Gastroduodenal arterial aneurysm and chronic pancreatitis. A case and review of the literature

A case of pseudoaneurysm of the gastroduodenal artery due to chronic pancreatitis is reported. Pancreatitis causing splanchnic arterial aneurysm is more likely to affect the splenic artery than the gastroduodenal artery. Ten percent of cases of chronic pancreatitis are associated with splanchnic aneurysm. Hemorrhage occurs in 50% of cases. Color Doppler ultrasound is the best diagnostic tool, indicating the need for coeliac arteriography. In our case report, transcatheter embolization was performed with stainless steel coils and the pseudoaneurysm was successfully occluded.     

Modeling of crystal growth during rapid solidification

Models for computer simulation of solidification of alloys in two different geometries have been developed. These models allow us to study the roles of crystal nucleation and heat transfer and the effects of different modes of growth on the evolution of the microstructure during solidification. In particular, by applying the powerful and versatile tool comprised of the solute-drag model and the thermodynamic modeling of the alloy system, we are able to predict the formation of a microstructure consisting of alternating layers parallel to the growth front. This type of banded microstructure, experimentally observed in Al-Cu, Al-Fe, and Ag-Cu alloys, has not been satisfactorily explained before.     

Diagnostic validity of the Eppendorf Schizophrenia Inventory (ESI): A self-report screen for ultrahigh risk and acute psychosis.

[Correction Notice: An erratum for this article was reported in Vol 23(1) of Psychological Assessment (see record 2011-04411-006). Presents changes that are very small and do not in any way affect the findings of the research. These changes are explained in the correction.] Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild psychiatric complaints, highly symptomatic mood or anxiety disorder, UHR, acute psychosis). Diagnostic evaluation with established instruments was used for diagnosis in 3 research samples. UHR status was assessed with the Structured Interview for Prodromal Symptoms/Scale of Prodromal Symptoms (Miller et al., 1999) and the Bonn Scale for the Assessment of Basic Symptoms Prediction list (Gross, Huber, Klosterk?tter, & Linz, 1987; Klosterk?tter, Hellmich, Steinmeyer, & Schulze-Lutter, 2001). This study showed that members of different diagnostic groups rate themselves significantly differently on the ESI and its subscales. A new subscale was constructed, the UHR–Psychosis scale, that showed good utility in detecting individuals with interview-diagnosed UHR status and acute psychosis. The scale is also sensitive to the threshold between UHR and acute psychosis. Practical applications of the ESI include use as a diagnostic tool within various settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Action-specific influences on distance perception: A role for motor simulation.

Perception is influenced by the perceiver's ability to perform intended actions. For example, when people intend to reach with a tool to targets that are just beyond arm's reach, the targets look closer than when they intend to reach without the tool (J. K. Witt, D. R. Proffitt, & W. Epstein, 2005). This is one of several examples demonstrating that behavioral potential affects perception. However, the action-specific processes that are involved in relating the person's abilities to perception have yet to be explored. Four experiments are presented that implicate motor simulation as a mediator of these effects. When a perceiver intends to perform an action, the perceiver runs a motor simulation of that action. The perceiver's ability to perform the action, as determined by the outcome of the simulation, influences perceived distance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aortocaval fistula. Diagnosis using spiral x-ray computed tomography with 2D and 3D reconstructions

We report a case of arteriovenous fistula due to spontaneous rupture of an aortic aneurysm into the inferior vena cava. This is a rare complication of atheromatous aneurysm, often difficult to diagnose as the clinical presentation may be obscure. Although aortography is the reference diagnostic investigation, spiral CT acquisition with 3D and 2D reformation allowed visualization of the arteriovenous communication and provided an accurate diagnosis.     

Chiropractic management of primary nocturnal enuresis

A 74 year old patient presented with retention of urine as a result of an isolated right internal iliac artery aneurysm. The diagnostic difficulty leading to a delayed diagnosis resulted in rupture of the aneurysm. An endoaneurysmorrhaphy of the internal iliac artery was performed and the right common and external iliac arteries were anastomosed end to end. An early diagnosis and prompt therapy is recommended for this rare lesion.     

Experimental and Numerical Evaluation of the Heat Transfer Coefficient in Press Hardening

When producing thin ultra high strength steel components with the press hardening process, it is essential that the final component achieves desirable material properties. This applies in particular to passive automotive safety components where it is of great importance to accurately predict the final component properties early in the product development process. The transfer of heat is a key process that affects the evolution of the mechanical properties in the product and it is essential that the thermal contact conditions between the blank and tool are properly described in the forming simulations. In this study an experimental setup is developed combined with an elementary inverse simulation approach to predict the interfacial heat transfer coefficient (IHTC) when the hot blank and cold tool are in mechanical contact. Different process conditions such as contact pressure and blank material (22MnB5 and Usibor 1500P) are investigated. In the inverse simulation, a thermo‐mechanical coupled simulation model is used with a thermo‐elastic‐plastic constitutive model including effects from changes in the microstructure during quenching. The results from simulations give the variations of the heat transfer coefficient in time for best match to experimental results. It is found that the pressure dependence for the two materials is different and the heat transfer coefficient is varying during quenching. This information together with further testing will be used as a base in a future model of the heat transfer coefficient influence at different conditions in press hardening process.     

Dilated lesion at internal carotid artery posterior communicating artery junction

The diagnosis and surgical indication of an incidental aneurysm at the IC-PC junction is sometimes vague. In this report, 28 lesions in 26 cases with aneurysmal dilatation at the IC-PC junction, which were surgically treated, were analyzed. These lesions are classified according to the operative findings. Only 6 of the lesions were confirmed to be true aneurysms. However, 19 lesions were the dilated changes of the posterior communicating arteries (Pcom) themselves, without aneurysmal formation. Two lesions were accompanied with blood blister like aneurysm at the wall. Another one was dilated Pcom with peripheral Pcom occlusion. The correlation between operative findings and angiographic findings are studied, and the importance of the diagnostic angiographic findings of the Pcom is strongly emphasized for their diagnostic value.     

Rupture of a splenic artery aneurysm intra partum

The rupture of a splenic artery aneurysm in pregnancy and during labour is a rare event with a high maternal and fetal mortality rate. This report is, in view of previously reported cases, on the thirteenth case of a ruptured splenic artery aneurysm reporting survival of both mother and fetus. The etiology, clinical signs, diagnosis and therapy are discussed with reference to consideration of the literature. The necessity of an early differential diagnostic consideration of this rare occurrence is discussed, because this is the only way to achieve survival of mother and fetus.     

Management of cerebral aneurysms. How can current management be improved?

Rupture of cerebral aneurysms is a complex and devastating pathophysiologic event. The successful management of aneurysm rupture requires a dedicated multidisciplinary team. This article reviews pathophysiology; clinical grading that can be used to predict outcome and guide therapy; factors that may affect outcome such as rebleeding, poor clinical grade, intracerebral hemorrhage, intraventricular hemorrhage, and acute hydrocephalus; preoperative care and assessment; pharmacological therapy; anesthetic, surgical, and endovascular considerations; and postoperative care following aneurysm rupture.     

Primary biliary cirrhosis: an electronic diagnostic tool trial based on symptoms, (past) history and signs only, using the European database euricterus. The Euricterus PMG

BACKGROUND/AIMS: Primary Biliary Cirrhosis (PBC) is a relatively rare chronic progressive disease in which a working diagnosis of PBC easily leads to a final diagnosis by testing for anti-mitochondrial antibodies. Liver transplantation is the only effective treatment. The aim of this study was to test an electronic diagnostic tool (tool) for it's ability to include PBC in the working differential diagnosis. METHODOLOGY: In the European Union Euricterus project a large number of (sub)icteric patients in 17 discrete disease categories, PBC being one of them, were gathered prospectively. A tool was developed-using Bayes (B) and Trial Algorithm (TA) pattern-recognition and based on items related to the history, symptoms and signs of all Euricterus patients. We have tested the diagnostic tool on 143 PBC Euricterus patients. RESULTS: PBC was mentioned by the tool in 86% (B) and 91% (TA) of the 143 patients. These figures were higher for patients under 60 and (TA only) females. Females under 60 (n = 89) scored 92% B and 96% TA. A sole diagnosis of PBC was made in 31% (B) and 66% (TA). In the other patients with a PBC probability, 7 other (first) diagnoses were presented by the tool of which non-alcoholic active liver disease and pancreatic or biliary carcinoma were the leaders. These 7 diseases appeared evenly distributed along the percentual probabilities of PBC given by the tool (B) and also along Pugh and Mayo scores (B and TA). PBC was mentioned by the tool in all patients with a Pugh score 10 or higher (advanced disease, class C). In the patients in whom the tool did not mention PBC, the primary diagnoses came from 9 other disease categories. CONCLUSION: This electronic tool has been able to identify PBC as one of the differential diagnostic modalities in the large majority of a present population of PBC patients.     

Adrenergic-mediated connexin43 phosphorylation in the ocular ciliary epithelium

We report a case of aneurysmal rupture of the pancreaticoduodenal artery successfully treated by transcatheter arterial embolization. A 61-year-old man with a history of hypertension underwent surgery at our hospital in November 1995 for local peritonitis caused by perforation of the sigmoid colon secondary to cancer. On the 9th postoperative day, he developed shock, with complaints of epigastric and back pain. Abdominal computed tomography showed an enhanced mass, thought to be a peripancreatic aneurysm. Emergency angiography demonstrated an aneurysm arising from the arcade of the anterior pancreaticoduodenal artery. After diagnostic angiography, transcatheter arterial embolization was performed. With steel coils, the anterior superior pancreaticoduodenal artery and anterior inferior pancreaticoduodenal artery were embolized near the origin of the aneurysm. Angiography 7 weeks later revealed no recanalization of the aneurysm and the absence of anomalous collateral vessels. The patient has been well for 19 months without re-bleeding or recurrence of sigmoid colon cancer. Transcatheter arterial embolization is an effective therapeutic approach for aneurysm of the pancreaticoduodenal artery and is the preferred initial treatment.     

Arterial aneurysms in geriatric age

After reviewing the literature on the subject, the authors examine all the cases of aortic aneurysm referred to their attention. From the tests performed, they note that males are most often affected and the age group with the highest incidence is the seventh decade of life, in particular between 60-66 years old. After having observed a pulsing abdominal mass leading to a suspected diagnosis, the radiological methods recommended by the authors include echotomography or CT, or if required, magnetic resonance. Arteriography is less convincing than the previous tests for diagnostic purposes because, as well as providing a false image of the vessel lumen (owing to the overlay of stratified thrombi it can show a virtually normal lumen), it may cause a risk of embolism. The surgeon therefore prefers an intraoperative finding in the case of subrenal aneurysm. In conclusion, faced with a diagnosis of aneurysm of the abdominal aorta, in the majority of cases, having prepared the patient, it is necessary to perform aorto-bisiliac or bifemoral graft surgery depending on aneurysm size as soon as possible in order to avoid the fissuration or even the rupture of the aneurysm.     

Conservative treatment of uterine arteriovenous fistula

A case of a uterine arteriovenous aneurysm in a 20-year-old woman is described. The patients's main symptom was copious uterine bleeding. The diagnostic difficulties are described and the importance of arteriography is emphasized. The aneurysm was occluded at laparotomy by introducing gel-foam into the uterine artery. The patient subsequently became pregnant and after an uneventful pregnancy was delivered of a healthy child. Thus, this type of conservative treatment seems to offer a possible means of avoiding hysterectomy in young patients with this rare condition who wish to retain their fertility.     

Left ventricular aneurysm and peripheral embolism as cause of atypical foot pain

Sudden occlusion of a peripheral artery by embolization or acute thrombosis results in acute ischemia. This is most commonly associated with sudden onset of severe pain, numbness and pallor. Chronic ischemia from peripheral vascular disease results in intermittent claudication. We present a case of peripheral embolization from a left ventricular aneurysm in a previously asymptomatic male who presented to the emergency department complaining of two weeks of pain in his left great toe. Included in the discussion are important diagnostic tests for peripheral thromboembolism and ventricular aneurysm as well as suggestions for emergency department management.     

Quantitative Cellular Automaton Model for Biofilms

A fully quantitative cellular automaton (CA) biofilm model was developed. The model describes substrate and biomass as discrete particles existing and interacting in a specified physical domain. Substrate particles move by random walks, simulating molecular diffusion. Microbial particles grow attached to a surface or to other microbial particles, consume substrate particles, and duplicate if a sufficient amount of substrate is consumed. The dynamics of the system are simulated using stochastic processes that represent the occurrence of specific events, such as substrate diffusion, substrate utilization, biofilm growth, and biofilm decay and detachment. The ability of the CA model to predict substrate gradients and fluxes was evaluated by comparing model simulations to predictions from a traditional differential equations model. One and 2D CA models were evaluated. In general, CA model predictions of steady-state flux, biofilm thickness, and substrate gradients inside the biofilm fitted well the differential equations model results; the 2D model had a better agreement at high substrate concentrations. Fully quantitative CA biofilm models offer an alternative approach to simulate biofilm activity and development. Specific advantages of CA modeling include the ability to simulate growth of heterogeneous biofilms with irregular boundary conditions, and the possibility of developing computationally efficient parallel processing algorithms for the quantitative simulation of biofilms in two and three dimensions.     

Mechanical Analysis of Idealized Shallow Hydraulic Fracture

The characteristics of hydraulic fractures created at shallow depths are known from excavations and borings, but this understanding has lagged behind the ability to predict fracture growth. This paper describes a simple analysis based on elasticity theory and fracture mechanics that will predict characteristics of shallow hydraulic fractures that are relatively flat lying. The analysis gives closed-form expressions for the injection pressure, fracture aperture, and radial length as functions of time, fracture toughness, and elastic modulus. The analysis is first used to estimate fracture toughness and elastic modulus of shallow formations from field tests of hydraulic fracturing. Those parameters are used to calibrate the model and predict the growth of fractures. The average relative error of the predictions is about 20% and increases with the dip and degree of asymmetry of the fracture.     

Evaluation of the MMCLIFE 3.0 code in predicting crack growth in titanium aluminide composites

Crack growth and fatigue life predictions made with the MMCLIFE 3.0 code are compared to test data for unidirectional, continuously reinforced SCS-6/Ti-14Al-21Nb (wt pct) composite laminates. The MMCLIFE 3.0 analysis package is a design tool capable of predicting strength and fatigue performance in metal matrix composite (MMC) laminates. The code uses a combination of micromechanic lamina and macromechanic laminate analyses to predict stresses and uses linear elastic fracture mechanics to predict crack growth. The crack growth analysis includes a fiber bridging model to predict the growth of matrix flaws in 0-deg laminates and is capable of predicting the effects of interfacial shear stress and thermal residual stresses. The code has also been modified to include edge-notch flaws in addition to center-notch flaws. The model was correlated with constant amplitude, isothermal data from crack growth tests conducted on 0- and 90-deg SCS-6/Ti-14-21 laminates. Spectrum fatigue tests were conducted, which included dwell times and frequency effects. Strengths and areas for improvement for the analysis are discussed. This article is based on a presentation made in the symposium “Fatigue and Creep of Composite Materials” presented at the TMS Fall Meeting in Indianapolis, Indiana, September 14–18, 1997, under the auspices of the TMS/ASM Composite Materials Committee.     

Fenestrated oculomotor nerve caused by internal carotid-posterior communicating artery aneurysm: case report

OBJECTIVE AND IMPORTANCE: The fenestrated oculomotor nerve associated with the internal carotid-posterior communicating artery aneurysm is very rare. CLINICAL PRESENTATION: A 48-year-old woman had a history of subarachnoid hemorrhage caused by a ruptured right middle cerebral artery aneurysm, which was wrapped with good postoperative course. Twenty years later, the patient suffered frontal headache with a mild oculomotor nerve paresis in the right side. Follow-up neuroimaging studies demonstrated a de novo right internal carotid-posterior communicating artery aneurysm. INTERVENTION: The aneurysm was exposed and clipped via a right pterional route. The fenestrated oculomotor nerve associated with the aneurysm was confirmed at surgery. CONCLUSION: We speculated that the fenestration was most likely caused, by the growth of the aneurysm.     

基于商用CFD软件的双层皮幕墙热工性能模拟程序的开发

Double-skin facade （DSF） is widely used in commercial buildings for its excellent performance in saving energy. But it＇s very difficult for the ordinary designers to predict the thermal performance of DSF due to the complexity of the energy transmitting through the DSF and the difficulty of manipulating the complicated commercial CFD （computational fluid dynamic） simulation software. This paper take an effort in the foundation of the DSF analysis code with VC ＋ ＋ 6. 0 based on the commercial CFD software. This code is complied to analyze and predict the thermal behaviorof the ‘standard＇geometry natural ventilation DSF. The analyzer can gain the thermal behavior and the air flow characteristics of DSF after entered the relevant parameters of the model. This code gives the designer a tool to make quick design decisions in analyzing and optimizing DSF.