Dynamic Impedance Monitoring of Large Diameter-Vessel Sealing in Bipolar Electrosurgeries

2019 ◽  
Author(s):  
Xiaoran Li ◽  
Che-Hao Yang ◽  
Roland K. Chen ◽  
Wei Li
Keyword(s):  
Ex Vivo ◽  
Large Diameter ◽  
Small Diameter ◽  
Operation Time ◽  
Tissue Impedance ◽  
Fea Model ◽  
Post Surgery ◽  
Vessel Sealing ◽  
Dynamic Impedance ◽  
Impedance Monitoring

Abstract Vessel sealing with a bipolar electrosurgical device has become a common practice in modern operation rooms. Despite all the advantages, such as easier operation, less bleeding, and shorter post-surgery recovery time, side effects including sticking, charring, and rebleeding, often occur, leading to increased operation time and sometimes complications that are potentially fatal. Tissue impedance during the electrosurgical procedure has been used to improve the surgical outcome However, this method has only been effective for small-diameter vessels of 3–5 mm. Overall, little is found in literature on dynamic impedance monitoring of blood vessel sealing using bipolar electrosurgical devices. In this study, an experimental setup was designed and built to perform vessel sealing tests on large-diameter blood vessels with mimicking blood flow. Ex vivo porcine carotid artery samples with a diameter about 7 mm were used. Burst pressures after sealing were measured. It was found that the tissue impedance started with an initial decrease, followed by a rapid increase, and ended with a plateau that was orders of magnitude higher than the initial impedance. The rapid increase of impedance provides indication of protein denaturing, thus the seal completion. This feature was used to monitor the electrosurgical vessel sealing process. It is shown that a burst pressure at least twice the normal human systolic blood pressure can be achieved with heating until the maximum tissue impedance is reached. A FEA model was developed in COMSOL to understand the dynamic impedance behavior in the vessel sealing process.

Dynamic Impedance Monitoring for Large Diameter Vessel Sealing Using Bipolar Electrosurgery

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Xiaoran Li ◽  
Wei Li ◽  
Che-Hao Yang ◽  
Roland K. Chen
Keyword(s):  
Large Diameter ◽  
Electrical Power ◽  
Heating Process ◽  
Tissue Impedance ◽  
Vessel Sealing ◽  
Dynamic Impedance ◽  
Element Simulation ◽  
Normal Human ◽  
In The Beginning ◽  
Bipolar Electrosurgery

Abstract Vessel sealing using bipolar electrosurgery is becoming a common practice in modern operating rooms. Despite all the advantages such as faster operation, less bleeding, and shorter postsurgery recovery time, side effects including sticking, charring, and rebleeding still occur, leading to increased surgery time and sometimes fatal complications. Tissue impedance during the electrosurgical process has been used to determine the electrical power of the process. However, little has been done to understand the dynamic tissue impedance and its effectiveness in monitoring the vessel sealing process. Moreover, the samples used in previous studies all had small diameters of 2–5 mm. In this study, an experimental setup was developed to perform vessel sealing tests using large-diameter blood vessel samples with mimicking blood flow. The tissue impedance during the heating process was obtained. Burst pressures after sealing were measured. A finite element simulation model was developed to understand the dynamic impedance behavior. It is seen that the tissue impedance increases rapidly in the beginning of the heating process and remains at a level that is several orders of magnitude higher than the initial value. This rapid impedance increase indicates protein denaturing, thus can be used to monitor the electrosurgical vessel sealing process. An impedance-based monitoring algorithm was developed, with which a burst pressure at least twice the normal human systolic blood pressure was achieved.

scholarly journals Multicenter Experience With Large Diameter Balloon-Expandable Stent-Grafts for the Treatment of Infrarenal Penetrating Aortic Ulcers

2021 ◽  
pp. 152660282110282
Author(s):  
Jan Stana ◽  
Carlota Fernandez Prendes ◽  
Lukasz Kruszyna ◽  
Ioannis Thomas Passaloglou ◽  
Maria Antonella Ruffino ◽  
...  
Keyword(s):  
Stent Graft ◽  
Large Diameter ◽  
Small Diameter ◽  
Operation Time ◽  
Stent Fracture ◽  
Stent Grafts ◽  
Femoral Access ◽  
Mortality And Morbidity ◽  
Perioperative Morbidity ◽  
Aortic Stent Graft

Purpose To describe the use of large-diameter balloon-expandable stent-grafts (BeGraft aortic stent-graft, Bentley InnoMed GmbH, Hechingen, Germany) in the treatment of infrarenal penetrating aortic ulcer (iPAU). Materials and Methods Retrospective analysis of patients undergoing endovascular treatment with the BeGraft aortic stent-graft in 8 European centers from January 2017 to October 2020. Demographics, perioperative data, and midterm outcomes were collected. Endpoints of the study were technical feasibility, early mortality, and morbidity. Results A total of 40 patients were included. The mean age was 73.9±7.05 years and 63.2% were male. Indications for treatment included size and morphology (65%), presence of symptoms (29.5%), and contained ruptures (5.5%). Urgent treatment was performed in 5% of cases. Technical success was 97.5%. Median operation time was 58 minutes (19–170 minutes), with 27.5% of patients having additional procedures during the main intervention (1 additional repair with a C-TAG (W.L. Gore & Associates, Inc, Flagstaff, AZ, USA) thoracic endoprosthesis, 5 covered endovascular reconstruction of aortic bifurcation procedures, 3 extensions with proximal cuffs, and 2 percutaneous angioplasties of the common iliac arteries). Percutaneous femoral access was used in 72.5%, while groin cut-down was performed in 27.5%. Repair was successful with only 1 stent in 45% of cases, while 37.5% required 2 stents and nearly 17.5% required 3/4 stent-grafts. The 30-day mortality was 0%, with a 2.5% reintervention rate (1 patient required evacuation of an intra-abdominal hematoma). Median follow-up was 13.9 months (2–39 months), during which no vascular-related reinterventions or deaths were reported. In 4 patients, a type II endoleak was observed. No cases of graft migration, thrombosis, or stent-fracture were observed. Conclusions The treatment of iPAU with the BeGraft aortic stent-graft in a selective patient group is feasible with low rate of perioperative morbidity and mortality. Balloon-expandable stent-grafts offer the option to repair iPAUs with a shorter coverage of the aorta using low-profile sheath, that enables treatment in the presence of calcified access vessels and small diameter aortic bifurcations.

The Benefit of Using Multiple Thin Tanks Versus a Short Big Tank for Thermal Storage in Ceramic-Sphere Packed Bed With Airflow

2019 ◽  
Vol 142 (2) ◽  
Author(s):  
Yan Wang ◽  
Peiwen Li ◽  
Zhifeng Wang ◽  
Bei Yang ◽  
Guofeng Yuan
Keyword(s):  
Heat Transfer ◽  
Storage System ◽  
Large Diameter ◽  
Small Diameter ◽  
Operation Time ◽  
Thermal Storage ◽  
Packed Bed ◽  
Heat Transfer Fluid ◽  
Optimization Methodology ◽  
Energy Storage Efficiency

Abstract To make a better thermal storage system that uses air as the heat transfer fluid flowing through a packed-bed of ceramic spheres (Al2O3) as thermal storage materials, the present work studied cases using multiple small-diameter thin tanks to replace a large-diameter big tank while keeping the same total volume and the same air flow rate. Performance analysis of thermal storage has been conducted for comparison and optimization. The long flow passage and faster flow velocity of air in the small-diameter tanks was found to significantly benefit thermal storage performance compared with that of a short big tank. It resulted in a longer duration of discharge of high-temperature airflow, if the same operation time is applied to the two situations. The faster airflow enhances the heat transfer between air and thermal storage material, although it incurs larger pressure loss. Overall, the energy storage efficiency of using several thin tanks can be significantly better than that of using a big short tank if the height-to-diameter ratio in the multiple thin tanks is properly optimized. The optimization methodology and results are of great significance to the development of thermal storage systems that use air as heat transfer fluid and rocks or ceramic spheres as the packed-bed material for thermal storage.

Differences in the brain stem terminations of large- and small-diameter vestibular primary afferents

1995 ◽  
Vol 74 (3) ◽  
pp. 1362-1366 ◽  
Author(s):  
J. A. Huwe ◽  
E. H. Peterson
Keyword(s):  
Brain Stem ◽  
Large Diameter ◽  
Small Diameter ◽  
Movement Control ◽  
Three Dimensions ◽  
Significant Shift ◽  
Axon Diameter ◽  
Vestibular Complex ◽  
The Brain ◽  
Adjacent Brain

1. We visualized the central axons of 32 vestibular afferents from the posterior canal by extracellular application of horseradish peroxidase, reconstructed them in three dimensions, and quantified their morphology. Here we compare the descending limbs of central axons that differ in parent axon diameter. 2. The brain stem distribution of descending limb terminals (collaterals and associated varicosities) varies systematically with parent axon diameter. Large-diameter afferents concentrate their terminals in rostral regions of the medial/descending nuclei. As axon diameter decreases, there is a significant shift of terminal concentration toward the caudal vestibular complex and adjacent brain stem. 3. Rostral and caudal regions of the medial/descending nuclei have different labyrinthine, cerebellar, intrinsic, commissural, and spinal connections; they are believed to play different roles in head movement control. Our data help clarify the functions of large- and small-diameter afferents by showing that they contribute differentially to rostral and caudal vestibular complex.

scholarly journals Persisting inter‐limb differences in patients following total hip arthroplasty four to five years after surgery? A preliminary cross‐sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stefanie John ◽  
David Weizel ◽  
Anna S. Heumann ◽  
Anja Fischer ◽  
Katja Orlowski ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Center Of Pressure ◽  
Operation Time ◽  
Hip Strength ◽  
Total Hip ◽  
Control Subjects ◽  
Post Surgery ◽  
Flexion Extension ◽  
Hip Flexion

Abstract Background Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of this preliminary study was to include patients four to five years after undergoing THA and to investigate potential differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects. Methods Sixteen patients (age: 65.20 ± 5.32 years) following unilateral THA (post-operation time: 4.7 ± 0.7 years) and ten, healthy, age-matched control subjects (age: 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate. Results The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p = 0.02), for hip flexion ROM (p < 0.01) and for balance in terms of the length of center of pressure (COP) (p = 0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p < 0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p < 0.05). Conclusions The first results of this explorative study indicated that inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Further studies are required to replicate these findings with a larger sample size. Trial registration DRKS, DRKS00016945. Registered 12 March 2019 – Retrospectively registered,

scholarly journals Elastic Modulus and Elasticity Ratio of Malignant Breast Lesions with Shear Wave Ultrasound Elastography: Variations with Different Region of Interest and Lesion Size

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1015
Author(s):  
Antonio Bulum ◽  
Gordana Ivanac ◽  
Eugen Divjak ◽  
Iva Biondić Špoljar ◽  
Martina Džoić Dominković ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Shear Wave ◽  
Large Diameter ◽  
Small Diameter ◽  
Shear Wave Elastography ◽  
Lesion Size ◽  
Ultrasound Elastography ◽  
Breast Lesions ◽  
Malignant Breast ◽  
The Impact

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

Analysis Influence of Pile Embedded Depth and Diameter on Pile Tip Resistance

2013 ◽  
Vol 353-356 ◽  
pp. 459-462
Author(s):  
Ying Jie Zheng ◽  
Bin Fang ◽  
Lian Xiang Li
Keyword(s):  
Large Diameter ◽  
Small Diameter ◽  
Stiffness Ratio ◽  
Initial Stiffness ◽  
Tip Resistance

Pile tip absolute settlement curves and relative settlement curves of several working cases were analyzed. It is found that load-settlement curve characteristic related to the selection standard. The tip resistance initial stiffness of each case was analyzed. Results show that the small diameter pile has higher initial stiffness than large diameter pile, embedded depth has little influence on initial stiffness ratio, but increment of initial stiffness is linear with embedded depth growth.

scholarly journals Decellularised Human Umbilical Artery as a Vascular Graft Elicits Minimal Pro-Inflammatory Host Response Ex Vivo and In Vivo

2021 ◽  
Vol 22 (15) ◽  
pp. 7981
Author(s):  
Alexander Høgsted Ahlmann ◽  
Shu Fang ◽  
Sussi Bagge Mortensen ◽  
Line Weis Andersen ◽  
Pernille Gejl Pedersen ◽  
...  
Keyword(s):  
Vascular Graft ◽  
Umbilical Artery ◽  
Ex Vivo ◽  
White Blood Cells ◽  
Small Diameter ◽  
M1 Macrophages ◽  
Host Immune Responses ◽  
Cytokine Levels ◽  
Anti Inflammatory Cytokine

Small diameter (<6 mm) vessel grafts still pose a challenge for scientists worldwide. Decellularised umbilical artery (dUA) remains promising as small diameter tissue engineered vascular graft (TEVG), yet their immunogenicity remains unknown. Herein, we evaluated the host immune responses, with a focus on the innate part, towards human dUA implantation in mice, and confirmed our findings in an ex vivo allogeneic human setup. Overall, we did not observe any differences in the number of circulating white blood cells nor the number of monocytes among three groups of mice (1) dUA patch; (2) Sham; and (3) Mock throughout the study (day −7 to 28). Likewise, we found no difference in systemic inflammatory and anti-inflammatory cytokine levels between groups. However, a massive local remodelling response with M2 macrophages were observed in the dUA at day 28, whereas M1 macrophages were less frequent. Moreover, human monocytes from allogeneic individuals were differentiated into macrophages and exposed to lyophilised dUA to maximize an eventual M1 response. Yet, dUA did not elicit any immediate M1 response as determined by the absence of CCR7 and CXCL10. Together this suggests that human dUA elicits a minimal pro-inflammatory response further supporting its use as a TEVG in an allogeneic setup.

New method of poultry selection

2021 ◽  
pp. 61-66
Author(s):  
E. Rehleckaya ◽  
A. Dymkov ◽  
L. Lazarets ◽  
A. Maltsev
Keyword(s):  
Egg Production ◽  
Initial Period ◽  
Large Diameter ◽  
Small Diameter ◽  
Live Weight ◽  
Individual Variability ◽  
Egg Laying ◽  
New Method ◽  
Egg Diameter ◽  
Correlation Rate

Purpose: Install the influence of the «small diameter of the egg» on the living mass and the reproductive qualities of chickens of meat crosses and the quail of meat breeds.Materials and methods. The selection was carried out along egg production and mass of eggs and additionally on the average small diameter of 5 eggs by value of ≥0.5σ from the average for the herd, while the evaluation on the basis of the «small diameter of the egg» was carried out in chickens aged 238 days of life, quails — 70 days of life. Calculated the average for each female and the average for the herd. For further reproduction, chickens carrying eggs with a small egg diameter ≥0.5σ from the average for the herd. Studies were held in SibNIP on quail and on the courses.Results. In the initial period of the egg laying, the individual variability of the small diameter of the egg — more than 10% (in the future, the figure decreased). The close correlation rate of the small egg diameter in the first half of the egg laying with such at the end of the bird's operation period was revealed. It has been established that the large diameter of the egg has a positive reliable connection with a lively mass, but negative with egg production. The reliable correlation rate of the small diameter of the egg with a live weight at a 42-day age, as well as with the derivation of eggs. The inheritance coefficients of the small diameter of the egg are comparable to the inheritance coefficients of the mass of eggs and significantly exceed those for a large diameter of the egg. The selection according to the small diameter of the eggs by ≥0.5σ from the average for the herd led to the fact that the chickens of the experimental groups reliably exceeded the live weight in the SB level of 1.57%, in the line G8 — by 1.35%. The superiority of a lively mass of quail of experienced groups was more pronounced than that of the chickens: the Pharaoh breed — by 4.15%, the Texas white breed is 4.22%. In relation to the derivation of eggs, a similar trend was traced. The derivation of eggs in quails of experienced groups was more than 4.59–4.98%; Country, respectively, 4.57–5.22%. Egg production of females of comparable groups of both chickens and quail was almost on the same level, and the difference was unreliable.Conclusion. It was established that a new method of breeding the poultry of the meat direction of productivity allows without decreasing egg production to increase the living mass of chickens of meat crosses by 1.5%, rewinds of meat breeds — by 4%, the derivation of eggs, respectively, by 4–5%. The method is intended for early prediction of females productivity during breeding selection.

Copolymer-Nanoparticles Mixture in a Cylindrical Pore

NANO ◽  
2017 ◽  
Vol 12 (04) ◽  
pp. 1750045
Author(s):  
Jun-Xing Pan ◽  
Yu-Qi Guo ◽  
Yu-Fang Han ◽  
Min-Na Sun ◽  
Jin-Jun Zhang
Keyword(s):  
Phase Transition ◽  
Electrical Conductivity ◽  
Polymer Nanocomposites ◽  
Diblock Copolymer ◽  
Large Diameter ◽  
Small Diameter ◽  
Confinement Effect ◽  
Cylindrical Pore ◽  
Disorder Phase Transition ◽  
Novel Structures

Computer simulation is carried out for investigating the effect of nanoparticles on diblock copolymer morphology under cylindrical confinement. The phase diagrams of polymer nanocomposites with nanoparticle-block wetting strength and concentration of nanoparticles are obtained in different nanopores. In small diameter nanopore, there is almost no influence of nanoparticles on the diblock copolymer morphology because of the stronger confinement effect; in middle diameter nanopore, the system can self-assemble into various novel structures due to the interaction between confinement effect and nanoparticles effect; in large diameter nanopore, due to the stronger effect of nanoparticles, a disorder-order-disorder phase transition occurs with the wetting strength and concentration of nanoparticles increasing. This result can be useful in designing new nanocomposites with advanced electrical conductivity and/or mechanical strength.

Sign in / Sign up

Export Citation Format

Share Document