BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary ap...BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure(endoVAC)therapy in treating this complex condition.CASE SUMMARY A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain,fever,and dyspnea.Imaging revealed an EPF with associated pleural and pericardial effusions.Initial management with an esophageal stent failed,prompting the use of an endoVAC system.The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support.The fistula successfully closed,and the patient recovered,demonstrating no new symptoms at a 6-month follow-up.CONCLUSION EndoVAC therapy can effectively manage EPF,providing a minimally invasive treatment option.展开更多
The effects of vacuum assistance on the microstructure and mechanical properties of high pressure die cast A390alloy at different slow shot speeds were evaluated.Plate-shaped specimens of hypereutectic A390aluminum al...The effects of vacuum assistance on the microstructure and mechanical properties of high pressure die cast A390alloy at different slow shot speeds were evaluated.Plate-shaped specimens of hypereutectic A390aluminum alloy were produced on a TOYO BD?350V5cold chamber die casting machine incorporated with a self-improved TOYO vacuum system.According to the results,the vacuum pressure inside the die cavity increased linearly with the increasing slow shot speed at the beginning of mold filling.Meanwhile,tensile properties of vacuum die castings were deteriorated by the porosity content.In addition,the average primary silicon size decreased from23to14μm when the slow shot speed increased from0.05to0.2m/s,which has a binary functional relationship with the slow shot speed.After heat treatment,microstructural morphologies revealed that needle-shaped and thin-flaked eutectic silicon particles became rounded while Al2Cu dissolved intoα(Al)matrix.Furthermore,the fractography revealed that the fracture mechanism has evolved from brittle transgranular fracture to a fracture mode with many dimples after heat treatment.展开更多
BACKGROUND Esophagogastric leakage is one of the most severe postoperative complications.Partial disruption of the anastomosis,can be successfully treated with an endoscopic vacuum assisted closure(E-VAC).The advantag...BACKGROUND Esophagogastric leakage is one of the most severe postoperative complications.Partial disruption of the anastomosis,can be successfully treated with an endoscopic vacuum assisted closure(E-VAC).The advantage of that method of treatment is the ability to adjust a vacuum dressing individually to the size of the dehiscence and thus to reduce the risk of a secondary fistula or abscess.The authors present two patients with postoperative gastroesophageal leakage treated successfully with E-VAC.CASE SUMMARY Two male patients developed a potentially life threatening esophagogastric leakage.Patient A underwent resection of the distal half of the esophagus and upper part of the stomach due to Siewert type II adenocarcinoma of the gastroesophageal junction.Proximal resection of the stomach was performed in the patient B after massive bleeding from Mallory-Weiss tears.Both patients were treated successfully with an individually adapted E-VAC with concomitant correction of fluid and electrolyte disturbances,and treatment of sepsis with appropriate antibiotics.CONCLUSION Endoscopic vacuum closure is an effective alternative to endoscopic stenting or relaparotomy.Through individual approach it allows a more accurate assessment of healing.展开更多
The most common process to manufacture advanced composites is the costly autoclave.One of the out-of-autoclave alternatives is the low-cost vacuum assisted resin infusion(VARI)which produces quality parts with less po...The most common process to manufacture advanced composites is the costly autoclave.One of the out-of-autoclave alternatives is the low-cost vacuum assisted resin infusion(VARI)which produces quality parts with less pollution.Epoxy resin is a widely used composite matrix resin,but its high flammability limits its use as interior composite parts for vehicles.The usual flame retardant for epoxy involves halogen,which is effective but has high smoke toxicity.As a result,halogen-free flame retardant epoxy resin systems become dominant.In this paper,phosphorus flame retardant was combined with benzoxazine(BOZ)to produce synergistic effect and achieve satisfactory flame retardance,as well as mechanical improvement for the epoxy resin.Differential scanning calorimetry(DSC),dynamic mechanical analysis(DMA),thermal gravitational analysis(TGA),the cone calorimeter(CC),and limiting oxygen index(LOI)were used to characterize the resins.The results showed significant improvement on the flame retardance of the synergistically modified resins.Specifically,the carbon residue increased by 113.6%,and the char thickness increased by 6 to 7 times,compared to those of the flammable benchmark resin.The LOI reached 33 and passed the UL94 V-0 vertical burn rating.The modified resins also exhibited adequate stability and viscosity suitable for VARI processes.展开更多
AIM: To evaluate the efficacy and safety of endoscopic-vacuum assisted closure (E-VAC) therapy in the treatment of cervical esophageal leakage. METHODS: Between May and November 2012, three male patients who developed...AIM: To evaluate the efficacy and safety of endoscopic-vacuum assisted closure (E-VAC) therapy in the treatment of cervical esophageal leakage. METHODS: Between May and November 2012, three male patients who developed post-operative cervical esophageal leakage were treated with E-VAC therapy. One patient had undergone surgical excision of a pharyngo-cervical liposarcoma with partial esophageal resection, and the other two patients had received surgical treatment for symptomatic Zenker's diverticulum. Following endoscopic verification of the leakage, a trimmed polyurethane sponge was fixed to the distal end of a nasogastric silicone tube and endoscopically positioned into the wound cavity, and with decreasing cavity size the sponge was positioned intraluminally to cover the leak. Continuous suction was applied, and the vacuum drainage system was changed twice a week.RESULTS: The initial E-VAC placement was technically successful for all three patients, and complete closure of the esophageal leak was achieved without any procedure-related complications. In all three patients, the insufficiencies were located either above or slightly below the upper esophageal sphincter. The median duration of the E-VAC drainage was 29 d (range: 19-49 d), with a median of seven sponge exchanges (range: 5-12 sponge exchanges). In addition, the E-VAC therapy reduced inflammatory markers to within normal range for all three patients. Two of the patients were immediately fitted with a percutaneous enteral gastric feeding tube with jejunal extension, and the third patient received parenteral feeding. All three patients showed normal swallow function and no evidence of stricture after completion of the E-VAC therapy. CONCLUSION: E-VAC therapy for cervical esophageal leakage was well tolerated by patients. This safe and effective procedure may significantly reduce morbidity and mortality following cervical esophageal leakage.展开更多
Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all ...Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all patients. We are presenting the combined use of Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP) to improve the result in this difficult case. The use of VAC device is a well known procedure in the treatment of adult difficult wounds closure. It consists of a sponge applied directly on the abdominal wall defect, covered with a transparent dressing and connected to a controlled continuous negative pressure system [1]. Platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma. Due to this combination it provides multiple growth and healing factors actively secreted by platelets which have been shown to begin and accelerate wound healing [2] [3]. The association between VAC and PRP was effective in the shrinkage and reduction of the abdominal defect. Fifteen months after the removal of the VAC device the fascia appears competent with a cutaneus scar that will need a plastic correction in the future. The VAC should be considered as a helpful and effective device in case of complicated giant gastroschisis or omphalocele when traditional treatment is not sufficient.展开更多
An experimental procedure was designed to monitor the preform thickness change real-time throughout the vacuum assisted resin infusion( VARI) process. Two kinds of liquid with different viscosity were infused with dif...An experimental procedure was designed to monitor the preform thickness change real-time throughout the vacuum assisted resin infusion( VARI) process. Two kinds of liquid with different viscosity were infused with different post-filling time. The variation of the part thickness during the VARI process was studied. And the effect of the post-filling time on the part thickness was investigated.The results indicate that the compaction behavior of the preform can be divided into three stages,and the fiber volume fraction varies with the post-filling time in a similar sinusoid form. In addition,the post-filling should be overtime for the greatest fiber volume fraction,and when the resin is infused with higher viscosity,the greatest fiber volume fraction is higher.展开更多
Co-cured vacuum assisted resin infusion process(co-VARI process),which combined vacuum assisted resin infusion(VARI)with prepreg vacuum bag only process(VBO),was adopted to fabricate T-shaped stiffened skin with non-c...Co-cured vacuum assisted resin infusion process(co-VARI process),which combined vacuum assisted resin infusion(VARI)with prepreg vacuum bag only process(VBO),was adopted to fabricate T-shaped stiffened skin with non-crimp fabric(NCF)stiffener and prepreg skin.During compaction stage of co-VARI process,prepreg resin impregnated fiber fabric under elevated temperature and vacuum pressure.This phenomenon was characterized by fluorescent micrographs with different holding temperature and time.Its influences on processing quality and mechanical performance for co-VARI stiffened skin with different filler materials at triangular region were further analyzed by optical micrographs and pull-off test,respectively.The results show that increasing holding temperature and prolonging holding time can promote prepreg resin impregnation in fiber fabric.Moderate prepreg resin impregnation is favorable to reduce resin rich region and increase fiber volume fraction at prepreg-fabric interface.Moreover,prepreg resin impregnation effect plays significant roles on pull-off performance for co-VARI stiffened skin with fabric filler but has negligible influences on specimens with prepreg filler.In addition,compared with stiffened skin with fabric filler,superior processing quality and pull-off performances are achieved for co-VARI stiffened skin with prepreg core filler.These results are helpful to optimize processing procedures and fabricate composite structure by coVARI process.展开更多
Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 ...Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 and October 2005, 154 biopsies in 152 patients with microcalcifications were performed using the upright-type 11-gauge stereotactic vacuum-assisted biopsy device. Patients in whom this biopsy was diagnosed as carcinoma or a borderline lesion, had a subsequent surgical excision of the lesion. Histopathological and radiological features of the two specimens were then compared with each other. Results: Microcalcification was identified on specimen mammograms and microscopic slides in 97.4% of cases. Of 154 Mammotome biopsies 98 (63.6%) were benign, 51 (33.1%) were malignant, 3 (1.9%) showed atypical hyperplasia, and 2 (1.3%) were indeterminate, respectively. Of the 48 cases that received surgical excision, 6 of 36 ductal carcinomas in situ (16.7%) upstaged to invasive ductal carcinoma and 1 of 2 atypical ductal hyperplasias was upstaged to ductal carcinoma in situ. The positive predictive value of the 11-gauge Mammotome for the diagnosis of invasion in breast cancer was 100%. Linear calcification and pleomorphic calcification linear/segmental distribution was reliable indications of malignancy. The mean follow-up time of the benign lesions was 22 months, and without evidence of lesion growth. Complications included vasovagal reactions (6.3%), bleeding (0.6%) and hematoma (2.6%). Conclusion: The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed.展开更多
The green synthesis of nitrate(NO_(3)^(−))via electrocatalytic nitrogen oxidation reaction(NOR)is a promising strategy for artificial nitrogen fixation,which shows great advantages than traditional nitrate synthesis b...The green synthesis of nitrate(NO_(3)^(−))via electrocatalytic nitrogen oxidation reaction(NOR)is a promising strategy for artificial nitrogen fixation,which shows great advantages than traditional nitrate synthesis based on Haber–Bosch and Ostwald processes.But the poor N_(2)absorption,high bond energy of N≡N(941 kJ·mol^(−1)),and competing multi-electron-transfer oxygen evolution reaction(OER)limit the activity and selectivity.Herein,we fabricated MXene-derived irregular TiO_(2)−x nanoparticles anchored Cu nanowires(Cu-NWs)electrode for efficient electrocatalytic nitrogen oxidation,which exhibits a NO_(3)−yield of 62.50μg·h^(−1)·mgcat^(−1)and a Faradaic efficiency(FE)of 22.04%,and a significantly enhanced NO_(3)−yield of 92.63μg·h^(−1)·mgcat^(−1),and a FE of 40.58%under vacuum assistance.The TiO_(2)−x/Cu-NWs electrode also shows excellent reproducibility and stability under optimal experimental conditions.Moreover,a Zn-N_(2)reaction device was assembled with TiO_(2−x)/Cu-NWs as an anode and Zn plate as a cathode,obtaining an extremely high NO_(3)−yield of 156.25μg·h^(−1)·mgcat^(−1).The Zn-nitrate battery shows an open circuit voltage(OCV)of 1.35 V.This work provides novel strategies for enhancing the performance of ambient N_(2)oxidation to obtain higher NO_(3)^(−)yield.展开更多
Vacuum-assisted breast biopsy (VABB) plays a fundamental role in the preoperative assessment of breast lesions pro- viding large histology samples that are useful to define diagnoses and biological parameters to guide...Vacuum-assisted breast biopsy (VABB) plays a fundamental role in the preoperative assessment of breast lesions pro- viding large histology samples that are useful to define diagnoses and biological parameters to guide treatment planning. This technique has been used in our institute since 2000 and two new wireless handheld ultrasound-guided VABB de- vices have been introduced since May 2012. In this report we analyze our experience with these revolutionary devices which are able to provide the option of single-insertion contiguous tissue samples respectively with a 13/14-gauge aperture. Our initial experience on 75 lesions shows that these devices are safe, fast, procedurally advantageous for operators and well accepted by patients. Finally VABB procedures can markedly reduce the need for surgical biopsy.展开更多
Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy(UGVAB).Methods Among 392 a...Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy(UGVAB).Methods Among 392 appropriately selected patients,187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009.All lesions were removed as completely as possible.The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure.Results During the procedure,only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort.An accurate pathological diagnosis was obtained in all lesions.There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure.The rates of malignant or premalignant pathology,postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion.If each lesion was considered as a subject of study,there was no significant difference between the two groups.Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.展开更多
Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been appro...Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been approved for this use since 2006 by the National Institute for Health and Clinical Excellence in the UK. The aim of this systematic review is to evaluate the efficacy and safety of this procedure based on the up to date available evidence. Methods: A comprehensive literature search of the Cochrane library, Medline, Embase, PubMed, Google scholar, Trip-database, Internet, and the reference lists of relevant articles was performed. We searched for literature with sizeable cases of therapeutic vacuum-assisted excision of fibroadenomas. All prospective studies with more than 20 study participants were screened. The study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach. All were in English. Results: Of the four case series that fulfilled the inclusion criteria there were 516 patients in which 520 procedures were performed. Overall complete excision rate was 89.4%. In two of the studies, this was 100% when the lesions were less than 1.5 cm but reduced to 61% when between 1.5 and 2 cm. Most common significant complication was bleeding with 2 cases of pneumothorax. None of the studies can be regarded as high quality going by GRADE approach. Conclusion: Within the limit of the current published case series, UGVAE appears to be an effective and safe procedure for excision of small fibroadenomas of less than 15 mm in size. A well designed case control study or randomized controlled trials with a sufficient sample size is needed to further assess its safety, effectiveness and more importantly, patients’ satisfaction especially in larger sized fibroadenomas.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
文摘BACKGROUND Esophagopericardial fistula(EPF)is a rare,life-threatening condition with limited scientific literature and no established management guidelines.This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure(endoVAC)therapy in treating this complex condition.CASE SUMMARY A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain,fever,and dyspnea.Imaging revealed an EPF with associated pleural and pericardial effusions.Initial management with an esophageal stent failed,prompting the use of an endoVAC system.The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support.The fistula successfully closed,and the patient recovered,demonstrating no new symptoms at a 6-month follow-up.CONCLUSION EndoVAC therapy can effectively manage EPF,providing a minimally invasive treatment option.
基金Project(51775297)supported by the National Natural Science Foundation of ChinaProject(2015M580093)supported by the China Postdoctoral Science Foundation
文摘The effects of vacuum assistance on the microstructure and mechanical properties of high pressure die cast A390alloy at different slow shot speeds were evaluated.Plate-shaped specimens of hypereutectic A390aluminum alloy were produced on a TOYO BD?350V5cold chamber die casting machine incorporated with a self-improved TOYO vacuum system.According to the results,the vacuum pressure inside the die cavity increased linearly with the increasing slow shot speed at the beginning of mold filling.Meanwhile,tensile properties of vacuum die castings were deteriorated by the porosity content.In addition,the average primary silicon size decreased from23to14μm when the slow shot speed increased from0.05to0.2m/s,which has a binary functional relationship with the slow shot speed.After heat treatment,microstructural morphologies revealed that needle-shaped and thin-flaked eutectic silicon particles became rounded while Al2Cu dissolved intoα(Al)matrix.Furthermore,the fractography revealed that the fracture mechanism has evolved from brittle transgranular fracture to a fracture mode with many dimples after heat treatment.
文摘BACKGROUND Esophagogastric leakage is one of the most severe postoperative complications.Partial disruption of the anastomosis,can be successfully treated with an endoscopic vacuum assisted closure(E-VAC).The advantage of that method of treatment is the ability to adjust a vacuum dressing individually to the size of the dehiscence and thus to reduce the risk of a secondary fistula or abscess.The authors present two patients with postoperative gastroesophageal leakage treated successfully with E-VAC.CASE SUMMARY Two male patients developed a potentially life threatening esophagogastric leakage.Patient A underwent resection of the distal half of the esophagus and upper part of the stomach due to Siewert type II adenocarcinoma of the gastroesophageal junction.Proximal resection of the stomach was performed in the patient B after massive bleeding from Mallory-Weiss tears.Both patients were treated successfully with an individually adapted E-VAC with concomitant correction of fluid and electrolyte disturbances,and treatment of sepsis with appropriate antibiotics.CONCLUSION Endoscopic vacuum closure is an effective alternative to endoscopic stenting or relaparotomy.Through individual approach it allows a more accurate assessment of healing.
文摘The most common process to manufacture advanced composites is the costly autoclave.One of the out-of-autoclave alternatives is the low-cost vacuum assisted resin infusion(VARI)which produces quality parts with less pollution.Epoxy resin is a widely used composite matrix resin,but its high flammability limits its use as interior composite parts for vehicles.The usual flame retardant for epoxy involves halogen,which is effective but has high smoke toxicity.As a result,halogen-free flame retardant epoxy resin systems become dominant.In this paper,phosphorus flame retardant was combined with benzoxazine(BOZ)to produce synergistic effect and achieve satisfactory flame retardance,as well as mechanical improvement for the epoxy resin.Differential scanning calorimetry(DSC),dynamic mechanical analysis(DMA),thermal gravitational analysis(TGA),the cone calorimeter(CC),and limiting oxygen index(LOI)were used to characterize the resins.The results showed significant improvement on the flame retardance of the synergistically modified resins.Specifically,the carbon residue increased by 113.6%,and the char thickness increased by 6 to 7 times,compared to those of the flammable benchmark resin.The LOI reached 33 and passed the UL94 V-0 vertical burn rating.The modified resins also exhibited adequate stability and viscosity suitable for VARI processes.
基金Supported by The Deutsche Forschungsgemeinschaft in the framework of the "Open Access Publishing" Program
文摘AIM: To evaluate the efficacy and safety of endoscopic-vacuum assisted closure (E-VAC) therapy in the treatment of cervical esophageal leakage. METHODS: Between May and November 2012, three male patients who developed post-operative cervical esophageal leakage were treated with E-VAC therapy. One patient had undergone surgical excision of a pharyngo-cervical liposarcoma with partial esophageal resection, and the other two patients had received surgical treatment for symptomatic Zenker's diverticulum. Following endoscopic verification of the leakage, a trimmed polyurethane sponge was fixed to the distal end of a nasogastric silicone tube and endoscopically positioned into the wound cavity, and with decreasing cavity size the sponge was positioned intraluminally to cover the leak. Continuous suction was applied, and the vacuum drainage system was changed twice a week.RESULTS: The initial E-VAC placement was technically successful for all three patients, and complete closure of the esophageal leak was achieved without any procedure-related complications. In all three patients, the insufficiencies were located either above or slightly below the upper esophageal sphincter. The median duration of the E-VAC drainage was 29 d (range: 19-49 d), with a median of seven sponge exchanges (range: 5-12 sponge exchanges). In addition, the E-VAC therapy reduced inflammatory markers to within normal range for all three patients. Two of the patients were immediately fitted with a percutaneous enteral gastric feeding tube with jejunal extension, and the third patient received parenteral feeding. All three patients showed normal swallow function and no evidence of stricture after completion of the E-VAC therapy. CONCLUSION: E-VAC therapy for cervical esophageal leakage was well tolerated by patients. This safe and effective procedure may significantly reduce morbidity and mortality following cervical esophageal leakage.
文摘Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all patients. We are presenting the combined use of Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP) to improve the result in this difficult case. The use of VAC device is a well known procedure in the treatment of adult difficult wounds closure. It consists of a sponge applied directly on the abdominal wall defect, covered with a transparent dressing and connected to a controlled continuous negative pressure system [1]. Platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma. Due to this combination it provides multiple growth and healing factors actively secreted by platelets which have been shown to begin and accelerate wound healing [2] [3]. The association between VAC and PRP was effective in the shrinkage and reduction of the abdominal defect. Fifteen months after the removal of the VAC device the fascia appears competent with a cutaneus scar that will need a plastic correction in the future. The VAC should be considered as a helpful and effective device in case of complicated giant gastroschisis or omphalocele when traditional treatment is not sufficient.
基金The Fundamental Research Funds for the Central Universities,China(No.2232014D3-26)Innovation Fund of the Chinese National Engineering Research Center,China(No.SAM C14-JS-15-049)Science and Technology Commission of Shanghai Municipality,China(No.14DZ1100402)
文摘An experimental procedure was designed to monitor the preform thickness change real-time throughout the vacuum assisted resin infusion( VARI) process. Two kinds of liquid with different viscosity were infused with different post-filling time. The variation of the part thickness during the VARI process was studied. And the effect of the post-filling time on the part thickness was investigated.The results indicate that the compaction behavior of the preform can be divided into three stages,and the fiber volume fraction varies with the post-filling time in a similar sinusoid form. In addition,the post-filling should be overtime for the greatest fiber volume fraction,and when the resin is infused with higher viscosity,the greatest fiber volume fraction is higher.
文摘Co-cured vacuum assisted resin infusion process(co-VARI process),which combined vacuum assisted resin infusion(VARI)with prepreg vacuum bag only process(VBO),was adopted to fabricate T-shaped stiffened skin with non-crimp fabric(NCF)stiffener and prepreg skin.During compaction stage of co-VARI process,prepreg resin impregnated fiber fabric under elevated temperature and vacuum pressure.This phenomenon was characterized by fluorescent micrographs with different holding temperature and time.Its influences on processing quality and mechanical performance for co-VARI stiffened skin with different filler materials at triangular region were further analyzed by optical micrographs and pull-off test,respectively.The results show that increasing holding temperature and prolonging holding time can promote prepreg resin impregnation in fiber fabric.Moderate prepreg resin impregnation is favorable to reduce resin rich region and increase fiber volume fraction at prepreg-fabric interface.Moreover,prepreg resin impregnation effect plays significant roles on pull-off performance for co-VARI stiffened skin with fabric filler but has negligible influences on specimens with prepreg filler.In addition,compared with stiffened skin with fabric filler,superior processing quality and pull-off performances are achieved for co-VARI stiffened skin with prepreg core filler.These results are helpful to optimize processing procedures and fabricate composite structure by coVARI process.
基金Supported by a grant from the Sasakawa Foundation (Japan) of Japan China Medical Association
文摘Objective: The aim of this study was to evaluate the utility of an upright-type 11-gauge stereotactic vacuumassisted biopsy device (Mammotome) for the diagnosis of breast microcalcifications Methods: Between May 2001 and October 2005, 154 biopsies in 152 patients with microcalcifications were performed using the upright-type 11-gauge stereotactic vacuum-assisted biopsy device. Patients in whom this biopsy was diagnosed as carcinoma or a borderline lesion, had a subsequent surgical excision of the lesion. Histopathological and radiological features of the two specimens were then compared with each other. Results: Microcalcification was identified on specimen mammograms and microscopic slides in 97.4% of cases. Of 154 Mammotome biopsies 98 (63.6%) were benign, 51 (33.1%) were malignant, 3 (1.9%) showed atypical hyperplasia, and 2 (1.3%) were indeterminate, respectively. Of the 48 cases that received surgical excision, 6 of 36 ductal carcinomas in situ (16.7%) upstaged to invasive ductal carcinoma and 1 of 2 atypical ductal hyperplasias was upstaged to ductal carcinoma in situ. The positive predictive value of the 11-gauge Mammotome for the diagnosis of invasion in breast cancer was 100%. Linear calcification and pleomorphic calcification linear/segmental distribution was reliable indications of malignancy. The mean follow-up time of the benign lesions was 22 months, and without evidence of lesion growth. Complications included vasovagal reactions (6.3%), bleeding (0.6%) and hematoma (2.6%). Conclusion: The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed.
基金the Natural Science Foundation of Shandong Province(No.ZR2021MB075)the National Natural Science Foundation of China(No.51602297).
文摘The green synthesis of nitrate(NO_(3)^(−))via electrocatalytic nitrogen oxidation reaction(NOR)is a promising strategy for artificial nitrogen fixation,which shows great advantages than traditional nitrate synthesis based on Haber–Bosch and Ostwald processes.But the poor N_(2)absorption,high bond energy of N≡N(941 kJ·mol^(−1)),and competing multi-electron-transfer oxygen evolution reaction(OER)limit the activity and selectivity.Herein,we fabricated MXene-derived irregular TiO_(2)−x nanoparticles anchored Cu nanowires(Cu-NWs)electrode for efficient electrocatalytic nitrogen oxidation,which exhibits a NO_(3)−yield of 62.50μg·h^(−1)·mgcat^(−1)and a Faradaic efficiency(FE)of 22.04%,and a significantly enhanced NO_(3)−yield of 92.63μg·h^(−1)·mgcat^(−1),and a FE of 40.58%under vacuum assistance.The TiO_(2)−x/Cu-NWs electrode also shows excellent reproducibility and stability under optimal experimental conditions.Moreover,a Zn-N_(2)reaction device was assembled with TiO_(2−x)/Cu-NWs as an anode and Zn plate as a cathode,obtaining an extremely high NO_(3)−yield of 156.25μg·h^(−1)·mgcat^(−1).The Zn-nitrate battery shows an open circuit voltage(OCV)of 1.35 V.This work provides novel strategies for enhancing the performance of ambient N_(2)oxidation to obtain higher NO_(3)^(−)yield.
文摘Vacuum-assisted breast biopsy (VABB) plays a fundamental role in the preoperative assessment of breast lesions pro- viding large histology samples that are useful to define diagnoses and biological parameters to guide treatment planning. This technique has been used in our institute since 2000 and two new wireless handheld ultrasound-guided VABB de- vices have been introduced since May 2012. In this report we analyze our experience with these revolutionary devices which are able to provide the option of single-insertion contiguous tissue samples respectively with a 13/14-gauge aperture. Our initial experience on 75 lesions shows that these devices are safe, fast, procedurally advantageous for operators and well accepted by patients. Finally VABB procedures can markedly reduce the need for surgical biopsy.
文摘Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy(UGVAB).Methods Among 392 appropriately selected patients,187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009.All lesions were removed as completely as possible.The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure.Results During the procedure,only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort.An accurate pathological diagnosis was obtained in all lesions.There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure.The rates of malignant or premalignant pathology,postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion.If each lesion was considered as a subject of study,there was no significant difference between the two groups.Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.
文摘Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been approved for this use since 2006 by the National Institute for Health and Clinical Excellence in the UK. The aim of this systematic review is to evaluate the efficacy and safety of this procedure based on the up to date available evidence. Methods: A comprehensive literature search of the Cochrane library, Medline, Embase, PubMed, Google scholar, Trip-database, Internet, and the reference lists of relevant articles was performed. We searched for literature with sizeable cases of therapeutic vacuum-assisted excision of fibroadenomas. All prospective studies with more than 20 study participants were screened. The study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach. All were in English. Results: Of the four case series that fulfilled the inclusion criteria there were 516 patients in which 520 procedures were performed. Overall complete excision rate was 89.4%. In two of the studies, this was 100% when the lesions were less than 1.5 cm but reduced to 61% when between 1.5 and 2 cm. Most common significant complication was bleeding with 2 cases of pneumothorax. None of the studies can be regarded as high quality going by GRADE approach. Conclusion: Within the limit of the current published case series, UGVAE appears to be an effective and safe procedure for excision of small fibroadenomas of less than 15 mm in size. A well designed case control study or randomized controlled trials with a sufficient sample size is needed to further assess its safety, effectiveness and more importantly, patients’ satisfaction especially in larger sized fibroadenomas.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.