683 resultados para Mechanic anastomosis
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BACKGROUND: Pediatric truncal vascular injuries occur infrequently and have a reported mortality rate of 30% to 50%. This report examines the demographics, mechanisms of injury, associated trauma, and outcome of patients presenting for the past 10 years at a single institution with truncal vascular injuries. METHODS: A retrospective review (1997-2006) of a pediatric trauma registry at a single institution was undertaken. RESULTS: Seventy-five truncal vascular injuries occurred in 57 patients (age, 12 +/- 3 years); the injury mechanisms were penetrating in 37%. Concomitant injuries occurred with 76%, 62%, and 43% of abdominal, thoracic, and neck vascular injuries, respectively. Nonvascular complications occurred more frequently in patients with abdominal vascular injuries who were hemodynamically unstable on presentation. All patients with thoracic vascular injuries presenting with hemodynamic instability died. In patients with neck vascular injuries, 1 of 2 patients who were hemodynamically unstable died, compared to 1 of 12 patients who died in those who presented hemodynamically stable. Overall survival was 75%. CONCLUSIONS: Survival and complications of pediatric truncal vascular injury are related to hemodynamic status at the time of presentation. Associated injuries are higher with trauma involving the abdomen.
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Total restorative proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA) has become the standard of care for the surgical treatment of ulcerative colitis. Despite its correlation with an excellent quality of life and favorable long-term outcomes, RP/IPAA has been associated with several complications. Prolapse of the ileoanal pouch is a rare and debilitating complication that should be considered in the differential diagnosis of pouch failure. Limited data exist regarding the prevalence and treatment of pouch prolapse. We present the case of a recurrent J-pouch prolapse treated with a novel minimally invasive "salvage" approach involving a robotic-assisted laparoscopic rectopexy with mesh.
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Diverticulitis is a common disease in western countries and its incidence is increasing especially among young patients. Colonic diverticulosis, incidentally diagnosed by endoscopy or CT-scanning, has no immediate clinical consequences. Progression to diverticulitis develops in only 4 % of cases. In the last decades management of diverticular disease evolved and expectative treatment and less invasive techniques have gained importance. Elective resection has traditionally been advised after a second episode of diverticulitis or after a first episode if the patient was less than 50 years of age or complicated disease occurred. Recent changes in understanding the natural history of diverticular disease have substantially modified treatment paradigms. Elective resection in case of recurrent diverticular disease should be performed on a individual basis and in cases with complications like intestinal obstruction or fistulas. Primary anastomosis is an option even in emergency surgery due to colonic perforation, while diverting operations are indicated for selected patient groups with a high risk profile. Several prospective studies showed good results for laparoscopic drainage and lavage in the setting of perforated diverticulitis with generalized peritonitis, though this concept needs to be controlled with randomized clinical trials before application into the daily practice. This article should provide a short overview of trends in the surgical treatment of diverticulitis, help to understand the natural history of the disease and thereby explain the currently lower frequency of surgical interventions for diverticulitis.
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BACKGROUND Since the pioneering work of Jacobson and Suarez, microsurgery has steadily progressed and is now used in all surgical specialities, particularly in plastic surgery. Before performing clinical procedures it is necessary to learn the basic techniques in the laboratory. OBJECTIVE To assess an animal model, thereby circumventing the following issues: ethical rules, cost, anesthesia and training time. METHODS Between July 2012 and September 2012, 182 earthworms were used for 150 microsurgical trainings to simulate discrepancy microanastomoses. Training was undertaken over 10 weekly periods. Each training session included 15 simulations of microanastomoses performed using the Harashina technique (earthworm diameters >1.5 mm [n=5], between 1.0 mm and 1.5 mm [n=5], and <1.0 mm [n=5]). The technique is presented and documented. A linear model with main variable as the number of the week (as a numeric covariate) and the size of the animal (as a factor) was used to determine the trend in time of anastomosis over subsequent weeks as well as differences between the different size groups. RESULTS The linear model showed a significant trend (P<0.001) in time of anastomosis in the course of the training, as well as significant differences (P<0.001) between the groups of animal of different sizes. For diameter >1.5 mm, mean anastomosis time decreased from 19.6±1.9 min to 12.6±0.7 min between the first and last week of training. For training involving smaller diameters, the results showed a reduction in execution time of 36.1% (P<0.01) (diameter between 1.0 mm and 1.5 mm) and 40.6% (P<0.01) (diameter <1.0 mm) between the first and last weeks. The study demonstrates an improvement in the dexterity and speed of nodes' execution. CONCLUSION The earthworm appears to be a reliable experimental model for microsurgical training of discrepancy microanastomoses. Its numerous advantages, as discussed in the present report, show that this model of training will significantly grow and develop in the near future.
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This report describes the clinical, laboratory and ultrasonographic findings in a Simmental heifer with a ceco-cecal intussusception. The general condition of the heifer was moderately reduced and it showed mild colic signs. Physical examination revealed a firm longish mass visible and palpable in the right flank. Findings upon rectal examination, fecal output und defecation were normal. Ultrasound examination of the mass revealed features typical for an intussusception. Based on the slow development of symptoms, normal fecal output and ultrasonography findings, a ceco-cecal intussusception was diagnosed. Right flank laparatomy was performed under general anaesthesia, and an end-to-side anastomosis between the jejunum and the spiral colon was made after resection of the intussuscepted intestines. Recovery was uneventful.
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Individuals who do not respond to medical therapy for ulcerative colitis (UC) often undergo proctocolectomy followed by ileal-pouch anal anastomosis (IPAA) in hopes of resolving symptoms associated with UC. Inflammation of the ileal pouch, better known as pouchitis, is the most common complication of the IPAA procedure. The causes and development of pouchitis is not well understood. To better understand pathogenesis of pouchitis, pouch aspirates of patients having undergone IPAA were quantitatively analyzed for fecal IL-8, IL-17, and IL-23 levels. According to published literature IL-8 has been linked to pouchitis whereas IL-17 and IL-23 are associated with intestinal inflammation. The study had 80 participants, 33 patients diagnosed with Crohn's Disease (CD) of the pouch, 19 patients diagnosed with pouchitis, and 28 diagnosed with having normal pouches. Patient characteristics and histopathological findings for all patients were noted and statistically compared in addition to fecal cytokine levels. This study supported previous literature that IL-8 production was associated with pouch inflammation. However, IL-17 and IL-23 levels in both CD of the pouch and pouchitis were not significantly different to the levels noted in normal pouch.^
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A rock salt-lamprophyre dyke contact zone (sub-vertical, NE-SW strike) was investigated for its petrographic, mechanic and physical properties by means of anisotropy of magnetic susceptibility (AMS) and rock magnetic properties, coupled with quantitative microstructural analysis and thermal mathematical modelling. The quantitative microstructural analysis of halite texture and solid inclusions revealed good spatial correlation with AMS and halite fabrics. The fabrics of both lamprophyre and rock salt record the magmatic intrusion, "plastic" flow and regional deformation (characterized by a NW-SE trending steep foliation). AMS and microstructural analysis revealed two deformation fabrics in the rock salt: (1) the deformation fabrics in rock salt on the NW side of the dyke are associated with high temperature and high fluid activity attributed to the dyke emplacement; (2) On the opposite side of the dyke, the emplacement-related fabric is reworked by localized tectonic deformation. The paleomagnetic results suggest significant rotation of the whole dyke, probably during the diapir ascent and/or the regional Tertiary to Quaternary deformation.
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Grain-size, mineral and chemical compositions of suspended particulate matter (SPM) from waters of the Severnaya (North) Dvina River mouth area during the spring flood in May 2004 is studied. Data published on composition of riverine SPM in the White Sea basin are very poor. The spring flood period when more than half of annual runoff is supplied from the river to the sea in during short time is understood more poorly. The paper considers comparison results of the grain size compositions of SPM and bottom sediments. Data of laser and hydraulic techniques of grain size analysis are compared. Short-period variations of SPM concentration and composition representing two diurnal peaks of the tide level are studied. It is found that SPM is mainly transferred during the spring flood as mineral aggregates up to 40 µm diameter. Sandy-silty fraction of riverine SPM settles in delta branches and channels, and bulk of clay-size material is supplied to the sea. Mineral and chemical compositions of SPM from the North Dvina River are determined by supply of material from the drainage basin. This material is subjected to intense mechanic separation during transfer to the sea. Key regularities of formation of mineral composition of SPM during the flood time are revealed. Effect of SPM grain size composition on distribution of minerals and chemical elements in study in the dynamic system of the river mouth area are characterized.
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Esta investigación presenta un modelo de material para aleaciones de solidificación direccional que poseen un comportamiento mecánico transversalmente isótropo. Se han realizado una serie de ensayos de tracción sobre probetas cilíndricas a varias velocidades de deformación y a varias temperaturas sobre la superaleación de base níquel de solidificación direccional MAR-M 247 con objeto de conocer su comportamiento mecánico. Los ensayos se realizaron sobre probetas cilíndricas cuya dirección longitudinal forma 0º y 90º con la de la orientación de crecimiento de los granos. Para representar el comportamiento plástico anisótropo se ha formulado una función de plastificación de forma no cuadrática basada en la transformación lineal de tensores. Con el propósito de simplificar en todo lo posible el modelo se ha considerado un endurecimiento isótropo. Para probar la validez del modelo propuesto se ha implementado el mismo como modelo de material definido por el usuario en el código no lineal de elementos finitos LS-DYNA. In this research a material model for directionally solidified alloys with transversely isotropic mechanic behavior is presented. In order to characterize the mechanical behavior of the Mar-M 247 directionally solidified nickel based superalloy, tensile tests of axisymmetric smooth specimens were performed at various strain rates and temperatures. The specimens were machined making sure that the longitudinal axis of them was forming 0º and 90º with the grain growth orientation. To represent the plastic flow, a non-quadratic anisotropic function based on linear transformation of tensors has been formulated. For the sake of simplicity isotropic strain hardening of the material has been considered. To prove the validity of the model, a material subroutine has been implemented in LS-DYNA non-linear finite element code as a user defined material model.
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Gran parte del patrimonio construido cuenta con edificios cuya estructura está compuesta por elementos de madera. El volumen económico que supone el mantenimiento y renovación de dicho patrimonio es considerable, por ello, es de especial interés el estudio de las diferentes técnicas de refuerzo aplicables a este tipo de estructuras. Las estructuras de madera han sido tradicionalmente reforzadas con piezas del mismo material, aumentando la sección de los elementos dañados, o con acero. La aparición de los materiales compuestos de polímeros reforzados con fibras, y su progresiva aplicación en obras de construcción, hizo que a principios de la década de los noventa se comenzara a aplicar este material en refuerzos de estructuras de madera (Puente de Sins, 1992). La madera es un material natural con una excelente relación entre sus características mecánicas y su peso. Con el uso de materiales compuestos como refuerzo ésta característica se mantiene. En cuanto a su modelo constitutivo, se admite un comportamiento elástico lineal a tracción paralela a la fibra hasta la rotura, mientras que a compresión, se considera un comportamiento lineal elástico inicial, seguido de un tramo plástico. En vigas de madera aserrada sometidas a flexión predomina el modo de fallo por tracción localizándose la fractura frecuentemente en el canto inferior. Los FRP tienen un comportamiento elástico lineal a tracción hasta la rotura y cuentan con excelentes propiedades mecánicas en relación a su peso y volumen. Si se refuerza la viga por el canto inferior se aumentará su capacidad de absorber tracciones y por tanto, es previsible que se produzca un incremento en la capacidad de carga, así como un aumento de ductilidad. En este trabajo se analizan los beneficios que aportan distintos sistemas de refuerzos de materiales compuestos. El objetivo es contribuir al conocimiento de esta técnica para la recuperación o aumento de las propiedades resistentes de elementos de madera sometidos a flexión. Se ha llevado a cabo un estudio basado en datos obtenidos experimentalmente mediante el ensayo a flexión de vigas de madera de pino silvestre reforzadas con materiales compuestos. Las fibras que componen los tejidos utilizados para la ejecución de los refuerzos son de basalto y de carbono. En el caso de los compuestos de fibra de basalto se aplican en distintos gramajes, y los de carbono en tejido unidireccional y bidireccional. Se analiza el comportamiento de las vigas según las variables de refuerzo aplicadas y se comparan con los resultados de vigas ensayadas sin reforzar. Además se comprueba el ajuste del modelo de cálculo no lineal aplicado para predecir la carga de rotura de cada viga reforzada. Con este trabajo queda demostrado el buen funcionamiento del FRP de fibra de basalto aplicado en el refuerzo de vigas de madera y de los tejidos de carbono bidireccionales con respecto a los unidireccionales. ABSTRACT Many of the buildings of the built heritage include a structure composed by timber elements. The economic volume involved in the maintenance and renewal of this built heritage is considerable, therefore, the study of the different reinforcement techniques applicable to this type of structure is of special interest. The wooden structures have traditionally been reinforced either with steel or with pieces of the same material, increasing the section of the damaged parts. The emergence of polymer composites reinforced with fibers, and their progressive use in construction, started to be applied as reinforcement in timber structures at the beginning of the nineties decade in the 20th century (Sins Bridge, 1992). Wood is a natural material with an excellent ratio between its mechanic characteristics and its weight. This feature is maintained with the use of composites as reinforcement. In terms of its constitutive model, linear elastic behavior parallel to the fiber up to fracture is admitted when subjected to tensile stress, while under compression, an initial linear elastic behavior, followed by a section plasticizing, is considered. In sawn timber beams subjected to bending, the predominant failure is mainly due to tensile stress; and frequently the fracture is located at the beam lower face. The FRP have a linear elastic behavior until fracture occurs, and have excellent mechanical properties in relation to their weight and volume. If the beam is reinforced by its lower face, its capacity to absorb tensile stresses will increase, and therefore, an increase in its carrying capacity is likely to be produced, as well as an increase in ductility. This work analyzes the benefits different reinforcement systems of composite materials provide, with the aim of contributing to the knowledge of this technique for recovering or increasing the strength properties of timber elements subjected to bending loads. It is a study based on data obtained experimentally using bending tests of pine timber beams reinforced with composite materials. Fibers used for the execution of the reinforcement are basalt and carbon. Basalt fiber composites are applied in different grammages, whereas with carbon composites, unidirectional and bidirectional fabrics are used. The behavior of the beams was analyzed regarding the reinforcement variables applied, and the results are compared with those of the tested beams without reinforcement. Furthermore it has been proved adjunting the nonlinear calculation model applied to predict the failure load of each reinforced beam. This work proves the good behavior of fiber reinforce plastic (FRP) with basalt fiber when applied to timber beams, and that of bidirectional carbon fabrics as opposed to the unidirectional ones.
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Continuous and long-pulse lasers have been extensively used for the forming of metal sheets for macroscopic mechanical applications. However, for the manufacturing of Micro-Mechanical Systems (MMS), the applicability of such type of lasers is limited by the long relaxation time of the thermal fields responsible for the forming phenomena. As a consequence, the final sheet deformation state is attained only after a certain time, what makes the generated internal residual stress fields more dependent on ambient conditions and might difficult the subsequent assembly process. The use of short pulse (ns) lasers provides a suitable parameter matching for the laser forming of an important range of sheet components used in MEMS. The short interaction time scale required for the predominantly mechanic (shock) induction of deformation residual stresses allows the successful processing of components in a medium range of miniaturization (particularly important according to its frequent use in such systems). In the present paper, Laser Shock Micro-Forming (LSμF) is presented as an emerging technique for Microsystems parts shaping and adjustment along with a discussion on its physical foundations and practical implementation possibilities developed by the authors.
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This paper shows the results of the study of physical, mechanic and chemical behaviour of some natural zeolite types sampled in different outcrops of the world, mainly from Mexico, Cuba and Spain, as well as their incidence in certain practical applications, by means of the utilization of its pozzuolanic properties. Results emphasize that every natural zeolite variety gives different answers in the assays, probably influenced by the subtle variability of their chemical composition. Key words: zeolites, pozzuolanic, density, geometric, strength
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El desarrollo del Proyecto consiste, por una parte, en el estudio sobre la respuesta de los materiales piezoeléctricos como generadores de energía en un entorno acuoso que está sometido a variaciones de potencial y, por otra, en el estudio técnico y económico de un equipo basado en la utilización esta fuente de energía y su comercialización en el mercado energético. Esta energía es la que se obtiene de la fuerza de arrastre del agua al desplazarse a causa del movimiento ondulatorio de las olas y que el elemento al flexionar es capaz de transformar. El proyecto contempla a partir de modelos, el funcionamiento eléctrico y mecánico de un generador piezoeléctrico, el sistema de electrónica necesaria para su inserción optimizada en la red eléctrica. A partir de esto se desarrolla una instalación que puede adaptarse a los requerimientos del estudio previo. Empleando un modelo de relación técnica y económica se establece una conexión entre estas dos secciones para hacerse una idea de la rentabilidad económica de un equipo de este estilo a día de hoy. El propósito final, es el de estudiar un nuevo tipo de energía, y comenzar una línea que puede llevar a un lugar muy interesante del sector energético. ABSTRACT This Project presents an analysis on the performance of piezoelectric materials as energy producer in an aquatic environment subject to potential variations. Additionally, the Project contains a technical and an economic analysis on the equipment based on the use of this energy source, as well as its commercialization. Energy is obtained by the water drag force when it is moved by the wave’s movement and by its transformation by the piezoelectric material. The Project studies the electric and mechanic functioning of a piezoelectric generator and the necessary electronic system for its optimized insertion on the electricity distribution network. Based on this, it is developed a system that can be adapted to the previous study requirements. The use of a technical and economic relation model allows the establishment of a connection among them in order to estimate the economic profitability of such equipment nowadays. The final objective of this Project is analyzing a new source of energy, which could start a new investigation line that may lead the energetic sector to a very interesting future.
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There are significant levels of concern about the relevance and the difficulty of learning some issues on Strength of Materials and Structural Analysis. Most students of Continuum Mechanics and Structural Analysis in Civil Engineering usually point out some key learning aspects as especially difficult for acquiring specific skills. These key concepts entail comprehension difficulties but ease access and applicability to structural analysis in more advanced subjects. Likewise, some elusive but basic structural concepts, such as flexibility, stiffness or influence lines, are paramount for developing further skills required for advanced structural design: tall buildings, arch-type structures as well as bridges. As new curricular itineraries are currently being implemented, it appears appropriate to devise a repository of interactive web-based applications for training in those basic concepts. That will hopefully train the student to understand the complexity of such concepts, to develop intuitive knowledge on actual structural response and to improve their preparation for exams. In this work, a web-based learning assistant system for influence lines on continuous beams is presented. It consists of a collection of interactive user-friendly applications accessible via Web. It is performed in both Spanish and English languages. Rather than a “black box” system, the procedure involves open interaction with the student, who can simulate and virtually envisage the structural response. Thus, the student is enabled to set the geometric, topologic and mechanic layout of a continuous beam and to change or shift the loading and the support conditions. Simultaneously, the changes in the beam response prompt on the screen, so that the effects of the several issues involved in structural analysis become apparent. The system is performed through a set of web pages which encompasses interactive exercises and problems, written in JavaScript under JQuery and DyGraphs frameworks, given that their efficiency and graphic capabilities are renowned. Students can freely boost their self-study on this subject in order to face their exams more confidently. Besides, this collection is expected to be added to the "Virtual Lab of Continuum Mechanics" of the UPM, launched in 2013 (http://serviciosgate.upm.es/laboratoriosvirtuales/laboratorios/medios-continuos-en-construcci%C3%B3n)
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Esta tesis presenta los resultados de la investigación realizada sobre la inertización de cenizas volantes procedentes de residuos sólidos urbanos y su posterior encapsulación en distintas matrices de mortero. Durante el proceso de inertización, se ha logrado la inertización de éste residuo tóxico y peligroso (RTP) y también su valorización como subproducto. De esta forma se dispone de nueva “materia prima” a bajo coste y la eliminación de un residuo tóxico y peligroso con la consiguiente conservación de recursos naturales alternativos. La caracterización química de las cenizas analizadas refleja que éstas presentan altas concentraciones de cloruros, Zn y Pb. Durante la investigación se ha desarrollado un proceso de inertización de las cenizas volantes con bicarbonato sódico (NaHCO3) que reduce en un 99% el contenido en cloruros y mantiene el pH en valores óptimos para que la concentración de los metales pesados en el lixiviado sea mínima debido a su estabilización en forma de carbonatos insolubles. Se han elaborado morteros con cuatro tipos distintos de cementos (CEM-I, CEM-II, CAC y CSA) incorporando cenizas volantes inertizadas en una proporción igual a un 10% en peso del árido utilizado. Los morteros ensayados abarcan distintas dosificaciones tanto en la utilización de áridos con distintos diámetros (0/2 y 0/4), como en la relación cemento/árido (1/1 y 1/3). Se han obtenido las propiedades físicas y mecánicas de estos morteros mediante ensayos de Trabajabilidad, Estabilidad Dimensional, Carbonatación, Porosidad y Resistencias Mecánicas. De igual forma, se presentan resultados de ensayos de lixiviación de Zn, Pb, Cu y Cd, sobre probetas monolíticas de los morteros con los mejores comportamientos físico/mecánicos, donde se ha analizado el contenido en iones de dichos metales pesados lixiviados mediante determinación voltamperométrica de redisolución anódica Se concluye que todos los morteros ensayados son técnicamente aceptables, siendo los más favorables los elaborados con Cemento de Sulfoaluminato de Calcio (CSA) y con Cemento de Aluminato de Calcio (CAC). En este último caso, se mejoran las resistencias a compresión de los morteros de referencia en más de un 48%, y las resistencias a flexión en más de un 67%. De igual forma, los ensayos de lixiviado revelan la completa encapsulación de los iones de Zn y la mitigación en el lixiviado de los iones de Pb. Ambos morteros podrían ser perfectamente validos en actuaciones en las que se necesitase un producto de fraguado rápido, altas resistencias iniciales y compensación de las retracciones con una elevada estabilidad dimensional. En base a esto, el material podría ser utilizado como mortero de reparación en viales y pavimentos que requiriesen altas prestaciones, tales como: soleras industriales, pistas de aterrizaje, aparcamientos, etc. O bien, para la confección de elementos prefabricados sin armaduras estructurales, dada su elevada resistencia a flexión. ABSTRACT This dissertation presents the results of a research on inerting fly ash from urban solid waste and its subsequent encapsulation in mortar matrixes. The inerting of this hazardous toxic waste, as well as its valorization as a by-product has been achieved. In this way, a new "raw material" is available through a simple process and the toxic and hazardous waste is eliminated, and consequently, conservation of alternative natural resources is strengthened. Chemical analysis of the ashes analyzed shows high concentrations of soluble chlorides, Zn and Pb. An inerting process of fly ash with sodium bicarbonate (NaHCO3) has been developed which reduces 99% the content of chlorides and maintains pH at optimal values, so that the concentration of heavy metals in the leachate is minimum, due to its stabilization in the form of insoluble carbonates. Mortars with four different types of cements (CEM-I, CEM-II, CAC and CSA) have been developed by the addition of inertized fly ash in the form of carbonates, in the proportion of 10% in weight of the aggregates used. The samples tested include different proportions in the use of aggregates with different sizes (0/2 and 0/4), and in the cement/aggregate ratio (1/1 and 1/3). Physical/mechanical properties of these mortars have been studied through workability, dimensional stability, carbonation, porosity and mechanic strength tests. Leaching tests of Zn, Pb, Cu and Cd ions are also being performed on monolithic samples of the best behavioral mortars. The content in leachated heavy metal ions is being analyzed through stripping voltammetry determination. Conclusions drawn are that the tested CAC and CSA cement mortars present much better behavior than those of CEM-I and CEM-II cement. The results are especially remarkable for the CAC cement mortars, improving reference mortars compression strengths in more than 48%, and also bending strengths in more than 67%. Leaching tests confirm that the encapsulation of Zn and Pb is achieved and leachate of both ions is mitigated within the mortar matrixes. For the above stated reasons, it might be concluded that mortars made with calcium aluminate cements or calcium sulfoaluminate with the incorporation of treated fly ash, may be perfectly valid for uses in which a fast-curing product, with high initial strength and drying shrinkage compensation with a high dimensional stability is required. Based on this, the material could be used as repair mortar for structures, roads and industrial pavements requiring high performance, such as: industrial floorings, landing tracks, parking lots, etc. Alternatively, it could also be used in the manufacture of prefabricated elements without structural reinforcement, given its high bending strength.