dynamical behavior of the homogeneous Higgs field φ, or the formations of AdS domains or bubbles unless the Hubble scale is small enough H < Λ {sub I} .« less

All atypia diagnosed at stereotactic vacuum-assisted breast biopsy do not need surgical excision.

PubMed

de Mascarel, Isabelle; Brouste, Véronique; Asad-Syed, Maryam; Hurtevent, Gabrielle; Macgrogan, Gaëtan

2011-09-01

The necessity of excision is debatable when atypia are diagnosed at stereotactic vacuum-assisted breast biopsy (microbiopsy). Among the 287 surgical excisions performed at Institut Bergonié from 1999 to 2009, we selected a case-control study group of 151 excisions; 52 involving all the diagnosed cancers and 99 randomly selected among the 235 excisions without cancer, following atypical microbiopsy (24 flat epithelial atypia; 50 atypical ductal hyperplasia; 14 lobular neoplasia; 63 mixed lesions). Mammographical calcification (type, extension, complete removal) and histological criteria of epithelial atypia (type, number of foci, size/extension), topography and microcalcification extension at microbiopsy were compared according to the presence or absence of cancer at excision. Factors associated with cancer at excision were Breast Imaging Reporting and Data System (BI-RADS5) lesions, large and/or multiple foci of mammographical calcifications, histological type, number, size and extension of atypical foci. Flat epithelial atypia alone was never associated with cancer at excision. BI-RADS5, atypical ductal hyperplasia (alone or predominant) and >3 foci of atypia were identified as independent pejorative factors. There was never any cancer at excision when these pejorative factors were absent (n=31). Presence of one (n=59), two (n=23) or three (n=14) factors was associated with cancer in 24, 15 and 13 cases with an odds ratio=5.8 (95% CI: 3-11.2) for each additional factor. We recommend that mammographical data and histological characteristics be taken into account in the decision-making process after diagnosis of atypia on microbiopsy. With experienced senologists and strict histological criteria, some patients could be spared surgery resulting in significant patient, financial and time advantages.

100-D Ponds closure plan. Revision 1

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

Petersen, S.W.

1997-09-01

The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit ismore » clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure.« less

40 CFR 265.404 - Closure.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

40 CFR 265.404 - Closure.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

40 CFR 265.404 - Closure.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

40 CFR 265.404 - Closure.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

40 CFR 265.404 - Closure.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Physical, and Biological Treatment § 265.404 Closure. At closure, all hazardous waste and hazardous waste residues must be removed from treatment processes or equipment, discharge control equipment, and discharge...

7 CFR 225.7 - Program monitoring and assistance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... school closures during the period from October through April (or at any time of the year in an area with... available all necessary Program materials in sufficient time to enable applicant sponsors to prepare adequately for the Program. (c) Food specifications and meal quality standards. With the assistance of the...

Pressure-tight closure for thermoelements

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

Not Available

1937-06-14

The thermoelements were arranged in a pressure-tight housing for measuring temperatures on the inside of high-pressure hydrogenation equipment. Should the housing ever leak due to failure of the material or the grinding action of the high sand content of the coal paste, the stall was liable to be set on fire. If, in an installation protected in this manner, an element housing should leak, the pressure tight closure at one end of the housing prevented an escape of the gas and product and the stall could continue to run without danger. The final form of this closure was discussed inmore » detail in this report. In the development of this closure, particular value was attached to a compact construction. In the sealing for a 30-mm high pressure tube, four steel and four constantan wires were insulated and arranged pressure-tight. Each of the three fillers had a different purpose. The hard-rubber insert took the surface pressure, the rubber stopper provided a seal and the cast gypsum provided protection against heat should hot gas or product reach the closure in case of a leaky housing. Two drawings were given showing the thermoelement-closure, and the final form of the closure. The report discussed methods of evacuating from the thermohousings any accumulations of condensed water, which could damage insulation, or hydrogen, which continually diffused in small amounts during operation and which could attack the iron elements of the thermocouples. The pressure-tight closures for thermoelements had been successful at preventing fires due to leakage for more than nine months of operation. 2 sketches.« less

Impact of MenAfriVac in nine countries of the African meningitis belt, 2010-15: an analysis of surveillance data.

PubMed

Trotter, Caroline L; Lingani, Clément; Fernandez, Katya; Cooper, Laura V; Bita, André; Tevi-Benissan, Carol; Ronveaux, Olivier; Préziosi, Marie-Pierre; Stuart, James M

2017-08-01

In preparation for the introduction of MenAfriVac, a meningococcal group A conjugate vaccine developed for the African meningitis belt, an enhanced meningitis surveillance network was established. We analysed surveillance data on suspected and confirmed cases of meningitis to quantify vaccine impact. We compiled and analysed surveillance data for nine countries in the meningitis belt (Benin, Burkina Faso, Chad, Côte d'Ivoire, Ghana, Mali, Niger, Nigeria, and Togo) collected and curated by the WHO Inter-country Support Team between 2005 and 2015. The incidence rate ratios (IRRs) of suspected and confirmed cases in vaccinated and unvaccinated populations were estimated with negative binomial regression models. The relative risk of districts reaching the epidemic threshold of ten per 100 000 per week was estimated according to district vaccination status. The incidence of suspected meningitis cases declined by 57% (95% CI 55-59) in vaccinated compared with unvaccinated populations, with some heterogeneity observed by country. We observed a similar 59% decline in the risk of a district reaching the epidemic threshold. In fully vaccinated populations, the incidence of confirmed group A disease was reduced by more than 99%. The IRR for non-A serogroups was higher after completion of MenAfriVac campaigns (IRR 2·76, 95% CI 1·21-6·30). MenAfriVac introduction has led to substantial reductions in the incidence of suspected meningitis and epidemic risk, and a substantial effect on confirmed group A meningococcal meningitis. It is important to continue strengthening surveillance to monitor vaccine performance and remain vigilant against threats from other meningococcal serogroups and other pathogens. World Health Organization. Copyright © 2017 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

78 FR 50443 - Notice of Temporary Closure to Target Shooting on Public Lands in Yakima County, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... increased significantly over the past few years and is important to engage these groups to assist in... message or question with the above individual. You will receive a reply during normal hours. SUPPLEMENTARY... provided for by 18 U.S.C. 3571. This 2-year temporary closure will allow the BLM to utilize public input to...

50 CFR 648.161 - Closures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Bluefish Fishery § 648.161 Closures. (a) EEZ closure. NMFS shall close the EEZ to fishing for bluefish by... dealer permit holders that no commercial quota is available for landing bluefish in that state. ...

Economic Development Assistance for Communities Affected by Employment Changes Due to Military Base Closures (BRAC)

DTIC Science & Technology

2009-06-16

resolution of disapproval is passed by Congress. Following the actual base closings and realignments, DOD develops an environmental remediation plan...examination of the BRAC process, For environmental remediation issues, see CRS Report RS21822, Military Base Closures: DOD’s 2005 Internal Selection...review and remediation . 2 Prior to the 1988 BRAC round, military installations were closed, or their missions were altered by order of the Secretary of

Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial.

PubMed

Rink, Cameron; Wernke, Matthew M; Powell, Heather M; Gynawali, Surya; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

2016-01-01

A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation. ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1.

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure.

PubMed

Roushdy, Alaa; Abd El Razek, Yasmeen; Mamdouh Tawfik, Ahmed

2018-01-01

To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure. Seventy-six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end-diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes. The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short-axis views as well as the color flow width and color flow extent (P < .0001). The device closure group had statistically significant higher end-systolic and end-diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short-axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure. The selection between PDA coil or device closure can be done on the basis of multiple anatomic and hemodynamic echocardiographic variables. © 2017 Wiley Periodicals, Inc.

Mitigation of infectious disease at school: targeted class closure vs school closure.

PubMed

Gemmetto, Valerio; Barrat, Alain; Cattuto, Ciro

2014-12-31

School environments are thought to play an important role in the community spread of infectious diseases such as influenza because of the high mixing rates of school children. The closure of schools has therefore been proposed as an efficient mitigation strategy. Such measures come however with high associated social and economic costs, making alternative, less disruptive interventions highly desirable. The recent availability of high-resolution contact network data from school environments provides an opportunity to design models of micro-interventions and compare the outcomes of alternative mitigation measures. We model mitigation measures that involve the targeted closure of school classes or grades based on readily available information such as the number of symptomatic infectious children in a class. We focus on the specific case of a primary school for which we have high-resolution data on the close-range interactions of children and teachers. We simulate the spread of an influenza-like illness in this population by using an SEIR model with asymptomatics, and compare the outcomes of different mitigation strategies. We find that targeted class closure affords strong mitigation effects: closing a class for a fixed period of time--equal to the sum of the average infectious and latent durations--whenever two infectious individuals are detected in that class decreases the attack rate by almost 70% and significantly decreases the probability of a severe outbreak. The closure of all classes of the same grade mitigates the spread almost as much as closing the whole school. Our model of targeted class closure strategies based on readily available information on symptomatic subjects and on limited information on mixing patterns, such as the grade structure of the school, shows that these strategies might be almost as effective as whole-school closure, at a much lower cost. This may inform public health policies for the management and mitigation of influenza

Plant Closings. Limited Advance Notice and Assistance Provided Dislocated Workers. Report to Congressional Committees.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

This is the final report in a series issued to assist Congress in assessing the problems of worker dislocation and employer practices related to advance notice and assistance provided to workers. A national survey of 2,600 business establishments was conducted to determine: (1) the extent of business closures and permanent layoffs between January…

Radiation hard vacuum switch

DOEpatents

Boettcher, Gordon E.

1990-01-01

A vacuum switch with an isolated trigger probe which is not directly connected to the switching electrodes. The vacuum switch within the plasmatron is triggered by plasma expansion initiated by the trigger probe which travels through an opening to reach the vacuum switch elements. The plasma arc created is directed by the opening to the space between the anode and cathode of the vacuum switch to cause conduction.

Radiation hard vacuum switch

DOEpatents

Boettcher, Gordon E.

1990-03-06

A vacuum switch with an isolated trigger probe which is not directly connected to the switching electrodes. The vacuum switch within the plasmatron is triggered by plasma expansion initiated by the trigger probe which travels through an opening to reach the vacuum switch elements. The plasma arc created is directed by the opening to the space between the anode and cathode of the vacuum switch to cause conduction.

Vacuum effects over the closing of enterocutaneous fistulae: a mathematical modeling approach.

PubMed

Cattoni, D I; Chara, O

2008-01-01

Enterocutaneous fistulae are pathological communications between the intestinal lumen and the abdominal skin. Under surgery the mortality of this pathology is very high, therefore a vacuum applying system has been carried previously on attempting to close these fistulae. The objective of this article is the understanding of how these treatments might work through deterministic mathematical modelling. Four models are here proposed based on several assumptions involving: the conservation of the flow in the fistula, a low enough Reynolds number justifying a laminar flow, the use of Poiseuille law to model the movement of the fistulous liquid, as well as phenomenological equations including the fistula tissue and intermediate chamber compressibility. Interestingly, the four models show fistulae closing behaviour during experimental time (t<60 sec). To compare the models, both, simulations and pressure measurements, carried out on the vacuum connected to the patients, are performed. Time course of pressure are then simulated (from each model) and fitted to the experimental data. The model which best describes actual measurements shows exponential pumping flux kinetics. Applying this model, numerical relationship between the fistula compressibility and closure time is presented. The models here developed would contribute to clarify the treatment mechanism and, eventually, improve the fistulae treatment.

Ethnic differences in primary angle-closure glaucoma.

PubMed

Yip, Jennifer L Y; Foster, Paul J

2006-04-01

Observational studies from different countries have shown that populations of East Asian origin have a higher frequency of primary angle-closure glaucoma compared with those of European or African descent. As half of all cases of glaucoma reside in Asia, and with primary angle-closure glaucoma carrying a higher rate of visual morbidity, primary angle-closure glaucoma poses an important public health problem; however, the inconsistent use of techniques and definitions to detect and diagnose primary angle-closure glaucoma has resulted in difficulties in interpreting the accuracy and comparability of such data. Therefore it is important to review these studies in the light of a consistent classification system. There are increasing reports that support previous findings on the incidence and prevalence of primary angle-closure glaucoma in different ethnic groups. There have also been further investigations into the mechanism and natural history of primary angle-closure glaucoma in Asian populations. International investigations into primary angle-closure glaucoma have demonstrated reproducible evidence that ethnic variations do exist. Cross-sectional studies in this area have also suggested that differences in anterior chamber depth, together with its association with peripheral anterior synechiae, may be part of the underlying mechanism behind these differences. The ideas generated need to be further explored with longitudinal data of changes in anterior chamber depth and peripheral anterior synechiae in different populations. The detailed mechanisms behind the development of angle-closure and primary angle-closure glaucoma should also be investigated.

ASD Closure in Structural Heart Disease.

PubMed

Wiktor, Dominik M; Carroll, John D

2018-04-17

While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up. With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.

32 CFR 989.25 - Base closure and realignment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

32 CFR 989.25 - Base closure and realignment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

Laser-assisted corneal welding in cataract surgery: retrospective study.

PubMed

Menabuoni, Luca; Pini, Roberto; Rossi, Francesca; Lenzetti, Ivo; Yoo, Sonia H; Parel, Jean-Marie

2007-09-01

To evaluate the efficacy of laser welding to close corneal wounds in cataract surgery. Department of Ophthalmology, Hospital of Misericordia e Dolce, Prato, Italy. This retrospective nonrandomized interventional case series included 20 eyes of 20 patients. All eyes had cataract with visual acuity worse than 20/200. Ten patients had phacoemulsification surgery, and 10 had extracapsular cataract extraction (ECCE). Surgeries were followed by laser-assisted closure of the corneal wounds by diode laser welding of the stroma using a technique established in animal models. Preoperative and postoperative (1, 3, 7, 30, and 90 days) astigmatism, level of inflammation, Seidel testing, and endothelial cell counts were obtained. There were minor differences in preoperative and postoperative astigmatism except in 1 eye in the ECCE group. The Seidel test showed no wound leakage during the follow-up examinations, and endothelial cell loss was similar to that published for standard surgical cataract procedures. No collateral effects of the laser welding were detected, nor was postoperative inflammation. Astigmatism was slightly affected by the use of laser welding for corneal wound closure after phacoemulsification and ECCE. The laser-assisted corneal sealing procedure was rapid and safe and could serve as an alternative to corneal suturing, with significant potential applications for the closure of longer incisions, such as those used in penetrating keratoplasty.

Vacuum-assisted cell loading enables shear-free mammalian microfluidic culture

PubMed Central

Kolnik, Martin; Tsimring, Lev S; Hasty, Je

2012-01-01

Microfluidic perfusion cultures for mammalian cells provide a novel means for probing single-cell behavior but require the management of culture parameters such as flow-induced shear stress. Methods to eliminate shear stress generally focus on capturing cells in regions with high resistance to fluid flow. Here, we present a novel trapping design to easily and reliably load a high density of cells into culture chambers that are extremely isolated from potentially damaging flow effects. We utilize a transient on-chip vacuum to remove air from the culture chambers and rapidly replace the volume with a liquid cell suspension. We demonstrate the ability of this simple and robust method to load and culture three commonly used cell lines. We show how the incorporation of an on-chip function generator can be used for dynamic stimulation of cells during long-term continuous perfusion culture. PMID:22961584

Patent ductus arteriosus closure using an Amplatzer™ ventricular septal defect closure device

PubMed Central

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs. PMID:24294051

Vacuum fluctuations in an ancestor vacuum: A possible dark energy candidate

NASA Astrophysics Data System (ADS)

Aoki, Hajime; Iso, Satoshi; Lee, Da-Shin; Sekino, Yasuhiro; Yeh, Chen-Pin

2018-02-01

We consider an open universe created by bubble nucleation, and study possible effects of our "ancestor vacuum," a de Sitter space in which bubble nucleation occurred, on the present universe. We compute vacuum expectation values of the energy-momentum tensor for a minimally coupled scalar field, carefully taking into account the effect of the ancestor vacuum by the Euclidean prescription. We pay particular attention to the so-called supercurvature mode, a non-normalizable mode on a spatial slice of the open universe, which has been known to exist for sufficiently light fields. This mode decays in time most slowly, and may leave residual effects of the ancestor vacuum, potentially observable in the present universe. We point out that the vacuum energy of the quantum field can be regarded as dark energy if mass of the field is of order the present Hubble parameter or smaller. We obtain preliminary results for the dark energy equation of state w (z ) as a function of the redshift.

Robotic treatment of a type 2 calyceal diverticulum in a child: is suture closure and marsupialisation enough for a good outcome?

PubMed

Sripathi, V; Mitra, Aparajita; Padankatti, Rajiv L; Ganesan, T

2017-10-27

Calyceal diverticula in children are rare and 20% eventually become symptomatic. Following the use of laparoscopic or endoscopic treatments, 85% of children report symptomatic relief. However, complete radiological resolution is seen only in three-fourths of the laparoscopic group and a quarter of those treated via endoscopy. Diathermy ablation of the lining and/or prolonged double J stenting has not altered this outcome. The robotic approach is superior to the other two techniques as the leak can be clearly identified and securely suture ligated. We believe that this is the third published report of the successful closure of a calyceal diverticulum in a child using robotic assistance. A ten-year-old boy presented with severe pain in the right flank and a palpable renal swelling. Retrograde injection of contrast outlined a large exophytic calyceal diverticulum (type 2) in the lower pole. Robotic assistance allowed precise suture closure of the neck as well as partial marsupialisation of the diverticulum. The child was discharged within 48 h and remains symptom free 18 months later. Calyceal diverticula are rare but technically challenging entities. We have shown a good outcome with only suture closure of the leak. Diathermy ablation of the lining and prolonged internal stenting were avoided.

Evaluation of the Momentum Closure Schemes in MPAS-Ocean

NASA Astrophysics Data System (ADS)

Zhao, Shimei; Liu, Yudi; Liu, Wei

2018-04-01

In order to compare and evaluate the performances of the Laplacian viscosity closure, the biharmonic viscosity closure, and the Leith closure momentum schemes in the MPAS-Ocean model, a variety of physical quantities, such as the relative reference potential energy (RPE) change, the RPE time change rate (RPETCR), the grid Reynolds number, the root mean square (RMS) of kinetic energy, and the spectra of kinetic energy and enstrophy, are calculated on the basis of results of a 3D baroclinic periodic channel. Results indicate that: 1) The RPETCR demonstrates a saturation phenomenon in baroclinic eddy tests. The critical grid Reynolds number corresponding to RPETCR saturation differs between the three closures: the largest value is in the biharmonic viscosity closure, followed by that in the Laplacian viscosity closure, and that in the Leith closure is the smallest. 2) All three closures can effectively suppress spurious dianeutral mixing by reducing the grid Reynolds number under sub-saturation conditions of the RPETCR, but they can also damage certain physical processes. Generally, the damage to the rotation process is greater than that to the advection process. 3) The dissipation in the biharmonic viscosity closure is strongly dependent on scales. Most dissipation concentrates on small scales, and the energy of small-scale eddies is often transferred to large-scale kinetic energy. The viscous dissipation in the Laplacian viscosity closure is the strongest on various scales, followed by that in the Leith closure. Note that part of the small-scale kinetic energy is also transferred to large-scale kinetic energy in the Leith closure. 4) The characteristic length scale L and the dimensionless parameter D in the Leith closure are inherently coupled. The RPETCR is inversely proportional to the product of D and L. When the product of D and L is constant, both the simulated RPETCR and the inhibition of spurious dianeutral mixing are the same in all tests using the Leith

Umbilical hernia following gastroschisis closure: a common event?

PubMed

Tullie, L G C; Bough, G M; Shalaby, A; Kiely, E M; Curry, J I; Pierro, A; De Coppi, P; Cross, K M K

2016-08-01

To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2.39 kg (1-3.52) and 23 (43 %) were male. Fourteen patients (26 %) underwent sutureless closure: 12 primary, 2 staged; and 39 (74 %) sutured closure: 19 primary, 20 staged. Sutured closure was interrupted sutures in 24 patients, 11 pursestring and 4 not specified. Fifty patients were followed-up over 53 months (10-101) and 22 (44 %) developed umbilical hernias. There was a significantly greater hernia incidence following sutureless closure (p = 0.0002). In sutured closure, pursestring technique had the highest hernia rate (64 %). Seven patients underwent operative hernia closure; three secondary to another procedure. Seven patients had their hernias resolve. One patient was lost to follow-up and seven remain under observation with no reported complications. There is a significant umbilical hernia incidence following sutureless and pursestring sutured gastroschisis closure. This has not led to complications and the majority have not undergone repair.

Vacuum Virtues

ERIC Educational Resources Information Center

Rathey, Allen

2007-01-01

Upright vacuums, like cars, vary in quality, features and performance. Like automobiles, some uprights are reliable, others may be problematic, and some become a problem as a result of neglect or improper use. So, how do education institutions make an informed choice and, having done so, ensure that an upright vacuum goes the distance? In this…

Duct closure

DOEpatents

Vowell, Kennison L.

1987-01-01

A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

Three point-advancement closure for skin defects.

PubMed

Tamir, G; Birkby, C S; Berg, D

1999-10-01

Circular skin defects are common following Mohs' surgery. Traditional closure (primary, flap, or graft) may involve extensive surgery. Multidirectional advancement closures such as the purse-string closure have been advocated as another useful tool in such cases. To describe a variation on purse-string closure that, in certain cases, is an excellent alternative to other reconstructions, and will provide good cosmetic and functional outcome. A three-point anchoring suture is placed after undermining to advance the surrounding tissue toward the centre, creating a "Mercedes Benz" or tripod closure following removal of "dog-ears." Circular wounds in designated areas can be more easily closed, creating well-tolerated, favourable scars. Large wounds may be closed with the advantage of avoidance of larger flaps, of decreased wound healing compared to second intention, and of minimizing removal of healthy tissue. An initial trial of closure with this method does not limit subsequent use of other repairs should it be less than satisfactory.

Wound Healing of Cutaneous Sulfur Mustard Injuries: Strategies for the Development of Improved Therapies

DTIC Science & Technology

2005-01-05

nutritional support 5.10 Vacuum Assisted ClosureTM 5.11 Use of non-invasive bioengineering methods to assess treatment efficacy 6. Summary 7...for any therapeutic regimen to be successful, a healthy immunological,8 4 nutritional /metaboliC,81 and psychological 6 status needs to be maintained... Yucatan miniature pigs,91 and young pigs are highly resistant to contamination and infection.92 Furthermore, pigs are amenable to habituation and can be

Microfabricated triggered vacuum switch

DOEpatents

Roesler, Alexander W [Tijeras, NM; Schare, Joshua M [Albuquerque, NM; Bunch, Kyle [Albuquerque, NM

2010-05-11

A microfabricated vacuum switch is disclosed which includes a substrate upon which an anode, cathode and trigger electrode are located. A cover is sealed over the substrate under vacuum to complete the vacuum switch. In some embodiments of the present invention, a metal cover can be used in place of the trigger electrode on the substrate. Materials used for the vacuum switch are compatible with high vacuum, relatively high temperature processing. These materials include molybdenum, niobium, copper, tungsten, aluminum and alloys thereof for the anode and cathode. Carbon in the form of graphitic carbon, a diamond-like material, or carbon nanotubes can be used in the trigger electrode. Channels can be optionally formed in the substrate to mitigate against surface breakdown.

Influence of Gap Distance on Vacuum Arc Characteristics of Cup Type AMF Electrode in Vacuum Interrupters

NASA Astrophysics Data System (ADS)

Cheng, Shaoyong; Xiu, Shixin; Wang, Jimei; Shen, Zhengchao

2006-11-01

The greenhouse effect of SF6 is a great concern today. The development of high voltage vacuum circuit breakers becomes more important. The vacuum circuit breaker has minimum pollution to the environment. The vacuum interrupter is the key part of a vacuum circuit breaker. The interrupting characteristics in vacuum and arc-controlling technique are the main problems to be solved for a longer gap distance in developing high voltage vacuum interrupters. To understand the vacuum arc characteristics and provide effective technique to control vacuum arc in a long gap distance, the arc mode transition of a cup-type axial magnetic field electrode is observed by a high-speed charge coupled device (CCD) video camera under different gap distances while the arc voltage and arc current are recorded. The controlling ability of the axial magnetic field on vacuum arc obviously decreases when the gap distance is longer than 40 mm. The noise components and mean value of the arc voltage significantly increase. The effective method for controlling the vacuum arc characteristics is provided by long gap distances based on the test results. The test results can be used as a reference to develop high voltage and large capacity vacuum interrupters.

Anterior Segment Imaging for Angle Closure.

PubMed

Chansangpetch, Sunee; Rojanapongpun, Prin; Lin, Shan C

2018-04-01

To summarize the role of anterior segment imaging (AS-imaging) in angle closure diagnosis and management, and the possible advantages over the current standard of gonioscopy. Literature review and perspective. Review of the pertinent publications with interpretation and perspective in relation to the use of AS-imaging in angle closure assessment focusing on anterior segment optical coherence tomography and ultrasound biomicroscopy. Several limitations have been encountered with the reference standard of gonioscopy for angle assessment. AS-imaging has been shown to have performance in angle closure detection compared to gonioscopy. Also, imaging has greater reproducibility and serves as better documentation for long-term follow-up than conventional gonioscopy. The qualitative and quantitative information obtained from AS-imaging enables better understanding of the underlying mechanisms of angle closure and provides useful parameters for risk assessment and possible prediction of the response to laser and surgical intervention. The latest technologies-including 3-dimensional imaging-have allowed for the assessment of the angle that simulates the gonioscopic view. These advantages suggest that AS-imaging has a potential to be a reference standard for the diagnosis and monitoring of angle closure disease in the future. Although gonioscopy remains the primary method of angle assessment, AS-imaging has an increasing role in angle closure screening and management. The test should be integrated into clinical practice as an adjunctive tool for angle assessment. It is arguable that AS-imaging should be considered first-line screening for patients at risk for angle closure. Copyright © 2018 Elsevier Inc. All rights reserved.

A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology

PubMed Central

Hurd, Theresa; Rossington, Alan; Trueman, Paul; Smith, Jennifer

2017-01-01

Objective: Negative pressure wound therapy (NPWT) has been shown to be effective in the management of chronic and surgical wounds. The two most widely used modalities of NPWT are vacuum-assisted closure (V.A.C.) therapy (KCI, Inc., San Antonio, Texas) and the RENASYS NPWT system (Smith & Nephew, Hull, United Kingdom). This evaluation compares the performance of the two systems in the management of wounds of mixed etiology. Approach: The evaluation is based on retrospective evaluation of more than 1,000 patients treated with NPWT in a community setting in Canada. Results: Patients were well matched according to their baseline characteristics, including age, sex, and wound characteristics. No difference was seen between the two NPWT systems in terms of the percentage of patients reaching their predetermined treatment goal (90.0% and 93.6%, respectively). The time taken to achieve the treatment goal (median 8 weeks in both groups), percentage reduction in wound area (64.2% and 65.3%, respectively), and weekly rate of reduction in wound area (9.7% and 9.4%, respectively; p = 0.156). Innovation: This evaluation is believed to comprise the largest cohort of patients treated with NPWT published to date and is one of the few studies that have attempted to provide a direct comparison of the performance of alternative NPWT systems. Conclusion: Findings suggest that there are no clinically meaningful differences in the efficacy and performance of the two most widely used NPWT devices, based on consideration of a number of wound outcomes. PMID:28116226

Analytic closures for M1 neutrino transport

DOE PAGES

Murchikova, E. M.; Abdikamalov, E.; Urbatsch, T.

2017-04-25

Carefully accounting for neutrino transport is an essential component of many astrophysical studies. Solving the full transport equation is too expensive for most realistic applications, especially those involving multiple spatial dimensions. For such cases, resorting to approximations is often the only viable option for obtaining solutions. One such approximation, which recently became popular, is the M1 method. It utilizes the system of the lowest two moments of the transport equation and closes the system with an ad hoc closure relation. The accuracy of the M1 solution depends on the quality of the closure. Several closures have been proposed in themore » literature and have been used in various studies. We carry out an extensive study of these closures by comparing the results of M1 calculations with precise Monte Carlo calculations of the radiation field around spherically symmetric protoneutron star models. We find that no closure performs consistently better or worse than others in all cases. The level of accuracy that a given closure yields depends on the matter configuration, neutrino type and neutrino energy. As a result, given this limitation, the maximum entropy closure by Minerbo on average yields relatively accurate results in the broadest set of cases considered in this work.« less

Factors associated with increasing nursing home closures.

PubMed

Castle, Nicholas G; Engberg, John; Lave, Judith; Fisher, Andrew

2009-06-01

We determine the rate of nursing home closures for 7 years (1999-2005) and examine internal (e.g., quality), organizational (e.g., chain membership), and external (e.g., competition) factors associated with these closures. The names of the closed facilities and dates of closure from state regulators in all 50 states were obtained. This information was linked to the Online Survey, Certification, and Reporting data, which contains information on internal, organizational, and market factors for almost all nursing homes in the United States. One thousand seven hundred and eighty-nine facilities closed over this time period (1999-2005). The average annual rate of closure was about 2 percent of facilities, but the rate of closure was found to be increasing. Nursing homes with higher rates of deficiency citations, hospital-based facilities, chain members, small bed size, and facilities located in markets with high levels of competition were more likely to close. High Medicaid occupancy rates were associated with a high likelihood of closure, especially for facilities with low Medicaid reimbursement rates. As states actively debate about how to redistribute long-term care services/dollars, our findings show that they should be cognizant of the potential these decisions have for facilitating nursing home closures.

31 CFR 413.1 - Closure of streets.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

31 CFR 413.1 - Closure of streets.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

31 CFR 413.1 - Closure of streets.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

31 CFR 413.1 - Closure of streets.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

31 CFR 413.1 - Closure of streets.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Closure of streets. 413.1 Section 413.1 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) SECRET SERVICE, DEPARTMENT OF THE TREASURY CLOSURE OF STREETS NEAR THE WHITE HOUSE § 413.1 Closure of streets. (a) District...

Interdisciplinary consensus on the uses and technique of MR-guided vacuum-assisted breast biopsy (VAB): results of a European consensus meeting.

PubMed

Heywang-Köbrunner, Sylvia H; Sinnatamby, Ruchi; Lebeau, Annette; Lebrecht, Antje; Britton, Peter D; Schreer, Ingrid

2009-11-01

Quality assurance of MR-guided vacuum-assisted breast biopsy (VAB). A consensus was achieved based on the existing literature and experience of an interdisciplinary group comprising European specialists in breast imaging and VAB. Full imaging work-up must be completed according to existing standards before an indication for MR-guided VAB is established. The procedure should be reserved for lesions demonstrable by MRI alone. Acquisition of >24 cores (11-Gauge) should be routinely attempted, with the intention of sufficiently removing small lesions for accurate diagnosis. Following biopsy the patient should be re-imaged to demonstrate the biopsy site and its proximity to the lesion and hence the likely accuracy of the sampling. All patients should be discussed in a regular interdisciplinary conference and a documented consensus reached regarding patient management. Regular audit and review of all MR-guided VAB results and subsequent follow-up are recommended. This consensus includes protocols for the indication, performance parameters, interdisciplinary interpretation therapeutic recommendation, documentation and follow-up of MR-guided VAB. It does not replace official recommendations for percutaneous biopsy.

77 FR 75186 - Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT AGENCY: Bureau of... Lake Mountains in Utah County, Utah, to recreational target shooting to protect public safety. This... shooting closure within the described area will remain in effect no longer than two years from December 19...

APPARATUS AND METHOD FOR WELDING END CLOSURE TO CONTAINER

DOEpatents

Frantz, C.E.; Correy, T.B.

1959-08-01

A semi-automatic apparatus is described for welding a closure to the open end of a can containing a nuclear fuel slug. An arc is struck at the center of the closure and is shifted to a region near its periphery. Then the assembly of closure, can, and fuel slug is rotated so that the peripheral region of the closure is preheated. Next the arc is shifted to the periphery itself of the closure, and the assembly is rotated so that the closure is welded to the can.

Online Work Force Analyzes Social Media to Identify Consequences of an Unplanned School Closure - Using Technology to Prepare for the Next Pandemic.

PubMed

Rainey, Jeanette J; Kenney, Jasmine; Wilburn, Ben; Putman, Ami; Zheteyeva, Yenlik; O'Sullivan, Megan

assess the impact of an unplanned school closure due to a public health event would be informative. An online workforce can effectively assist with the review process.

Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

PubMed

Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

2015-12-01

To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at

Rubber closures for freeze-dried products.

PubMed

Hopkins, G H

1976-10-01

Once a biological product has been developed to perform its required medical or pharmaceutical function, it is essential that a container-closure system by chosen which will preserve the efficacy of the product up to the point of administration. The general requirements applicable to proper closure function will be reviewed and the suitability of natural and synthetic elastomers to perform these functions will be discussed. The specialized application of elastomeric materials as closures for freeze-dried products presents additional requirements which are superimposed upon those previously discussed. The first of these unique considerations relates to the proper physical design which will permit the outgassing of water vapor during the sublimation step in the lyophilizing chamber. During this outgassing the design must also permit the closure to remain affixed in the neck while only partially inserted. Since these preparations are lyophilized because they are unstable in aqueous solutions, the elastomer used must constitute an effective barrier to the transmission of moisture vapor through the closure. The MVT and gas transmission properties of elastomers will be discussed. Special consideration will be given to the extremely low temperatures used in the sublimation, stoppering, and storage before use of lyophilized products. The phenomenon of glass transition points with different elastomers will be explained as its relation to satisfactory performance of the closure function at low temperatures.

Laser Glass Frit Sealing for Encapsulation of Vacuum Insulation Glasses

NASA Astrophysics Data System (ADS)

Kind, H.; Gehlen, E.; Aden, M.; Olowinsky, A.; Gillner, A.

Laser glass frit sealing is a joining method predestined in electronics for the sealing of engineered materials housings in dimensions of some 1 mm2 to several 10 mm2. The application field ranges from encapsulation of display panels to sensor housings. Laser glass frit sealing enables a hermetical closure excluding humidity and gas penetration. But the seam quality is also interesting for other applications requiring a hermetical sealing. One application is the encapsulation of vacuum insulation glass. The gap between two panes must be evacuated for reducing the thermal conductivity. Only an efficient encapsulating technique ensures durable tight joints of two panes for years. Laser glass frit sealing is an alternative joining method even though the material properties of soda lime glass like sensitivity to thermal stresses are much higher as known from engineered materials. An adapted thermal management of the process is necessary to prevent the thermal stresses within the pane to achieve crack free and tight glass frit seams.

Silicone absorption of elastomeric closures--an accelerated study.

PubMed

Degrazio, F L; Hlobik, T; Vaughan, S

1998-01-01

There is a trend in the parenteral industry to move from the use of elastomeric closures which are washed, siliconized, dried and sterilized in-house at the pharmaceutical manufacturers' site to pre-prepared closures purchased from the closure supplier. This preparation can consist of washing to reduce particle-load and bioburden, siliconization, placement in ready-to-sterilize bags and may eventually extend to sterilization by steam autoclave or gamma irradiation. Since silicone oil lubrication is critical to the processability/machinability of closures, research was designed to investigate this phenomenon in closures prepared using the Westar RS (Ready-to-Sterilize) process. This paper presents the data gathered in a study of the characteristic of silicone absorption into elastomeric closures under accelerated conditions. Variables such as silicone viscosity, rubber formulation, effect of sterilization and others are considered.

Patent ductus arteriosus closure using an Amplatzer(™) ventricular septal defect closure device.

PubMed

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs.

Helicobacter pylori vacA s1m1 genotype but not cagA or babA2 increase the risk of ulcer and gastric cancer in patients from Southern Mexico.

PubMed

Román-Román, Adolfo; Martínez-Carrillo, Dinorah Nashely; Atrisco-Morales, Josefina; Azúcar-Heziquio, Julio César; Cuevas-Caballero, Abner Saúl; Castañón-Sánchez, Carlos Alberto; Reyes-Ríos, Roxana; Betancourt-Linares, Reyes; Reyes-Navarrete, Salomón; Cruz-Del Carmen, Iván; Camorlinga-Ponce, Margarita; Cortés-Malagón, Enoc Mariano; Fernández-Tilapa, Gloria

2017-01-01

The vacA , cagA and babA2 genotypes of Helicobacter pylori are associated with gastric pathology. The objectives were to determine the frequency of infection and distribution of the vacA , cagA and babA2 genotypes of H. pylori in patients with gastric ulcer, chronic gastritis and gastric cancer, and to evaluate the association of virulent genotypes with diagnosis. We studied 921 patients with symptoms of dyspepsia or with presumptive diagnosis of gastric cancer. The DNA of H. pylori and the vacA , cagA and babA2 genes was detected by PCR in total DNA from gastric biopsies. The association of H. pylori and of its cagA , vacA and babA2 genotypes with diagnosis was determined by calculating the odds ratio (OR). Chronic gastritis was confirmed in 767 patients, gastric ulcer in 115 and cancer in 39. The prevalence of H. pylori was 47.8, 49.6 and 61.5% in those groups, respectively. H. pylori was more frequent in the surrounding tissue (69.2%) than in the tumor (53.8%). The vacA s1m1 genotype predominated in the three groups (45.2, 61.4 and 83.3%, respectively). H. pylori was associated with cancer (OR adjusted  = 2.08; 95% CI 1.05-4.13; p  = 0.035) but not with ulcer (OR adjusted  = 1.07; 95% CI 0.71-1.61; p  = 0.728). The s1m1 genotype was associated with ulcer and cancer (OR adjusted  = 2.02; 95% CI 1.12-3.62; p  = 0.019 and OR adjusted  = 6.58; 95% CI 2.15-20.08; p  = 0.001, respectively). babA2 was associated with gastric cancer, and cagA was not associated with the diagnosis. In population from Southern Mexico, H. pylori and the s1m1 genotype were associated with gastric cancer and the s1m1 / cagA +/ babA2 + strains predominated in tumor and adjacent tissue.

Randomized clinical trial of intestinal ostomy takedown comparing pursestring wound closure vs conventional closure to eliminate the risk of wound infection.

PubMed

Camacho-Mauries, Daniel; Rodriguez-Díaz, José Luis; Salgado-Nesme, Noel; González, Quintín H; Vergara-Fernández, Omar

2013-02-01

The use of temporary stomas has been demonstrated to reduce septic complications, especially in high-risk anastomosis; therefore, it is necessary to reduce the number of complications secondary to ostomy takedowns, namely wound infection, anastomotic leaks, and intestinal obstruction. To compare the rates of superficial wound infection and patient satisfaction after pursestring closure of ostomy wound vs conventional linear closure. Patients undergoing colostomy or ileostomy closure between January 2010 and February 2011 were randomly assigned to linear closure (n = 30) or pursestring closure (n = 31) of their ostomy wound. Wound infection within 30 days of surgery was defined as the presence of purulent discharge, pain, erythema, warmth, or positive culture for bacteria. Patient satisfaction, healing time, difficulty managing the wound, and limitation of activities were analyzed with the Likert questionnaire. The infection rate for the control group was 36.6% (n = 11) vs 0% in the pursestring closure group (p < 0.0001). Healing time was 5.9 weeks in the linear closure group and 3.8 weeks in the pursestring group (p = 0.0002). Seventy percent of the patients with pursestring closure were very satisfied in comparison with 20% in the other group (p = 0.0001). This study was limited by the heterogeneity in the type of stoma in both groups. The pursestring method resulted in the absence of infection after ostomy wound closure (shorter healing time and improved patient satisfaction).

Vacuum probe surface sampler

NASA Technical Reports Server (NTRS)

Zahlava, B. A. (Inventor)

1973-01-01

A vacuum probe surface sampler is described for rapidly sampling relatively large surface areas which possess relatively light loading densities of micro-organism, drug particles or the like. A vacuum head with a hollow handle connected to a suitable vacuum source is frictionally attached to a cone assembly terminating in a flared tip adapted to be passed over the surface to be sampled. A fine mesh screen carried by the vacuum head provides support for a membrane filter which collects the microorganisms or other particles. The head assembly is easily removed from the cone assembly without contacting the cone assembly with human hands.

Clinical impact of the disposable ventouse iCup® versus a metallic vacuum cup: a multicenter randomized controlled trial.

PubMed

Equy, Véronique; David-Tchouda, Sandra; Dreyfus, Michel; Riethmuller, Didier; Vendittelli, Françoise; Cabaud, Victoire; Langer, Bruno; Margier, Jennifer; Bosson, Jean-Luc; Schaal, Jean-Patrick

2015-12-15

Assisted vaginal delivery by vacuum extraction is frequent. Metallic resterilizible metallic vacuum cups have been routinely used in France. In the last few years a new disposable semi-soft vacuum extraction cup, the iCup, has been introduced. Our objective was to compare maternal and new-born outcomes between this disposable cup and the commonly used Drapier-Faure metallic cup. This was a multicenter prospective randomized controlled open clinical trial performed in the maternity units of five university hospitals and one community hospital in France from October 2009 to February 2013. We included consecutive eligible women with a singleton gestation of at least 37 weeks who required vacuum assisted delivery. Women were randomized to vacuum extraction using the iCup or usual Drapier-Faure metallic cup. The primary outcome was a composite criterion including both the risk of cup dysfunction and the most frequent maternal and neonatal harms: the use of other instruments after attempted vacuum extraction, caesarean section after attempted vacuum extraction, three detachments of the cup, caput succedaneum, cephalohaematoma, episiotomy and perineal tears. 335 women were randomized to the disposable cup and 333 to extraction using the metallic cup. There was no significant difference between the two groups for the primary outcome. However, failed instrumental delivery was more frequent in the disposable cup group, mainly due to detachment: 35.6 % vs 7.1 %, p < 0.0001. Conversely, perineal tears were more frequent in the metallic cup group, especially third or fourth grade perineal tears: 1.7 % versus 5.0 %, p = 0.003. There were no significant differences between the two groups concerning post-partum haemorrhage, transfer to a neonatal intensive care unit (NICU) or serious adverse events. While the disposable cup had more detachments and extraction failures than the standard metallic cup, this innovative disposable device had the advantage of fewer perineal

40 CFR 265.1202 - Closure and post-closure care.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

40 CFR 265.1202 - Closure and post-closure care.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

40 CFR 265.1202 - Closure and post-closure care.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

40 CFR 265.1202 - Closure and post-closure care.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., STORAGE, AND DISPOSAL FACILITIES Hazardous Waste Munitions and Explosives Storage § 265.1202 Closure and... as long as it remains in service as a munitions or explosives magazine or storage unit. (b) If, after...

Some Recent Developments in Turbulence Closure Modeling

NASA Astrophysics Data System (ADS)

Durbin, Paul A.

2018-01-01

Turbulence closure models are central to a good deal of applied computational fluid dynamical analysis. Closure modeling endures as a productive area of research. This review covers recent developments in elliptic relaxation and elliptic blending models, unified rotation and curvature corrections, transition prediction, hybrid simulation, and data-driven methods. The focus is on closure models in which transport equations are solved for scalar variables, such as the turbulent kinetic energy, a timescale, or a measure of anisotropy. Algebraic constitutive representations are reviewed for their role in relating scalar closures to the Reynolds stress tensor. Seamless and nonzonal methods, which invoke a single closure model, are reviewed, especially detached eddy simulation (DES) and adaptive DES. Other topics surveyed include data-driven modeling and intermittency and laminar fluctuation models for transition prediction. The review concludes with an outlook.

Comparison of work rates, energy expenditure, and perceived exertion during a 1-h vacuuming task with a backpack vacuum cleaner and an upright vacuum cleaner.

PubMed

Mengelkoch, Larry J; Clark, Kirby

2006-03-01

The purpose of this study was to evaluate two types of industrial vacuum cleaners, in terms of cleaning rates, energy expenditure, and perceived exertion. Twelve industrial cleaners (six males and six females, age 28-39 yr) performed two 1-h vacuuming tasks with an upright vacuum cleaner (UVC) and a backpack vacuum cleaner (BPVC). Measures for oxygen uptake (VO2) and ratings of perceived exertion (RPE) were collected continuously during the 1-h vacuuming tasks. Cleaning rates for the UVC and BPVC were 7.23 and 14.98 m2min(-1), respectively. On a separate day subjects performed a maximal treadmill exercise test to determine their maximal aerobic capacity (peak VO2). Average absolute energy costs (in Metabolic equivalents), relative energy costs of the vacuum task compared to the subjects' maximal aerobic capacity (% peak VO2), and RPE responses for the 1-h vacuuming tasks were similar between vacuum cleaners, but % peak VO2 and RPE values differed between genders. These results indicate that the BPVC was more efficient than the UVC. With the BPVC, experienced workers vacuumed at a cleaning rate 2.07 times greater than the UVC and had similar levels of energy expenditure and perceived effort, compared to the slower cleaning rate with the UVC.

Analysis of Mining-induced Valley Closure Movements

NASA Astrophysics Data System (ADS)

Zhang, C.; Mitra, R.; Oh, J.; Hebblewhite, B.

2016-05-01

Valley closure movements have been observed for decades in Australia and overseas when underground mining occurred beneath or in close proximity to valleys and other forms of irregular topographies. Valley closure is defined as the inward movements of the valley sides towards the valley centreline. Due to the complexity of the local geology and the interplay between several geological, topographical and mining factors, the underlying mechanisms that actually cause this behaviour are not completely understood. A comprehensive programme of numerical modelling investigations has been carried out to further evaluate and quantify the influence of a number of these mining and geological factors and their inter-relationships. The factors investigated in this paper include longwall positional factors, horizontal stress, panel width, depth of cover and geological structures around the valley. It is found that mining in a series passing beneath the valley dramatically increases valley closure, and mining parallel to valley induces much more closure than other mining orientations. The redistribution of horizontal stress and influence of mining activity have also been recognised as important factors promoting valley closure, and the effect of geological structure around the valley is found to be relatively small. This paper provides further insight into both the valley closure mechanisms and how these mechanisms should be considered in valley closure prediction models.

Smear layer removal and canal cleanliness using different irrigation systems (EndoActivator, EndoVac, and passive ultrasonic irrigation): field emission scanning electron microscopic evaluation in an in vitro study.

PubMed

Mancini, Manuele; Cerroni, Loredana; Iorio, Lorenzo; Armellin, Emiliano; Conte, Gabriele; Cianconi, Luigi

2013-11-01

The purpose of this study was to evaluate the effectiveness of different irrigating methods in removing the smear layer at 1, 3, 5, and 8 mm from the apex of endodontic canals. Sixty-five extracted single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer, Ballaigues, Switzerland) and irrigated with 5.25% NaOCl at 37°C. Teeth were divided into 5 groups (2 control groups [n = 10] and 3 test groups [n = 15]) according to the final irrigant activation/delivering technique (ie, sonic irrigation, passive ultrasonic irrigation [PUI], or apical negative pressure). Root canals were then split longitudinally and observed by field emission scanning electron microscopy. The presence of debris and a smear layer at 1, 3, 5, and 8 mm from the apex was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. The EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK) was significantly more efficient than PUI and the control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System (Discus Dental, Culver City, CA) removed statistically significantly more smear layer than all groups at 1, 3, 5, and 8 mm from the apex. At 5 and 8 mm from the apex, PUI and the EndoVac did not differ statistically significantly, but both performed statistically better than the control groups. In our study, none of the activation/delivery systems completely removed the smear layer from the endodontic dentine walls; nevertheless, the EndoActivator and EndoVac showed the best results at 3, 5, and 8 mm (EndoActivator) and 1, 3, 5, and 8 mm (EndoVac) from the apex. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The Presence of Phage Orthologous Genes in Helicobacter pylori Correlates with the Presence of the Virulence Factors CagA and VacA.

PubMed

Kyrillos, Alexandra; Arora, Gaurav; Murray, Bradley; Rosenwald, Anne G

2016-06-01

The bacterium Helicobacter pylori is associated with ulcers and the development of gastric cancer. Several genes, including cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), are associated with increased gastric cancer risk. Some strains of H. pylori also contain sequences related to bacteriophage phiHP33; however, the significance of these phage-related sequences remains unknown. We assessed the extent to which phiHP33-related sequences are present in 335 H. pylori strains using homology searches then mapped shared genes between phiHP33 and H. pylori strains onto an existing phylogeny. One hundred and twenty-one H. pylori strains contain phage orthologous sequences, and the presence of the phage-related sequences correlates with the presence of CagA and VacA. Mapping of the phage orthologs onto a phylogeny of H. pylori is consistent with the hypothesis that these genes were acquired by horizontal gene transfer. phiHP33 phage orthologous sequences might be of significance in understanding virulence of different H. pylori strains. © 2015 John Wiley & Sons Ltd.

PREFACE: International Symposium on Vacuum Science & Technology and its Application for Accelerators (IVS 2012)

NASA Astrophysics Data System (ADS)

Pandit, V. S.; Pal, Gautam

2012-11-01

clearly indicates that industry has advanced quite significantly. During the symposium, the Indian Vacuum Society honoured two distinguished personalities for their remarkable and significant contributions to the field of vacuum science and development of technology in the country. Awards were presented for both oral and poster papers during the symposium. A committee evaluated the scientific content and clarity of presentation of contributed papers. We believe that deliberations and discussions at the symposium will help gain a better understanding of the complicated and involved technology of vacuum science and be of benefit to scientists and technologists. Subimal Saha Convener Gautam Pal Co-Convener V S Pandit Secretary Surajit Pal Treasurer Conference photograph International Advisory Committee National Advisory Committee S BanerjeeDAE/IndiaR K Bhandari (Chairman)VECC Rockett AngusAVS/USAD L BandyopadhyayIVS A V Dadve CdrPfeiffer Vac /IndiaS B BhattIPR M Barma TIFR/IndiaK G BhushanBARC R K BhandariVECC/IndiaAlok ChakrabartiVECC R C BudhaniNPL, IndiaD P ChakravartyBARC Shekhar ChanderCEERI/IndiaTushar DesaiMumbai Univ S C ChetalIGCAR/IndiaR DeyVECC K L ChopraIIT Delhi/IndiaS C GadkariBARC Christian DayKIT/GermanyS K GuptaIUVSTA/India Kraemer DieterFAIR/GermanyShrikrishna GuptaBARC L M GantayatBARC/IndiaRajendra JatharAgilent Technologies R B GroverDAE, BARC/IndiaS N JoshiCEERI P D Gupta RRCAT/IndiaD KanjilalIUAC Szajman JakubVSA/AustraliaC MallikVECC R N JayarajNFC/IndiaS G MarkandeyaBRNS S KailasBARC/IndiaK C MittalBARC P K KawIPR/IndiaS NagarjunHHV Bangalore Lalit KumarMTRDC/IndiaK G M NairIGCAR Jean Larour Ecole/FranceGautam Pal (Co-convener)VECC Marminga LiaTRIUMF/CanadaSurajit Pal (Treasurer)VECC Shekhar MishraFermilab/USA V S Pandit (Secretary)VECC Ganapatirao MyneniJlab/USaR G PillayTIFR S V NarasaiahHHV/IndiaMohan PradeepNPL K RadhakrishnanISRO/IndiaY Ranga RaoVac Techniques A S Raja RaoIVS/IndiaR RanganathanSINP T RamasamiDST/IndiaSubimal Saha (Convener

Online Work Force Analyzes Social Media to Identify Consequences of an Unplanned School Closure – Using Technology to Prepare for the Next Pandemic

PubMed Central

Rainey, Jeanette J.; Kenney, Jasmine; Wilburn, Ben; Putman, Ami; Zheteyeva, Yenlik; O’Sullivan, Megan

2016-01-01

and their families. Using social media to assess the impact of an unplanned school closure due to a public health event would be informative. An online workforce can effectively assist with the review process. PMID:27655229

A radiation hard vacuum switch

DOEpatents

Boettcher, G.E.

1988-07-19

A vacuum switch with an isolated trigger probe which is not directly connected to the switching electrodes. The vacuum switch within the plasmatron is triggered by plasma expansion initiated by the trigger probe which travels through an opening to reach the vacuum switch elements. The plasma arc created is directed by the opening to the space between the anode and cathode of the vacuum switch to cause conduction. 3 figs.

Transabdominal preperitoneal herniorrhaphy using laser-assisted tissue soldering in a porcine model.

PubMed

Lanzafame, Raymond J; Soltz, Barbara A; Stadler, Istvan; Soltz, Robert

2009-01-01

Collagen solder is capable of fixation of surgical meshes during laparoscopic herniorrhaphy without compromising tissue integration, increasing adhesions or inflammation. This pilot study describes development of instrumentation and techniques for transabdominal preperitoneal (TAPP) herniorrhaphy using laser-assisted soldering technology. Anesthetized 20-kg to 25-kg female Yorkshire pigs underwent laparoscopy performed using a 3-trocar technique. Peritoneal incisions were made and pockets created in the preperitoneal space for mesh placement. Parietex TEC mesh segments embedded in 60% collagen-solder were soldered to the muscle surface by using a prototype laser (1.45micro, 4.5W CW, 5mm spot, and 55 degrees C set temperature) and custom laparoscopic handpiece. Parietex TEC mesh segments (Control) were affixed to the muscle with fibrin sealant (Tisseel). Peritoneal closure was with staples (Control) or by soldering collagen embedded Vicryl mesh segments over the peritoneal incision (Mesh/TAPP). Segments were inserted using a specially designed introducer. Animals were recovered and underwent second-look laparoscopy at 6 weeks postimplantation. Mesh sites were harvested after animals were euthanized. The mesh-solder constructs were easily inserted and affixed in the TAPP approach. Tisseel tended to drip during application, particularly in vertical and ventral locations. Postoperative healing was similar to Control segments in all cases. Mesh/TAPP closures healed without scarring or adhesion formation. Collagen-based tissue soldering permits normal wound healing and may mitigate or reduce use of staples for laparoscopic mesh fixation and peritoneal closure. Laser-assisted mesh fixation and peritoneal closure is a promising alternative for laparoscopic herniorrhaphy. Further development of this strategy is warranted.

32 CFR 989.25 - Base closure and realignment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure... frequently contain provisions limiting the extent of environmental analysis required for actions taken under...

32 CFR 989.25 - Base closure and realignment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure... frequently contain provisions limiting the extent of environmental analysis required for actions taken under...

Comparison of vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification systems.

PubMed

Han, Young Keun; Miller, Kevin M

2009-08-01

To compare vacuum rise time, vacuum limit accuracy, and occlusion break surge of 3 new phacoemulsification machines. Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. The vacuum rise time under normal and enhanced aspiration modes, vacuum limit accuracy, and occlusion break surge of the Infiniti Vision System, Stellaris Vision Enhancement System, and WhiteStar Signature Phacoemulsification System were tested. Vacuum rise time and limit accuracy were measured at limit settings of 400 mm Hg and 600 mm Hg. Surge area was recorded at vacuum limit settings of 200 mm Hg, 300 mm Hg, 400 mm Hg, and 500 mm Hg. The Infiniti had the fastest vacuum rise times under normal and enhanced aspiration modes. At 4 seconds, the vacuum limit accuracy was greatest with the Infiniti at the 400 mm Hg limit and the Signature at the 600 mm Hg limit. The Stellaris did not reach either vacuum target. The Infiniti performed better than the other 2 machines during testing of occlusion break surge at all vacuum limit settings above 200 mm Hg. Under controlled laboratory test conditions, the Infiniti had the fastest vacuum rise time, greatest vacuum limit accuracy at 400 mm Hg, and least occlusion break surge. These results can be explained by the lower compliance of the Infiniti system.

A reliable and safe gastrotomy closure technique assessed in a porcine survival model pilot study: success of the Queen's closure.

PubMed

Hookey, L C; Bielawska, B; Samis, A; Jalink, D; Ellis, R; Khokhotva, V; Hurlbut, D; Mercer, D

2009-06-01

The evolution of NOTES to clinical implementation has been hampered by lack of a reliable, safe, and easy-to-implement technique for closure of the opening created in accessing the peritoneum. The Queen's closure uses a combination of endoscopic clips and loop devices to seal such defects in the stomach wall. This study aimed to assess the Queen's closure in a porcine survival model. Five 30-kg pigs underwent endoscopic transgastric surgery with exploration of the peritoneum. The endoscope was then withdrawn back into the stomach and the closure performed. The animals were recovered, monitored closely, and underwent endoscopy 1 week after surgery. They were then euthanized at 2 (n = 2) and 3 (n = 3) weeks after surgery with subsequent necropsy. The mean procedure time (from intubation of the esophagus to withdrawal of the endoscope) was 79 minutes (range 45-105 minutes) with a mean time of exploration of the peritoneum of 14 minutes (range 8-25 minutes). All animals recovered well with no apparent pain, distress, or signs of infection. Endoscopic examination 1 week after surgery revealed all the closures to be intact and only identifiable by a small ulcer. At necropsy, the gastrotomy site was identifiable only by minor serosal adhesions. Histological study demonstrated full-thickness closure with minimal inflammation. The Queen's closure is a reliable and safe technique that provides full-thickness gastrotomy closure without any observed complications. The technique has proven to be transferable knowledge that holds promise for clinical implementation.

Use of cryopoor plasma for albumin replacement and continuous antimicrobial infusion for treatment of septic peritonitis in a dog.

PubMed

Ropski, Meaghan K; Guillaumin, Julien; Monnig, Andrea A; Townsend, Katy; McLoughlin, Mary A

2017-05-01

To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device. Postoperatively the patient experienced severe hypotension, which responded to norepinephrine constant rate infusion (CRI) after failing to improve with fluid therapy or dopamine CRI. Further treatment included antimicrobial CRI and supportive care including careful fluid therapy. Due to low effective circulating volume paired with intersititial fluid overload and large volume abdominal effusion, fluid therapy consisted of a combination of human serum albumin, canine albumin, synthetic colloids, and isotonic crystalloids. Cryopoor plasma (CPP) was used as a source of canine albumin and intravascular volume. On Day 4, food dye was given through a nasogastric tube due to suspicion of dehiscence of the anastomosis site. Dehiscence was confirmed during abdominal exploratory, and a second resection and anastomosis was performed. Abdominal partial closure with vacuum-assisted closure device was performed. Supportive care was continued with CPP CRI and imipenem CRI. Planned relaparotomy to change the vacuum-assisted closure device was performed 48 hours later, with abdominal closure 96 hours after anastomosis. The patient was discharged on Day 15. Recheck 12 months later was normal. This case includes novel techniques such food dye via nasogastric tube to identify anastomosis dehiscence, use of CPP as a source of canine albumin, and antimicrobial CRI in a dog with septic peritonitis. © Veterinary Emergency and Critical Care Society

40 CFR 264.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 26 2014-07-01 2014-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

40 CFR 264.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 26 2011-07-01 2011-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

40 CFR 264.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 27 2012-07-01 2012-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

40 CFR 264.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 27 2013-07-01 2013-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

40 CFR 264.118 - Post-closure plan; amendment of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... days after an unexpected event has occurred which has affected the post-closure plan. An owner or... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Post-closure plan; amendment of plan... FACILITIES Closure and Post-Closure § 264.118 Post-closure plan; amendment of plan. (a) Written Plan. The...

Air bearing vacuum seal assembly

DOEpatents

Booth, Rex

1978-01-01

An air bearing vacuum seal assembly capable of rotating at the speed of several thousand revolutions per minute using an air cushion to prevent the rotating and stationary parts from touching, and a two stage differential pumping arrangement to maintain the pressure gradient between the air cushion and the vacuum so that the leak rate into the vacuum is, for example, less than 1 .times. 10.sup.-4 Pa m.sup.3 /s. The air bearing vacuum seal has particular application for mounting rotating targets to an evacuated accelerator beam tube for bombardment of the targets with high-power charged particle beams in vacuum.

The use of urinary bladder matrix in the treatment of complicated open wounds.

PubMed

Lanteri Parcells, Alexis; Abernathie, Brenon; Datiashvili, Ramazi

2014-07-01

Management of complicated open wounds represents a challenge when reconstructive options are not applicable. Urinary bladder matrix (UBM) provides a biocompatible material that allows inductivetissue remodeling. The use of urinary bladder matrix inthe treatment of 5 patients with complicated open wounds that failed toheal with conventional therapy is presented. A 3-year old male sustained a second-degree oil burn measuring 8 cm x 4 cm to his dorsal forearm; UBM was applied weekly and the wound epithelialized in 3 weeks. A 52-year old male sustained massive second and third degree burns to his leg after a fire; UBM was applied weekly and the wound epithelialized in 28 weeks. A 61-year old female sustained a severe crushing injury to her right knee. A gastrocnemius muscle transfer and rectus abdominus muscle free flap transfer both failed, then UBM and vacuum-assisted closure therapy were applied and the wound epithelialized in 24 weeks. A 54-year old female underwent a breast mastectomy and immediate reconstruction with pedicled transverse rectus abdominus flap. The patient developed partial necrosis and the wound was managed with UBM and vacuum-assisted closure therapy. The wound epithelialized in 12 weeks. A 36-year old female sustained severe degloving injuries to both hands with exposed metacarpals. Weekly application of UBM provided tissue remodeling over the bones, which allowed successful skin grafting and closure. These experiences show UBM to be an effective method in management of complicated open wounds in select cases. Further studies need to be implemented to confirm this conclusion.

Vacuum-Gauge Connection For Shipping Container

NASA Technical Reports Server (NTRS)

Henry, Robert H.

1990-01-01

External connector enables measurement of vacuum in stored part. Remote-readout connector added to shipping container and connected to thermo-couple vacuum gauge in vacuum-insulated cryogenic line packed in container. Enables monitoring of condition of vacuum without opening container.

Control of aperture closure initiation during trunk-assisted reach-to-grasp movements.

PubMed

Rand, Miya K; Van Gemmert, Arend W A; Hossain, Abul B M I; Shimansky, Yury P; Stelmach, George E

2012-06-01

The present study investigated how the involvement and direction of trunk movement during reach-to-grasp movements affect the coordination between the transport and grasping components. Seated young adults made prehensile movements in which the involvement of the trunk was varied; the trunk was not involved, moved forward (flexion), or moved backward (extension) in the sagittal plane during the reach to the object. Each of the trunk movements was combined with an extension or flexion motion of the arm during the reach. Regarding the relationship between the trunk and arm motion for arm transport, the onset of wrist motion relative to that of the trunk was delayed to a greater extent for the trunk extension than for the trunk flexion. The variability of the time period from the peak of wrist velocity to the peak of trunk velocity was also significantly greater for trunk extension compared to trunk flexion. These findings indicate that trunk flexion was better integrated into the control of wrist transport than trunk extension. In terms of the temporal relationship between wrist transport and grip aperture, the relationship between the time of peak wrist velocity and the time of peak grip aperture did not change or become less steady across conditions. Therefore, the stability of temporal coordination between wrist transport and grip aperture was maintained despite the variation of the pattern of intersegmental coordination between the arm and the trunk during arm transport. The transport-aperture coordination was further assessed in terms of the control law according to which the initiation of aperture closure during the reach occurs when the hand crosses a hand-to-target distance threshold for grasp initiation, which is a function of peak aperture, wrist velocity and acceleration, trunk velocity and acceleration, and trunk-to-target distance at the time of aperture closure initiation. The participants increased the hand-to-target distance threshold for grasp

CONTROL OF APERTURE CLOSURE INITIATION DURING TRUNK-ASSISTED REACH-TO-GRASP MOVEMENTS

PubMed Central

Rand, Miya K.; Van Gemmert, Arend W. A.; Hossain, Abul B.M.I.; Shimansky, Yury P.; Stelmach, George E.

2012-01-01

The present study investigated how the involvement and direction of trunk movement during reach-to-grasp movements affect the coordination between the transport and grasping components. Seated young adults made prehensile movements in which the involvement of the trunk was varied; the trunk was not involved, moved forward (flexion), or moved backward (extension) in the sagittal plane during the reach to the object. Each of the trunk movements was combined with an extension or flexion motion of the arm during the reach. Regarding the relation between the trunk and arm motion for arm transport, the onset of wrist motion relative to that of the trunk was delayed to a greater extent for the trunk extension than for the trunk flexion. The variability of the time period from the peak of wrist velocity to the peak of trunk velocity was also significantly greater for trunk extension compared to trunk flexion. These findings indicate that trunk flexion was better integrated into the control of wrist transport than trunk extension. In terms of the temporal relationship between wrist transport and grip aperture, the relation between the time of peak wrist velocity and the time of peak grip aperture did not change or became less steady across conditions. Therefore, the stability of temporal coordination between wrist transport and grip aperture was maintained despite the variation of the pattern of intersegmental coordination between the arm and the trunk during arm transport. The transport-aperture coordination was further assessed in terms of the control law according to which the initiation of aperture closure during the reach occurs when the hand crosses a hand-to-target distance threshold for grasp initiation that is a function of peak aperture, wrist velocity and acceleration, trunk velocity and acceleration, and trunk-to-target distance at the time of aperture closure initiation. The participants increased the hand-to-target distance threshold for grasp initiation in

Uncertainty Quantification of Multi-Phase Closures

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

Nadiga, Balasubramanya T.; Baglietto, Emilio

In the ensemble-averaged dispersed phase formulation used for CFD of multiphase ows in nuclear reactor thermohydraulics, closures of interphase transfer of mass, momentum, and energy constitute, by far, the biggest source of error and uncertainty. Reliable estimators of this source of error and uncertainty are currently non-existent. Here, we report on how modern Validation and Uncertainty Quanti cation (VUQ) techniques can be leveraged to not only quantify such errors and uncertainties, but also to uncover (unintended) interactions between closures of di erent phenomena. As such this approach serves as a valuable aide in the research and development of multiphase closures.more » The joint modeling of lift, drag, wall lubrication, and turbulent dispersion|forces that lead to tranfer of momentum between the liquid and gas phases|is examined in the frame- work of validation of the adiabatic but turbulent experiments of Liu and Banko , 1993. An extensive calibration study is undertaken with a popular combination of closure relations and the popular k-ϵ turbulence model in a Bayesian framework. When a wide range of super cial liquid and gas velocities and void fractions is considered, it is found that this set of closures can be validated against the experimental data only by allowing large variations in the coe cients associated with the closures. We argue that such an extent of variation is a measure of uncertainty induced by the chosen set of closures. We also nd that while mean uid velocity and void fraction pro les are properly t, uctuating uid velocity may or may not be properly t. This aspect needs to be investigated further. The popular set of closures considered contains ad-hoc components and are undesirable from a predictive modeling point of view. Consequently, we next consider improvements that are being developed by the MIT group under CASL and which remove the ad-hoc elements. We use non-intrusive methodologies for sensitivity analysis and calibration