Treatment of superior vena cava (SVC) syndrome and inferior vena cava (IVC) thrombosis in a patient with colorectal cancer: combination of SVC stenting and IVC filter placement to palliate symptoms and pave the way for port implantation

Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

Safety of inferior vena cava filter retrieval in anticoagulated patients

PURPOSES: To evaluate the safety of inferior vena cava (IVC) filter retrieval in therapeutically anticoagulated patients in comparison to prophylactically or not therapeutically anticoagulated patients with respect to retrieval-related hemorrhagic complications. MATERIALS AND METHODS: This was a retrospective study of 115 consecutive attempted IVC filter retrievals in 110 patients. Filter retrievals were stratified as performed in patients who were therapeutically anticoagulated (group 1), prophylactically anticoagulated (group 2), or not therapeutically anticoagulated (group 3). The collected data included anticoagulant and antiplatelet medications (type, form and duration of administration, dosage) at the time of retrieval. Phone interviews and chart review was performed for the international normalized ratio (INR), activated partial thromboplastin time, platelet count, infusion of blood products, and retrieval-related hemorrhagic complications. RESULTS: Group 1 included 65 attempted filter retrievals in 61 therapeutically anticoagulated patients by measured INR or dosing when receiving low-molecular-weight heparin (LMWH). Four retrievals were not successful. In patients receiving oral anticoagulation, the median INR was 2.35 (range, 2 to 8). Group 2 comprised 23 successful filter retrievals in 22 patients receiving a prophylactic dose of LMWH. Group 3 included 27 attempted filter retrievals in 27 patients not receiving therapeutic anticoagulation. Six retrievals were not successful. Five patients were receiving oral anticoagulation with a subtherapeutic INR (median, 1.49; range, 1.16 to 1.69). No anticoagulation medication was administered in 22 patients. In none of the groups were hemorrhagic complications related to the retrieval procedures identified. CONCLUSIONS: These results suggest that retrieval of vena cava filters in anticoagulated patients is safe. Interruption or reversal of anticoagulation for the retrieval of vena cava filters is not indicated.

Flow impairment during protected carotid artery stenting: impact of filter device design

PURPOSE: To investigate the impact of filter design on blood flow impairment in the internal carotid artery (ICA) among patients undergoing carotid artery stenting (CAS) using filter-type emboli protection devices (EPD). METHODS: Between July 2003 and March 2007, 115 filter-protected CAS procedures were performed at an academic institution in 107 consecutive patients (78 men; mean age 68 years, range 38-87). The Angioguard, FilterWire EZ, and Spider filters were used in 68 (59%), 32 (28%), and 15 (13%) of cases, respectively. Patient characteristics, procedural and angiographic data, and outcomes were prospectively entered into an electronic database and reviewed retrospectively along with all angiograms. RESULTS: Flow impairment while the filter was in place was observed in 25 (22%) cases. The presumptive reason of flow impairment was filter obstruction in 21 (18%) instances and flow-limiting spasm at the level of the filter in 4 (4%). In all cases, flow was restored after retrieval of the filter. Flow obstruction in the ICA occurred more frequently with Angioguard (22/68; 32.3%) than with FilterWire EZ (2/32; 6.2%) or Spider (1/15; 6.7%; p = 0.004). No flow occurred in 13 (19%) procedures, all of them protected with Angioguard; no patient treated with other devices experienced this event (p = 0.007). Two (8.0%) strokes occurred in procedures associated with flow impairment, while 1 (1.1%) event was observed in the presence of preserved flow throughout the intervention (p = 0.11). CONCLUSION: Flow impairment in the ICA during filter-based CAS is common and related to the type of filter used.

Effect of bacterial filter on measurement of interrupter resistance in preschool and school-aged children

BACKGROUND: The interrupter technique is increasingly used in preschool children to assess airway resistance (Rint). Use of a bacterial filter is essential for prevention of cross-infection in a clinical setting. It is not known how large an effect this extra resistance and compliance exert upon interrupter measurements, especially on obstructive airways and in smaller children. We aim to determine the contribution of the filter to Rint, in a sample of children attending lung function testing at an asthma clinic. METHODS: Interrupter measurements were performed according to ATS/ERS guidelines during quiet normal breathing at an expiratory flow trigger of 200 ml s(-1), with the child seated upright with cheeks supported and wearing a nose clip. A minimum of 10 interrupter measurements was made with and without a bacterial filter. Spirometric and plethysmographic tests were also performed. RESULTS: A small but significant difference (0.12 (95% CI 0.06-0.17) kPa s L(-1), P = 0.0002) with 2x SD of 0.34 kPa s L(-1) was observed between Rint with and without filter in 39 children, with a large spread. This difference was not dependent on Rint magnitude, age or height, nor on lung function parameters (effective resistance, forced expiratory volume in 1 sec, and maximal expiratory flow at 50% of expired vital capacity). CONCLUSIONS: A bacterial filter causes a small difference but is not clinically significant, with a wide spread comparable to the variability of the technique and recommended cut-offs for assessing repeatability and bronchodilation. Age, height or severity of obstruction need not be corrected for in general.

Study of the effect of biodiesel fuel on passive oxidation in a catalyzed particulate filter

A 2007 Cummins ISL 8.9L direct-injection common rail diesel engine rated at 272 kW (365 hp) and 317 kW (425 hp) was used to load the filter to 2.2 g/L and passively oxidize particulate matter (PM) within an aftertreatment system consisting of a diesel oxidation catalyst (DOC) and catalyzed particulate filter (CPF). The tests conducted with the engine rated at 365 hp used a 2007 DOC and CPF. The tests conducted with the engine rated at 425 hp used a 2010 DOC and 2007 CPF. Understanding the passive NO2 oxidation kinetics of PM within the CPF allows for reducing the frequency of active regenerations (hydrocarbon injection) and the associated fuel penalties. Modeling the passive oxidation of accumulated PM in the CPF will lead to creating accurate state estimation strategies. The MTU 1-D CPF model will be used to simulate data collected from this study to examine differences in the PM oxidation kinetics when soy methyl ester (SME) biodiesel is used as the source of fuel for the engine, and when the engine is operated at a higher power rating. A test procedure developed by Hutton et al. [1, 2] was modified to improve the ability to model the experimental data and provide additional insight into passively oxidized PM in a partially regenerated CPF. A test procedure was developed to allow PM oxidation rates by NO2 to be determined from engine test cell data. An experimental matrix consisting of CPF inlet temperatures from 250 to 450 °C with varying NOX/PM from 25 to 583and NO2/PM ratios from 5 to 240 was used. SME biodiesel was volumetrically blended with ULSD in 10% (B10) and 20% (B20) portions. This blended fuel was then used to evaluate the effect of biodiesel on passive oxidation rates. Four tests were performed with B10 and four tests with B20. Gathering data to determine the effect of fuel type (ULSD and biodiesel blends) on PM oxidation is the primary goal. The engine used for this testing was then configured to a higher power rating and one of the tests planned was performed. Additional testing is scheduled to take place with ULSD fuel to determine the affect the engine rating has on the PM oxidation. The experimental reaction rates during passive oxidation varied based upon the average CPF temperature, NO2 concentrations, and the NOX/PM ratios for each engine rating and with all fuels. The data analysis requires a high fidelity model that includes NO2 and thermal oxidation mechanisms and back diffusion to determine the details of the PM oxidation process.

Quickbird satellite imagery for riparian management : characterizing riparian filter strips and detecting concentrated flow in an agricultural watershed

Riparian ecology plays an important part in the filtration of sediments from upland agricultural lands. The focus of this work makes use of multispectral high spatial resolution remote sensing imagery (Quickbird by Digital Globe) and geographic information systems (GIS) to characterize significant riparian attributes in the USDA’s experimental watershed, Goodwin Creek, located in northern Mississippi. Significant riparian filter characteristics include the width of the strip, vegetation properties, soil properties, topography, and upland land use practices. The land use and vegetation classes are extracted from the remotely sensed image with a supervised maximum likelihood classification algorithm. Accuracy assessments resulted in an acceptable overall accuracy of 84 percent. In addition to sensing riparian vegetation characteristics, this work addresses the issue of concentrated flow bypassing a riparian filter. Results indicate that Quickbird multispectral remote sensing and GIS data are capable of determining riparian impact on filtering sediment. Quickbird imagery is a practical solution for land managers to monitor the effectiveness of riparian filtration in an agricultural watershed.

Kalman Filter approaches on crane swing

The purpose of this study is to explore a Kalman Filter approach to estimating swing of crane-suspended loads. Measuring real-time swing is needed to implement swing damping control strategies where crane joints are used to remove energy from a swinging load. The typical solution to measuring swing uses an inertial sensor attached to the hook block. Measured hook block twist is used to resolve the other two sensed body rates into tangential and radial swing. Uncertainty in the twist measurement leads to inaccurate tangential and radial swing calculations and ineffective swing damping. A typical mitigation approach is to bandpass the inertial sensor readings to remove low frequency drift and high frequency noise. The center frequency of the bandpass filter is usually designed to track the load length and the pass band width set to trade off performance with damping loop gain. The Kalman Filter approach developed here allows all swing motions (radial, tangential and twist) to be measured without the use of a bandpass filter. This provides an alternate solution for swing damping control implementation. After developing a Kalman Filter solution for a two-dimensional swing scenario, the three-dimensional system is considered where simplifying assumptions, suggested by the two-dimensional study, are exploited. One of the interesting aspects of the three-dimensional study is the hook block twist model. Unlike the mass-independence of a pendulum's natural frequency, the twist natural frequency depends both on the pendulum length and the load’s mass distribution. The linear Kalman Filter is applied to experimental data demonstrating the ability to extract the individual swing components for complex motions. It should be noted that the three-dimensional simplifying assumptions preclude the ability to measure two "secondary" hook block rotations. The ability to segregate these motions from the primary swing degrees of freedom was illustrated in the two-dimensional study and could be included into the three-dimensional solution if they were found to be important for a particular application.

Optional vena cava filter with disengaging centering struts: retrieval in an animal model

An optional inferior vena cava (IVC) filter prototype was evaluated for safety and long-term retrievability as an initial feasibility study in an animal model. This filter has four centering struts that have the ability to disengage from the filtering cone portion, allowing the legs to slide out of endothelial growth. Retrieval of six filters in three animals was successful up to 27 weeks. There was no substantial filter tilt, migration, or IVC damage. In conclusion, this filter design may help overcome some of the shortcomings in currently approved optional IVC filters, including long-term retrieval difficulties, tilting, or migration.

IMPACT OF ENGINE CALIBRATION ON PM OXIDATION IN A CATALYZED PARTICULATE FILTER OVER A TRANSIENT CYCLE: A MODELLING STUDY

The combustion strategy in a diesel engine has an impact on the emissions, fuel consumption and the exhaust temperatures. The PM mass retained in the CPF is a function of NO2 and PM concentrations in addition to the exhaust temperatures and the flow rates. Thus the engine combustion strategy affects exhaust characteristics which has an impact on the CPF operation and PM mass retained and oxidized. In this report, a process has been developed to simulate the relationship between engine calibration, performance and HC and PM oxidation in the DOC and CPF respectively. Fuel Rail Pressure (FRP) and Start of Injection (SOI) sweeps were carried out at five steady state engine operating conditions. This data, along with data from a previously carried out surrogate HD-FTP cycle [1], was used to create a transfer function model which estimates the engine out emissions, flow rates, temperatures for varied FRP and SOI over a transient cycle. Four different calibrations (test cases) were considered in this study, which were simulated through the transfer function model and the DOC model [1, 2]. The DOC outputs were then input into a model which simulates the NO2 assisted and thermal PM oxidation inside a CPF. Finally, results were analyzed as to how engine calibration impacts the engine fuel consumption, HC oxidation in the DOC and the PM oxidation in the CPF. Also, active regeneration for various test cases was simulated and a comparative analysis of the fuel penalties involved was carried out.

Layer-cake, anoxia, and other myths: A new look at the Devonian-Mississippian Bakken Formation Reservoir, Williston Basin, North Dakota

The Upper Devonian-Mississippian Bakken Formation in the Williston Basin is one of the most prolific onshore petroleum systems in the continental U.S., consisting of a middle carbonate-siliciclastic member sandwiched between two organic-rich units, the Lower and Upper Bakken shales. Dr. Egenhoff discusses the formation’s surprising departures from standard stratigraphy models and depositional models which contribute to its unique characteristics.

Form und Filter - Algorithmen der Bilderverarbeitung und Stilanalyse

Die Grundbegriffe Wölfflins lassen sich mit Hilfe digitaler Algorithmen nachmodellieren. Welches Wissen wird damit gewonnen? Auch Wölfflin hat auf mediale Veränderungen reagiert, indem er die Doppel-Projektion von Dias in den binären Differenzen der Grundbegriffe nachbildete. Sie lesen der Projektion zweier Bilder eine historische Differenz aus, die für die Disziplin der Kunstgeschichte grundlegend ist. Ein digitale Nachbildung dieser Differenz wäre tautologisch: sie würde ein gewusstes Wissen wiederholen. Fruchtbar wird der Einsatz digitaler Algorithmen dann, wenn sie nicht nur etwas bekanntes abbilden, sondern wenn man fragt, zu welcher "methodischen Grenzerweiterung" sie beitragen könnten.

A Skull-Stripping Filter for ITK

Skull-stripping (or brain extraction) is an important pre-processing step in neuroimage analysis. This document describes a skull-stripping filter implemented using the Insight Toolkit ITK, which we named itk::StripTsImageFilter. It is a composite filter based on existing ITK classes. The filter has been implemented with usability, robustness, speed and versatility in mind, rather than accuracy. This makes it useful for many pre-processing tasks in neuroimage analysis. This paper is accompanied by the source code, input data and a testing environment.