Acute compartment syndrome, which is an orthopedic emergency, induces irreversible tissue necrosis by increasing the compartment pressure. In serious cases, this event may result in functional impairment, loss of the lower limb, and death by renal failure. When the patient initially presents with pain and swelling that are similar to deep vein thrombosis, a differential diagnosis between the two diseases is very critical. The authors encountered a case of acute compartment syndrome after anticoagulant therapy in a patient presenting with painful swelling of the left leg following a massage that was initially misdiagnosed as deep vein thrombosis. A fasciotomy was performed on this case with satisfactory results. This paper reports this case with a review of the relevant literature.
Orthotopic liver transplantation has become the treatment of choice for patients with end-stage liver disease. Various early or delayed vascular complications, including arterial pseudoaneurysm, thrombosis, or stenosis, and venous stenosis or occlusion, may lead to graft failure. Early detection and prompt management of such complications are essential to achieve successful transplantation and prevent the need for retransplantation. This report presents differentiating points, using computed tomography and digital subtraction angiography findings and measurement of pressure gradient across the stenotic lesion, that require immediate intervention in patients with inferior vena cava stenosis after orthotopic liver transplantation.
The hydrothermal vein type deposits which comprise the Kasihan, Jompong and Gempol mineralized areas are primarily copper and zinc deposits, but they are also associated with lead and/or gold mineralization. The deposits occur within the Tertiary sedimentary and volcanic rocks in the Southern Mountain zone of the eastern Java island, Indonesia. Mineralization can be separated into two or three distinct stages (pre-and/or post- ore mineralization stages and main ore mineralization stage) which took place mainly along pre-existing fault breccia zones. The main phase of mineralization (the main ore stage) can be usually classified into three substages (early, middle and late) according to ore mineral assemblages, paragenesis, textures and their chemical compositions. Ore mineralogy and paragenesis of the three areas in the district are different from each other. Pyrite, pyrrhotite (/arsenopyrite), iron-rich (up to 20.5 mole % FeS) sphalerite and (Cu-)Pb-Bi sulfosalts are characteristic of the deposits in the Kasihan (/Jompong) area. On the other hand, pyrite + hematite + magnetite + iron-poor (2.7 to 3.6 mole % FeS) sphalerite assemblage is restricted to the Gempol area. Fluid inclusion data suggest that fluids of the main ore stage evolved from initial high temperatures (near $350^{\circ}C$) to later lower temperatures (near $200^{\circ}C$) with salinities ranging from 0.8 to 10.1 equiv. wt. percent NaCl. Each area represents a separate hydrothermal system: the mineralization at Kasihan and Jompong were largely due to early fluid boiling coupled with later cooling and dilution, whereas the mineralization at Gempol was mainly resulted from cooling and dilution by an influx of cooler meteoric waters. Fluid inclusion evidence of boiling indicates that pressures of ${\geq}95$ to 255 bars (${\geq}95$ bars for the Gempol area: $\approx$ 120 to 170 bars for the Jompong area: $\approx$ 140 to 255 bars for the Kasihan area) during portions of main ore stage mineralization. Equilibrium thermodynamic interpretation indicates that the evolution trends of the temperature versus fS2 variation of ore stage fluids in the Pacitan district follow two fashions: ore fluids at Kasihan and Jompong changed from the pyrite-pyrrhotite sulfidation stage towards pyritehematite- magnetite state, whereas those at Gempol evolved nearly along pyrite-hematite-magnetite reaction curve with decreasing temperature. The sulfur isotope compositions of sulfide minerals are consistent with an igneous source of sulfur with a ${\delta}^{34}S_{{\Sigma}s}$ value of about 3.3 per mil. The oxygen and hydrogen isotopic compositions of the fluids in each area indicate a progressive shift from the dominance of highly exchanged meteoric water at early hydrothermal systems towards an un- or less-exchanged meteoric water at later hydrothermal systems.
Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
Tuberculosis and Respiratory Diseases
/
v.65
no.4
/
pp.292-300
/
2008
Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.
Syenite is not a common rock, unlike granitic rocks formed the major component of the continental crust. The aim of this study is to decipher the occurrences and detailed descriptive characteristics of the syenite distributed in Sancheong area, and to investigate the petrogenesis of the syenitic magma based on geochemical study. The dominant minerals in syenite are alkali feldspar (usually orthoclase and rarely microcline), plagioclase, amphibole, biotite, and quartz. Syenites are found in a wide variety of colors. The anhedral hornblende and biotite filling the boundary of feldspar and quartz indicate that the hydrous minerals were crystallized lately, and that water was insufficient at the beginning of crystallization in magma. According to the analysis of mineral composition, amphibole in syenite is mostly ferro-edenite, and the pressure is calculated as 3.3~4.9 kb with 11.9~17.3 km of emplacement depth. Biotite and pyroxene are plotted in the region of annite and hedenbergite, respectively. Based on petrochemical studies of major elements, syenite belongs to alkaline series, metaluminous, and I-type. On the other hand, the variation patterns of trace and rare earth elements of syenite differ from the patterns of diorite and granite. In the geochemical characteristics, syenite is different from gabbro-diorite spatially adjacent to syenite, as well as granite. These results suggest that each rock has been generated from the different sources of magma. Additionally, based on the experimental data, the syenitic magma can be formed (1) by the partial melting at a high pressure and dry system, (2) when the initial crystallization minerals to be residue with migration of the residual melts separated from the ascending cotectic magma (3) when fluorine compositions to be plentiful in the protolith and/or at depth of the magma. Based on the petrographic characteristics of the syenite, Sancheong syenitic magma may have been formed by partial melting in a dry system.
Pressurized grouting is a common technique in geotechnical engineering applications to increase the stiffness and strength of the ground mass and to fill boreholes or void space in a tunnel lining and so on. Recently, the pressurized grouting has been applied to a soil-nailing system which is widely used to improve slope stability. Because interaction between pressurized grouting paste and adjacent ground mass is complicated and difficult to analyze, the soil-nailing design has been empirically performed in most geotechnical applications. The purpose of this study is to analyze the ground behavior induced by pressurized grouting paste with the aid of laboratory model tests. The laboratory tests are carried out for four kinds of granitic residual soils. When injecting pressure is applied to grout, the pressure measured in the adjacent ground initially increases for a while, which behaves in the way of the membrane model. With the lapse of time, the pressure in the adjacent ground decreases down to a value of residual stress because a portion of water in the grouting paste seeps into the adjacent ground. The seepage can be indicated by the fact that the ratio of water/cement in the grouting paste has decreased from a initial value of 50% to around 30% during the test. The reduction of the W/C ratio should cause to harden the grouting paste and increase the stiffness of it, which restricts the rebound of out-moved ground into the original position, and thus increase the in-situ stress by approximately 20% of the injecting pressures. The measured radial deformation of the ground under pressure is in good agreement with the expansion of a cylindrical cavity estimated by the cavity expansion theory. In-situ test revealed that the pullout resistance of a soil nailing with pressurized grouting is about 36% larger than that with regular grouting, caused by grout radius increase, residual stress effect, and/or roughness increase.
Variables influencing the free face movement due to rock blasting include the physical and mechanical properties, in particular the discontinuity characteristics, explosive type, charge weight, burden, blast-hole spacing, delay time between blast-holes or rows, stemming conditions. These variables also affects the blast vibration, air blast and size of fragmentation. For the design of surface blasting, the priority is given to the safety of nearby buildings. Therefore, blast vibration has to be controlled by analyzing the free face movement at the surface blasting sites and also blasting operation needs to be optimized to improve the fragmentation size. High-speed digital image analysis enables the analyses of the initial movement of free face of rock, stemming optimality, fragment trajectory, face movement direction and velocity as well as the optimal detonator initiation system. Even though The high-speed image analysis technique has been widely used in foreign countries, its applications can hardly be found in Korea. This thesis aims at carrying out a fundamental study for optimizing the blast design and evaluation using the high-speed digital image analysis. A series of experimentation were performed at two large surface blasting sites with the rock type of shale and granite, respectively. Emulsion and ANFO were the explosives used for the study. Based on the digital images analysis, displacement and velocity of the free face were scrutinized along with the analysis fragment size distribution. In addition, AUTODYN, 2-D FEM model, was applied to simulate detonation pressure, detonation velocity, response time for the initiation of the free face movement and face movement shape. The result show that regardless of the rock type, due to the displacement and the movement velocity have the maximum near the center of charged section the free face becomes curved like a bow. Compared with ANFO, the cases with Emulsion result in larger detonation pressure and velocity and faster reaction for the displacement initiation.
Mineralized zone in the Dongyang talc deposits occurs on the lowest dolomite member of the Hyangsanri Dolomite belonging to the Ogcheon Supergroup. Ore bodies are emplaced as pipe-like body along the axis of minor folds plunging $40^{\circ}$ to the west developed in these dolomite layers. Amphibolite and chlorite schist are found along the upper or lower contact of all ore bodies (Kim et al., 1963; Park and Kim, 1966). Following the recrystallization and silicification of dolomite, tremolite and tabular and leafy talc(I) of the earlier stage formed, and microcrystalline talc(II) formed in the later stage. Talc(l) and tremolite formed by the reaction between dolomite and the fluid. Whereas talc (II) formed by the reaction between dolomite and fluid, or by the reaction between early formed tremolite and fluid. During the early stage of mineralization, the fluid was the $H_2O-CO_2$ system dominant in $CO_2$, In the later stage, the composition of the fluid changed to $H_2O-NaCl-CO_2$system, and finally to the $H_2O-NaCl$ system. The pressure and temperature conditions of the formation of tremolite associated with talc(I) were 1,640~2,530 bar, and $440{\sim}480^{\circ}C$, respectively. The pressure and temperature condition of talc(II) ore formation was 1,400~2,200 bar, and $360{\sim}390^{\circ}C$, respectively. These conditions are much lower than the metamorphic pressure and temperature of the rocks from the Munjuri Formation located about 5 km to the noJ:th of Dongyang talc deposit ${\delta}^{13}C$ and ${\delta}^{18}O$ values of dolomite which is the host rock of the talc ore deposit are 2.9~5.7‰ (PDB), and -7.4~l6.8‰ (PDB), respectively. These values are little higher than those from the Cambro-Ordovician limestones of the Taebaeksan region, but belong to the range of the unaltered sedimentary dolomite. ${\delta}^{18}O$and ${\delta}D$ values of the talc from Dongyang deposit are 8.6~15.8‰ (vs SMOW), and -65~-90‰ (vs SMOW), respectively, belonging to the range of magmatic origin. These values are quite different from those measured in the metamorphic rocks of Munjuri and Kyemyungsan Formation. ${\delta}^{34}S$ value of anhydrite is 22.4‰ (CDT), which is much lower than ${\delta}^{34}S$ (30‰ vs COT) of sulfate of early Paleozoic period, and indicates the possibility of the addition of magmatic sulfur to the system. Talc ores show the textures of weak foliation and well developed crenulation cleavages. Talc ore deposit in the area is concluded as hydrothermal replacement deposit formed before the latest phase of the deformations that Ogcheon Belt has undergone.
In order to investigate the possibility of waste logs after oak mushroom production as a source of an alternative energy and to obtain the fundamental data of supercritical water hydrolysis that has been paid attention as a new saccharification method of lignocellulosics, supercritical water hydrolysis of normal log woods (Quercus acutissima Carruth) and waste logs was carried out. With the increase of reaction time and temperature, the color of the degradation products has been dark and the degradation rate and the crystalline index increased. However the increase of reaction pressure affected the color of the degradation products and the degradation rate at only low reaction temperature. In the early stage of the reaction, the degradation of hemicellulose was progressed, while in the late stage, the cellulose was degraded. The increase of reaction time and reaction temperature (less than $415^{\circ}C$) improved the sugar yield, while at high temperature(more than $415^{\circ}C$), the sugar yield was decreased. Based on the result of the sugar yield, the optimal hydrolysis condition of Q. acutissima Carruth by supercritical water was determined to be $415^{\circ}C$, 60 seconds and 230 pressure bar with the sugar yield of 2.68% (w/w). At the optimal condition, the supercritical water hydrolysis of waste logs after the mushroom production was carried out and the sugar yield was increased to 358% (w/w). The major degradation products of waste logs by supercritical water hydrolysis were 1,1'-oxybis-benzene and 1,2-benzendicarboxylic acid by the GC-MS analysis. At the reaction condition with low degradation rate, the fatty acids such as pentadecanoic acid, 14-methyl-heptadecanoic acid were identified. With the increase of the reaction temperature and time, the amounts of phenol and benzene were increased, but the reaction pressure did not affect the kinds of degradation products. Holocellulose content was 60.6~79.2% in the water insoluble residue and the monosaccharide yield of the water insoluble residue was 49.2~675% by the acid hydrolysis. The monosaccharide yield of water-soluble portion was increased largely by the second hydrolysis using dilute acid.
Implantable flexible sensor using polymer/metal multilayer processing technique for telemetrical real-time blood pressure monitoring is presented. The realized sensor is mechanically flexible, which can be less invasively implanted and attached on the outside of blood vessel to monitor the variation of blood pressure. Therefore, unlike conventional detecting methods which install sensor on the inside of vessel, the suggested monitoring method can monitor the relative blood pressure without injuring blood vessel. The major factor of sudden death of adults is a disease of artery like angina pectoris and myocardial infarction. A disease of circulatory system resulted from vessel occlusion by plaque can be preventable and treatable early through continuous blood pressure monitoring. The procedure of suggested new method for monitoring variation of blood pressure is as follows. First, integrated sensor is attached to the outer wall of blood vessel. Second, it detects mechanical contraction and expansion of blood vessel. And then, reader antenna recognizes it using telemetrical method as the relative variation of blood pressure. There are not any active devices in the sensor system; therefore, the transmission of energy and signal depends on the principle of mutual inductance between internal antenna of LC resonator and external antenna of reader. To confirm the feasibility of the sensing mechanism, in vitro experiment using silicone rubber tubing and blood is practiced. First of all, pressure is applied to the silicone tubing which is filled by blood. Then the shift of resonant frequency with the change of applied pressure is measured. The frequency of 2.4 MHz is varied while the applied pressure is changed from 0 to 213.3 kPa. Therefore, the sensitivity of implantable blood pressure is 11.25 kHz/kPa.
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