Comparação entre a técnica femoral com dispositivo de hemostasia e a técnica radial em pacientes submetidos à estratégia invasiva precoce

A via de acesso arterial é um importante sítio de complicações após a realização de procedimentos coronários invasivos. Dentre as estratégias para a redução de complicações vasculares, encontra-se estabelecida a eficácia da técnica radial. Os dispositivos de oclusão vascular propiciam maior conforto ao paciente, reduzindo o tempo de hemostasia e repouso no leito. Entretanto, a inconsistência de dados comprovando sua segurança limita sua adoção rotineira como estratégia para redução de complicações vasculares, requerendo evidências de estudos randomizados com metodologia adequada. O objetivo deste estudo foi comparar a incidência de complicações no sítio de punção arterial entre a técnica radial e a técnica femoral com utilização de Angio-Seal em pacientes com síndrome coronariana aguda sem supradesnível do segmento ST submetidos à estratégia invasiva precoce. Trata-se de um ensaio clínico unicêntrico, de não inferioridade, no qual duzentos e quarenta pacientes foram randomizados para a técnica radial ou técnica femoral com utilização de Angio-Seal. O objetivo primário foi a ocorrência de complicações no sítio de punção arterial até 30 dias após o procedimento, incluindo sangramento grave, hematoma >= 5 cm, hematoma retroperitoneal, síndrome compartimental, pseudoaneurisma, fístula arteriovenosa, infecção, isquemia de membro, oclusão arterial, lesão de nervo adjacente ou necessidade de reparo vascular cirúrgico. Em relação às características demográficas e clínicas, houve diferença apenas quanto ao gênero, com presença maior de pacientes do sexo feminino no grupo radial (33,3% versus 20,0%, p=0,020). Não se observaram diferenças entre os grupos quanto ao diagnóstico de admissão, alterações isquêmicas presentes no eletrocardiograma, elevação de marcadores de necrose miocárdica ou escores de risco, bem como quanto à farmacoterapia antitrombótica adjunta e características da intervenção coronária percutânea. A hemostasia foi obtida na totalidade dos procedimentos do grupo radial com a utilização da pulseira compressora seletiva TR Band e em 95% dos procedimentos realizados pela técnica femoral com o Angio-Seal (p=0,029). Exceto pela maior incidência de oclusão arterial no grupo radial comparado ao femoral, não houve diferenças entre os demais desfechos analisados. Segundo o teste de não inferioridade para complicações na via de acesso arterial aos 30 dias, verificou-se que a utilização do Angio-Seal não produziu resultados inferiores ao acesso radial, considerando-se a margem de 15% (12,5% versus 13,3%, diferença -0,83%, IC 95% -9,31 - 7,65, p para não inferioridade <0,001). Os resultados principais deste estudo demonstram que, em uma população de pacientes com diagnóstico de síndrome coronariana aguda sem supradesnível do segmento ST, submetida à estratificação de risco invasiva, a utilização do dispositivo de oclusão vascular Angio-Seal confere ao procedimento efetivado pelo acesso femoral inferioridade na incidência de complicações no sítio de punção arterial aos 30 dias quando comparado ao acesso radial.

Kuumalanka-anemometri virtausmittauksissa

Tässä työssä selostetaan kuumalanka-anemometrin käyttö virtausmittauksissa. Kuumalanka-anemometrilla saadaan mitattua virtausnopeuden ja -suunnan lisäksi nopeusheilahteluja. Mittaustaajuus on tyypillisesti useita kymmeniä tuhansia mittauksia sekunnissa ja signaali on jatkuva. Nykytekniikalla pystytään helposti tallentamaan mittauslaitteistolta saatu viesti tietokoneelle ja muuntamaan se nopeudeksi. Hetkellisten nopeuksien avulla voidaan laskea turbulenttisen virtauksen ominaisuuksia, kuten turbulenssin intensiteetti ja spektri. Kuumalanka-anemometrissa lämmitetään sähköisesti ohutta lankaa, joka on mitattavassa virtauksessa. Langan sähköteho on suunnilleen yhtäsuuri kuin langasta konvektiolla siirtyvä lämpöteho. Tällöin on teoreettisesti mahdollista laskea virtausnopeus lämpötehosta lämmönsiirtokorrelaatioilla. Käytännössä laitteisto joudutaan kuitenkin erikseen kalibroimaan, mutta sähkötehon teoreettista riippuvuutta konvektiosta käytetään hyväksi. Kuumalangan lämmitettävä osuus on tyypillisesti halkaisijaltaan 5 µm ja pituudeltaan noin 1 mm. Sitä käytetään pääasiassa kaasuvirtausten mittaamiseen ja valtaosassa mittauksissa virtausaineena on ilma. Kuumalanka voi olla toteutettu kuumakalvotekniikalla, jossa halkaisijaltaan noin 50 - 70 µm paksuinen kuitu on päällystetty ohuella sähköä johtavalla kalvolla. Kuumakalvoanturin ei tarvitse olla muodoltaan sylinterimäinen, se voi olla mm. kartiomainen tai kiilamainen. Erikoispäällystetyllä kuumakalvoanturilla on mahdollista mitata myös nestevirtauksia. Mitattaessa kaasuvirtauksia kuumakalvon etuna on selvästi parempi kestävyys verrattuna kuumalankaan. Nimitystä kuumalanka-anemometri käytetään yleisesti molemmista anturityypeistä Tämän työn alussa käsitellään sylinterin yli tapahtuvaan virtaukseen liittyvää virtausmekaniikkaa ja lämmönsiirtoa. Anemometrin sähköinen osa, laitteisto ja sen kalibrointi käydään läpi. Langan suuntariippuvuuden laskentaan esitetään tarvittavat yhtälöt. Työssä esitellään kolme laitteistolla tehtyä perusmittausta: anturin kohtauskulman muuttaminen, pyörähdyssymmerisen suihkun nopeuskenttä ja tuulitunnelin rajakerros. Lisäksi esitellään yksi käytännöllinen ja vaativampi mittaus, jossa on mitattu nopeusprofiili radiaalikompressorin diffuusorin loppuosassa.

Suurnopeuskompressorin tekninen markkinoilletuonti

Diplomityössä tarkastellaan suurnopeuskompressorin kehityspolkua suurnopeusteknologian lähtökohdista prototyypiksi ja edelleen teolliseksi tuotteeksi. Työssä tarkastelun kohteena on sähköteholtaan 20….250 kW oleva, suurnopeussähkökoneella ja öljyttömillä magneettilaakereilla varustettu keskipainekompressori. Tyypillisesti kompressorin painesuhde on 1,2 … 2,4. Ko. kompressorin käyttökohteina on tarkasteltu mm. pienen kunnallisen jätevedenpuhdistamon käsittelyaltaiden ilmastusta, suuren kaupungin vastaavan puhdistuslaitoksen ilmastuskäyttöä ja teollista käyttöä lasivillatehtaan ns. linkokompressorina. Suurnopeuskompressori soveltuu hyvin rinnankytkentään ns. ryhmäohjaimen avulla, jolloin rinnan voi olla kytkettynä jopa 16 kompressoria, joiden päällä oloa optimoidaan säätöteknisesti niin, että koko laitos on kuin yksi kompressori. Työssä tarkastellaan myös kompressorin em. sovellutuksista yli kahdeksan vuoden ajalta kaupallista kohteista saatuja käyttökokemuksia. Pääsäätöisesti voi sanoa, että jokaisessa uudessa sovellutuksessa ilmenee uusia reunaehtoja ja järjestelmäkohtaisia vaatimuksia, jotka täytyy huomioida kompressorin säädössä ja ominaisparametreissa.

A micro gas turbines for UK domestic combined heat and power

Various micro-radial compressor configurations were investigated using one-dimensional meanline and computational fluid dynamics (CFD) techniques for use in a micro gas turbine (MGT) domestic combined heat and power (DCHP) application. Blade backsweep, shaft speed, and blade height were varied at a constant pressure ratio. Shaft speeds were limited to 220 000 r/min, to enable the use of a turbocharger bearing platform. Off-design compressor performance was established and used to determine the MGT performance envelope; this in turn was used to assess potential cost and environmental savings in a heat-led DCHP operating scenario within the target market of a detached family home. A low target-stage pressure ratio provided an opportunity to reduce diffusion within the impeller. Critically for DCHP, this produced very regular flow, which improved impeller performance for a wider operating envelope. The best performing impeller was a low-speed, 170 000 r/min, low-backsweep, 15° configuration producing 71.76 per cent stage efficiency at a pressure ratio of 2.20. This produced an MGT design point system efficiency of 14.85 per cent at 993 W, matching prime movers in the latest commercial DCHP units. Cost and CO2 savings were 10.7 per cent and 6.3 per cent, respectively, for annual power demands of 17.4 MWht and 6.1 MWhe compared to a standard condensing boiler (with grid) installation. The maximum cost saving (on design point) was 14.2 per cent for annual power demands of 22.62 MWht and 6.1 MWhe corresponding to an 8.1 per cent CO2 saving. When sizing, maximum savings were found with larger heat demands. When sized, maximum savings could be made by encouraging more electricity export either by reducing household electricity consumption or by increasing machine efficiency.

Experimental and Numerical Analysis of Different Volutes in a Centrifugal Compressor

In a centrifugal compressor the flow around the diffuser is collected and led to the pipe system by a spiral-shaped volute. In this study a single-stage centrifugal compressor with three different volutes is investigated. The compressorwas first equipped with the original volute, the cross-section of which was a combination of a rectangle and semi-circle. Next a new volute with a fully circular cross-section was designed and manufactured. Finally, the circular volute wasmodified by rounding the tongue and smoothing the tongue area. The overall performance of the compressor as well as the static pressure distribution after the impeller and on the volute surface were measured. The flow entering the volute was measured using a three-hole Cobra-probe, and flow visualisations were carriedout in the exit cone of the volute. In addition, the radial force acting on theimpeller was measured using magnetic bearings. The complete compressor with thecircular volute (inlet pipe, full impeller, diffuser, volute and outlet pipe) was also modelled using computational fluid dynamics (CFD). A fully 3-D viscous flow was solved using a Navier-Stokes solver, Finflo, developed at Helsinki University of Technology. Chien's k-e model was used to take account of the turbulence. The differences observed in the performance of the different volutes were quite small. The biggest differences were at low speeds and high volume flows,i.e. when the flow entered the volute most radially. In this operating regime the efficiency of the compressor with the modified circular volute was about two percentage points higher than with the other volutes. Also, according to the Cobra-probe measurements and flow visualisations, the modified circular volute performed better than the other volutes in this operating area. The circumferential static pressure distribution in the volute showed increases at low flow, constant distribution at the design flow and decrease at high flow. The non-uniform static pressure distribution of the volute was transmitted backwards across the vaneless diffuser and observed at the impeller exit. At low volume flow a strong two-wave pattern developed into the static pressure distribution at the impeller exit due to the response of the impeller to the non-uniformity of pressure. The radial force of the impeller was the greatest at the choke limit, the smallest atthe design flow, and moderate at low flow. At low flow the force increase was quite mild, whereas the increase at high flow was rapid. Thus, the non-uniformityof pressure and the force related to it are strong especially at high flow. Theforce caused by the modified circular volute was weaker at choke and more symmetric as a function of the volume flow than the force caused by the other volutes.

A model to predict R134a refrigerant leakage through the radial clearance of rolling piston compressors

In this paper a non-isothermal two-phase model for oil-R134a refrigerant mixture flow is presented to predict the R134a leakage through the radial clearance of rolling piston compressors. The flow is divided in a liquid single-phase region and in a two-phase region, in which the homogeneous model is used to simulate the flow. The refrigerant leakage is determined using the mixture mass flow rate and the refrigerant mass fraction variation along the flow. The results are obtained for inlet pressures varying from 200 to 700 kPa, inlet temperatures ranging from 40 to 60 degrees C, and minimal clearances between 10 and 60 mu m. The results are firstly compared to existing isothermal model data, showing that there is a significant difference between the leakage flow rates predicted by isothermal and non-isothermal models. Finally, a useful general equation for compressor designers is proposed to calculate the refrigerant leakage for a large range of operation conditions. (C) 2012 Elsevier Ltd and IIR. All rights reserved.

Numerical simulation of a radial diffuser turbulent airflow

In the present work are presented results from numerical simulations performed with the ANSYS-CFX (R) code. We have studied a radial diffuser flow case, which is the main academic problem used to study the flow behavior on flat plate valves. The radial flow inside the diffuser has important behavior such as the turbulence decay downstream and recirculation regions inside the valve flow channel due to boundary layer detachment. These flow structures are present in compressor reed valve configurations, influencing to a greater extent the compressor efficiency. The main target of the present paper was finding the simulation set-up (computational domain, boundary conditions and turbulence model) that better fits with experimental data published by Tabatabai and Pollard. The local flow turbulence and velocity profiles were investigated using four different turbulence models, two different boundary conditions set-up, two different computational domains and three different flow conditions (Re-in - Reynolds number at the diffuser inlet). We used the Reynolds stress (BSL); the k-epsilon; the RNG k-epsilon; and the shear stress transport (SST) k-omega turbulence models. The performed analysis and comparison of the computational results with experimental data show that the choice of the turbulence model, as well as the choice of the other computational conditions, plays an important role in the results physical quality and accuracy. (c) 2007 Elsevier B.V. All rights reserved.

Estudo experimental da interação fluido-estrutura em um modelo de válvula de compressor de refrigeração

Pós-graduação em Engenharia Mecânica - FEIS

Estudo experimental da interação fluido-estrutura no escoamento em um difusor radial

Pós-graduação em Engenharia Mecânica - FEIS

Simulação do escoamento bifásico da mistura óleo-refrigerante através da folga radial de compressores rotativos de pistão rolante

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Pressure distribution on the frontal disk for turbulent flows in a radial diffuser

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fracture Of Distal Humerus: Mipo Technique With Visualization Of The Radial Nerve.

To evaluate the outcomes in patients treated for humerus distal third fractures with MIPO technique and visualization of the radial nerve by an accessory approach, in those without radial palsy before surgery. The patients were treated with MIPO technique. The visualization and isolation of the radial nerve was done by an approach between the brachialis and the brachiorradialis, with an oblique incision, in the lateral side of the arm. MEPS was used to evaluate the elbow function. Seven patients were evaluated with a mean age of 29.8 years old. The average follow up was 29.85 months. The radial neuropraxis after surgery occurred in three patients. The sensorial recovery occurred after 3.16 months on average and also of the motor function, after 5.33 months on average, in all patients. We achieved fracture consolidation in all patients (M=4.22 months). The averages for flexion-extension and prono-supination were 112.85° and 145°, respectively. The MEPS average score was 86.42. There was no case of infection. This approach allowed excluding a radial nerve interposition on site of the fracture and/or under the plate, showing a high level of consolidation of the fracture and a good evolution of the range of movement of the elbow. Level of Evidence IV, Case Series.

Comparison of radial growth rate of the mutualistic fungus of Atta sexdens rubropilosa forel in two culture media

In vitro culture of the mutualistic fungus of leaf-cutting ants is troublesome due to its low growth rate, which leads to storage problems and contaminants accumulation. This paper aims at comparing the radial growth rate of the mutualistic fungus of Atta sexdens rubropilosa Forel in two different culture media (Pagnocca B and MEA LP). Although total MEA LP radial growth was greater all along the bioassay, no significant difference was detected between growth efficiencies of the two media. Previous evidences of low growth rate for this fungus were confirmed. Since these data cannot point greater efficiency of one culture medium over the other, MEA LP medium is indicated for in vitro studies with this mutualistic fungus due its simpler composition and translucent color, making the analysis easier.

Radial variation of anatomical features, wood density and decay resistance in teak (Tectona grandis) from two qualities of growing sites and two climatic regions of Costa Rica

The objective of this study was to show the radial variation of some anatomic characteristics, wood density and natural durability of teak (Tectona grandis L.F.) growing in Costa Rica. Samples of trees 13 years old were obtained from two growing sites (high and low growing) of plantations established in a humid tropical climate (CHT) and dry tropical climate (CST). The variables measured of the fibers as well as for the rays were not affected by the climate or the type of growing site, except for the length of the fibers. The fibers of teak wood from the best growing site were significantly larger. Vessels were found with a greater frequency for the CST but mostly solitary in comparison with the CBT. Average density, maximum density and the variation within the ring presented a light higher magnitude for the CST. The quality of the growing site did not affect these variables. The resistance of fungus attack was similar in the area of heartwood near the pith compared to the heartwood near the sapwood for all the conditions evaluated. Nevertheless, it was observed in some trees a similar resistance of fungus attack for areas of sapwood compared to similar areas of heartwood.

Suppression subtractive hybridization profiles of radial growth phase and metastatic melanoma cell lines reveal novel potential targets

Background: Melanoma progression occurs through three major stages: radial growth phase (RGP), confined to the epidermis; vertical growth phase (VGP), when the tumor has invaded into the dermis; and metastasis. In this work, we used suppression subtractive hybridization (SSH) to investigate the molecular signature of melanoma progression, by comparing a group of metastatic cell lines with an RGP-like cell line showing characteristics of early neoplastic lesions including expression of the metastasis suppressor KISS1, lack of alpha v beta 3-integrin and low levels of RHOC. Methods: Two subtracted cDNA collections were obtained, one (RGP library) by subtracting the RGP cell line (WM1552C) cDNA from a cDNA pool from four metastatic cell lines (WM9, WM852, 1205Lu and WM1617), and the other (Met library) by the reverse subtraction. Clones were sequenced and annotated, and expression validation was done by Northern blot and RT-PCR. Gene Ontology annotation and searches in large-scale melanoma expression studies were done for the genes identified. Results: We identified 367 clones from the RGP library and 386 from the Met library, of which 351 and 368, respectively, match human mRNA sequences, representing 288 and 217 annotated genes. We confirmed the differential expression of all genes selected for validation. In the Met library, we found an enrichment of genes in the growth factors/receptor, adhesion and motility categories whereas in the RGP library, enriched categories were nucleotide biosynthesis, DNA packing/repair, and macromolecular/vesicular trafficking. Interestingly, 19% of the genes from the RGP library map to chromosome 1 against 4% of the ones from Met library. Conclusion: This study identifies two populations of genes differentially expressed between melanoma cell lines from two tumor stages and suggests that these sets of genes represent profiles of less aggressive versus metastatic melanomas. A search for expression profiles of melanoma in available expression study databases allowed us to point to a great potential of involvement in tumor progression for several of the genes identified here. A few sequences obtained here may also contribute to extend annotated mRNAs or to the identification of novel transcripts.