short term result
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Author(s):  
Mohamed A. Eleiwa ◽  
Amr M. Aborahma ◽  
Mohamed A. El-Heniedy

Aim: The aim of this study is to evaluate initial and short-term result of duplex guided angioplasty (DGA) for treatment of femoropopliteal arterial lesions. Methods: From October 2017 to September 2020, 50 limbs in 50 patients (30 males) underwent DGA in our institution. The study was conducted on patients suffered from chronic lower limb ischemia of grade IIb, III and IV (according to Fontaine Classifications) resulting from femoropopliteal lesions (occlusion or stenosis). Arterial access was done under duplex guidance followed by advancing a guidewire across the diseased femoropopliteal segment(s). The diseased segment(s) were then balloon-dilated. Intimal dissection or residual stenosis causing diameter reductions greater than 30% were stented with a self-expandable stent under duplex guidance. Completion duplex examinations and ankle brachial indices were obtained after the procedure. Results: The mean age of patients was 64 ±8 years. Critical ischemia was the indication in 44%, and disabling claudication was the indication in 6% of cases. Technical success was achieved in 46 cases (92%). 31 cases (62%) went through transluminal crossing of the lesions using duplex guidance alone, 11 cases (22%) went transluminally using duplex combined with contrast-free fluoroscopic assistance and 4 cases (8%) was subjected to subintimal angioplasty using combined techniques. Stenting was done in 24 cases (48%), 16 cases (32%) were having floating intimal flap; while the other 8 cases (16%) had residual stenosis > 30%. A primary patency rate of 92% was obtained by the end of the 12 months follow-up period. Conclusion: Duplex can be used as a first strategy for the treatment of femoropopliteal arterial diseases. However, the pitfalls in DGA technique make it insufficient to replace the classic fluoroscopy.


2020 ◽  
Vol 25 (4) ◽  
pp. 621-629
Author(s):  
Fernando Mesa ◽  
Diana Marcela Devia Narváez ◽  
German Correa Vélez

At present, numerical analysis provides us with powerful tools to determine the solution of various problems whose mathematical model can be represented by a system of linear equations, these tools correspond to a number of direct and iterative methods, among which are Carl's method. Gustav Jakob Jacobi and the Doolittle and Crout method, which we analyze and compare in this document. To do this we will initially explore the concepts of conditioning the problem to determine how stable is the system from which the model was obtained, until we reach the decomposition of LU arrays proposed in the Doolittle and Crout method. As a result of the analysis and comparison in this document, depending on what is sought when solving a system of equations, either very large or small enough for our computer, we can choose an approximation that will bring a short-term result with an error. Due to the starting point as proposed in the Jacobi method, or it is possible to reach a direct result by implementing fewer iterations as proposed in the Doolittle and Crout metho


Author(s):  
V. P. Lyalyuk

In the commissioning period of the development of pulverized coal injection technology (PCI) on a blast furnace No. 9 with a volume of 5000 m3 of PJSC “ArcelorMittal Kryvyi Rih”, frequent cases of burnout of refrigerators of the cooling system of the shoulders and air tyueres appeared due to the highly developed peripheral gas flow. An attempt to limit the gas flow at the periphery by controlling the distribution of charge materials on the top produced a short-term result. Based on the prevailing ideas, that to reduce the intensity of the peripheral gas flow, it is necessary to increase the speed of the blast and, accordingly, the kinetic energy of the blast flow, flowing out of the air tuyeres of a blast furnace, it was decided to reduce their diameter. As a result of analysis of the operation of the specified blast furnace using the technology of PCI on tuyeres with a diameter of 150 and 140 mm, increased peripheral gas flow with a smaller diameter was established. Based on the results of the analysis, conclusions were made by many researchers and it was shown that with constant kinetic energy of the blast, flowing from the tuyeres of different diameters, the dimensions of the combustion zone are always larger before the tuyeres of a larger diameter. This is explained by the fact that the kinetic energy of the gas flow is only a part of their total mechanical energy. It was shown that to analyze the change in the size of the combustion zones and the depth of penetration of the hearth gas, it is necessary to use the full mechanical energy of the flows of the combined blast on the cut of the tuyere and hearth gas. It was established that the transition to PCI in a blast furnace instead of natural gas, it always causes an increase in the peripheral gas flow. The main reason for this phenomenon is associated with a decrease in the total mechanical energy of blast and hearth gas. It was recommended on a blast furnace with a volume of 5000 m3 with a hearth diameter of 14.7 m and the PCI technology to maintain the total mechanical energy of the blast flow at least 2100–2600 kJ/s, and the full mechanical energy of the hearth gas flow at least 5100–5300 kJ/s.


MedPharmRes ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 7-9
Author(s):  
Phan Minh Tri ◽  
Do Hoai Ky ◽  
Vo Truong Quoc ◽  
Doan Tien My ◽  
Pham Huu Thien Chi

Introduction: The tumor of pancreatic body and tail are relatively rare compared to those of head of pancreas. Splenic preservation in pancreatic carcinoma’s surgery should be decided on every case. This study to determine the feasibility of distal pancreatectomy with splenic preservation, the rate of early complications of splenectomy surgery to preserve the spleen and the factors: tumor size, tumor location, tumor characteristic to help assess the possibility of preserving the splenic vessels in distal pancreatectomy with splenic preservation. Methods: retrospective study, case series description for all patients aged 16 years and older with distal pancreatectomy and splenic preservation from 01/01/2012 to 31/12/2017. Result: We had 47 case of distal pancreatectomy with splenic preservation. There were 26 cases of splenic preservation with preserving the splenic vessels (Kimura technique), 13 cases of splenectomy but not preserving the splenic vessels (Warshaw technique). There were 16 cases of laparoscopic surgery, 31 cases open surgery, general complication in surgery 11 cases. The mean age was 41.13 (17-76 years old). The mean hospital stay was 7.7 days (3 days - 21 days). General complication after surgery in 7 cases, pancreatic fistula in 5 cases, no cases need re-operation, no mortality. Conclusion: The rate of intraopertative incidence was 23.4%; complications after surgery 14.9%. No case of re-operation or mortality in the study. Factors such as tumor size, tumor location, tumor characteristic did not help assess the possibility of preserving the splenic vessels in of distal pancreatectomy with splenic preservation.


Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 333-341 ◽  
Author(s):  
HL Li ◽  
YC Chan ◽  
HY Jia ◽  
SW Cheng

Objective Despite endovascular advances in fenestrated and branched devices, thoracic endovascular aortic repair (TEVAR) for arch pathologies remains challenging. The aim of this study was to provide a contemporary review on the current evidence for in situ fenestration during TEVAR and to evaluate its short- and mid-term clinical outcome in the management of arch pathology. Methods A systematic literature review on in situ fenestration of thoracic aortic stent-graft from January 2003 to September 2018 was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Results Our initial search yielded 169 studies, of which 21 articles were relevant to the topic and were finally included. One hundred and forty-five in situ fenestration procedures in 99 patients were reviewed, involving 25 innominate arteries (17%), 33 left common carotid arteries (23%) and 87 left subclavian arteries (60%). Twelve patients (12/99, 12%) had two-vessel fenestration and three-vessel fenestration was performed in 17 patients (17/99, 17%). Technical success was achieved in 136 arteries (136/145, 93%). Talent/Valiant with monofilament twill woven polyester fabric was the most common (50/99, 51%) stent-graft used for fenestration. Three methods reported for in situ fenestration were needle, laser and radiofrequency. Needle was the most frequently used device for fenestration, which was performed in 60 patients (60/99, 61%). Three patients (3/99, 3%) died with 30 days, none were in situ fenestration TEVAR procedure-related. Perioperative complications including one (1%) retrograde type A aortic dissection, two (2%) type II endoleaks, and three (3%) strokes were reported. The pooled estimate for overall technical success, perioperative mortality and stroke was 88.3% (95% CI, 78.6%–93.9%), 5.9% (95% CI, 2.5%–13.4%) and 9.5% (95% CI, 4.1%–20.6%), respectively. Four patients (4/96, 4%) died during follow-up, none were aortic-related. All the fenestration bridging stents were reportedly patent, with only 1 (1/96, 1%) asymptomatic left subclavian stent stenosis. Two patients (2/96, 2%) with type II endoleak from left subclavian artery required secondary intervention. Conclusion In situ fenestration appeared to be a feasible and effective method to extend proximal landing zone during TEVAR. It had an acceptable short-term result with high technical success and low fenestration related morbidity. Long-term durability data were lacking, and there was no high level evidence to recommend the routine use of in situ fenestration TEVAR for the management of arch pathology.


2019 ◽  
Vol 13 (1) ◽  
pp. 371-376
Author(s):  
Abduljabbar Mohammed Alsameai ◽  
Basema Abdullah Khabaz ◽  
Mohammed Abdo Alraawi ◽  
Mohammed M Al Moaleem

Introduction: Maxillary canines play strategic roles in maintaining the normal function and visibility of teeth. However, rare cases of bilateral permanent congenitally missing maxillary canines were occurring. Replacing these missing canines with dental implant prostheses is an optimal treatment plan for aesthetics and functions. Case Report: In this case report, we described the replacement of bilateral maxillary canines with osseointegrated implants to support all-ceramic prostheses for a young female patient. This treatment avoids the conventional preparation of adjacent teeth as a part of prosthetic reconstructions. In addition to that, all-ceramic crowns are biocompatible with oral cavity structures. Conclusion: The stable short-term result has been achieved with the replacement of the bilateral congenitally missed canines with an implant and cemented all-ceramic crowns, with 3-years cumulative success rate.


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