Recently, we met a 12 year old female patient who suffered from bacterial endocarditis and pericarditis which were complicated by patent ductus arteriosus. She was admitted to our hospital because of dyspnea, fever, headache, and generalized ache for 10 days. The initial diagnosis was bacterial endocarditis and pericarditis complicated by patent ductus arteriosus and congestive heart failure. At first, we tried to treat the patient medically with digitalis, diuretics, and massive antibiotics. On echocardiography large amount of pericardial fluid was accumulated mainly right anterior aspect and also noted a large vegetation at pulmonary valve area. With vigorous medical treatment including repeated pericardiocentesis, the patient showed no improvement. So we decided to perform pericardiectomy for elimination of the most probable septic focus. On operation, we encountered an unpredicted event, the pericardium was thickened, distended, and its surface showed pulsating which meant connecting to systemic circulation. We decided to close the operative wound and reoperate her under cardiopulmonary bypass later. On the next day, we operated her under cardiopulmonary bypass later. On the next day we operated her under cardiopulmonary bypass. The operative findings were ruptured main pulmonary artery about 1.5cm in diameter on its ventral portion, the blood from the ruptured main pulmonary artery was filled up the localized pericardial sac due to previous pericarditis. Through the ruptured main pulmonary artery, we also found 0.5cm diametered patent ductus arteriosus. With the aid of partial cardiopulmonary bypass and inserting 24F ballooned Foley catheter at aorta, pericardiectomy was performed first. After completion of the pericardiectomy, total cardiopulmonary bypass was established. With minimum pump flow [0.3L/min/m2] the PDA was closed with two Teflon-felted 4-0 Prolene interrupted sutures. The ruptured main pulmonary artery was also closed using thickened pericardium with three Teflon-felted 4-0 Prolene interrupted sutures. The operation was successful and postoperative course was uneventful. She was discharged on the 16th POD. We report this case as a very rare secondary complication of bacterial endocarditis complicated by patent ductus arteriosus.
Journal of the Korea institute for structural maintenance and inspection
/
v.23
no.4
/
pp.137-144
/
2019
In coupon test of carbon fiber reinforced polymers (CFRP) as brittle materials, the converted strain derived from total deformation and effective length was introduced and its advantages were described. In general, measured value from strain gauge is used for determining the tensile properties of material, but it is not quite effective in CFRP because brittle material can not redistribute its stress and it only represents local behavior. For this reason, the converted strain response can be utilized effectively as a supplementary indicator, which evaluated the average value of tensile properties in brittle material and confirmed the strain measured by strain gauge. In addition, the converted strain clearly visualized 1) the effect of initial internal strain caused by fabrication errors and setup misalignment when applying gripping force and 2) post-response of partial rupture of CFRP caused by non-uniform strain distribution. non-uniform strain distribution.
Jeon, Hong Jun;Lee, Jong Young;Cho, Byung-Moon;Yoon, Dae Young;Oh, Sae-Moon
Journal of Korean Neurosurgical Society
/
v.62
no.1
/
pp.35-45
/
2019
Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.
Lucas Mognon Santiago Prates;Felipe Piana Vendramell Ferreira;Alexandre Rossi;Carlos Humberto Martins
Steel and Composite Structures
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v.46
no.4
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pp.451-469
/
2023
The use of precast hollow-core slabs (PCHCS) in civil construction has been increasing due to the speed of execution and reduction in the weight of flooring systems. However, in the literature there are no studies that present a finite element model (FEM) to predict the load-slip relationship behavior of pushout tests, considering headed stud shear connector and PCHCS placed at the upper flange of the downstand steel profile. Thus, the present paper aims to develop a FEM, which is based on tests to fill this gap. For this task, geometrical non-linear analyses are carried out in the ABAQUS software. The FEM is calibrated by sensitivity analyses, considering different types of analysis, the friction coefficient at the steel-concrete interface, as well as the constitutive model of the headed stud shear connector. Subsequently, a parametric study is performed to assess the influence of the number of connector lines, type of filling and height of the PCHCS. The results are compared with analytical models that predict the headed stud resistance. In total, 158 finite element models are processed. It was concluded that the dynamic implicit analysis (quasi-static) showed better convergence of the equilibrium trajectory when compared to the static analysis, such as arc-length method. The friction coefficient value of 0.5 was indicated to predict the load-slip relationship behavior of all models investigated. The headed stud shear connector rupture was verified for the constitutive model capable of representing the fracture in the stress-strain relationship. Regarding the number of connector lines, there was an average increase of 108% in the resistance of the structure for models with two lines of connectors compared to the use of only one. The type of filling of the hollow core slab that presented the best results was the partial filling. Finally, the greater the height of the PCHCS, the greater the resistance of the headed stud.
Pengcheng Gao;Bin Zhang ;Jishen Li ;Fan Miao ;Shaowei Tang ;Sheng Cao;Hao Yang ;Jianqiang Shan
Nuclear Engineering and Technology
/
v.55
no.3
/
pp.999-1008
/
2023
Deformed fuel rods can cause a partial blockage of the flow area in a subchannel. Such flow blockage will influence the core coolant flow and further the core heat transfer during the reflooding phase and subsequent severe accidents. Nevertheless, most of the system analysis codes simulate the accident process based on the assumed flow blockage ratio, resulting in inconsistencies between simulated results and actual conditions. This paper aims to study the influence of flow blockage in severe accident scenario of the CAP1400 reactor. First, the flow blockage model of ISAA code is improved based on the FRTMB module. Then, the ISAA-FRTMB coupling system is adopted to model and calculate the QUENCH-LOCA-0 experiment. The correctness and validity of the flow blockage model are verified by comparing the peak cladding temperature. Finally, the DVI Line-SBLOCA accident is induced to analyze the influence of flow blockage on subsequent CAP1400 reactor core heat transfer and core degradation. From the results of the DVI Line-SBLOCA accident analysis, it can be concluded that the blockage ratio is in the range of 40%-60%, and the position of severe blockage is the same as that of cladding rupture. The blockage reduces the circulation area of the core coolant, which in turn impacts the heat exchange between the core and the coolant, leading to the early failure and collapse of some core assemblies and accelerating the core degradation process.
Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
Clinics in Shoulder and Elbow
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v.14
no.1
/
pp.20-26
/
2011
Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.
The Journal of Korean Orthopaedic Ultrasound Society
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v.2
no.1
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pp.1-6
/
2009
Purpose: The goal of this study is to evaluate the relationship between the clinical findings and ultrasonographic findings of plantar fasciitis. Materials and Methods: Forty-nine symptomatic heels of 36 patients with plantar fasciitis and 21 asymptomatic heels were included. Twenty-three patients had unilateral lesions and 13 had bilateral lesions. Of these, 16 were men and 20 were women. The average age of the patients was 48.6 years. The plantar fascia thickness was measured at its insertion of the calcaneus. Qualitative parameters such as decreased echogenity, biconvexity, partial rupture and calcification of plantar fascia, and subcalcaneal spur on plain radiographs were also noted. Comparisons of ultrasonographic parameters between symptomatic heels and asymptomatic heels as well as between unilateral and bilateral groups were done. Results: There was no differences in the age, sex, body mass index, and duration of symptom between the unilateral and bilateral group. There were a statistically significant difference between the thickness of plantar fascia of unilateral group (mean 5.2 mm, SD1.5 mm) and that of bilateral group (mean 4.4 mm, SD 1.4 mm) (p=0.045). The hypoechogenity of plantar fascia and subcalcaneal spur did not differ between two groups. No fascial rupture or fascial calcification were identified. There was a statistically significant difference between the thickness of plantar fascia of symptomatic heels (mean 4.8 mm, SD1.5 mm) and that of asymptomatic heels (mean 3.1 mm, SD 0.5 mm) (p=0.000). The thickness of plantar fasia was negatively correlated with duration of symptoms (p=0.046). Conclusion: The thickness of plantar fascia in plantar fasciitis seems to be negatively correlated with the duration of symptoms, and the thickness of symptomatic heels and unilateral group was significantly thicker than that of asymptomatic heels and bilateral group, respectively.
This study was conducted to investigate the effects of dietary seleno-yeast on histological response in juvenile olive flounder Paralichthys olivaceus. Fish averaging $4.0{\pm}0.1g$ (mean ${\pm}$ SD) were fed one of the four semi-purified diets containing 0.56, 1.07, 2.86 and 4.56 mg Selenoyeast/kg diet ($Se_{0.56}$, $Se_{1.07}$, $Se_{2.86}$ and $Se_{4.56}$, respectively) in triplicates for 12 weeks. Swelling of blood cell in glomerulus, the rupture of some epithelial cell in the renal tubules and enlarged macrophage were observed in the $Se_{1.07}$ group. The hepatopancreas had hepatic cell, capillary and zymogen in the pancreas and was normal in the $Se_{0.56}$ group. Swelling of hepatocyte gradually decreased with increase in selenoyeast supplementation. The gill lamellae showed partial abnormal condition (terminal clubbing) in the $Se_{0.56}$ group, but there were little differences between these and other treatments. These results indicated that the optimum dietary supplementation level of selenoyeast in juvenile olive flounder, Paralichthys olivaceus, could be less than 1.07 mg selenoyeast/kg diet based on histological responses of the fish.
At this, in this study, some tests were conducted to come up with a method to minimize intervention, to reduce the secondary damage to original materials, and to produce remarkable reinforcing effects. The followings show objective standards. The proportion of original material to steel reinforcement bar (the ratio of steel reinforcement bar) needs to be calculated in light of weathering intensity. Second, in the case of partial damage, prosthetic treatment is applied to add new stone materials to original materials. In that case, the ratio of steel reinforcement bar should be calculated based on material that is highly resistant to weathering. With the results of this study, it is possible to suggest conditions that can structurally stabilize stone cultural heritage, according to the weathering area. As a result, the ratio of steel reinforcement bars can be 0.13 to 0.23 in the case of $800kgf/cm^2$ or less, 0.24 to 0.28 in $800kgf/cm^2$ or higher, and 0.29 to 0.5 in $1200kgf/cm^2$ or higher. In particular, there is the need to take the coefficient of rupture of stone material and the properties of the steel reinforcement bar into account in cases of calculating the ratio of steel reinforcement bars according to weathering intensity.
Kim, Jae Hoon;Kim, Jae Min;Yi, Hyeong Joong;Bak, Koang Hum;Kim, Choong Hyun;Oh, Suck Jun
Journal of Korean Neurosurgical Society
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v.29
no.9
/
pp.1188-1194
/
2000
Objective : Internal carotid-posterior communicating artery(IC-PC) aneurysms can be clipped easily without any special preparations. Occasionally, however, it is difficult to clip the low-lying IC-PC aneurysms without some kinds of additional procedures. Clinical Material and Methods : We experienced four cases of low-lying IC-PC aneurysms, which the intradural anterior clinoidectomy and/or anterior petroclinoid fold(APF) resection was essential to expose the proximal side of the aneurysmal neck and/or proximal control. One patient harbored two low-lying IC-PC aneurysms bilaterally. The patients were divided into two groups according to the necessity of anterior clinoidectomy : Group I(n=4) that needed an intradural clinoidectomy and/or APF resection and Group II(n=29) that had IC-PC aneurysms, easily clipped without any special preparation. Also, various radiometric parameters were measured through the preoperative angiograms. Results : The incidence of such aneurysms was 12% among a total of thirty-three surgically treated IC-PC aneurysms during lasr 3 years. Among four cases, three cases presented with subarachnoid hemorrhage and all aneurysmal sac projected to postero-inferior direction. In our study, We initially considered the necessity of intraoperative anterior clinoid process(ACP) removal and/or resection of APF in cases of shorter distance less than 5.6mm between the proximal aneurysmal sac and tip of the ACP(p<0.001), and the proximal portion of aneurysmal neck has located below the interclinoid line(p=0.001). Conclusion : Through a careful preoperative evaluation, some radiometric parameters can be used to determine whether the ACP should be removed in clipping of the low-lying IC-PC aneurysms. Unlike to total removal of the ACP, the intradural partial anterior clinolidectomy and/or APF resection, which are more familiar to surgeons, reduce the risks of the premature rupture, operative time, and also contribute a more precise clip placement with proximal control than the extradural clinoidectomy.
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