Efficacy of the Hepcon system in reducing hemorrhagic and thrombotic complications in antiphospholipid syndrome patients undergoing cardiac surgery.

Introduction: Patients with Antiphospholipid Syndrome (APS) undergoing cardiopulmonary bypass (CPB) surgery are at increased risk for thrombotic and hemorrhagic complications. Anticoagulation during CPB is typically monitored with activated clotting time (ACT) which may be falsely prolonged in patients with APS. The Hepcon Hemostasis Management System quantitatively determines the whole blood heparin concentration through heparin/protamine titration.

Massive intracardiac thrombosis during coronary artery bypass grafting surgery.

Thrombosis is a potential life-threatening complication in patients undergoing cardiac surgery. Various clinical and heritable conditions, like cancer, trauma, immobilization, the presence of factor V Leiden or prothrombin 20210A, deficiency of or resistance to the inhibitor proteins C, S, or antithrombin, elevated levels of coagulation proteins, antiphospholipid antibody syndrome, pregnancy, and the use of exogenous hormones, may contribute to catastrophic thrombosis. Massive thrombi with cerebrovascular and cardiovascular events develop in patients with polycythemia vera (PV).

DagSolid: a new Geant4 solid class for fast simulation in polygon-mesh geometry.

Even though a computer-aided design (CAD)-based geometry can be directly implemented in Geant4 as polygon-mesh using the G4TessellatedSolid class, the computation speed becomes very slow, especially when the geometry is composed of a large number of facets. To address this problem, in the present study, a new Geant4 solid class, named DagSolid, was developed based on the direct accelerated geometry for the Monte Carlo (DAGMC) library which provides the ray-tracing acceleration algorithm functions. To develop the DagSolid class, the new solid class was derived from the G4VSolid class, and its ray-tracing functions were linked to the corresponding functions of the DAGMC library.

Introducing improved voxel navigation and fictitious interaction tracking in GATE for enhanced efficiency.

Geant4 Application for Emission Tomography (GATE) is a widely used, well-validated and very versatile application for Monte Carlo simulations in emission tomography. However, its computational performance is poor, especially for voxelized phantoms, partly due to the use of a very general particle tracking algorithm. In this work, two methods are proposed to reduce the time spent on particle tracking in the phantom: a newly introduced 'regular navigation algorithm' of Geant4 and fictitious interaction tracking (also known as Woodcock tracking) for photons.

Bleeding following deep hypothermia and circulatory arrest in children.

Deep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding.