Search results for: endoscopic vacuum therapy

Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

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Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

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Authors: Mihail Nagea, Olivera Lupescu, Nicolae Ciurea, Alexandru Dimitriu, Alina Grosu

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Introduction: As severe open injuries are more and more frequent in modern traumatology, threatening not only the integrity of the affected limb but even the life of the patients, new methods desired to cope with the consequences of these traumas were described. Vacuum therapy is one such method which has been described as enhancing healing in trauma with extensive soft-tissue injuries, included those with septic complications. Material and methods: Authors prospectively analyze 15 patients with severe lower limb trauma with MESS less than 6, with considerable soft tissue loss following initial debridement and fracture fixation. The patients needed serial debridements and vacuum therapy was applied after delayed healing due to initial severity of the trauma, for an average period of 12 days (7 - 23 days).In 7 cases vacuum therapy was applied for septic complications. Results: Within the study group, there were no local complications; secondary debridements were performed for all the patients and vacuum system was re-installed after these debridements. No amputations were needed. Medical records were reviewed in order to compare the outcome of the patients: the hospital stay, anti-microbial therapy, time to healing of the bone and soft tissues (there is no standard group to be compared with) and the result showed considerable improvements in the outcome of the patients. Conclusion: Vacuum therapy improves healing of the soft tissues, including those infected; hospital stay and the number of secondary necessary procedures are reduced. Therefore it is considered a valuable support in treating trauma of the limbs with severe soft tissue injuries.

Keywords: complex injuries, negative pressure, open fractures, wound therapy

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Authors: Gia Lam Le, Dennis T. Bergado, Thi Ngoc Truc Nguyen

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This study focuses on behaviors of improved soft clay using prefabricated vertical drain (PVD) combined with vacuum and electro-osmotic preloading. Large-scale consolidations of reconstituted soft Bangkok clay were conducted for PVD improvement with vacuum (vacuum-PVD), and vacuum combined with heat (vacuum-thermo-PVD). The research revealed that vacuum-thermo-PVD gives high efficiency of the consolidation rate compared to the vacuum-PVD. In addition, the magnitude of settlement of the specimen improved by the vacuum-thermo-PVD is higher than the vacuum-PVD because the assistance of heat causes the collapse of the clay structure. Particularly, to reach 90% degree of consolidation, the thermal-vacuum-PVD reduced about 58% consolidation time compared to the vacuum-PVD. The increase in consolidation rate is resulted from the increase in horizontal coefficient of consolidation, Ch, the reduction of the smear effect expressed by the ratio of the horizontal hydraulic conductivity in the undisturbed zone, kh, and the horizontal hydraulic conductivity in the smeared zone, ks. Furthermore, the shear strength, Su, increased about 100% when compared using the vacuum-thermal-PVD to the vacuum PVD. In addition, numerical simulations gave reasonable results compared to the laboratory data.

Keywords: PVD improvement, vacuum preloading, prefabricated vertical drain, thermal PVD

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Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli

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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.

Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery

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Authors: Han Xiao, Ruan Qi, Zhang Lei, Qi Yan

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Space environment simulator is a facility used to conduct thermal test for spacecraft, and vacuum vessel is the main body of it. According to the requirements for thermal tests of the spacecraft and its solar array panels, the primary vessel and the side vessels are designed to be a combinative structure connected with aperture, which ratio reaches 0.7. Since the vacuum vessel suffers 0.1MPa external pressure during the process of thermal test, in order to ensure the simulator’s reliability and safety, it’s necessary to calculate the vacuum vessel’s intensity and stability. Based on the impact of large openings to vacuum vessel structure, this paper explored the reinforce design and analytical way of vacuum vessel with large openings, using a large space environment simulator’s vacuum vessel design as an example. Tests showed that the reinforce structure is effective to fulfill the requirements of external pressure and the gravity. This ensured the reliability of the space environment simulator, providing a guarantee for developing the spacecraft.

Keywords: vacuum vessel, large opening, space environment simulator, structure design

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Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

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Authors: Elif Aykin Dincer, Mustafa Erbas

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The vacuum drying behavior of beef slices (10 x 4 x 0.2 cm3) was experimentally investigated at the temperature of 60, 70, and 80°C under 25 mbar ultimate vacuum pressure and the mathematical models (Lewis, Page, Midilli, Two-term, Wangh and Singh and Modified Henderson and Pabis) were used to fit the vacuum drying of beef slices. The increase in drying air temperature resulted in a decrease in drying time. It took approximately 206, 180 and 157 min to dry beef slices from an initial moisture content to a final moisture content of 0.05 kg water/kg dry matter at 60, 70 and 80 °C of vacuum drying, respectively. It is also observed that the drying rate increased with increasing drying temperature. The coefficients (R2), the reduced chi-square (x²) and root mean square error (RMSE) values were obtained by application of six models to the experimental drying data. The best model with the highest R2 and, the lowest x² and RMSE values was selected to describe the drying characteristics of beef slices. The Page model has shown a better fit to the experimental drying data as compared to other models. In addition, the effective moisture diffusivities of beef slices in the vacuum drying at 60 - 80 °C varied in the range of 1.05 – 1.09 x 10-10 m2/s. Consequently, this results can be used to simulate vacuum drying process of beef slices and improve efficiency of the drying process.

Keywords: beef slice, drying models, effective diffusivity, vacuum

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Authors: Ali H. Mahfouz, Gao Ming-Jun, Mohamad Sharif

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Slurry dredged soil at coastal area has a high water content, poor permeability, and low surface intensity. Hence, it is infeasible to use vacuum preloading method to treat this type of soil foundation. For the special case of super soft ground, a floating bridge is first constructed on muddy soil and used as a service road and platform for implementing the modified vacuum preloading method. The modified technique of vacuum preloading and its construction process for the super soft soil foundation improvement is then studied. Application of modified vacuum preloading method shows that the technology and its construction process are highly suitable for improving the super soft soil foundation in coastal areas.

Keywords: super soft foundation, dredger fill, vacuum preloading, foundation treatment, construction technology

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Authors: Naglaa A. Abd Elkader, Haithem A. Farghali

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The present study carried out on fifteen clinical cases of different species of dogs which admitted to surgical clinic of veterinary medicine with different symptoms (Acute vomiting, hematemesis and anorexia). There was diagnostic march which including plain radiograph and endoscopic examination. Treatment was including surgical interference and endoscopic retrieval followed by medicinal treatment. This study was aimed the detection of different foreign bodies by the most suitable method according to the type of the foreign bodies.

Keywords: stomach, endoscopy, foreign bodies, dogs

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

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Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

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Authors: Farid Arya, Trevor Hyde

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The development of vacuum glazing represents a significant advancement in the area of low heat loss glazing systems with the potential to substantially reduce building heating and cooling loads. Vacuum glazing consists of two or more glass panes hermetically sealed together around the edge with a vacuum gap between the panes. To avoid the glass panes from collapsing and touching each other under the influence of atmospheric pressure an array of support pillars is provided between the glass panes. A high level of thermal insulation is achieved by evacuating the spaces between the glass panes to a very low pressure which greatly reduces conduction and convection within the space; therefore heat transfer through this kind of glazing is significantly lower when compared with conventional insulating glazing. However, vacuum glazing is subject to inherent stresses due to atmospheric pressure and temperature differentials which can lead to fracture of the glass panes and failure of the edge seal. A flexible edge seal has been proposed to minimise the impact of these issues. In this paper, vacuum glazing system with rigid and flexible edge seals is theoretically studied and their advantages and disadvantages are discussed.

Keywords: flexible edge seal, stress, support pillar, vacuum glazing

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Authors: Paul Henshall, Philip Eames, Roger Moss, Stan Shire, Farid Arya, Trevor Hyde

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Encapsulating the absorber of a flat plate solar thermal collector in vacuum by an enclosure that can be evacuated can result in a significant increase in collector performance and achievable operating temperatures. This is a result of the thermal insulation effectiveness of the vacuum layer surrounding the absorber, as less heat is lost during collector operation. This work describes experimental thermal insulation characterization tests of prototype vacuum flat plate solar thermal collectors that demonstrate the improvement in absorber heat loss coefficients. Furthermore, this work describes the selection and sizing of a getter, suitable for maintaining the vacuum inside the enclosure for the lifetime of the collector, which can be activated at low temperatures.

Keywords: vacuum, thermal, flat-plate solar collector, insulation

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Authors: David Hasurungan

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This paper objective is to assess the power distribution reliability improvement by retrofitting obsolete vacuum contactor. The case study in Badak Liquefied Natural Gas (LNG) plant is presented in this paper. To support plant operational, Badak LNG is equipped with 4.16 kV switchgear for supplying the storage and loading facilities, utilities facilities, and train facilities. However, there is a problem in two switch gears of sixteen switch gears. The problem is the obsolescence issue in its vacuum contactor. Not only that, but the same switchgear also has suffered from electrical fault due to contact fingering misalignment. In order to improve the reliability in switchgear, the vacuum contactor retrofit project is done. The retrofit will introduce new vacuum contactor design. The comparison between existing design and the new design is presented in this paper. Meanwhile, The reliability assessment and calculation are performed using software Reliasoft 7.

Keywords: reliability, obsolescence, retrofit, vacuum contactor

Procedia PDF Downloads 291

Authors: Farid Arya, Trevor Hyde, Paul Henshall, Phillip Eames, Roger Moss, Stan Shire

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Vacuum flat plate solar thermal collectors offer several advantages over other collectors namely the excellent optical and thermal characteristics they exhibit due to a combination of their wide surface area and high vacuum thermal insulation. These characteristics can offer a variety of applications for industrial process heat as well as for building integration as they are much thinner than conventional collectors making installation possible in limited spaces. However, many technical challenges which need to be addressed to enable wide scale adoption of the technology still remain. This paper will discuss the challenges, expectations and requirements for the flat-plate vacuum solar collector development. In addition, it will provide an overview of work undertaken in Ulster University, Loughborough University, and the University of Warwick on flat-plate vacuum solar thermal collectors. Finally, this paper will present a detailed experimental investigation on the development of a vacuum panel with a novel sealing method which will be used to accommodate a novel slim hydroformed solar absorber.

Keywords: hot box calorimeter, infrared thermography, solar thermal collector, vacuum insulation

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Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

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Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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Authors: Vladimir M. Tomović, Branislav V. Šojić, Predrag M. Ikonić, Ljiljana S. Petrović, Anamarija I. Mandić, Natalija R. Džinić, Snežana B. Škaljac, Tatjana A. Tasić, Marija R. Jokanović

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In this paper influence of packaging method (vacuum and modified atmosphere packaging) on lipid oxidative stability and sensory properties of odor and taste of the traditional sausage Petrovská klobása were examined. These parameters were examined during storage period (7 months). In the end of storage period, vacuum packed sausage showed better oxidative stability. Propanal content was significantly lower (P<0.05) in vacuum packed sausage compared to these values in unpacked and modified atmosphere packaging sausage. Hexanal content in vacuum packed sausage was 1.85 µg/g, in MAP sausage 2.98 µg/g and in unpacked sausage 4.94 µg/g. After 2 and 7 months of storage, sausages packed in vacuum had the highest grades for sensory properties of odor and taste.

Keywords: lipid oxidation, MAP, sensory properties, traditional sausage, vacuum

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Authors: Sharmeelee Subramaniam, Muhd Harris Ramli, Fauziah Ahmad

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The application of vacuum pressure to accelerate ground consolidation has been growing significantly in recent years. This ground improvement technique has its advantages, especially in areas where suitable fill is scarce, as it minimizes the surcharge fill height required for the preloading. A study was carried out to examine the response of soft subsoil subjected to vacuum consolidation in combination with embankment loading, surcharge preloading and PVD with two-way drainage. This paper shall describe a procedure to determine the optimum surcharge height and penetration depth of prefabricated vertical drains (PVD) where vacuum consolidation is combined with the use of PVD in soft clay deposits with two-way drainage.

Keywords: prefabricated vertical drain, soft soil, surcharge preload, vacuum consolidation

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Authors: Zarrin Nasri

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Microwave irradiation is an innovative technology in the petroleum industry. This kind of energy has been considered to convert vacuum residue of oil refineries into useful products. The advantages of microwaves energy are short time, fast heating, high energy efficiency, and precise process control. In this paper, the effects of catalyst type and amount have been investigated on upgrading of vacuum residue using microwave irradiation. The vacuum residue used in this research is from Tehran oil refinery, Iran. Additives include different catalysts, active carbon as sensitizer, and sodium borohydride as a solid hydrogen donor. Various catalysts contain iron, nickel, molybdenum disulfide, iron oxide and copper. The amount of catalysts in two cases of presence and absence of sodium borohydride have been evaluated. The objective parameters include temperature, asphaltene, viscosity, and API. The specifications of vacuum residue are API, 8.79, viscosity, 16391 cSt (60°C), asphaltene, 13.3 wt %. The results show that there is a significant difference between the effects of catalysts. Among the used catalysts, Fe powder is the best catalyst for upgrading vacuum residue using microwave irradiation and resulted in asphaltene reduction, 31.3 %; viscosity reduction, 76.43 %; and 23.43 % in API increase.

Keywords: asphaltene, microwave, upgrading, vacuum residue, viscosity

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Authors: Saran Toure

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Complex shaped parts manufactured using out of autoclave prepreg vacuum bagging has a high quality finish. This is not only due to in the control of resin to fibre ratio in prepregs, but also to a reduction in fibre misalignment, slippage and stresses occurring within plies during compaction. In a bid to further reduce deformation modes and control failure modes, we carried experiments where, we introduced wetted fabrics within a prepreg plybook during compaction. Here are presented the results obtained from the vacuum bagging of a complex shaped part. The shape is that of a turbine fan blade with smooth curves all throughout ending with sharp edged angles. The quality of the final part made from this blade is compared to that of the same blade made from standard vacuum bagging process of prepregs, without introducing wetted fabrics.

Keywords: complex shaped part, prepregs, drapability, vacuum bagging

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Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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Authors: Shikha Gupta, Suneet Kathuria, Supriya Sampley, Sunil Katyal

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Opioids are being increasingly used these days as adjuvants to local anesthetics in spinal anesthesia. The aim of this prospective, randomized, double‑blind study is to compare the effects of adding sufentanil or fentanyl to low dose bupivacaine in spinal anesthesia for endoscopic urological procedures. A total of 90 elective endoscopic urological surgery patients, 40‑80 years old, received spinal anesthesia with 7.5 mg hyperbaric bupivacaine 0.5% (Group A) or by adding sufentanil 10 μg (Group B) or fentanyl 25 μg (Group C) to 5 mg hyperbaric bupivacaine 0.5%. These groups were compared in terms of the quality of spinal anesthesia as well as analgesia. Analysis of variance and Chi‑square test were used for Statistical analysis. The onset of sensory and motor blockade was significantly rapid in Group A as compared with Groups B and C. The maximum upper level of sensory block was higher in Group A patients than Groups B and C patients. Quality of analgesia was significantly better and prolonged in sufentanil group as compared with other two groups. Motor block was more intense and prolonged in Group A as compared with Groups B and C patients. Request for post‑operative analgesic was significantly delayed in Group B patients. Hence in conclusions, spinal anesthesia for endoscopic urological procedures in elderly patients using low dose bupivacaine (5 mg) combined with 10 μg sufentanil is associated with a lower incidence of hemodynamic instability, better quality and prolonged duration as compared to that by adding 25 μg fentanyl.

Keywords: adjuvants, bupivacaine, fentanyl, intrathecal, low dose spinal, sufentanil

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Authors: Zhang Lei, Zhan Haiyang, Gu Miao

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A universal software platform is developed for improving the defects in the practical one. This software platform has distinct advantages in modularization, information management, and the interfaces. Several technologies such as computer technology, virtualization technology, network technology, etc. are combined together in this software platform, and four working modes are introduced in this article including single mode, distributed mode, cloud mode, and the centralized mode. The application area of the software platform is extended through the switch between these working modes. The software platform can arrange the thermal vacuum test process automatically. This function can improve the reliability of thermal vacuum test.

Keywords: software platform, thermal vacuum test, control and measurement, work mode

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Authors: ELdessouky Sheta, Sayed Elzomor, Haithem Farghali, Kawkab A. Ahmed, Naglaa A. Abd Elkader

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The present investigation has been dealt with Spirocerca (S.) lupi infested mongrel dogs. This parasitic disease is highly infective to human beings and carnivores. The diagnosis march has been comprised the lateral contrast thoracic radiographs, fecal examination, blood profile, endoscopic examination and histopathological sections of deep seated pinch biopsies. These infested dogs have been put under an adopted treatment with Ivermectin injection combined with oral prednisolone. The obtained results reveal an absence of the pessimistic recognitions particularly after 3 weeks from the onset of treatment. Endoscopically the presented esophageal nodules are marked out in the distal third of infested dogs' esophagus as masses assigned into the esophageal lumen and fundus of stomach. The endoscopic outlook of Spirocerca lupi lesions has been considered an integral procedure of the diagnostic march and for evaluation of treatment follow up. The diagnostic procedures and the recommended treatment are the vet's guidance to care for Spirocerca lupi in dogs, hoping in future to prevent this disease from being spread among human beings and other carnivores.

Keywords: endoscopy, esophagus, stomach spirocercosis, dogs

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Authors: Andrey Davydov, Konstantin Sveshnikov, Yulia Voronina

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There is now a lot of interest to the non-perturbative QED-effects, caused by diving of discrete levels into the negative continuum in the supercritical static or adiabatically slowly varying Coulomb fields, that are created by the localized extended sources with Z > Z_cr. Such effects have attracted a considerable amount of theoretical and experimental activity, since in 3+1 QED for Z > Z_cr,1 ≈ 170 a non-perturbative reconstruction of the vacuum state is predicted, which should be accompanied by a number of nontrivial effects, including the vacuum positron emission. Similar in essence effects should be expected also in both 2+1 D (planar graphene-based hetero-structures) and 1+1 D (one-dimensional ‘hydrogen ion’). This report is devoted to the study of such essentially non-perturbative vacuum effects for the supercritical Dirac-Coulomb systems in 1+1D and 2+1D, with the main attention drawn to the vacuum polarization energy. Although the most of works considers the vacuum charge density as the main polarization observable, vacuum energy turns out to be not less informative and in many respects complementary to the vacuum density. Moreover, the main non-perturbative effects, which appear in vacuum polarization for supercritical fields due to the levels diving into the lower continuum, show up in the behavior of vacuum energy even more clear, demonstrating explicitly their possible role in the supercritical region. Both in 1+1D and 2+1D, we explore firstly the renormalized vacuum density in the supercritical region using the Wichmann-Kroll method. Thereafter, taking into account the results for the vacuum density, we formulate the renormalization procedure for the vacuum energy. To evaluate the latter explicitly, an original technique, based on a special combination of analytical methods, computer algebra tools and numerical calculations, is applied. It is shown that, for a wide range of the external source parameters (the charge Z and size R), in the supercritical region the renormalized vacuum energy could significantly deviate from the perturbative quadratic growth up to pronouncedly decreasing behavior with jumps by (-2 x mc^2), which occur each time, when the next discrete level dives into the negative continuum. In the considered range of variation of Z and R, the vacuum energy behaves like ~ -Z^2/R in 1+1D and ~ -Z^3/R in 2+1D, exceeding deeply negative values. Such behavior confirms the assumption of the neutral vacuum transmutation into the charged one, and thereby of the spontaneous positron emission, accompanying the emergence of the next vacuum shell due to the total charge conservation. To the end, we also note that the methods, developed for the vacuum energy evaluation in 2+1 D, with minimal complements could be carried over to the three-dimensional case, where the vacuum energy is expected to be ~ -Z^4/R and so could be competitive with the classical electrostatic energy of the Coulomb source.

Keywords: non-perturbative QED-effects, one- and two-dimensional Dirac-Coulomb systems, supercritical fields, vacuum polarization

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Authors: Jafar Khodagholizadeh

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In this talk, we study the tensor mode equation of perturbation in the presence of nonzero $-\Lambda$ as dark energy, whose dynamic nature depends on the Hubble parameter $ H$ and/or its time derivative. Dark energy, according to the total vacuum contribution, has little effect during the radiation-dominated era, but it reduces the squared amplitude of gravitational waves (GWs) up to $60\%$ for the wavelengths that enter the horizon during the matter-dominated era. Moreover, the observations bound on dark energy models, such as running vacuum model (RVM), generalized running vacuum model (GRVM), and generalized running vacuum subcase (GRVS), are effective in reducing the GWs’ amplitude. Although this effect is less for the wavelengths that enter the horizon at later times, this reduction is stable and permanent.

Keywords: gravitational waves, dark energy, GW's amplitude, all stage universe

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Authors: Bao Shu-Feng, Lou Yan, Dong Zhi-Liang, Mo Hai-Hong, Chen Ping-Shan

Abstract:

For soft foundation filled by newly dredged mud, after improved by Vacuum Preloading Technology (VPT), the soil strength was increased only a little, the effective improved depth was small, and the ground bearing capacity is still low. To analyze the causes in depth, it was conducted in laboratory of several comparative single well model experiments of VPT. It was concluded: (1) it mainly caused serious clogging problem and poor drainage performance in vertical drains of high content of fine soil particles and strong hydrophilic minerals in dredged mud, too fast loading rate at the early stage of vacuum preloading (namely rapidly reaching-80kPa) and too small characteristic opening size of the filter of the existed vertical drains; (2) it commonly reduced the drainage efficiency of drainage system, in turn weaken vacuum pressure in soils and soil improvement effect of the greater partial loss and friction loss of vacuum pressure caused by larger curvature of vertical drains and larger transfer resistance of vacuum pressure in horizontal drain.

Keywords: newly dredged mud, single well model experiments of vacuum preloading technology, poor drainage performance of vertical drains, poor soil improvement effect, causes analysis

Procedia PDF Downloads 285

Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

Abstract:

Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

Procedia PDF Downloads 80

Authors: Farid Arya, Trevor Hyde, Andrea Trevisi, Paolo Basso, Danilo Bardaro

Abstract:

Heat transfer through multiple pane windows can be reduced by creating a vacuum pressure less than 0.1 Pa between the glass panes, with low emittance coatings on one or more of the internal surfaces. Fabrication of vacuum glazing (VG) requires the formation of a hermetic seal around the periphery of the glass panes together with an array of support pillars between the panes to prevent them from touching under atmospheric pressure. Atmospheric pressure and temperature differentials induce stress which can affect the integrity of the glazing. Several parameters define the stresses in VG including the glass thickness, pillar specifications, glazing dimensions and edge seal configuration. Inherent stresses in VG can result in fractures in the glass panes and failure of the edge seal. In this study, stress in VG with different glass thicknesses is theoretically studied using Finite Element Modelling (FEM). Based on the finding in this study, suggestions are made to address problems resulting from the use of thinner glass panes in the fabrication of VG. This can lead to the development of high performance, light and thin VG.

Keywords: vacuum glazing, stress, vacuum insulation, support pillars

Procedia PDF Downloads 188

Authors: Bongsu Choi, Tae-Ho Song

Abstract:

Vacuum insulation panel (VIP) is a promising thermal insulator for buildings, refrigerator, LNG carrier and so on. In general, it has the thermal conductivity of 2~4 mW/m•K. However, this thermal conductivity is that measured at the center of VIP. The total effective thermal conductivity of VIP is larger than this value due to the edge conduction through the envelope. In this paper, the edge conduction of VIP is examined theoretically, numerically and experimentally. To confirm the existence of the edge conduction, numerical analysis is performed for simple two-dimensional VIP model and a theoretical model is proposed to calculate the edge conductivity. Also, the edge conductivity is measured using the vacuum guarded hot plate and the experiment is validated against numerical analysis. The results show that the edge conductivity is dependent on the width of panel and thickness of Al-foil. To reduce the edge conduction, it is recommended that the VIP should be made as big as possible or made of thin Al film envelope.

Keywords: envelope, edge conduction, thermal conductivity, vacuum insulation panel

Procedia PDF Downloads 404