Double Sleeve Research Articles

Patients with Pulmonary Artery Reconstruction or Double Sleeve Resection Show Inferior Survival than Patients with Bronchial Sleeve Resection for Non-small Cell Lung Cancer.

Sleeve lobectomy or resection with pulmonary artery reconstruction is a technique that allows for resection of locally advanced central lung carcinoma, preserving lung function, and is associated with lower morbidity and mortality than pneumonectomy. This survey aimed to assess the long-term survival comparing different types of sleeve lobectomy and identify risk factors affecting survival.All consecutive patients who underwent anatomical resection for primary non-small cell lung cancer with bronchial sleeve or pulmonary artery reconstruction in our department between September 2003 and September 2021 were included in this study. Cases with carinal sleeve pneumonectomy were excluded. Data were evaluated retrospectively.Bronchial sleeve resection was performed in 227 patients, double sleeve resection in 67 patients, and 45 cases underwent isolated lobectomy with pulmonary artery reconstruction. The mean follow-up was 33.5 months. The 5-year survival was 58.5% for patients after bronchial sleeve, 43.2% after double sleeve, and 36.8% after resection with vascular reconstruction. The difference in overall survival of these three groups was statistically significant (p=0.012). However, the UICC stage was higher in cases with double sleeve resection or resection with vascular reconstruction (p=0.016). Patients with lymph node metastases showed shorter overall survival (p=0.033). The 5-year survival rate was 60.1% for patients with N0 and 47% for patients with N1 and N2 status. Induction therapy, vascular sleeve resection, and double sleeve resection were independent adverse predictors for overall survival in multivariate analysis.Sleeve lobectomy and resection with vascular reconstruction are safe procedures with good long-term survival. However, double sleeve resection and vascular sleeve resection were adverse predictors of survival, possibly due to a higher UICC stage in these patients.

Flow rate adjustable ratio analysis of a novel control valve with double sleeve

Control valves are indispensable fluid control units in various industrial systems, and adjustable ratio is a crucial performance indicator of these valves. It represents the ratio between the maximum and the minimum controllable flow of the valve. And adjustable ratio stands as a significant measure of control valve regulation capability. This paper presents a novel sleeve-type control valve with a combined valve core structure composed of an inner sleeve, an outer sleeve, and a valve plug. Throttle windows and orifices are machined onto both sleeves. A dual-layer sleeve movement mechanism is realized through a gear transmission structure, allowing rotation of the inner sleeve and vertical movement of the valve plug. This design can achieve higher adjustable ratios and regulation precision. The sleeve structure design include structural parameters of the inner sleeves, outer sleeves and the shape of the throttle windows. In this study, we get the flow rates at various openings by numerical simulations. And the adjustable ratio of the valve with orifice sleeves reaches up to 695:1. Furthermore, we validate the flow regulation accuracy and maximum adjustable ratio of the combined valve core control valve by experimental methods. This work has a relevance for the design and investigation of control valves under high-pressure differential and high-flow conditions.

Flexural performance of a fully-prefabricated concrete slab with double-grouted sleeve connectors: An experimental and theoretical study

A novel fully-prefabricated concrete slab linked using double-grouted sleeve connectors is proposed to avoid projecting rebar and in-situ concrete, reduce linking length, and accelerate construction. This paper provides a systematic experimental investigation on the flexural performance of fully-prefabricated slabs under four-point bending. A total of four prefabricated specimens were tested with various diameters of the bottom transition and gap bars, and one cast-in-situ specimen served as a comparison. The results showed that the double sleeve connectors and gap bars in the slabs performed satisfactorily, and the load-bearing capacity of the proposed slab was very close to that of the control counterpart. The precast slab showed 19.1% and 42.8% increases in yield load-bearing capacity and 9.0% and 22.4% increases in ultimate load-bearing capacity, respectively, as the bottom gap rebar diameter increased by 4 mm and 8 mm. The cracking load of the precast slab was 30.0% smaller than that of the control slab, whereas all the cracks did not cross the interface between the grouting mortar and prefabricated part. Altering the linking bar diameter had a significant impact on the deformation shape of the slab. Increasing the bottom transition or gap bar diameter can significantly improve the deflection control capability of the slab. Theoretical calculations are conducted to predict the cracking load, load-bearing capacity, and deflection of the proposed slab, the predictions of which are found to agree satisfactorily with experimental data and can be applied to practical engineering design.

Double sleeve resections.

Double sleeve lung resections are complex surgical procedures that require specialized surgical expertise and careful patient selection. These procedures allow for the preservation of lung tissue while still achieving complete tumor resection for central tumors. Although initially considered high-risk operations, double sleeve lung resections have become a viable option for central tumors. Recent studies have shown that double sleeve lung resections are associated with lower morbidity and mortality rates than pneumonectomy. Furthermore, double sleeve lung resections may be associated with similar or even better long-term oncological outcomes compared to pneumonectomy, with the added benefit of preserving lung parenchyma and reducing the incidence of postoperative complications.

Double sleeve guided placement of quadruple zygomatic implants for rehabilitation of a patient with ectodermal dysplasia: A clinical report

The surgical and prosthodontic treatment for a 22-year-old man with ectodermal dysplasia is described and illustrated. He had never managed to wear complete dentures, and implant-retained or implant-supported prostheses were indicated. However, the placement of conventional maxillary endosseous implants was contraindicated. A novel surgical template with double sleeves was used to guide osteotomies for 4 zygomatic implants used with an unloaded, one-stage approach. After confirming osseointegration, prosthetic rehabilitation began with an interim implant-supported fixed prosthesis to evaluate esthetics, phonetics, and hygiene maintenance. Clinical challenges included lip biting and speech articulation.

Comparison of Double Sleeve Lobectomy by Uniportal Video-Assisted Thoracic Surgery (VATS) and Thoracotomy for NSCLC Treatment.

BackgroundWith the development of the surgical technique and experience of surgeons, uniportal VATS has been used in double sleeve lobectomy to treat non-small cell lung cancer (NSCLC). This retrospective study aims to evaluate the efficacy and safety of uniportal VATS in NSCLC treatment.MethodsWe reviewed 42 NSCLC patients who underwent double sleeve lobectomy in Shanghai Pulmonary Hospital from June 2015 to November 2017. 21 patients received double sleeve lobectomy through uniportal VATS and 21 through conventional thoracotomy with large incision.ResultsThe characteristics of patients were similar between the two groups. The operation time was longer in the uniportal VATS group (p=0.021) and the drainage on postoperation day 1 was significantly less in the uniportal VATS group (p=0.004). Patients reported a lower postoperative pain level in the uniportal VATS group than in the thoracotomy group (p=0.002). No statistically significant difference showed in other aspects.ConclusionUniportal VATS double sleeve lobectomy for NSCLC treatment is safe and effective. Lower postoperative pain level was found in the uniportal VATS group. Its complication rate and postoperation survival were similar to the conventional thoracotomy approach with large incision. But a large randomized clinical trial is still necessary for further investigation.

Outcomes of minimally invasive sleeve resection.

Sleeve resection allows for preservation of lung parenchyma and improved long-term outcomes when compared with pneumonectomy. Little is known about minimally invasive sleeve resection, especially indications, feasibility, technical aspects, complications, and outcomes. We reviewed our institutional experience with sleeve resections via a minimally invasive approach. We performed a retrospective review of a prospectively maintained database from 01/01/2010 to 11/01/2017. Indications, operative details, pathology, postoperative complications were reviewed and longer-term follow-up was reviewed. Fifteen patients were identified (5 males, 10 females). Details are presented in Table 1. Patients ranged in age from 7 to 82 years (median, 57 years). Approaches included video-assisted thoracoscopic surgery (VATS) and robotic. Airway sleeve resection was performed in all patients with an additional arterioplasty in 4, one patient having a double sleeve. Length of stay ranged from 3 to 10 days (median, 5 days). Indication for surgery included carcinoid in 5 (1 atypical), NSCLC in 6, and 4 additional pathologies. Complications occurred in 6 patients: air leak [2], pericardial effusion [1], transient brachial plexopathy [1], and atrial fibrillation [2]. There were no anastomotic complications. Median follow-up was 4.2 years. There were no anastomotic strictures. In experienced centers, sleeve resection via a minimally invasive approach is feasible with acceptable morbidity and mortality. Results in this small series appear comparable with the open approach.

Bond Strength between Old and New Concretes with Focus on the Strengthening of Reinforced Concrete Columns - Slant Shear Test versus Double Sleeve Test

The purpose of this paper is to present the main aspects and results of an experimental study to determine the bond strength between the concrete of a column of an existing structure (old concrete) and the concrete that will be used in its strengthening project (new concrete). For the bond strength tests, a specimen was conceived, called Double Sleeve specimen. The bond strength results obtained from the tests using Double Sleeve specimens, called Double Sleeve Tests, were compared to the results obtained from using the Slant Shear Test. The values for the bond strength between the two concretes, obtained from the Double Sleeve Tests, were either below or above the values obtained from linear regression of the Slant Shear Test results, depending on the sleeve diameter and the ratio of transverse reinforcement used. This fact, enabled concludes that the Double Sleeve Test is the most appropriate test to evaluate the bond strength between concretes of columns strengthened.

Video-assisted thoracoscopic surgery bronchial sleeve lobectomy.

A sleeve lobectomy (SL) is considered a valid option instead of a pneumonectomy in patients affected by central non-small cell lung cancer (NSCLC). In the last few years, the improvement of video-assisted thoracoscopic surgery (VATS) has allowed experienced surgeons to carry out this challenging operation by a minimally invasive approach. A full pre-operative assessment enclosing a flexible fiber-optic bronchoscopy evaluation and a multidisciplinary team discussion of the clinical case must be accomplished. There is no strictly an indication for the number of thoracoscopic ports: VATS SL is reported from 1 to 3-4 incisions. A significant variability in the technique of the anastomosis is documented and depends on the personal use and ability of the surgeon. However the operational principles are the same of an open SL: free bronchial margins at the frozen section examination, tension-free anastomosis, avoid luminal disparity and en-bloc resection. Due to the extent of the tumour, VATS SL can be associated to other complex resections like arterioplasty, or double sleeve (bronchial and artery) mainly on the left side. A patient underwent a VATS SL must be enrolled in an enhanced recovery pathway (ERP): physiological rehabilitation is a key point to achieve good outcomes and avoid complications.

이중 슬리브를 갖는 직사각형 평면 모노폴 안테나 설계

In this paper, a wideband antenna accomplished by adding a double sleeve of a rectangular planar monopole structure is proposed. In order to impedance matching of proposed antenna, the antenna performance was improved by adding two gap sleeves and outer sleeve for double sleeve structure. HFSS simulator of ANSYS corp. was used in order to confirm the antenna parameter characteristic. According to the simulation results, the VSWR was less than 2 for the range of 2.5GHz~10.5GHz. The frequency bandwidth is 8GHz. The frequency range of the actual fabricated antenna was 2.92GHz~10.32GHz, the frequency bandwidth is 7.4GHz. The measured radiation pattern frequency is 3GHz, 6GHz and 9GHz. The results are similar with dipole antenna pattern in all frequency. The antenna size is . The utilization possibility of the ultra-wideband planar monopole antenna could be confirmed according to compare and analyze the simulation and measurement data.

Double-sleeve and carinal resections using the uniportal VATS technique: a single centre experience.

Video-assisted thoracic surgery (VATS) double-sleeve lobectomy and carinal resections are two of the most complex procedures in thoracic surgery. The uniportal approach provides an advantage for performing these procedures successfully; however, knowledge of the important technical details is required. This study describes the experience of implementing these procedures by Russian specialists. Six patients (one woman; mean age, 57.3±3.6 years) who underwent a uniportal VATS double sleeve and carinal resections were consecutively included in this study. A 5- to 6-cm incision was made at the fifth intercostal space on the middle axillary line. Double sleeve left upper lobectomy was completed in four cases. One case of the right sleeve carinal pneumonectomy and one case of the right sleeve carinal upper lobectomy were completed. The mean operation time was 280±13 minutes. There was no conversion to thoracotomy. The mean postoperative hospital stay was 10.8±0.8 days. There was no postoperative mortality. In one case of double-sleeve lobectomy, postoperative pneumonia developed. The postoperative diagnoses of the four uniportal double-sleeve cases were as follows: T2aN2M0 in one case, T3N1M0 in two cases, and T2aN0M0 in one case. The postoperative diagnoses of the two uniportal totally carinal resections were as follows: T4N0M0 and T3N0M0. This study results suggest that a uniportal VATS approach might be a feasible option for complex sleeve resections with acceptable postoperative outcomes in the advanced stages of lung cancer. To further evaluate the feasibility, safety, and efficacy of this technique, more experience would be required.

Double sleeve uniportal video-assisted thoracoscopic lobectomy for non-small cell lung cancer.

Double sleeve (vascular and bronchial) lobectomy is a reasonable alternative to pneumonectomy in patients with centrally located tumors involving the pulmonary artery and bronchus. However, it is a challenging and complex procedure even when performed through thoracotomy.

Sleeve resection for postlobectomy stump fistulas: a case report

In this article, we present three cases who had postresectional bronchial stump fistulas after resection for lung cancer. Two cases had right upper lobectomy and one case had a right upper double (bronchial and vascular) sleeve bilobectomy operation. Two cases underwent sleeve resections of the right main bronchus, while one patient underwent resection of the carina for the treatment of bronchopleural fistula. Sleeve resection may be an alternative treatment method for bronchopleural stump fistulas that develop after lung cancer resection.

Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis

It has been reported that sleeve lobectomy (SL) concomitant with or without pulmonary artery reconstruction (PAR) might be an alternative procedure for pneumonectomy (PN) in non-small cell lung cancer (NSCLC). The aim of this study was to assess whether SL or PN offers a low morbidity and mortality and better long-term survival. We performed a meta-analysis of studies published in English between 1996 and 2006 to comprehensively compare the postoperative mortality, morbidity, locoregional recurrences, and time-to-event outcomes of SL and PN in NSCLC, and reviewed the recent literatures on PAR in the corresponding period as well. Twelve studies met the defined criteria including a total of 2984 subjects, and five studies for PAR. The odds ratio for postoperative mortality (SL vs PN) was 0.65 (95% confidence interval (CI): 0.42-1.01), 1.01 (95% CI: 0.70-1.44) for postoperative complications, and 0.91 (95% CI: 0.45-1.82) for locoregional recurrences. The weighted mean operative mortality for PAR was 3.3%, and 32.4% for complications. The estimated combined hazard ratio for overall survival in 10 studies was 0.70 (95% CI: 0.62-0.79) in favor of SL group. The median overall survival was 60 months for the SL group, 26 months for the PN group, and 30 months for PAR group. Survival difference in patients with pN0 or pN1 at 1 year demonstrated a pooled risk difference (SL vs PN) of 0.03 (95% CI: -0.08-0.13), 0.13 (95% CI: 0.00-0.25) in patients with pN2 at 1 year, 0.21 (95% CI: 0.07-0.36) in patients with pN0 or pN1 at 5 years, and 0.06 (95% CI: -0.10-0.21) in patients with pN2 at 5 years. Our results suggests that SL with or without PAR can be accomplished safely in selected patients without increasing the morbidity and mortality as compared to PN, that SL even with PAR offers better long-term survival than does PN, and that a more radical operation such as PN is not a more appropriate procedure, even in higher stage tumors.

712 両吸込両袖付型遠心送風機の振動に関する実験的研究(騒音機・騒音・音質)

712 両吸込両袖付型遠心送風機の振動に関する実験的研究(騒音機・騒音・音質)

Bronchoplastic procedures and pulmonary artery reconstruction in the treatment of stage III lung cancer invading pulmonary artery

To summarize the clinical results of bronchoplastic procedures and pulmonary artery reconstruction or combined with other resection and plasty of heart, great vessels in the treatment of 304 patients with locally advanced lung cancer. From February, 1983 to December, 2001, double sleeve resection and reconstruction of bronchus and pulmonary artery, or combined with other resection of heart, great vessels were carried out in 304 patients with locally advanced lung cancer. The operations included double sleeve left upper lobectomy in 199 cases; double sleeve right upper lobectomy in 21 cases; double sleeve right upper middle lobectomy in 14 cases; double sleeve left upper lobectomy combined with resection of left atrium in 8 cases; double sleeve right upper lobectomy combined with superior vena cava (SVC) resection and reconstruction with Gortex graft in 29 cases; double sleeve right upper middle lobectomy combined with SVC resection and reconstruction in 21 cases; double sleeve right upper middle lobectomy, carinal and SVC resection and reconstruction in 11 cases; left pneumonectomy combined right main pulmonary artery and pulmonary artery trunk resection and reconstruction with Gortex graft in 1 case. There were 3 operative deaths. The operative mortality was 1% in this series. Sixty four patients had operative complications. The operative complication rate was 21.05% (64/304). The 1-, 3-, 5- and 10 year survival rates were 81.75%, 60.14%, 37.21% and 24.39% respectively. Double sleeve lobectomy or comblined with other resection and reconstruction of heart, great vessels can significantly improve the prognosis and increase the curative rate and long term survival in patients with locally advanced lung cancer.

Numerical analysis of sleeve monopole in parallel-plate waveguide

A monopole with double sleeves, which consists of a resonant loading and a conventional sleeve monopole, is experimentally investigated. The loaded monopole is put vertically in a parallel-plate waveguide and driven by a coaxial feeder. The new structure exhibits a remarkably broad impedance bandwidth. In this paper, a modal expansion technique is used to numerically evaluate the impedance characteristics of the monopole by modeling the fields between the plates using cylindrical harmonic functions. A Fourier least-square integration is applied to finding the expansion coefficients by the boundary and continuity conditions. Prior to modeling the proposed sleeve monopole, the developed analysis scheme is examined for its convergence and accuracy. Calculated results are validated by the measurements. For the optimum design at 5.8 Ghz, we investigate the effects of the structure parameters on the impedance characteristics. © 2001 John Wiley & Sons, Inc. Int J RF and Microwave CAE 11: 86–98, 2001.

Comments on "A design of AM/FM mobile telephone triband antenna" [with reply

Ploussios has read the paper by Egashira et al. (see ibid., vol.42, p.538, 1994), in which they describe the design of multiple band antennas using "double sleeves." He claims that the design of multiple band antennas employing multiple coaxial sleeves of the type described in the paper has been done before and is patented by Ploussios. The patent, 4509056, entitled "Multifrequency antenna employing tuned sleeve chokes," describes the use of multiple coaxial chokes in monopole and dipole type elements. The chokes (sleeves) are arranged in series and parallel, resulting in operation over selected frequency bands that are not harmonically related. The patent includes a description of two- and three-band monopole and dipole designs. Egashira et al. reply to the Comment. They conclude that it is their view that the triband antenna of the AM/FM and mobile telephone (with two bands of mobile station band and base one) cannot be designed using the ideas in Dr. Ploussios' patent.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

A design of AM/FM mobile telephone triband antenna

In vehicles, antennas for AM/FM broadcasting (BC) and cellular mobile telephone (MT) are usually mounted on the car's body. However, a triband antenna which can be used for both AM/FM BC and MT is more desirable to decrease the number of antennas. An outline of the general design for the AM/FM MT triband antenna with coils is described. Next, the design of a new triband antenna with double sleeves instead of coils is presented. The double sleeves consist of two coaxial lines connected in series. It is shown that the triband antenna with double sleeves has good characteristics, including radiation patterns and voltage standing-wave ratio (VSWR). >

A simple technique for maintaining digital hypothermia during replantation surgery.

A simple technique using inexpensive and readily available materials is described for maintaining digital hypothermia during replantation surgery. Direct contact between soft-tissues and ice or water is prevented, and, thus, avoids undesirable maceration and also reduces the risk of cold-thermal injury, which would further prejudice the success of replantation. The technique is intended for use during prolonged replantation procedures, for example, in cases of trans-metacarpal amputation requiring revascularisation of more than one digit. The principle of using a water-tight sleeve could easily be extended to more proximal amputations, such as at the level of the wrist, by placing the entire hand within a double glove sleeve.