Evaluation of crack resistance of welded joints with soft interlayers

Introduction. Welded joints in large-sized metal structures (e.g., in the structures of ship hulls) subject to low-cycle fatigue are considered. The characteristic appearance of soft interlayers, which are significantly plastically deformed under working loads, was noted. Deformation of the metal structure with damage, especially in the form of cracks, reduces the strength and reliability of structural elements and joints. Pre-deformation negatively affects plasticity; therefore, much depends on the residual plasticity of the cracking material. At the same time, with a decrease in residual plasticity, such an important reliability indicator as the resistance of the material to crack propagation — the fracture toughness – decreases. The paper is devoted to the development of a model that includes analytical dependences for assessing the crack resistance of metal structures and their welded joints with soft interlayers according to the crack resistance limit for all crack sizes.Materials and Methods. The theory and methods of linear mechanics of materials destruction, structural-mechanical approach are used. The calculation results were analyzed and compared to the experimental data and other analytical solutions. The numerical experiment was performed for the ferrite-perlite steel grades of 10, 50, 22K, St3sp, etc., widely used in industry, as well as for alloy steels hardened to medium and high strength of 30KhGSA, 37KhN3A, etc. Results. Analytical dependences are obtained for calculating the relative crack resistance limit according to three main known mechanical characteristics of the state of the material of the soft interlayer of the welded joint.Discussion and Conclusions. The results obtained can be used to assess the crack resistance of pre-deformed structural elements and welded joints (including those with soft interlayers) operating under a transverse load. The results of experimental data and analytical calculations are shown in dimensionless form, which enables to obtain invariant results with respect to the fracture toughness limit.

Eyelid Diseases

This chapter reviews eyelid malpositions, benign and malignant tumors, infections, and inflammatory diseases of the eyelid. Eyelid lesions can originate in any layer or structure within the eyelid and eyelid adnexa. Benign tumors of the eyelid can often be diagnosed based on their characteristic appearance. A biopsy should be performed if an eyelid lesion is not easily diagnosed based on clinical appearance. Blepharitis and meibomitis are very common disorders. Despite their prevalence, these diseases are often overlooked and misdiagnosed. Meibomian gland dysfunction is a major cause of evaporative dry eye and can occur along with aqueous deficient dry eye. Bacteria, fungi, viruses, and parasites can cause infection of the eyelids in different locations, anterior, posterior, angular, which can have different courses, acute, intermediate, or chronic. This chapter also contains photos with a rare disorder, Urbach-Wiethe disease, demonstrating the lesions of lipoid proteinosis at the lower and upper eyelids.

CBCT of maxillary central incisor with internal resorption: a case report

Objectives: The aim of this case report is to report the radiographic features of an internal resorption in maxillary central incisor and to emphasize the benefits of CBCT in this case. Case Report: A 14-year-old male went to Universitas Padjadjaran Dental Hospital with a discoloration of his fracture upper anterior teeth. The anamnesis revealed that the patient had history of a fall in about 6 years ago. Patient didn’t complain about pain when examination happened and wanted to have his teeth treated. Periapical radiograph showed an internal resorption in maxillary central incisor. Cone beam computed tomography (CBCT) was used to see other findings before determining the treatment plan. Conclusion: Internal resorption gives a characteristic appearance on the radiograph. CBCT modalities provide more information than conventional ones so that the use of this modality is not only to establish a diagnosis, but also can be used in determining the right treatment plan.

Case Report: A Case of Hailey–Hailey Disease Mimicking Condyloma Acuminatum and a Novel Splice-Site Mutation of ATP2C1 Gene

Hailey–Hailey disease (HHD) is a rare autosomal-dominant blistering disorder characterized by recurrent vesicular and erosive lesions at intertriginous sites. We described a 24-year-old male who presented with multiple bright red verrucous papules in his mons pubis, bilateral groins, scrotum, perineum, and crissum, clinically resembling condyloma acuminatum. The histopathology showed extensive acantholysis with the characteristic appearance of a dilapidated brick-wall. The mutation analysis revealed a novel splice-site mutation in the ATP2C1 gene. The patient was definitely diagnosed with HHD. The antibacterial treatments resulted in a dramatic improvement. Our findings help to broaden the understanding of clinical manifestations of HHD and improve the clinical diagnosis and treatment of this disease.

Clinical Characteristics and Long-Term Recombinant Human Growth Hormone Treatment of 18q- Syndrome: A Case Report and Literature Review

Background18q- syndrome is a rare chromosomal disease caused by the deletion of the long arm of chromosome 18. Some cases with 18q- syndrome can be combined with growth hormone deficiency (GHD), but data on the efficacy of recombinant human growth hormone (rhGH) treatment in 18q- syndrome are limited.MethodsHere, we report one case of 18q- syndrome successfully treated with long-term rhGH supplement. Previously reported cases in the literature are also reviewed to investigate the karyotype–phenotype relationship and their therapeutic response to rhGH.ResultsA 7.9-year-old girl was referred for evaluation for short stature. Physical exam revealed proportionally short stature with a height of 111.10 cm (−3.02 SD score (SDS)), low-set ears, a high-arched palate, a small jaw, webbed neck, widely spaced nipples, long and tapering fingers, and cubitus valgus. Thyroid function test indicated subclinical hypothyroidism. The peak value of growth hormone was 10.26 ng/ml in the levodopa provocation test. Insulin-like growth factor 1 (IGF-1) was 126 ng/ml (57–316 ng/ml). Other laboratory investigations, including complete blood cell count, liver and kidney function, gonadal function, serum adrenocorticotropin levels, and serum cortisol levels, were all within normal ranges. Karyotype analysis showed 46, XX, del (18) (q21). L-Thyroxine replacement and rhGH treatment were initiated and maintained in the following 7 years. At the age of 14.8, her height has reached 159.5 cm with a height SDS increase of 2.82 SDS (from −3.02 SDS to −0.20 SDS). No significant side effects were found during the treatment. The literature review indicated the average rhGH treatment duration of 16 patients was 5.9 ± 3.3 years, and the average height SDS significantly increased from −3.12 ± 0.94 SDS to −1.38 ± 1.29 SDS after the rhGH treatment (p < 0.0001).ConclusionThe main clinical manifestations of 18q- syndrome include characteristic appearance, intellectual disability, and abnormal genital development. The literature review suggested a significant height benefit for short stature with 18q- syndrome from long-term rhGH treatment.

Bowel Ischemia in COVID-19 Infection: One-Year Surgical Experience

Background COVID-19 is a deadly multisystemic disease, and bowel ischemia, the most consequential gastrointestinal manifestation, remains poorly described. Our goal is to describe our institution’s surgical experience with management of bowel ischemia due to COVID-19 infection over a one-year period. Methods All patients admitted to our institution between March 2020 and March 2021 for treatment of COVID-19 infection and who underwent exploratory laparotomy with intra-operative confirmation of bowel ischemia were included. Data from the medical records were analyzed. Results Twenty patients were included. Eighty percent had a new or increasing vasopressor requirement, 70% had abdominal distension, and 50% had increased gastric residuals. Intra-operatively, ischemia affected the large bowel in 80% of cases, the small bowel in 60%, and both in 40%. Sixty five percent had an initial damage control laparotomy. Most of the resected bowel specimens had a characteristic appearance at the time of surgery, with a yellow discoloration, small areas of antimesenteric necrosis, and very sharp borders. Histologically, the bowel specimens frequently have fibrin thrombi in the small submucosal and mucosal blood vessels in areas of mucosal necrosis. Overall mortality in this cohort was 33%. Forty percent of patients had a thromboembolic complication overall with 88% of these developing a thromboembolic phenomenon despite being on prophylactic pre-operative anticoagulation. Conclusion Bowel ischemia is a potentially lethal complication of COVID-19 infection with typical gross and histologic characteristics. Suspicious clinical features that should trigger surgical evaluation include a new or increasing vasopressor requirement, abdominal distension, and intolerance of gastric feeds.

Comparative Study between Generic versus Brand Latanoprost in treatment of Open Angle Glaucoma Patients

Background Glaucomas are a group of optic neuropathies characterized by progressive degeneration of retinal ganglion cells. Degeneration of these nerves results in cupping, a characteristic appearance of the optic disc and visual loss. Glaucoma can remain asymptomatic until it is severe, resulting in a high likelihood that the number of affected individuals is much higher than the number known to have it. Without adequate treatment glaucoma can progress to visual disability and eventual blindness which is irreversible. Many types of glaucoma are usually controlled with daily medical treatment consisting of eye drops lowering IOP. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping aqueous fluid flow better through the drainage angle. A generic medicine is defined as a product having the same qualitative and quantitative composition in active ingredients, as well as the same pharmaceutical form, as the reference medicine and whose bioequivalence has been shown by adequate bioavailability studies, also its low price makes it more affordable. Aim of the Work To evaluate intra ocular pressure control and compliance of the patient using a generic prostaglandins eye drops in comparison to a brand one in the management of glaucoma patients and its safety profile, to determine the value of the generic drug in glaucoma management. Patients and Methods This is a prospective interventional cross over study was done on 30 patients recruited from Glaucoma Clinic of National Eye Center, Rod El Farag from January 2019 to July 2019. Results The mean baseline IOP of both main groups on day 0 was 23.9 ± 3.3 mmHg at 9 AM, 23.6 ± 2.7 mmHg at 1 PM, 23.6 ± 2.3 mmHg at 6 PM before treatment with original or generic latanoprost (P = 1). Both treatments reduced the IOP from baseline (day 0 of each drug) at each time-point, and for the three diurnal IOP measurements at 3 months. Original latanoprost had a greater efficacy than generic latanoprost after 3 months, Original Latanoprost reduced the IOP after 3 months of treatment by -8.6 ± 0.84 mmHg at 9.00 AM, 7.4 ± 1.2 mmHg at 1.00 PM hours and -6.4 ± 1.8 mmHg at 6.00 PM, While Generic latanoprost reduced IOP after 3 months by -7.03 ± 0.95, -5.8 ± 1.1 and -4.9 ± 1.8 mmHg, respectively. Conclusion Original latanoprost has a tendency of better efficacy and tolerability with low incidence of conjunctival hyperaemia and ocular irritation compared with the generic latanoprost in management of open angle glaucoma patient.

Fibrolipomatous Hamartoma Arising from the Median Nerve—A Case Report

Fibrolipomatous hamartoma is a rare nonhereditary, congenital condition characterized by benign hyperplasia of fibroadipose tissue around nerve bundles. The median nerve is commonly affected. Underlying pathological process is mature adipose and fibrous tissue infiltrating the epineural and perineural compartments giving typical “pseudo-onion bulb” appearance on histology and “coaxial cable” appearance on magnetic resonance imaging (MRI). This case of fibrolipomatous hamartoma well illustrates its characteristic clinical, radiological, and histopathological features. Patient is a teenage female presented with painless gradually enlarging mobile lump in the central left palm. Ultrasound scan revealed a hyperechoic subcutaneous lesion, with intervening fine hypoechoic cable like structures following the course of median nerve which was thickened. Computed tomography (CT) confirmed thickened left median nerve with radiating isodense fascicles surrounded by fatty areas. There were no calcifications. MRI showed classic “coaxial cable” like T1, T2 isointense fascicles continuous with the median nerve surrounded by a fusiform lesion demonstrating fat signals on spin-echo sequences which dropped on fat-suppressed gradient echo sequences. Diagnosis of fibrolipomatous hamartoma arising from left median nerve was made, based on typical imaging findings. Biopsy confirmed fibrolipomatous hamartoma. Diagnosis can be made confidently on imaging alone especially with MRI, without the need of biopsy. Both CT and MRI demonstrate fatty mass encasing the thickened nerve fibers. On MRI, characteristic appearance is seen as T1 and T2 low intense tubular thickened neural bundles surrounded by high signal fatty tissue.

A rare presentation of KBG syndrome

KBG syndrome is a rare, genetic disorder characterizedby cognitive impairment, short stature, skeletal (mainly costovertebral) anomalies and a distinct craniofacial appearance. It is usually autosomal dominant in nature with a wide range of expressivity in its clinical features. We describe what appears to be the third case reported from India.The aim of this article is to review familiar clinical features and to highlight the endocrine management of KBG syndrome. We are hereby reporting a case of 17 year 10 months old adolescent who had neurocognitive impairment and a characteristic appearance, which led to the diagnosis of this genetic condition.

A Retrospective Assessment of the Initial Phase of Covid-19 and Its Implemented Treatment Strategies

Coronaviridae is a typical type of viral family comprised of an exceptionally huge RNA genome with a characteristic appearance and a noteworthy propensity to move from creatures to people. Since the start of the 21st century, three exceptionally contagious and pathogenic coronaviruses have traversed the species boundary and caused lethal pneumonia, exacting serious episodes, and causing human wellbeing crises to an unfathomable extent. The COVID-19 pandemic, presumably, is the most wrecking one, over the most recent 100 years after Spanish influenza. To the quick assessment of the various methodologies for a capability to evoke defensive resistance and well-being to shorten undesirable resistant potentiation, which assumes a significant function in this virus's pathogenesis. Considering the forthcoming public health crisis, researchers around the globe are consolidating their logical scientific possessions and offering initial information in an unprecedented way. In this review, we have tried to summarize some of the SAR-nCoV2 treatments that essentially focus on the potential drugs including Lopinavir/Ritonavir, Favipiravir, Remdesivir, Chloroquine phosphate, Hydroxychloroquine, Arbidol, and so on. Other potential vaccine developments with their difficulties associated and their current status are also being addressed. Keywords: