Experimentelle Untersuchung der radialen Verformbarkeit von Stents

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Infolge der mechanischen Unterstützung der Gefäßwand nach Stentimplantation kann eine akute Durchmesservergrößerung gegenüber konventioneller Ballonangioplastie (PTCA) erreicht und die Restenoserate gesenkt werden. Eine ausreichende Widerstandsfähigkeit gegenüber äußeren Kräften ist eine Grundvoraussetzung für optimale Ergebnisse in der Stentapplikation. Aufgrund der Vielzahl der verwendeten Materialien und Gestaltungsprinzipien bestehen große Unterschiede in dem mechanischen Verhalten der kommerziell verfügbaren Stents. Die Kenntnis dieser Verhaltensweisen stellt eine essentielle Grundlage einer an die Läsion angepaßten Stentauswahl dar. Obwohl bisher verschiedene Studien das Stentverhalten analysierten, fehlt es aufgrund unterschiedlicher Prüfverfahren an einer Vergleichbarkeit der Ergebnisse. Ziel dieses Beitrages ist die parallele Untersuchung von acht aktuellen Stenttypen. Zu diesem Zweck wurde eine Ultraschall-Meßvorrichtung zur standardisierten, quantitativen Evaluation der kompressiv-mechanischen Eigenschaften von Koronarstents entwickelt. Mit Hilfe dieser Vorrichtung konnte darüberhinaus der Einfluß der Stentimplantation auf das radiale Dehnungsverhalten der Arterienwand untersucht werden

Turbine Powered Simulator Calibration and Testing for Hybrid Wing Body Powered Airframe Integration

Propulsion airframe integration testing on a 5.75% scale hybrid wing body model us- ing turbine powered simulators was completed at the National Full-Scale Aerodynamics Complex 40- by 80-foot test section. Four rear control surface con gurations including a no control surface de ection con guration were tested with the turbine powered simulator units to investigate how the jet exhaust in uenced the control surface performance as re- lated to the resultant forces and moments on the model. Compared to ow-through nacelle testing on the same hybrid wing body model, the control surface e ectiveness was found to increase with the turbine powered simulator units operating. This was true for pitching moment, lift, and drag although pitching moment was the parameter of greatest interest for this project. With the turbine powered simulator units operating, the model pitching moment was seen to increase when compared to the ow-through nacelle con guration indicating that the center elevon and vertical tail control authority increased with the jet exhaust from the turbine powered simulator units

Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

BACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or bypass surgery (381), and 450 patients with unstable angina were randomly assigned to coronary stenting (226) or bypass surgery (224). All patients had multivessel disease considered to be equally treatable by either technique. Freedom from major adverse events, including death, myocardial infarction, and cerebrovascular events, at 1 year was not different in unstable patients (91.2% versus 88.9%) and stable patients (90.4% versus 92.6%) treated, respectively, with coronary stenting or bypass surgery. Freedom from repeat revascularization at 1 year was similar in unstable and stable angina treated with stenting (79.2% versus 78.9%) or bypass surgery (96.3% versus 96%) but was significantly higher in both unstable and stable patients treated with stenting (16.8% versus 16.9%) compared with bypass surgery (3.6% versus 3.5%). Neither the difference in costs between stented or bypassed stable or unstable angina ($2594 versus$3627) nor the cost-effectiveness was significantly different at 1 year. CONCLUSIONS: There was no difference in rates of death, myocardial infarction, and cerebrovascular event at 1 year in patients with unstable angina and multivessel disease treated with either stented angioplasty or bypass surgery compared with patients with stable angina. The rate of repeat revascularization of both unstable and stable angina was significantly higher in patients with stents

Fascia iliaca compartment block administrert av sykepleiere i akuttmottak.

Bakgrunn. Eldre med hoftebrudd opplever sterke smerter, og trenger bedre smertelindring. Å gi vanlig tradisjonelle smertestillende i form av opiater kan by på store utfordringer på grunn av aldersrelaterte fysiologiske enderinger, komorbiditet og kognitiv svekkelse. Bruk av større doser opiater kan medfører økte bivirkninger som kvalme, obstipasjon og respirasjonsdepresjon. Fascia iliaca compartment block (FICB) har vist seg å være en god og effektiv metode for å smertelindre eldre med hoftebrudd. Lang ventetid på kirurgisk behandling og smertelindring kan påvirker helsetilstanden til denne pasientgruppen. Risikoen for å utvikle komplikasjoner og dødelighet er høy og derfor trenger de rask kirurgisk behandling; helst innen 48 timer. I Norge er det vanligvis en legeoppgave å administrere FICB til hoftebruddpasienter. Hensikt. Hensikten med denne studien er å undersøke om FICB som ble administrert av sykepleiere i akuttmottaket ga god smertelindring, samt redusert ventetiden i akuttmottaket i den pre-operative fasen. Metode. Studien bygget på en retrospektiv analyse av data som ble samlet inn i en 2 års periode. Total 22 sykepleiere ble opplært og sertifisert til å administrere FICB ved bruk av landmarksteknikk. En sjekkliste ble brukt for å samle inn nødvendige data som blant annet registrering av smerter i ro og i bevegelse før og etter administrering av FICB. Resultat. Total 188 pasienter fikk FICB administrert av sykepleiere og 15 av leger i data samlingsperioden. Middelverdien på numerisk og verbal smertemåling hadde gått ned 60 minutter etter administrering. Pre-operativ ventetid var i underkant av 24 timer. Konklusjon. FICB administrert av sykepleiere i akuttmottaket er effektiv metode som gir god smertelindring til eldre med hoftebrudd. Ved å tillate sykepleiere å administrere FICB til eldre med hoftebrudd blir de raskere smertelindret, og legene får mulighet til å rette mer fokus på andre viktige pasientrelaterte arbeidsoppgave

Stability of wall-bounded flows using one-way spatial integration of Navier-Stokes equations

A method for constructing well-posed one-way equations for calculating disturbances of slowly-varying flows was recently introduced (Towne & Colonius, JCP, Vol. 300, 2015). The linearized Navier-Stokes equations are modified such that all upstream propagating modes are removed from the operator. The resulting equations, termed one-way Navier-Stokes equations, are stable and can be solved efficiently in the frequency domain as a spatial initial value problem in which initial perturbations are specified at the domain inlet and propagated downstream by spatial integration. To date, the method has been used to predict large-scale wavepacket structures and their acoustic radiation in turbulent jets. In this paper, the method is extended and applied to wall-bounded flows. Specifically, we examine the spatial stability of two- and three-dimensional boundary layers, corresponding to the Blasius and the Falkner-Skan-Cooke flows, and predict the evolution of unstable Tollmien-Schlichting waves and crossflow vortices, respectively. The method is validated against well-known results from the literature

Design, development and evaluation of a compact telerobotic catheter navigation system.

BACKGROUND: Remote catheter navigation systems protect interventionalists from scattered ionizing radiation. However, these systems typically require specialized catheters and extensive operator training. METHODS: A new compact and sterilizable telerobotic system is described, which allows remote navigation of conventional tip-steerable catheters, with three degrees of freedom, using an interface that takes advantage of the interventionalist\u27s existing dexterity skills. The performance of the system is evaluated ex vivo and in vivo for remote catheter navigation and ablation delivery. RESULTS: The system has absolute errors of 0.1 ± 0.1 mm and 7 ± 6° over 100 mm of axial motion and 360° of catheter rotation, respectively. In vivo experiments proved the safety of the proposed telerobotic system and demonstrated the feasibility of remote navigation and delivery of ablation. CONCLUSION: The proposed telerobotic system allows the interventionalist to use conventional steerable catheters; while maintaining a safe distance from the radiation source, he/she can remotely navigate the catheter and deliver ablation lesions. Copyright © 2015 John Wiley & Sons, Ltd