937 resultados para bile duct bypass


Relevância:

10.00% 10.00%

Publicador:

Resumo:

Niobium-silicide alloys have great potential for high temperature turbine applications. The two-phase Nb/Nb5Si3 in situ composites exhibit a good balance in mechanical properties. Using the 52 in drop tube, the effect of undercooling and rapid solidification on the solidification process and micro-structural characterization of Nb-Si eutectic alloy was studied. The microstructures of the Nb-Si composites were investigated by optics microscope (OM), X-ray diffraction (XRD) and scanning electron microscope (SEM) equipped with X-ray energy dispersive spectrometry (EDS). Up to 480 K, deep undercooling of the Nb-Si eutectic samples was successfully obtained, which corresponds to 25% of the liquidus temperature. Contrasting to the conventional microstructure usually found in the Nb-Si eutectic alloy, the microstructure of the undercooled sample is divided into the fine and coarse regions. The most commonly observed microstructure is Nb+Nb5Si3, and the Nb3Si phase is not be found. The change of coarseness of microstructure is due to different cooling rates during and after recalescence. The large undercooling is sufficient to completely bypass the high temperature phase field.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

In this paper, TASCflow3D is used to solve inner and outer 3D viscous incompressible turbulent flow (R-e = 5.6 X 10(6)) around axisymmetric body with duct. The governing equation is a RANS equation with standard k-epsilon turbulence model. The discrete method used is a finite volume method based on the finite element approach. In this method, the description of geometry is very flexible and at the same time important conservative properties are retained. The multi-block and algebraic multi-grid techniques are used for the convergence acceleration. Agreement between experimental results and calculation is good. It indicates that this novel approach can be used to simulate complex flow such as the interaction between rotor and stator or propulsion systems containing tip clearance and cavitation.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

An experimental investigation was conducted to study the holdup distribution of oil and water two-phase flow in two parallel tubes with unequal tube diameter. Tests were performed using white oil (of viscosity 52 mPa s and density 860 kg/m(3)) and tap water as liquid phases at room temperature and atmospheric outlet pressure. Measurements were taken of water flow rates from 0.5 to 12.5 m(3)/h and input oil volume fractions from 3 to 94 %. Results showed that there were different flow pattern maps between the run and bypass tubes when oil-water two-phase flow is found in the parallel tubes. At low input fluid flow rates, a large deviation could be found on the average oil holdup between the bypass and the run tubes. However, with increased input oil fraction at constant water flow rate, the holdup at the bypass tube became close to that at the run tube. Furthermore, experimental data showed that there was no significant variation in flow pattern and holdup between the run and main tubes. In order to calculate the holdup in the form of segregated flow, the drift flux model has been used here.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Supersonic combustion of thermally cracked kerosene was experimentally investigated in two model supersonic combustors with different entry cross-section areas. Effects of entry static pressure, entry Mach number, combustor entry geometry, and injection scheme on combustor performance were systematically investigated and discussed based on the measured static pressure distribution and specific thrust increment due to combustion. In addition, the methodology for characterizing flow rate and composition of cracked kerosene was detailed. Using a pulsed Schlieren system, the interaction of supercritical and cracked kerosene jet plumes with a Mach 2.5 crossflow was also visualized at different injection temperatures. The present experimental results suggest that the use of a higher combustor entry Mach number as well as a larger combustor duct height would suppress the boundary layer separation near the combustor entrance and avoid the problem of inlet un- start.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

In this paper, TASCflow3D is used to solve inner and outer 3D viscous incompressible turbulent flow (R-e = 5.6 X 10(6)) around axisymmetric body with duct. The governing equation is a RANS equation with standard k-epsilon turbulence model. The discrete method used is a finite volume method based on the finite element approach. In this method, the description of geometry is very flexible and at the same time important conservative properties are retained. The multi-block and algebraic multi-grid techniques are used for the convergence acceleration. Agreement between experimental results and calculation is good. It indicates that this novel approach can be used to simulate complex flow such as the interaction between rotor and stator or propulsion systems containing tip clearance and cavitation.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Niobium-silicide alloys have great potential for high temperature turbine applications. The two-phase Nb/Nb5Si3 in situ composites exhibit a good balance in mechanical properties. Using the 52 in drop tube, the effect of undercooling and rapid solidification on the solidification process and micro-structural characterization of Nb-Si eutectic alloy was studied. The microstructures of the Nb-Si composites were investigated by optics microscope (OM), X-ray diffraction (XRD) and scanning electron microscope (SEM) equipped with X-ray energy dispersive spectrometry (EDS). Up to 480 K, deep undercooling of the Nb-Si eutectic samples was successfully obtained, which corresponds to 25% of the liquidus temperature. Contrasting to the conventional microstructure usually found in the Nb-Si eutectic alloy, the microstructure of the undercooled sample is divided into the fine and coarse regions. The most commonly observed microstructure is Nb+Nb5Si3, and the Nb3Si phase is not be found. The change of coarseness of microstructure is due to different cooling rates during and after recalescence. The large undercooling is sufficient to completely bypass the high temperature phase field.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Following the quantitative determination of dust cloud parameters, this study investigates the flame propagation through cornstarch dust clouds in a vertical duct of 780 mm height and 160 x 160 mm square cross section, and gives particular attention to the effect of small scale turbulence and small turbulence intensity on flame characteristics. Dust suspensions in air were produced using an improved apparatus ensuring more uniform distribution and repeatable dust concentrations in the testing duct. The dispersion-induced turbulence was measured by means of a particle image velocimetry (PIV) system, and dust concentrations were estimated by direct weighing method. This quantitative assessment made it possible to correlate observed flame behaviors with the parameters of the dust cloud. Upward propagating dust flames, from both closed/open bottom end to open/closed top end of the duct, were visualized by direct light and shadow photography. From the observation of propagation regimes and the measurements of flame velocity, a critical value of the turbulence intensity can be specified below which laminar flame propagation would be established. This transition condition was determined to be 10 cm/s. Laminar flames propagated with oscillations from the closed bottom end to the open top end of the testing duct, while the turbulent flames accelerated continuously. Both laminar and turbulent flames propagated with steady velocity from the open bottom end to the closed top end of the duct. The measured propagation velocity of laminar flames appeared to be in the range of 0.45-0.56 m/s, and it was consistent with the measurements reported in the literature. In the present experimental study, the influence of dust concentration on flame propagation was also examined, and the flame propagation velocity was found weakly sensitive to the variations in dust concentration. Some information on the flame structure was revealed from the shadow records, showing the typical heterogeneous feature of the dust combustion process.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

160 p. (Bibliogr. 141-160)

Relevância:

10.00% 10.00%

Publicador:

Resumo:

湍流广泛存在于自然界和工程应用中。可压平板湍流是一种典型的壁湍流,对其进行直接数值模拟研究是壁湍流机理研究的基础。本文采用高精度紧致型差分格式求解三维可压N-S方程,利用MPI并行程序,直接数值模拟了来流马赫数为M的=2.25,雷诺数为Re=635O00/in.的空间发展的可压缩平板湍流边界层。本文主要研究了如下一些问题。方法研究方面:●针对壁湍流流动的特点,文中提出了与基于非等距网格高精度紧致型差分格式相结合的简化的迭代一隐式时间推进法,建立了可压缩平板湍流边界层直接数值模拟方法。提高了计算效率,并给出了迭代收敛的条件。●研究了不同网格加密方法对数值解分辨率的影响,指出在保证近物面附近物理平面内网格是均匀的条件下,采用坐标变换的方法也可得到近物面高分辨率的数值解,纠正了人们认为只有在基于非等距网格上才能得到高分辨率解的观点。●采用包括前缘在内的二维可压平板层流边界层直接数值模拟结果为三维可压平板湍流边界层计算提供上游边界条件,解决了国外采用的局限性很大的经验公式带来的不相容问题。物理问题的模拟研究:●在国内首次给出了超声速平板边界层从层流经bypass转披直到充分发展湍流的整个过程。所得流场统计特征(如平均速度分布,物面摩阻系数,脉动速度的均方根等)与相关理论和实验符合甚好。这些结果充分证实了本文所建立的数值方法的有效性和所得结果的可靠性。●在此基础上,文中分析了可压平板湍流边界层内的拟序结构的形成过程。研究了初始扰动对平板边界层流动转挨特征的影响,指出上游初始扰动中展向的非对称性是形成bypass转挨的关键因素,且较大的时间扰动频率使得边界层转披位置后移。这些结果为壁湍流控制提供一定依据。●在此基础上研究了可压缩效应对平均流动特征以及湍能的生成和耗散特征的影响,指出在Mc∞=2.25的情况下,Morkovin假设基本成立。但可压缩效应使得边界层内层中过渡层加宽;拟序结构有明显差别。与不可压相比上抛、下扫对不同区域的作用有所不同。在近壁区,湍动能方程中的压力-膨胀项和压力-速度相关项仍是不可忽略的量,这导致声的产生和可压缩效应对湍流的发展所产生的抑制作用。

Relevância:

10.00% 10.00%

Publicador:

Resumo:

本文采用生物渗流理论,建立了肝脏内不同生物流体流动的多重介质渗流模型,采用有限元法求解这种特殊的渗流问题,根据数值计算结果揭示了肝内血液、组织液以及胆汁等的流动规律,并探讨了肝脏血流动力学的一些问题。论文将肝脏内部与生物代谢功能有关的肝血窦和窦周间隙当作两重并存的多孔介质,血液在肝血窦中,以及组织液在窦周间隙中的流动均当作渗流处理,通过Starling公式考虑了两重介质之间的流量交换,从而建立了肝血窦-窦周间隙的双重介质模型。针对肝脏胆汁分泌功能,将肝脏内密布的毛血肝管网当作多孔介质,以受静压及渗透压驱动的流体跨壁流动表示肝汁从肝细胞向毛细肝管的分泌,肝汁在毛细胆管网中的流动作为渗流处理,从而建立了肝汁分泌与输运的双重介质模型。采用有限元法求解了生物流体的双重介质渗流问题,针对非牛顿渗流和两重介质的相互作用,本文发展了一种嵌套迭代方法,即采用直接迭代求解血液在肝血窦中的非线性渗流,采用交替迭代解决双重介质渗流中由跨壁流支引起的相互流体交换,直接迭代嵌套于交替迭代中。这种算法比较有效的解决了包含非牛顿渗流的双重介质渗流问题。根据生物多孔介质中微细管系统的构筑方式以及不同微细管系统之间的联系方式,论文提出将生物多孔介质划分为分级多孔介质和多重多孔介质两种主要类型。基于多相混合物的平均化的理论,论文推导了双重多孔介质中的动量守恒方程、质量守恒方程以及相应的渗流方程,建立了双重多孔介质渗流的平均化模型。基于分级多孔介质渗流的理论,论文将脏器中的血管树按管径分为不同级别的多孔介质,各级血管中和血液流动均作为渗流处理,从而提出了计算脏器整体血流的一种渗流方法。采用这种方法,在论文提出的肝血窦 - 窦周间隙双重介质渗流流模型的基础之上,初步研究了肝脏门静脉系统的血液动力学规律。采用本文提出的肝血窦 - 窦周间隙双重介质模型和胆汁分泌 - 流动的双重介质模型,得到了血液、组织液和胆汁在肝小叶中的压力分布和速度分布,并分析了肝血窦壁的跨壁流动模式,胆汁流量的影响因素,以及窦周间隙中组织液流量与肝血窦中血液流动及肝血窦壁渗透系数等因素的关系,揭示了肝脏内血液、组织液及胆汁等生物流体流动的一般规律。

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Due to their carcinogenic properties, polycyclic aromatic hydrocarbons (PAH) are important environmental contaminants which may lead to increased levels of neoplastic aberrations in fish liver. To measure the PAH contamination of fish, concentrations of PAH metabolites were determined in the bile. The main metabolite 1-hydroxypyrene was determined in concentrations from < 0.8 to 189 ng/ml in bile of dab caught in the North Sea and the Baltic Sea re-spectively. The concentrations are comparable to levels of 1-hydroxypyrene measured in cod and herring from the Baltic Sea. The highest concentrations in dab bile were measured in fish from the inner German Bight and the Kiel Bight.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The epidemic of HIV/AIDS in the United States is constantly changing and evolving, starting from patient zero to now an estimated 650,000 to 900,000 Americans infected. The nature and course of HIV changed dramatically with the introduction of antiretrovirals. This discourse examines many different facets of HIV from the beginning where there wasn't any treatment for HIV until the present era of highly active antiretroviral therapy (HAART). By utilizing statistical analysis of clinical data, this paper examines where we were, where we are and projections as to where treatment of HIV/AIDS is headed.

Chapter Two describes the datasets that were used for the analyses. The primary database utilized was collected by myself from an outpatient HIV clinic. The data included dates from 1984 until the present. The second database was from the Multicenter AIDS Cohort Study (MACS) public dataset. The data from the MACS cover the time between 1984 and October 1992. Comparisons are made between both datasets.

Chapter Three discusses where we were. Before the first anti-HIV drugs (called antiretrovirals) were approved, there was no treatment to slow the progression of HIV. The first generation of antiretrovirals, reverse transcriptase inhibitors such as AZT (zidovudine), DDI (didanosine), DDC (zalcitabine), and D4T (stavudine) provided the first treatment for HIV. The first clinical trials showed that these antiretrovirals had a significant impact on increasing patient survival. The trials also showed that patients on these drugs had increased CD4+ T cell counts. Chapter Three examines the distributions of CD4 T cell counts. The results show that the estimated distributions of CD4 T cell counts are distinctly non-Gaussian. Thus distributional assumptions regarding CD4 T cell counts must be taken, into account when performing analyses with this marker. The results also show the estimated CD4 T cell distributions for each disease stage: asymptomatic, symptomatic and AIDS are non-Gaussian. Interestingly, the distribution of CD4 T cell counts for the asymptomatic period is significantly below that of the CD4 T cell distribution for the uninfected population suggesting that even in patients with no outward symptoms of HIV infection, there exists high levels of immunosuppression.

Chapter Four discusses where we are at present. HIV quickly grew resistant to reverse transcriptase inhibitors which were given sequentially as mono or dual therapy. As resistance grew, the positive effects of the reverse transcriptase inhibitors on CD4 T cell counts and survival dissipated. As the old era faded a new era characterized by a new class of drugs and new technology changed the way that we treat HIV-infected patients. Viral load assays were able to quantify the levels of HIV RNA in the blood. By quantifying the viral load, one now had a faster, more direct way to test antiretroviral regimen efficacy. Protease inhibitors, which attacked a different region of HIV than reverse transcriptase inhibitors, when used in combination with other antiretroviral agents were found to dramatically and significantly reduce the HIV RNA levels in the blood. Patients also experienced significant increases in CD4 T cell counts. For the first time in the epidemic, there was hope. It was hypothesized that with HAART, viral levels could be kept so low that the immune system as measured by CD4 T cell counts would be able to recover. If these viral levels could be kept low enough, it would be possible for the immune system to eradicate the virus. The hypothesis of immune reconstitution, that is bringing CD4 T cell counts up to levels seen in uninfected patients, is tested in Chapter Four. It was found that for these patients, there was not enough of a CD4 T cell increase to be consistent with the hypothesis of immune reconstitution.

In Chapter Five, the effectiveness of long-term HAART is analyzed. Survival analysis was conducted on 213 patients on long-term HAART. The primary endpoint was presence of an AIDS defining illness. A high level of clinical failure, or progression to an endpoint, was found.

Chapter Six yields insights into where we are going. New technology such as viral genotypic testing, that looks at the genetic structure of HIV and determines where mutations have occurred, has shown that HIV is capable of producing resistance mutations that confer multiple drug resistance. This section looks at resistance issues and speculates, ceterus parabis, where the state of HIV is going. This section first addresses viral genotype and the correlates of viral load and disease progression. A second analysis looks at patients who have failed their primary attempts at HAART and subsequent salvage therapy. It was found that salvage regimens, efforts to control viral replication through the administration of different combinations of antiretrovirals, were not effective in 90 percent of the population in controlling viral replication. Thus, primary attempts at therapy offer the best change of viral suppression and delay of disease progression. Documentation of transmission of drug-resistant virus suggests that the public health crisis of HIV is far from over. Drug resistant HIV can sustain the epidemic and hamper our efforts to treat HIV infection. The data presented suggest that the decrease in the morbidity and mortality due to HIV/AIDS is transient. Deaths due to HIV will increase and public health officials must prepare for this eventuality unless new treatments become available. These results also underscore the importance of the vaccine effort.

The final chapter looks at the economic issues related to HIV. The direct and indirect costs of treating HIV/AIDS are very high. For the first time in the epidemic, there exists treatment that can actually slow disease progression. The direct costs for HAART are estimated. It is estimated that the direct lifetime costs for treating each HIV infected patient with HAART is between $353,000 to $598,000 depending on how long HAART prolongs life. If one looks at the incremental cost per year of life saved it is only $101,000. This is comparable with the incremental costs per year of life saved from coronary artery bypass surgery.

Policy makers need to be aware that although HAART can delay disease progression, it is not a cure and HIV is not over. The results presented here suggest that the decreases in the morbidity and mortality due to HIV are transient. Policymakers need to be prepared for the eventual increase in AIDS incidence and mortality. Costs associated with HIV/AIDS are also projected to increase. The cost savings seen recently have been from the dramatic decreases in the incidence of AIDS defining opportunistic infections. As patients who have been on HAART the longest start to progress to AIDS, policymakers and insurance companies will find that the cost of treating HIV/AIDS will increase.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

A Cirurgia de Revascularização do Miocárdio, realizada com o auxílio da Circulação Extracorpórea, está associada a alterações importantes na microcirculação e na produção e circulação de citocinas e marcadores inflamatórios. No presente estudo, foram avaliados 23 pacientes com indicação de Revascularização do Miocárdio, no dia do procedimento e 7 e 28 dias após a cirurgia. A microcirculação cutânea, enquanto reflexo da microcirculação coronariana, foi estudada através da hiperemia térmica e/ ou reativa pós oclusiva e da iontoforese de substâncias vasoativas por mecanismos dependentes e independentes do endotélio. A rigidez arterial foi aferida através da análise da onda de pulso digital. Foi avaliado ainda o impacto da doença e do procedimento cirúrgico sobre a produção e circulação sérica de citocinas e marcadores inflamatórios, tais como: PCR-HS, nitrito/ nitrato, IL-6, Il-7, IL-8, IL-10, IFN-γ, TNF-α e G-CSF. Foi observada uma tendência à redução da vasodilatação da microcirculação cutânea após a administração de doses acumulativas de acetilcolina (endotélio dependente) através da iontoforese de 7 e 28 dias após o procedimento cirúrgico. A hiperemia térmica foi mais pronunciada na avaliação basal do que aos 7 e 28 dias. A hiperemia reativa pós oclusiva não demonstrou alterações 7 dias após o procedimento. Aos 28 dias, houve um aumento da condutância microvascular cutânea. Quando avaliada a vasodilatação endotélio-independente (nitroprussiato de sódio), observamos aumento do fluxo microvascular cutâneo diretamente proporcional à carga/ dose aplicada, sem diferenças nos valores obtidos no basal e 7 e 28 dias após o procedimento. A rigidez arterial não apresentou alterações. A análise dos fatores inflamatórios e das citocinas demonstrou aumento marcante da IL-6 e da IL-8 após 7 dias do procedimento cirúrgico, com retorno parcial aos níveis basais da IL-6 e total da IL-8 após 28 dias. O IFN-γ, TNF-α e G-CSF apenas apresentaram níveis detectáveis na avaliação basal e IL-7 e IL-10 não demonstraram alterações significativas nos tempos avaliados. A PCR-HS demonstrou níveis mais elevados após 7 dias e retorno parcial aos níveis basais após 28 dias. O nitrito/ nitrato, após 7 dias, apresentou leve queda em sua concentração plasmática. Concluímos que a pequena diferença entre o valores obtidos entre o basal e após 7 dias do procedimento cirúrgico com a iontoforese de acetilcolina resulta em minimização do impacto endotelial e um valor constante deste dado após 28 dias, sugere recomposição fisiológica completa. Este resultado foi semelhante com a análise da hiperemia térmica e reativa pós oclusiva. As interleucinas IL-6 e IL-8, bem como a PCR-HS apresentaram comportamento correlacionável, refletindo a cinética inflamatória. A rigidez arterial não demonstrou alterações.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Não tem sido frequentes no Brasil estudos de avaliação da qualidade dos serviços de saúde. Tem sido adotado entendimento de qualidade como o grau em que processo de assistência aumenta a probabilidade de resultados favoráveis e diminui a probabilidade de resultados desfavoráveis, dado o estado do conhecimento médico. Indicadores de resultados de efeitos adversos do processo de assistência costumam ser empregados e, entre eles, para aquelas condições e procedimentos onde óbitos ocorrem com frequência, estão as taxas de mortalidade hospitalar. Entre esses procedimentos inclui-se a cirurgia de revascularizaçäo do miocárdio. Apesar de frequentes na literatura, particularmente norte-americana, não há estudos de escala realizados no Brasil. Para estudos deste tipo bases de dados administrativas tem sido empregadas. No Brasil recentemente tem sido exploradas as potencialidades dos bancos de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde do Ministério da Saúde (SIH-SUS) em diversos estudos. Como há registro de óbitos hospitalares no sistema é possível utilizá-lo para a obtenção de dados sobre mortalidade hospitalar. Os bancos de dados do SIH-SUS de 1996 a 1998 foram integrados e as variáveis disponíveis no banco obtido examinadas quanto a possibilidade de inclusão do estudo descritivo de características da cirurgia coronária no país. Foram identificadas aquelas variáveis que poderiam ser utilizadas para proceder algum grau de ajuste de risco para os casos atendidos pelos diferentes hospitais. Para que se obtivesse uma comparação do comportamento do ajuste obtido com essas variáveis com modelos mais completos que incorporassern mais variáveis, inclusive variáveis clínicas, foram estudadas para o mesmo período, as internações realizadas no Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, utilizando dados de banco específico do Serviço de Cirurgia Cardíaca. Além do estudo descritivo foram desenvolvidos para os casos deste hospital modelos de regressão logística incorporando variáveis pré-operatórias e com as variáveis disponíveis no SIH-SUS para avaliar as diferentes capacidades de ajuste de risco. Após a escolha de um modelo de risco com maior capacidade de ajuste, foram calculadas as taxas de mortalidade hospitalar e obtidos os valores de taxas esperadas após o ajuste de risco. Os hospitais forma ordenados de acordo com as razões entre as taxas observadas e esperadas e identificados aqueles hospitais que apresentavam razões estatisticamente significativas superiores e inferiores a média nacional. Estudou-se também o efeito do volume de casos sobre a mortalidade hospitalar. Foram obtidas informações de 41.989 cirurgias codificadas como cirurgia coronária com circulação extracorpórea realizadas em 131 hospitais brasileiros, em 22 unidades da federaçâo. A taxa anual por 100000 habitantes foi de 8,7 para o Brasil, com São Paulo apresentando taxa de 16,6. Para efeitos de comparação a taxa em anos em torno de 1997 foi de 144,5 nos EUA, 54,4 no Canadá, 90,0 na Austrália e 31,5 em Portugal. A taxa de mortalidade no período foi de 7,2 % (EUA, 2,8%; Canadá, 2,5%: França, 3,2%). A maioria de pacientes operados foi do sexo masculino (67,5%) e a idade média foi de 59,9 anos.