Value of ultrasonographic contrast in duplex scanning of leg arteries - Comparison with conventional duplex scanning and arteriography

Aim. Duplex scanning has been used in the evaluation of the aorta and proximal arteries of the lower extremities, but has limitations in evaluating the arteries of the leg. The utilization of ultrasonographic contrast (USC) may be helpful in improving the quality of the image in these arteries. The objective of the present study was to verify whether the USC increases the diagnostic accuracy of patency of the leg arteries and if it diminishes the time needed to perform duplex scanning.Methods. Twenty patients with critical ischemia (20 lower extremities) were examined by standard duplex scanning, duplex scanning with contrast and digital subtraction arteriography (DSA). The 3 arteries of the leg were divided into 3 segments, for a total of 9 segments per limb. Each segment was evaluated for patency in order to compare the 3 diagnostic methods. Comparison was made between standard duplex scanning and duplex scanning with contrast in terms of quality of the color-coded Doppler signal and of the spectral curve, and also of the time to perform the exams.Results. Duplex scanning with contrast was similar to arteriography in relation to patency diagnosis (p>0.3) and even superior in some of the segments. Standard duplex scanning was inferior to arteriography and to duplex scanning with contrast (p<0.001). There were improvements of 70% in intensity of the color-coded Doppler signal and 76% in the spectral curve after the utilization of contrast. The time necessary to perform the examinations was 23.7 minutes for standard duplex scanning and 16.9 minutes for duplex scanning with contrast (p<0.001).Conclusion. The use of ultrasonographic contrast increased the accuracy of the diagnosis of patency of leg arteries and diminished the time necessary for the execution of duplex scanning.

Extrinsic compression of popliteal artery in asymptomatic athlete and non-athlete individuals - A comparative study using duplex scan (color duplex sonography)

Aim. Extrinsic compression of the popliteal artery and absence of surrounding anatomical abnormalities characterize the functional popliteal artery entrapment syndrome (PAES). The diagnosis is confirmed to individuals who have typical symptoms of popliteal entrapment and occlusion or important stenosis of the popliteal artery with color duplex sonography (CDS), magnetic resonance imaging (MRI) or arteriography during active plantar flexion-extension maneuvers. However, variable result findings in normal asymptomatic subjects have raised doubts as to the validity of these tests. The purpose of this study was to compare the frequency of popliteal artery compression in 2 groups of asymptomatic subjects, athletes and non-athletes.Methods. Forty-two individuals were studied. Twenty-one subjects were indoor soccer players, and 21 were sedentary individuals. Physical activity was evaluated through questionnaires, anthropometric measurements, and cardiopulmonary exercise test. Evaluation of popliteal artery compression was performed in lower limbs with CDS, ankle-brachial index (ABI) measurements and continuous wave Doppler of the posterior tibial artery.Results. The athletes studied fulfilled the criteria of high level of physical activity whereas sedentary subjects met the criteria of low level of activity. Popliteal artery compression was observed with CDS in 6 (14.2%) studied subjects; 2 of whom (4.7%) were athletes and 4 (9.5%) were non-athletes. This difference was not statistically significant (p=0.21). Doppler of the tibial arteries and ABI measurements gave good specificity and sensibility in the identification of popliteal artery compression.Conclusion. The frequency of popliteal artery compression during maneuvers in normal subjects was 14.2% irrespective of whether or not they performed regular physical activities. Both Doppler and ABI showed good agreement with CDS and should be considered in screening popliteal arteries in individuals suspected of PAES.

Correlation between the intensity of venous reflux in the saphenofemoral junction and morphological changes of the great saphenous vein by duplex scanning in patients with primary varicosis

Aim. One of the major causes of chronic venous disease is venous reflux, the identification and quantification of which are important for diagnosis. Duplex scanning allows for the detection and quantification of reflux in individual veins. Evaluation of the great saphenous vein in primary varicosis is necessary for its preservation. Objective of the study is to evaluate a possible correlation between the intensity of reflux at the saphenofemoral junction, diameter alterations of the incompetent great saphenous vein and the practical effect of such correlation. Also to compare the clinical severity of the CEAP classification with such parameters.Methods. Three hundred limbs were submitted to duplex evaluation of their insufficient saphenous veins. Vein diameter was measured on five different points. Velocity and flow at reflux peak and reflux time were determined. The saphenous vein's diameters were correlated with velocity, flow and time. The three latter parameters and diameters were compared with clinical severity according to CEAP.Results. Correlation was found between the saphenous vein's diameters, velocity and flow. No correlation was observed between time and diameter in the thigh's upper and middle thirds. When comparing diameter, velocity and flow with CEAP clinical severity classification, an association was observed. The correlation between reflux time with clinical severity was weak.Conclusion. Reflux time is a good parameter for identifying the presence of reflux, but not for quantifying it. Velocity and peak flow were better parameters for evaluating reflux intensity as they were correlated with great saphenous vein alterations, and were associated with the disease's clinical severity. [Int Angiol 2010;29:323-30]

Aging behaviour of 25Cr-17Mn high nitrogen duplex stainless steel

The precipitation behaviour of a nickel free stainless steel containing 25% chromium, 17% manganese and 0.54% nitrogen, with duplex ferritic-austenitic microstructure, was studied using several complementary techniques of microstructural analysis after aging heat treatments between 600 and 1 000 degrees C for periods of lime between 15 and 6 000 min. During aging heat treatments, ferrite was decomposed into sigma phase and austenite by a eutectoid reaction, like in the Fe-Cr-Ni duplex stainless steel. Chromium nitride precipitation occurred in austenite, which had a high nitrogen supersaturation. Some peculiar aspects were observed in this austenite during its phase transformations. Chromium nitride precipitation occurred discontinuously in a lamellar morphology, such as pearlite in carbon steels. This kind of precipitation is not an ordinary observation in duplex stainless steels and the high levels of nitrogen in austenite can induce this type of precipitation, which has not been previously reported in duplex stainless steels. After chromium nitride precipitation in austenite, it was also observed sigma phase formation near the cells or colonies of discontinuously precipitated chromium nitride. Sigma phase formation was made possible by the depletion of nitrogen in those regions. Time-temperature-transformation (precipitation) diagrams were determined.

Microstructural and electrochemical characterization of friction stir welded duplex stainless steels

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influência da potência de laser Nd: YAG na soldagem do aço inoxidável duplex UNS S32205

Pós-graduação em Engenharia Mecânica - FEIS

Diagnosis of gastric cryptosporidiosis in birds using a duplex real-time PCR assay

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influência do aporte térmico da soldagem GTAW no balanço de fases Ferrita/Austenita do Aço Inoxidável Duplex UNS S32205

Pós-graduação em Engenharia Mecânica - FEIS

Corrosion protection of aluminium alloy by cerium conversion and conducting polymer duplex coatings

The corrosion protection of AA6063 aluminium alloy by cerium conversion, polyaniline conducting polymer and by duplex coatings has been investigated. The electrochemical behaviour was evaluated in aerated 3.5 wt.% NaCl. All coatings tested shifted the corrosion and pitting potentials to more positive values, indicating protection against corrosion. The duplex coatings are significantly more effective than each coating alone: corrosion and pitting potentials were shifted by +183 and +417 mV(SCE), respectively, by duplex coatings in relation to the untreated aluminium alloy. Optical microscopy and scanning electron microscopy are in agreement with the electrochemical results, reinforcing the superior performance of duplex coatings. (C) 2012 Elsevier Ltd. All rights reserved.

Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

Purpose: Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not significantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment. Materials and Methods: Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent. Results: Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function. Conclusion: Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system.

Brazeability of UNS 32101 and UNS S32304 lean duplex stainless steels

CAPES

Caratterizzazione tribologica e microstrutturale di acciai sottoposti a trattamenti duplex (trattamenti termochimici di diffusione seguiti da deposizione di rivestimenti in carbonio amorfo DLC)

Lo studio condotto in questa tesi ha lo scopo di esplorare possibili soluzioni alternative per aumentare la vita in esercizio di componenti per un contatto tribologico da strisciamento in motori idraulici. In particolare, per limitare l’usura e ridurre l’attrito fra i corpi a contatto, è stata presa in considerazione la deposizione di rivestimenti in carbonio amorfo idrogenato, appartenenti alla famiglia dei rivestimenti DLC (Diamond-Like Carbon), prodotti con tecnologia PACVD (Plasma Assisted Chemical Vapour Deposition), grazie alla collaborazione con la ditta STS srl presso la quale sono state prodotte ed in parte caratterizzate diverse tipologie di strati sottili a base carbonio-carbonio. Questa scelta è stata motivata dal fatto che i rivestimenti DLC combinano basso attrito ed alta resistenza ad usura, dato che l’elevata durezza (e resistenza ad usura) è data dalla presenza di un’elevata frazione di C ibridati sp3 (con struttura simil-diamante) fra loro interconnessi, mentre la tendenza al basso attrito contro la maggior parte degli antagonisti deriva dalla struttura lamellare (quindi a basso sforzo di taglio), tipica del C sp2 (simil-grafite), che permette lo scorrimento fra i piani basali. Nel corso del presente lavoro sono quindi stati presi in esame due gruppi di rivestimenti DLC, differenziati in base alla tipologia di interstrato impiegato per moderare le tensioni residue e migliorare l’adesione (CrN singolo strato o WC/C multistrato), depositati su acciaio 20MnV6 sottoposto preliminarmente a cementazione gassosa per ottenere una adeguata capacità di supporto del carico. Gli strati in esame sono stati caratterizzati dal punto di vista microstrutturale e meccanico (con prove sia di adesione e con prove di nanoindentazione). Successivamente, i materiali rivestiti sono stati sottoposti a prove tribologiche di laboratorio (block-on-ring) in condizioni di strisciamento non lubrificato, per effettuare una valutazione comparativa fra i rivestimenti ed identificare i meccanismi di usura prevalenti nelle diverse coppie tribologiche.

Postoperative changes in the superficial temporal artery and the external carotid artery duplex sonography after extra-intracranial bypass surgery in European Moyamoya disease

Despite Duplex ultrasonography being a noninvasive, easily repeatable, readily available and economical tool, this examination and its normal ranges are rarely described in Moyamoya disease (MMD).

Duplex sonographic criteria for measuring carotid stenoses

PURPOSE: The aim of this retrospective study was to determine optimal duplex sonographic criteria for use in our institution for diagnosing severe carotid stenoses and to correlate those findings with angiographic measurements obtained by the European Carotid Surgery Trial (ECST), North American Symptomatic Carotid Endarterectomy Trial (NASCET), and Common Carotid (CC) methods of grading carotid stenoses. METHODS: We analyzed the angiographic data using the ECST, NASCET, and CC methods and compared the results with the duplex sonographic findings. We then calculated the sensitivity, specificity, positive and negative predictive values, and accuracy of the duplex sonographic method. Taking these parameters into account, the optimal intrastenotic peak systolic velocity (PSV) and end diastolic velocity (EDV) were derived for diagnosing severe stenoses according to the 3 angiographic methods. RESULTS: Optimal PSV and EDV values for diagnosing a 70% or greater stenosis in our laboratory were as follows: with the NASCET method of angiographic grading of stenoses, PSV 220 cm/second or greater and EDV 80 cm/second or greater, and with the ECST and CC methods, PSV 190 cm/second or greater, and EDV 65 cm/second or greater. The optimal PSV and EDV for diagnosing a stenosis of 80% or greater with the ECST grading method were 215 cm/second or greater and 90 cm/second or greater, respectively. CONCLUSIONS: Duplex sonography is a sensitive and accurate tool for evaluating severe carotid stenoses. Optimal PSVs and EDVs vary according to the angiographic method used to grade the stenosis. They are similar for stenoses 70% or greater with the NASCET method and for stenoses 80% or greater with the ECST method.