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Objective: To compare the effects of blunt separation combined with early sheath removal and conventional catheterization on the incidence of bleeding, exudation and subcutaneous congestion after peripherally inserted central catheter (PICC). Methods: 250 patients with PICC catheterization in our hospital were selected, including 125 in the control group and 125 in the observation group. The conventional catheterization method was used in the control group: The sheath was removed by scalpel skin expansion and complete tube delivery in place. The observation group used blunt separation combined with early sheath removal. The success rate of one-time sheath delivery, immediate bleeding, 24-hour bleeding and exudation were compared. Results: The success rate of sheath delivery in the observation group was 100%; The amount of immediate blood loss and blood loss 24h after catheterization in observation group was obviously lower than that in the control group, with statistical significance (P < 0.05). There were 6 cases of exudation in the control group and no exudation in the observation group. There was significant difference in the incidence between the two groups (P < 0.05); There were 10 cases of subcutaneous congestion in the control group and 2 cases of subcutaneous congestion in the observation group. There was significant difference in the incidence between the two groups (P < 0.05); Conclusion: Blunt separation combined with early sheath removal can reduce the occurrence of local blood and fluid leakage after PICC catheterization.

Objectives To create an in vitro anatomic bench model that can mimic in vivo intrapelvic pressure (IPP) during ureteroscopy (URS) and compare it against existing in vivo and ex vivo data. Methods A silicone kidney model (Simagine Health) that permits intrarenal endoscopic navigation was engineered to have a fluid-tight seal for the ureteral opening and a Tuohy-Borst valve in the renal pelvis incorporating a 0.2 mm pressure sensor (Opsens). To calibrate the model, a Cobra ureteroscope (Wolf) was inserted to the pelvis with 200cmH2O irrigation, and the valve adjusted until an IPP of 54cmH2O was obtained (prior human data). All experiments were conducted with a laser fiber in the working channel, with and without ureteral access sheaths (UAS) (11/13F, 13/15F) at irrigation setting of 61, 102, 153, and 193cmH2O using an automated system (Rocamed). Study outcome was mean steady-state IPP for each UAS/irrigation condition. Results Fluid leakage through the Tuohy-Borst valve, which could be adjusted, was critical to simulate ureteric outflow during URS. IPP values for each condition corresponded with data from in vivo and ex vivo models. In the no UAS condition, IPP increased with increasing irrigation pressures, and surpassed 40cmH2O when ≥153cmH2O. When using a UAS, IPP was below 40cmH2O for all irrigation pressures. Conclusions An in vitro kidney model can simulate in vivo and ex vivo IPP profiles, and be tailored to different conditions by controlling fluid outflow. This bench model can be useful for testing of new technologies and their impact on IPP.

Uneven surface emissivity will cause illusory temperature variation in infrared surface temperature mapping. For this reason, most of the detailed reviews on the use of infrared thermography (IRT) for leakage detection have mainly focused on surfaces with homogeneous emissivity or the recognition of negative temperature gradients, while reports on sensing hot fluid leakage for uneven surface emissivity are very rare. In this study, a hypothesis is put forward and a new leakage detection method is proposed that uses a transient heating-cooling-heating process in association with a subtraction method of infrared images to eliminate the disturbance of inhomogeneous valve surface emissivities. A theoretical analysis is established that is experimentally tested as a case study. The results shows that the hypothesis is clear and the effect of the uneven emissivity is suppressed for the recognition of positive temperature gradients (hot fluid leakage) on a metal valve sample. The current work provides new insights on the modification of the surface emissivity under certain conditions, which has been a major limitation of passive IRT in the past.

God has given beautiful face and smile to human being. It is right of every individual to look good. If an individual lost his/her facial part due to certain cause, it has to be restored immediately. Patient will face severe mental trauma and functional disability after maxillofacial structure loss. Post-surgical maxillary defects pre-dispose the patient to hypernasal speech, fluid leakage into the nasal cavity, and impaired masticatory function. Such defects need special prosthesis to establish oro-nasal seal and rehabilitate the patient. After maxillectomy, the prosthodontist treats the defect with obturator. The obturator takes the retention from remaining teeth, undercut areas and scar bands around the defect. In this article, a technique for creating an interim maxillary hollow bulb obturator that engages the remaining teeth, undercut areas and scar band around the defect is described. Keywords: Maxillectomy, Obturator, Oroantral communication, Interim obturator, Pre-maxilla defect.

Diabetic Retinopathy is one of the common eye diseases due to the complication of diabetes mellitus. Cotton wool spots, rough exudates, haemorrhages and microaneurysms are the symptoms of the diabetic retinopathy due to the fluid leakage that is caused by the high blood glucose level disorder. Early treatment to prevent a permanent blindness is important as it could save the diabetic retinopathy vision. Hence, in this study, we proposed to employ an automated detection method to diagnose the diabetic retinopathy. The dataset was obtained from the Kaggle Database and been divided for training, testing and validation purposes. Furthermore, Transfer Learning models, namely VGG19 were employed to extract the features before being processed by Machine Learning classifiers which are SVM, kNN and RF to classify the diabetic retinopathy. VGG19-SVM pipeline produced the best accuracy in training, testing and validation processes, achieving 99, 99 and 96 percents respectively.

Background The types of endotracheal tube, positive end-expiratory pressure (PEEP) level, endotracheal tube cuff pressure level, and nursing activity may influence the occurrence of pulmonary aspiration in ventilated patients with an endotracheal tube, but the evidence on their degree of influence is still inconclusive. Aim The aim of this study was to examine the effect of endotracheal tubes with or without subglottic secretion drainage on fluid leakage across endotracheal tube cuffs under different PEEP levels, different cuff pressures, and with or without oral care. Method This was a benchtop study with a multifactorial experimental design using two sets of airway. The two types of endotracheal tubes were tested through 12 scenarios with 240 combinations of different PEEP levels (0, 5, and 10 cmH2O), endotracheal tube cuff pressures (15 and 25 cmH2O), and oral care (with or without) using two sets of airway manikins. Each scenario lasted for 30 min, and fluid leakage was measured at the end of each scenario. Generalised Linear Model test was used to analyse fluid leak at 30 min (with and without interaction effect). Results A total of 100 cases showed fluid leakage, with more fluid leakage occurring in low cuff pressure (15 cmH2O), no PEEP, and with oral care. Results of the Generalised Linear Model revealed that endotracheal tubes with subglottic secretion drainage, high PEEP (at 10 cmH2O), normal cuff pressure (at 25 cmH2O), and no oral care demonstrated a significant effect in reducing fluid leakage than endotracheal tubes without subglottic secretion drainage, low PEEP (at 5 or 0 cmH2O), and low cuff pressure (at 15 cmH2O) (all p Conclusion Using endotracheal tubes with subglottic secretion drainage, high PEEP, and normal cuff pressure and avoiding excessive endotracheal tube movement during oral care reduced fluid leakage. This study provided strong evidence to inform practice on reducing microaspiration in ventilated patients.

Background Isolation gowns are recommended to protect healthcare personnel, patients, and visitors from transfer of microorganisms and body fluids in patient isolation situations. Standards provide limited information about barrier performance of isolation gowns for possible exposure scenarios. One of the most vulnerable areas of the personal protective equipment ensemble is considered the glove-gown interface. However, current isolation gown classification standards do not consider the interface regions of the personal protective equipment system while assessing the level of protection. The purpose of this study was to quantitatively evaluate the fluid leakage through the glove-gown interface by simulating exposures and healthcare personnel arm movements in patient care for isolation settings. Methods We tested fluid leakage of two examination gloves with different cuff lengths and seven isolation gown models designed with varying levels of barrier resistance and multiple cuff types. Results Our results demonstrated that leakage through the glove-gown interface depends on multiple factors, including glove cuff length and gown cuff design. Gowns with the thumb loop design provided better protection than the elastic cuff design, and the elastic cuff design provided better protection compared to the knit cuff design for a given AAMI PB70 level. More importantly, a substantial penetration through gown fabrics was observed. Conclusions This research identifies a need to develop a standardized method to evaluate leakage at the glove-gown interface to improve worker protection.

Magnetorheological (MR) dampers are common methods that are used to mitigate cable vibrations with high effectiveness. Under the long-term effect of external loads and harsh environment, M...

Most spinal meningiomas arise from the thoracic dura in middle-aged and elderly women. Simpson grade 1 resection is recommended to avoid recurrence. For ventral and ventrolateral tumors, reconstruction after total dural resection is difficult, and spinal fluid leakage is likely. To overcome this concern, Saito et al. developed the technique of resecting the tumor with the inner dural layer, preserving the outer dural layer. Although meningioma rarely recurs, the recurrence period is approximately 8 years postoperatively. No studies have evaluated long-term (> 10-year) outcomes of the Saito method. Here, we report 10 cases of the Saito method with > 10-year follow-up and compare outcomes with those of other standard approaches. Twenty-nine pathology-confirmed meningioma patients underwent surgery in our department, ten with the Saito method. We investigated resection method (dura mater treatment), pathological type, and recurrence and compared pre- and postoperative clinical findings. The median follow-up was 132 months. Recurrence occurred after Simpson grades 3 and 4 resection. Simpson grades 1, 2, and the Saito method resulted in no recurrence. Neurological symptoms improved in all patients at final follow-up. This is the first report of long-term outcomes of the Saito method. The method achieved good neurological improvement with no recurrence in > 10-year follow-up.

Tracheoesophageal speech is the most common voicing method used by laryngectomees. This method requires the installation of tracheoesophageal prosthesis (TEP), which requires continuous maintenance to achieve optimal speaking abilities and prevent fluid leakage from the esophagus to the trachea. The present manuscript describes the available types of TEPs, the procedures used to maintain them, the causes for their failure due to fluid leakage, and the methods used for their prevention. Knowledge and understanding of these issues can assist the otolaryngologist in caring for laryngectomees who use tracheoesophageal speech.

The indwelling pleural catheter (IPC) is an established treatment for recurrent pleural effusion. Fluid leakage through the IPC insertion tract has been reported, but its occurrence is only limited to a short period after the procedure. Besides, the drainage efficacy of IPC may be limited by the presence of loculation in the pleural space, especially when intrapleural fibrinolytic is contraindicated. We report a case of fluid leakage through the healed entry site of IPC due to high pressure built from undrained pleural fluid locules, which was successfully treated with an additional drain targeting the largest undrained locule., This is the first case report for fluid leakage through a healed entry site of the indwelling pleural catheter due to high pressure built from undrained pleural fluid locules. The condition was successfully treated with an additional drain targeting the largest undrained locule.

Background Exposure to patients' blood/body fluids could be life-affecting, when providing care to patients with infectious diseases. Although the glove-gown interface is considered one of the weakest points of the protective ensemble system, there is a lack of research, and existing standards do not provide much guidance on strategies to minimize gaps between the gowns and gloves. Currently, there is no known standard test method to evaluate fluid leakage or assess performance improvements with new gowns/gloves. Study Design A novel test method with a robotic arm, which has the capability to simulate health care personnel's arm movements during fluid exposure, was developed to determine the leakage at the glove-gown interface. This article explains the test method and investigates the effect of movement, exposure type, exposure duration, procedure duration, and existence of pressure on the amount of leaked fluid at the glove-gown interface. Results Test results suggest that, with the exception of procedure duration, all parameters significantly affected the amount of fluid leaked at the glove-gown interface. Leakage was higher for soaking when compared to spraying, increased as the exposure duration increased, and was greater with the application of pressure. Conclusions The novel method developed in this study could be used by manufacturers of personal protective equipment to evaluate their products. Standard development organizations could adapt this test method in their specifications, testing standards, and guidelines.

Anastomotic leak is a leading cause of morbidity and mortality in gastrointestinal surgery. The serosal aspect of staple lines is commonly observed for integrity, but the mucosal surface and state of mucosa after firing is less often inspected. We sought to assess the degree of mucosal capture when using stapling devices and determine whether incomplete capture influences staple line integrity. Porcine ileum was transected in vivo and staple lines were collected and rated for degree of mucosal capture on a 5-point scale from 1 (mucosa mainly captured on both sides) to 5 (majority of mucosa not captured). Mucosal capture was also assessed in ex vivo staple lines, and fluid leakage pressure and location of first leak was assessed. Stapling devices studied were Echelon Flex GST with 60-mm blue (GST60B) and green (GST60G) cartridges, and Medtronic EndoGIA Universal with Tri-Staple Technology™ with 60 mm medium (EGIA60AMT) reloads (purple). GST60B and GST60G staple lines produced significantly better mucosal capture scores than the EGIA60AMT staple lines (p

Neurogenic Pulmonary Edema (NPE) is defined as the acute onset of dyspnea or a decrease in PaO2/FiO2 ratio, following an acute central nervous system (CNS) insult, in the absence of other obvious causes of lung injury. The most important cause of NPE is subarachnoid hemorrhage (SAH), followed by cerebraltrauma and epilepsy. The incidence of NPE after SAH in the literature may vary from 4 to 23% in greater studies, with SAH accounting for 43-73% of cases of NPE. It is postulated that an excessive adrenergic discharge would lead to pulmonary vasoconstriction and a rapid increase in pulmonary capillaryhydrostatic pressure, thus promoting fluid leakage to the alveolar space. NPE is generally treated in a supportive and conservative fashion, and patient management should be focused in the primary insult.

Premature rupture of membranes occurring in previable midtrimester patients is associated with perinatal mortality, and optimal therapeutic methods are yet to be established. This study’s objective...

Microaspiration of bacteriologically contaminated oropharyngeal secretions alongside the cuff of an endotracheal tube (ETT) is a key mechanism for development of ventilator-associated pneumonia. We have constructed a prototype double-cuffed ETT equipped with a supplemental port in-between the cuffs through which continuous positive airway pressure (CPAP) is delivered. Pressure in the intercuff space propels secretions upwards and produces 100% tracheal sealing in an in vitro model. We conducted a 24 h study to investigate the sealing effect of this ETT in 12 critically ill mechanically ventilated patients. Methylene blue, instilled through a bronchoscope on top of the proximal cuff, was used as leakage tracer. Fiberoptic visualisation of the trachea was performed 1 h and 24 h thereafter. Leakage was confirmed if blue dye was detected on the tracheal mucosa beyond the tip of the ETT. In no patient, dye passed by the cuffs during the study period. Presence of the ETT did not interfere with ventilator settings, patient mobilization, physiotherapy, and technical acts. Overall, pressures in the intercuff space remained between 10 and 15 cmH2O. Excessive pressure swings were swiftly corrected by the CPAP system. A double-cuffed ETT, offering “pressurized sealing” of the trachea, safely and effectively prevented leakage during 24 h mechanical ventilation.

Significance Serpiginous choroiditis is a rare yet visually debilitating condition. To date, there is no established consensus on treatment protocol. This article presents a case report of macular serpiginous choroiditis and reviews supporting data for immunosuppressive treatment plans. Purpose The purpose of this study was to examine a case of atypical serpiginous choroiditis with emphasis on diagnostic testing and treatment options. Case report A 62-year-old man presented with new, bilateral, yellow chorioretinal placoid lesions within the posterior pole. Optical coherence tomography revealed focal hyperreflective retinal pigment epithelium lesions with disruption of outer retinal layers. Fundus fluorescein angiography demonstrated stable hyperfluorescent lesions with the absence of fluid leakage. Further testing ruled out possible systemic correlation. Conclusions Macular serpiginous choroiditis is infrequently encountered; however, various differentials must be considered before making the diagnosis. Optical coherence tomography and fundus fluorescein angiography serve as useful tools in aiding the diagnosis. Treatment of serpiginous choroiditis must be initiated with caution given the high risk of adverse effects.

Diabetic macular edema (DME) is a variation with diabetic retinopathy. Vision loss and blindness are the most common effects of DME. DME is defined as thickening of the retina in diabetic patients due to fluid leakage within macula because of elevated sugar levels over long period. DME is assessed by detecting bright lesions called exudates and swelling of retina in fundus images. In the present paper, an algorithm is developed to detect DME, by estimating the pixel count from macula to nearest hard exudate. The macula and hard exudates are localized using image processing techniques. Severity of estimated from exudates analysis and color analysis. The algorithm is tested with 65 DME images with severity index 0, 1 and 2 from MESSIDOR database.

Background: Hospital beds are now high-tech, reprocessable, medical devices. The surface of the mattress (cover) is manufactured using polyurethane-coated fabric to ensure moisture-vapor transmission to prevent pressure ulcers. In recent years, due to multidrug-resistant organisms, healthcare organizations have used increasingly harsh chemicals to clean these mattresses. None of these chemicals are approved for use on polyurethane-coated fabric. Previous research has shown that many mattresses in hospitals are damaged. The US Food and Drug Administration, Centers for Disease Control and Prevention, ECRI, and manufacturers recommend routine mattress inspection and replacement of mattresses with any visible signs of stains, wear, or damage. Damaged mattresses have been linked to fluid leakage, resulting in patient exposure and outbreaks of healthcare-acquired infections. Methods: Four hospitals of a midwestern hospital system had all of their mattresses inspected for damage and staining to the mattress. After external examination, each mattress was opened, and the mattress core was evaluated for damage. The cover of each mattress was examined using the naked eye and then using an LED light to demonstrate smaller holes. Each bed frame was examined for evidence of rust, and the amount of rust was recorded. If available, the age of the mattress was determined based on a label on the mattress. Results: In total, 727 beds and mattresses were inspected. Of these mattresses, 523 (72%) were damaged. Also, 340 (47%) required replacement of the mattress cover, and 183 (25%) required replacement of the entire mattress (cover and core). For the 209 damaged mattresses (40%) with the date of manufacture label, 156 (75%) were Conclusions: These findings confirm previous reports that damaged mattresses are common in hospitals and potentially place patients at risk. Most of these failed mattresses are Funding: NoDisclosures: None

Peritoneal dialysis catheter complications that require nonsurgical or noninvasive correction by peritoneal dialysis (PD) nurses or practitioner are reviewed. Topics reviewed include compromised PD fluid flow, pericatheter fluid leakage, mechanical integrity disruption, catheter extrusion, and exit site/tunnel complications.

Diagnostic tools such as Point-of-Care (POC) analysis usually requires an on-site testing and measurements. Hence, to ease the fluid sample handling, microfluidics technology has been opted frequently to be incorporated with lab-on-chip (LOC). Therefore, an easy and conventional method of design and fabrication of the microfluidic device implemented. In this study, the device is fabricated with Polydimethylsiloxane (PDMS) and SU-8 using soft lithography technique. Herein, we focus on fluid transportation which is applied in clinical diagnostics and the transfer rate to the desired position as well as the fluid leakage during the transportation. Hence, the microfluidic sample transport channeling provides a practical solution for POC technological advances to study the biological systems that yield a better result in quantitative measurements and providing researchers new tools for life science research.

Fluid leakage from the Ampltz sheath during flexible nephroscopy after PCNL prevents dilatation of the pelvi-calyceal system and adequate visualization. This video demonstrates a simple technique to prevent such leakage.

The new screw-propelled 3D printer can realize 3D printing with granular plastic materials. The granular plastic material cost low and need not pay more attention on material flexibility. In this paper, the motion characteristics of bubbles produced in the printing processing of the screw-propelled 3D printer are studied. Through the analysis of the screw structure, and establish the corresponding three-dimensional model, the flow field of screw propulsion system is established by using FLUENT software. Through the simulation, the effects of the speed of the screw propeller, inlet pressure and screw pitch on the velocity of the bubble rise is studied. And the different locations of the bubble are concerned. In order to make the bubble escape from the fluid, a new structure of screw propeller is improved. The simulation result shows this improved structure can get a good performance to help to remove the bubbles in molt plastic material. And the fluid leakage can be compensated by increase the speed of the screw propeller.

Cardiac tamponade is a life-threatening compression of the heart due to accumulation of fluid surrounding the heart. It occurs in two out of 10 000 people annually and is universally fatal if the fluid is not timely drained.1 The more rapidly accumulation occurs, the quicker the patient develops symptoms, including dyspnoea, fatigue and chest pain.2 Vital sign changes include tachycardia, tachypnoea and hypotension with a narrow pulse pressure. Pericardiocentesis is the required treatment to drain this fluid improving cardiac output.3 Simulation is an adjunct education tool to practise rare but crucial procedures.1 Current manikins do not have the capabilities to practise pericardiocentesis. Only torso task trainers are available.4 5 Our objective was to develop a pericardiocentesis trainer model that could both reliably recreate the procedure and be placed in a manikin, with no fluid leakage. ### Model assembly and design The Department of Biomedical Engineering collaborated with the Department of Pediatrics to build an inexpensive pericardiocentesis model with the following constraints: 1. Fit existing child simulators without significant chest wall distortion. 2. Have components to protect simulator both structurally and electronically from fluid spills using self-sealing technology. 3. Provide realistic fluid removal. 4. Have easily refillable fluid compartment that does not require direct access to task trainer. 5. Costs less than $500 budget. The final design encompasses a two-piece tray system, a top and bottom tray, attached by a peg …

Summary Background To compare the Ramirez technique for the operative closure of large open myelomeningocele defects with conventional closure techniques in newborns. We hypothesized that the immediate surgical treatment with the Ramirez technique is superior to prior used operative techniques. Methods From 2003 to 2010, 23 children (8 female, 15 male) underwent closure of large open myelomeningocele defects using the Ramirez technique (group A), while from 1993 to 2002, 23 children (6 female, 17 male) underwent conventional closure techniques (group B). All children were included in the retrospective analysis with a mean follow-up period of 3.4 years. Results Perioperative variables were similar in both groups (P = ns). There were no hospital deaths in both groups. The operation time was significantly higher in group A (228.7 ± 76.8 versus 157.8 ± 70.3 min, P = 0.003). Mean length of hospital stay was significantly lower in group A (30.7 ± 16.4 days versus 52.0 ± 38.5; P = 0.02). Postoperative complication rate was significantly lower in group A (P = 0.01). Beyond postoperative day 10, liquor fluid leakage was significantly lower in group A (P = 0.05). During follow-up, there were no complications in group A. In group B, 2 children developed liquor fistulas. Conclusions The Ramirez technique allows efficient and safe closure of large open myelomeningocele defects and reduces incidence of postoperative liquor fistulae. The increased operation time and surgical efforts seem to be justified. Treatment of large myelomeningocele defects requires an interdisciplinary team including paediatrician-neonatologists, neurosurgeons and plastic surgeons.

The mining-induced fractured zone height (MIFZH) is of significant importance for water hazard prevention and regional eco-environmental conservation in the Jurassic coal field of western China. The paper discussed MIFZH developed in bedrock and Neogene laterite from two aspects of field measurement and theoretical analysis respectively. In theoretical analysis of MIFZH developed in bedrock, based on plate and shell theory, each stratum in bedrock above the coalface stress-decreasing zone was simplified as four clamped rectangular plates, and the value of the ultimate deflection of the thin plate and the height of the free space in the lower part of the stratum were compared to judge MIFZH. When MIFZH was developed in Neogene laterite, MIFZH was calculated by Pu’s theory and rock mass limit equilibrium theory in theoretical analysis; in on-site measurement, micro resistivity scanning imaging logging technology (MRSILT), overcoming the shortage of fluid leakage technology, was adopted to detect MIFZH, where its measured result proved the feasibility of theoretical analysis. The research results have important significance to water conservation mining and safety mining of the Jurassic coal seam in western China.

Introduction Some cystic liver tumors are huge when the diagnosis is made or surgery is needed. Although reducing tumor size by preoperative aspiration or drainage of the contents of the cystic tumor is helpful for liver resection, such procedures have a risk of tumor dissemination. Materials and surgical technique After the round ligament was dissected, a 12-Fr drainage catheter was inserted into the tumor via the round ligament under ultrasonography. At that time, close attention was paid to avoid having the catheter deviate outside the round ligament. Through the inserted catheter, fluid was drained from the cystic lesion, and the stump of the round ligament was clipped to avoid fluid leakage. The left Glissonian pedicle was then taped. Laparoscopic left hemihepatectomy was performed under a good operative field because of tumor shrinkage. Discussion Three cases underwent these procedures without any spillage of the contents of the cystic tumor. This method is useful for the reduction of tumor size and has a low risk of intra-abdominal leakage of the contents, resulting in a secure and good operative field.

This article deals with the study of the sealing properties on a bolted joint on a hydrostatic transmission. The main idea of this study is aimed at the probability assessment of fluid leakage due to the mechanics that play a significant role in the sealing properties. The study was performed via numerical analyses by using a FEM software package, ANSYS Workbench. The main focus when evaluating the results is aimed at the observation of the contact pressure and contact gap on the bolted joint. In this study two variables on the bolted joint, which can affect the sealing properties were taken into account, the torque applied through the bolts and the surface finish under the heads of the bolts.

Paper-based microfluidics is a rapidly progressing inter-disciplinary technology driven by the need for low-cost alternatives to conventional point-of-care diagnostic tools. For transport of reagents/analytes, such devices often consist of interconnected hydrophilic fluid-flow channels that are demarcated by hydrophobic barrier walls that extend through the thickness of the paper. Here, we present a laser-based fabrication procedure that uses polymerisation of a photopolymer to produce the required fluidic channels in paper. Experimental results showed that the structures successfully guide the flow of fluids and allow containment of fluids in wells, and hence the technique is suitable for fabrication of paper-based microfluidic devices. The minimum width for the hydrophobic barriers that successfully prevented fluid leakage was ~120 μm and the minimum width for the fluidic channels that can be formed was ~80 μm, the smallest reported so far for paper-based fluidic patterns.

The authors have developed the barrier screening method to seal coal bed methane drainage holes. The method reduces air leakage from enclosing rocks to evacuation holes. The compositions of screens with external seal preventing from fluid leakage to ambient medium are offered and analyzed.

Post-lumbar puncture headache (PLPH) is a well-known syndrome resulting from spinal fluid leakage and delayed closure of a dural defect. The main symptom of PLPH is headache in upright posture relieved by lying down. Outcome is usually benign and complications are uncommon. The functional impact can however be important, leading to delayed discharge, sick leave and, if information delivery is ineffective, iterative consultations. Preventive measures have been published, but the prevalence of PLPH remains high (15 to 40% after diagnostic lumbar puncture). Needle size and type are probably the most important factors for reducing the risk of PLPH. Recovery can be rapid, within a few days. If PLPH persists after four days, an epidural blood patch should be discussed. The objective of this review is to summarize the literature on PLPH, and share the experience of our emergency headache center with an atraumatic 25-gauge needle (pencan, 0.5×90mm or 0.5×103mm, Braun, Germany).

Carbon-neutral economies would require preventing the release of industrial-scale CO2 into the atmosphere by injecting into geologic formations. Large-scale injection of CO2 into deep reservoirs carries a potential for its undesired leakage into above zones, which can act as an obstacle to its large-scale implementation. Current methods for surveillance of CO2 leaks are costly and not very robust, especially the methods that simulate expected pressure behavior based on an assumed reservoir model. This study proposes a machine learning method for surveillance of fluid leakage using deconvolution response function (a non-linear function of time varying bottomhole pressure and injection rates) from injection and monitoring wells as a measure of leakage that is simulated via multivariate linear regression of all the wells present in the reservoir. Leakage is detected by comparing “expected” (baseline without leaks) deconvolution response of all monitoring wells with their “observed” deconvolution response. Three key advantages of the proposed method are that it i) uses only injection rates and bottomhole pressure data (with no reservoir or geological model), ii) is independent of physical process parameterization uncertainties, and iii) applicable to both conventional and unconventional (e.g. fractured tight formations) reservoirs with any fluid (e.g. compressible, incompressible). The proposed method is first trained to learn well history with no leakage, followed by its validation after which it can be used to detect leakage by tracking a meaningful deviation error (at least twenty times the error of no leakage base scenario over same time period) between expected well response and observed well response at all monitoring wells. The well history required for the proposed method comes directly from measurements made at wells in a real field, but in absence of field data the proposed method is illustrated through well history simulated by reservoir simulations; no such numerical simulations are required for application of this method in a real world scenario with well measurements.

To minimize fluid leakage and improve rotordynamic stability of traditional seals, a new kind of radial annular seal is presented in this article. The structure and the sealing principle are analyzed. Compared to the traditional labyrinth seal, the fluid leakage direction is altered from the axial to radial direction. The flow resistance is increased, and the flow-induced force is reduced greatly. There is also a tremendous improvement in the wear resistance of the seal. Three-dimensional numerical models of the traditional labyrinth seal and radial annular seal are set up. Calculated results show that the discharge coefficient of the radial annular seal is about 20% lower than that of the labyrinth seal. Though the rotating speed has a small influence on the radial seal force for both the radial annular seal and labyrinth seal, it has a large effect on the tangential seal force. The tangential seal force increases with the increasing speed, and the destabilizing force in the radial annular seal is reduced greatly when compared to that in the labyrinth seal. The radial seal force of the radial annular seal is about 1.5–2.5 times as strong as that of the labyrinth seal. The tangential seal force is about 30–50% lower than that of the labyrinth seal under the same eccentricity, and this ratio becomes larger and larger with the increasing speed. Finally, the dependency of the seal characteristics on the design parameters is studied. It is shown that the optimum ratios of the clearance s to the tooth thickness b ( s/ b) for the outward and inward flows are 4.5–5.5 and 11–13, respectively. The flow characteristics perform best with the ratio of the seal chamber width B to the tooth height H ( B/ H) on the same order of 5.5–7 for the two kinds of flows.

Both intraosseous and microcystic meningiomas are rare tumor types. We report the case of a 66-year-old woman with intraosseous microcystic meningioma without a mass lesion. She presented with a rare intraosseous microcystic meningioma manifesting as pain. Radiological examination revealed an osteolytic lesion in the right parietal bone. Magnetic resonance (MR) images showed iso- to hypointensity on T1-weighted images and hyperintensity on T2-weighted images corresponding to the lesion. T1-weighted MR imaging with gadolinium enhancement better defined the marginal area. The inner table of the skull was disrupted prominently, and both sides of the outer table were eroded. There was fluid leakage during surgery but no obvious tumor mass. Histological examination revealed microcystic meningioma in the inner part of the defective bone. A macroscopic lesion was not found, because most of the tumor comprised microcysts, and their contents leaked out during the surgical procedure. Intraosseous microcystic meningioma may be considered as one of the differential diagnoses when the intraosseous tumor in the skull has fluid leakage and does not have a mass lesion during the surgery.

Different pathological features such as microaneurysms, hemorrhages, cotton wool spots and exudates appear over the retina due to the progression of diabetic retinopathy and causes vision loss. Microaneurysms are the first clinical symptom of diabetic retinopathy, which causes fluid leakage at a latter stage. It is very tiny and has similar contrast to that of the blood vessel. Exudates consist of lipids and protein deposit comes from the damaged blood vessels and leads to diabetic macular edema. Exudates are brighter and having similar contrast to that of the optic disc. Microaneurysms and exudates are the features for estimating the vision degradation. Due to the appearance it is difficult to detect the microaneurysms and exudates from the color fundus images. In this paper, microaneurysms and exudates have been extracted using selective binary and Gaussian filtering regularized level set (SBGFRLS) algorithm on the pre-processed fundus image. The SBGFRLS uses the level set function and Gaussian smoothing kernel. Signed pressure force (SPF) is used for stopping the contours at weak or blurred edges. This can able to detect the boundaries automatically and help in global segmentation. The SBGFRLS algorithm is applied to the pre-processed image for detection of microaneurysms and exudates. The proposed method has been tested on standard diabetic retinopathy i.e., DIARETDB1 database. The average accuracy and specificity for the detection exudates are found to be 93.41% and 97.42%, respectively. The box plot for accuracy and specificity of the detection of exudates are plotted to show the distribution of performance values for different images in the database. The proposed method for detection of exudates provides better result as compared to the method discussed in the literature. Microaneurysms are extracted by using h extended minima algorithm to the blood vessel, optic disc and exudates inpainted image. The effect of blood vessel, optic disc and the exudates are suppressed in this inpainted image. The accuracy for detection of microaneurysms is found to be 90%. Along with the microaneurysms some spurious signals are detected which can be reduced by some post processing step.

Background Liver involvement in acute dengue infection is frequently observed and sometimes leads to acute liver failure, with fatal outcomes. Many factors are thought to contribute to liver dysfunction, including hypoxic injury due to decreased perfusion, direct damage by the virus and immune mediated injury. In this study, we sought to identify the pattern in the change in liver enzymes throughout the illness and its association with the degree of viraemia, onset and extent of plasma leakage and inflammatory mediators. Methods Serial daily blood samples were obtained from 55 adult patients with acute dengue from the time of admission to discharge and the liver function tests, viral loads and cytokines were assessed. The onset and extent of fluid leakage was measured by daily ultrasound examinations and all clinical and laboratory features were serially recorded. Results Aspartate transaminase (AST), alanine transaminase (ALT) and gamma glutamyl transferase (GGT) levels were elevated in patients with dengue infection throughout the illness. The highest AST levels were seen on day 6 of illness and both AST and GGT levels were significantly higher in patients with severe dengue (SD), when compared to those with non-severe dengue (NSD) on day 5 and 6 of illness. Three patients with SD had AST and ALT values of >1000/IU in the absence of any fluid leakage or a rise in the haematocrit (≥20 %). The peak of the AST levels and the lowest serum albumin levels were seen 24 h before the maximum fluid leakage and 24 h after the peak in viraemia. Both serum IL-10 and IL-17 levels were elevated during early illness and were significantly higher in those with SD when compared to NSD. Conclusion Dengue associated liver injury appears to peak around day 6 and 7. Therefore, liver function tests done at earlier dates might not reflect the extent of liver involvement in acute infection. Since severe liver involvement can occur in the absence of fluid leakage, after the peak viraemia, and since it is associated with high IL-17 and IL-10 levels, possible immune mechanisms leading to hepatic damage should be investigated. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1656-2) contains supplementary material, which is available to authorized users.

The purpose of this study is to report our initial experience with a new fully covered metallic stent with a novel design (AXIOS) to prevent migration and fluid leakage, in the drainage of pancreatic fluid collections (PFC).We included nine patients from four Spanish centers undergoing endoscopic ultrasound (EUS)-guided drainage of PFC with placement of an AXIOS stent. The lesions were accessed via transgastric (n = 7), transesophageal (n = 1), and transduodenal (n = 1) by using a novel access device (NAVIX) in six cases or a 19-G needle in three. Patients were individually followed prospectively for procedure indications, demographic data, previous imaging techniques, technical aspects, clinical outcomes, complications, and follow-up after endoscopic drainage.The mean size of lesions was 105 ± 26.3 mm (range, 70-150). In six cases, cystoscopy was performed through the stent, including necrosectomy in two. Median procedure time was 25 ± 13 min. A median number of two sessions were performed. The technical success rate was 88.8 % (8/9) due to one failure of the delivery system. One patient developed a tension pneumothorax immediately after transesophageal drainage. No migrations were reported, and all stents were removed easily. All patients had a successful treatment outcome achieving complete cyst resolution. Mean time to stent retrieval was 33 ± 40 days. Mean follow-up was 50 ± 1.3 weeks (range, 45-55), and only one patient presented a recurrence 4 weeks after the stent removal. Furthermore, comparison with ten previous consecutively recruited PFC cases drained by EUS-guided using plastic pigtail stents was done. Technical and clinical successes were similar. However, two stent migrations, two recurrences, and two complications were found. The number of stents used (n = 15) and the median procedure time (42.8 ± 3.1 min) were significantly higher.Drainage of PFC using dedicated devices as this novel metallic stent with special design seems to be an effective, feasible and safe alternative technique.

The introduction of grooves, micropores, and other forms of surface geometric modifications onto the mating seal plates has been performed to enhance the gas face seal performance. Reducing fluid leakage through the seal surface has been the main motivation for the development of efficient sealing technology for industrial turbomachinery. Pressure dams are generally etched on the seal inner and outer radii to improve even more the seal capability of reducing the gas leakage to atmosphere. This paper presents a finite element analysis carried out to determine the opening force, the flow leakage and the dynamic force coefficients of flat gas face seals with pressure dams operating under stringent conditions. Several curves of steady-state and dynamic seal performance characteristics depict the influence of the pressure dam position and width on the seal performance and efficiency.

Several vaccines, diagnostic tests, and medications are currently delivered intradermally, and it is likely that this route of administration will grow in importance. A phase I clinical study was conducted to evaluate the intradermal (ID) adapter, a prototype intradermal delivery aid, for safety and precision of injection. Healthy adult volunteers received two injections each of 0.1 mL of sterile saline solution in the upper deltoid region of the arm using the ID adapter. Injection performance was determined by the proportion of injections delivered to the dermal layer by measuring wheals and fluid leakage, and through ultrasound imaging. Of the 40 study injections, 100% were determined to be successful intradermal injections. Leakage of liquid at the injection site was negligible. Performance was similar with the bevel orientation both upward and downward. Minor bleeding and skin abrasions were the only reported adverse events. Injections were well tolerated based on self-reporting of pain of injection. Based on these results, the ID adapter appears to be safe and effective as an alternative to the Mantoux method of ID delivery for future use in clinical evaluations of ID delivery of vaccines, skin tests, and other drugs.

Persistent posttraumatic CSF fluid leakage may present a challenge to manage. Failure to address the leakage may result in complications such as meningitis, septicemia, radiculopathy, muscle weakness, and back pains. While the majority of the leakages may be managed conservatively, large dura defects as a result of gunshot wounds or motor vehicle accidents are best managed by surgical interventions. This may range from primary closure of the defect to fascial grafts, adhesive glues, and flaps. We present our experience with the use of flaps in a patient who had sustained such wounds in the thoracic spine. An island latissimus dorsal flap and a perforator fasciocutaneous flap were used to close the defect. Postoperatively the patient recovered well and the wounds healed without any complications.

Three dimensional solid-fluid interaction numerical analysis models of both the finger seal with herringbone-grooved pad and the finger seal with herringbone-grooved rotor were established in order to study the performance of hydrodynamic finger seal. The models investigated fluid radial under pad force and fluid leakage as a function of both the rotor speed and the high- to low-pressure differential. It was shown that the finger seal with herringbone-grooved structure in pad or in rotor could bring lift force under the finger pad so as to keep the finger seal in non-contacting status. For the two types of finger seal, their load carrying ability and fluid leakage varying with the pressure differential were almost same. In the same velocity of rotor surface, the load carrying capacity of the finger seal with herringbone- grooved rotor was greater and the leakage was less than that of the finger seal with herringbone-grooved pad respectively. With the conditions of rotor structure allowing, it is suggested to select the finger seal with herringbone-grooved rotor first for designing the hydrodynamic finger seal with herringbone-grooved structure.

Image processing has provided powerful techniques to extract from the acoustic signals the desired information on evaluation for leakage existence, leakage rate, and searching for leakage location, etc. The imagery NDE data available can add additional and significant dimension in nondestructive evaluation(NDE) information and thus for exploiting in applications. To extract such information the use of advanced image processing techniques is much needed. In recent years, there has been much increased use of acoustic signal image processing techniques in acoustic NDE. This approach will increase the efficiency of inspection procedures and reduce inspection time. In this paper we are concerned only with This paper is concerned mainly with the use of advanced image processing techniques in valve leakage detection and advanced image restoration and enhancement methods, which attempt to evaluate promptly by a visualization method the acoustic sources while detecting the valve leakage.

OBJECTIVES: To evaluate the sealing ability of five root canal sealers, including two experimental cements (MBP and MTA-Obtura) using the fluid filtration method. MATERIAL AND METHODS: Teeth were divided into 5 study groups: G1-AH Plus; G2-Acroseal; G3Sealapex; G4-MBP; G5-MTA-Obtura; and two controls. Chemical-mechanical preparation was performed with ProFile rotary nickel-titanium instruments 1 mm short of the apical foramen. The sealing ability was evaluated by fluid filtration at 15, 30, and 60 days. RESULTS: The statistical analysis showed significant difference between the materials at different periods (p

This study used an airway model to compare the ability of a pediatric endotracheal tube with a taper-shaped cuff to prevent microaspiration relative to endotracheal tubes with conventional cuffs. Four different types of 5.0-mm inner diameter cuffed pediatric endotracheal tubes (taper-shaped cuff [Taper], high-volume low-pressure [Hi-Lo], middle-volume low-pressure [Intermediate], and low-volume low-profile [Lo-Pro]) were fixed within vertically placed acrylic tubes. The cuffs were maintained at 10, 20, or 30 cmH2 O pressure and 3 mL of simulated stomach contents was added to the top of the cuffs. The volume of leakage around the cuffs after 5 min and 4 h was measured. After 5 min, the volume of leakage was significantly lower with the Taper than with the Hi-Lo, Intermediate, or Lo-Pro at all pressure settings. After 4 h, leakage was significantly lower with the Taper than with the other three tubes regardless of initial cuff pressure (P < 0.05).

Purpose: Standard polyvinylchloride (PVC) endotracheal tube (ETT) cuffs do not protect from aspiration across the cuff, a leading cause of ventilator-associated pneumonia (VAP). In a long-lasting in vitro study we compared the effect of different cuff materials (PVC, polyurethane, and guayule latex), shapes (cylindrical, conical), and positive end expiratory pressures (PEEP) in reducing fluid leakage across the cuff. Methods: We compared fluid leakage across a cylindrical double-layer guayule latex prototype cuff, three cylindrical PVC cuffs (Mallinckrodt Hi-Lo, Mallinckrodt HighContour, Portex Ivory), one conical PVC cuff (Mallinckrodt TaperGuard), and two polyurethane cuffs (Mallinckrodt SealGuard, conical; Microcuff, cylindrical). Ten centimeters of dyed water was poured above the cuffs inflated (pressure 30 cmH 2O) in a vertical cylinder (diameter 20 mm). A respiratory circuit connected the bottom of the cylinder to a breathing bag inflated at four pressures (PEEP = 0, 5, 10, 15 cmH2O). Pictures were taken every 60 s for 24 h to measure leakage as a reduction in the water column above the cuff. Five new ETTs of each type were tested. Results: The guayule latex cuffs showed no leakage at all the PEEP levels. Both the cylindrical and conical polyurethane cuffs showed limited leakage (2.1 ± 1.8 cm of water) only for PEEP zero. The PVC cuffs showed reduced leakage with increasing PEEP: 8.4 ± 1.5, 7.8 ± 2.2, 2.2 ± 1.0, and 0 cm of water at 0, 5, 10, and 15 cmH2O, respectively. Among all the PVC cuffs, the conical shape ensured higher sealing properties. Conclusions: The guayule latex cuffs always prevented fluid leakage; the polyurethane and PVC cuffs required incremental levels of PEEP to prevent fluid leakage ever-present at zero PEEP. © Copyright jointly held by Springer and ESICM 2010.

Leakage of oral secretions past endotracheal tubes (ETT) has been implicated in ventilator associated pneumonia. The aim of this bench study was to compare the ability of current generation ETT cuffs to prevent fluid leakage and to determine the specific mechanical ventilator settings that affect movement of fluid across an inflated ETT cuff.Using a 2.3-cm internal diameter (ID) tracheal model and simulated ventilatory support, we evaluated the impact of cuff pressure (20 and 30 cmH(2)O), positive end-expiratory pressure/continuous positive airway pressure (PEEP/CPAP, 0-15 cmH(2)O), peak inspiratory pressure (PIP, 15-45 cmH(2)O), and mode of ventilation (volume control, volume assist/control, pressure control, pressure assist/control, and CPAP) on leakage of fluid past the ETT cuffs of 16 ETTs. The tracheal model was configured in the vertical position with 35 ml of vitaminwater(®) on top of the inflated ETT cuff and mechanically ventilated. Fluid leakage past the cuff was determined by calculating the volume change in the tracheal model after each 30-min ventilation period. Initially five 8.0-mm-ID ETTs of each manufacturer type were evaluated at baseline ventilator settings. Tubes allowing a consistent leak within two SD of the mean leakage for the five tubes were numbered in consecutive order. A single tube from this group was then randomly selected for detailed evaluation.Cuff leakage varied among ETT types (p0.0001); median leak volume 6.0 ml (0.6-15.1) across all tubes under all conditions. Cuff leakage was inversely related to PEEP level, cuff pressure, and PIP except when PEEP was set at 15 cmH(2)O (all p0.0001). In addition, cuff leak varied among modes (p = 0.035).Cuff leakage varies greatly among ETT types and is affected by cuff pressure, PEEP, PIP, and mode.

Conclusions: By testing 125 samples, we confirmed that Cochlin-tomoprotein (CTP) is present in the perilymph, not in cerebrospinal fluid (CSF). Perilymph and CSF exist in two distinct compartments, even in the case of a malformed inner ear with a bony defect in the lamina cribrosa, as described here. Cochleostomy might have suddenly decreased the perilymph pressure, allowing the influx of CSF into the inner ear resulting in profuse fluid leakage, first perilymph then CSF. Objectives: The first purpose of this study was to further confirm the specificity of the perilymph-specific protein CTP that we reported recently. Secondly, we assessed the nature of the fluid leakage from the cochleostomy using the CTP detection test. Methods: A standardized CTP detection test was performed on 65 perilymph and 60 CSF samples. Samples of profuse fluid leakage collected from cochleostomy during cochlear implantation surgery of one patient with branchio-oto-renal (BOR) syndrome were also tested by the CTP detection test. Results: CTP was detected in 60 of 65 perilymph samples but not in any of the CSF samples. The leaked fluid was shown to contain CTP, i.e. perilymph, at the outset, and then the CTP detection signals gradually disappeared as time elapsed.

This paper is devoted to the modeling of fluid leakage through a shell in case of impact loading. The modeling of the fluid and the shell is based on SPH formulation. The proposed model is devoted to the prediction of failure of a shell filled with fluid. This paper is devoted to the numerical modeling of fluid–structure interaction. The pinballs technique is used for contact analysis. Numerical predictions are compared with analytical as well as with an original experiment. Copyright © 2009 John Wiley & Sons, Ltd.

Summary Central venous catheters (CVC) are widely used in the care of chronically ill patients, particularly those with intestinal failure receiving long-term parenteral nutrition. Serious complications such as infection, obstruction and catheter related thrombus are well recognised. We report two patients who developed localized pain on flushing the catheter. Radiological investigation revealed fluid leakage from the CVC, from a fracture within the skin tunnel in one case, and from the intravascular segment, with venous backflow probably related to a sleeve thrombus, in the other.