This study employs the self-organizing map method to investigate the upper-tropospheric outflow patterns of tropical cyclones(TCs)over the western North Pacific from 1979 to 2019,using the 200 hPa horizontal wind fiel...This study employs the self-organizing map method to investigate the upper-tropospheric outflow patterns of tropical cyclones(TCs)over the western North Pacific from 1979 to 2019,using the 200 hPa horizontal wind fields from the ERA5 reanalysis datasets.According to the number and orientation of TC outflow channels,as well as the wind speed,the outflow patterns are classified into five categories:southwestward single-channel pattern S1(26.1%);northwestward single-channel pattern S2(23.6%);northeastward single-channel pattern S3(23.6%);double-channel outflow pattern D(20.8%);and high latitude outflow pattern H(6.0%).Composite analysis shows that the orientations of the TC outflow channels are aligned with the direction of the environmental vertical wind shear and closely related to the distribution of the environmental inertial instability,upper-level divergence,and inner-core convective activities.TC intensity and intensity changes for different outflow patterns are also significantly different.Patterns S1 and S2 usually appear in the development phase and are thus prone to TC intensification,while patterns S3 and H usually occur in the weakening phase and are thus prone to TC weakening.The double-channel pattern(D)has the largest mean intensity and accounts for more than 60%of super-typhoon samples.展开更多
BACKGROUND Hepatic venous outflow obstruction(HVOO)is a rare but serious complication of liver transplantation,particularly in piggyback liver transplantation techniques where the inferior vena cava(IVC)is preserved.C...BACKGROUND Hepatic venous outflow obstruction(HVOO)is a rare but serious complication of liver transplantation,particularly in piggyback liver transplantation techniques where the inferior vena cava(IVC)is preserved.CASE SUMMARY A transplanted liver patient underwent retransplantation due to hepatic artery thrombosis and subsequently developed HVOO caused by graft compression of the IVC.A novel approach using a retrohepatic tissue expander effectively relieved the IVC compression,restored venous outflow,and stabilized hemodynamics.We discuss this case in the context of current treatment options and advances in HVOO management,from endovascular interventions such as balloon dilation and stenting to innovative surgical solutions such as graft repositioning and retrohepatic implants.CONCLUSION This case shows how important personalized treatments are for managing HVOO and how tissue expanders can be an adjustable and less invasive option.展开更多
In situ inflow and outflow permeability tests with the BAT probe at SarapuíII soft clay test site are presented.A description of the BAT permeability test is provided,discussing its advantages and shortcomings,es...In situ inflow and outflow permeability tests with the BAT probe at SarapuíII soft clay test site are presented.A description of the BAT permeability test is provided,discussing its advantages and shortcomings,especially in the case of very soft clays under low stresses.Pore pressures were monitored during probe installation and were found to be slightly lower than piezocone u2 pore pressures,consistent with the position of the filter.The role of filter tip saturation was investigated after the usual saturation procedure provided an unsatisfactory pore pressure response during probe installation.Results show that the vacuum saturation procedure provides adequate response during installation and increases the reliability of the coefficient of permeability determination in early measurements.Both inflow and outflow tests yielded similar results,indicating that careful execution of the test can lead to good test repeatability regardless of the loading condition.Various sequences of alternated inflow and outflow tests have yielded similar results,indicating that soil reconsolidation and filter clogging were negligible in the tests performed.Data are presented concerning the relationship between index parameters and the in situ coefficient of permeability for SarapuíII clay,which plot outside the range of existing databases.展开更多
BACKGROUND Postoperative complications like remnant hepatic vein(HV)outflow block and liver torsion can occur after right hepatectomy.Hepatic falciform ligament fixation is typically used to prevent liver torsion.We r...BACKGROUND Postoperative complications like remnant hepatic vein(HV)outflow block and liver torsion can occur after right hepatectomy.Hepatic falciform ligament fixation is typically used to prevent liver torsion.We report a novel procedure to manage outflow block.CASE SUMMARY An 80-year-old man developed HV outflow block after remnant right hepatectomy,despite liver fixation and intraoperative HV flow check.He had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and choledojejunostomy.The falciform ligament fixation was inadequate to maintain liver position.Emergency surgery was performed,using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal adhesion.His postoperative course was uneventful.CONCLUSION This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.展开更多
This paper is part of a series on the Azimuthally Symmetric Theory of Gravitation （ASTG）. This theory is built on Laplace-Poisson＇s well known equation and it has been shown that the ASTG is capable of explaining, ...This paper is part of a series on the Azimuthally Symmetric Theory of Gravitation （ASTG）. This theory is built on Laplace-Poisson＇s well known equation and it has been shown that the ASTG is capable of explaining, from a purely classical physics standpoint, the precession of the perihelion of solar planets as a consequence of the azimuthal symmetry emerging from the spin of the Sun. This symmetry has and must have an influence on the emergent gravitational field. We show herein that the emergent equations from the ASTG, under some critical conditions determined by the spin, do possess repulsive gravitational fields in the polar regions of the gravitating body in question. This places the ASTG on an interesting pedestal to infer the origins of outflows as a repulsive gravitational phenomenon. Outflows are a ubiquitous phenomenon found in star forming systems and their true origin is a question yet to be settled. Given the current thinking on their origin, the direction that the present paper takes is nothing short of an asymptotic break from conventional wisdom; at the very least, it is a complete paradigm shift because gravitation is not at all associated with this process, but rather it is thought to be an all-attractive force that only tries to squash matter together onto a single point. Additionally, we show that the emergent Azimuthally Symmetric Gravitational Field from the ASTG strongly suggests a solution to the supposed Radiation Problem that is thought to be faced by massive stars in their process of formation. That is, at ,- 8-10M⊙, radiation from the nascent star is expected to halt the accretion of matter. We show that in-falling material will fall onto the equatorial disk and from there, this material will be channeled onto the forming star via the equatorial plane, thus accretion of mass continues well past the value of - 8-10M⊙, albeit via the disk. Along the equatorial plane, the net force （with the radiation force included） on any material there-on right up to the surface of the star is directed toward the forming star, hence accretion of mass by the nascent star is un-hampered.展开更多
Aim： To explore the interaction between bladder compliance （BC） and bladder outflow obstruction （BOO） in men with benign prostatic hyperplasia （BPH） using cross-sectional and longitudinal studies. Methods： A t...Aim： To explore the interaction between bladder compliance （BC） and bladder outflow obstruction （BOO） in men with benign prostatic hyperplasia （BPH） using cross-sectional and longitudinal studies. Methods： A total of 181 men with BPH were recruited, and 100 of them were followed for one year. Cystometry was performed in a standing or a sitting position with 30 mL/min infusion. BC was manually corrected and defined. Obstruction coefficient （OCO）, linear passive urethral resistance relation and international continence society （ICS） nomogram were used to diagnose BOO. The obstructed parameters were compared between the reduced BC group and the non-reduced group. BC was compared between the first investigation at the beginning of study and the second investigation at the end of study during the one-year follow-up period. Results： The group with reduced BC had increased OCO and linear passive urethral resistance relation. BC was significantly lower in the obstructed group （55.7 mL/cm water） than that in unobstructed and equivocal one （74.9 mL/cm water, P 〈 0.01）. BC gradually reduced with the increased obstructed grade. There was a significantly weak negative correlation between BC and OCO （r = - 0.132, P 〈 0.01）. Over the one-year follow-up period in the longitudinal study, BC for all men changed from 54.4 to 48.8 mL/cm water （P 〉 0.05）, and BC for the group with BOO fell from 58.4 ± 70.1 to 46.5 ± 38.7 mL/cm water （P 〉 0.05）. Conclusion： In men with BPH, a significant systematic decrease occurred in BC in the obstructed group and a significant systematic increase with urethral resistance occurred in the low BC group. A longitudinal study of the tendency of BC reduction in a group with BOO is necessary in the future.展开更多
Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs mo...Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.展开更多
Objective: To investigate the electrophysiology effects and mechanism of iron overload on the slow response autorhythmic cells in the left ventricular outflow tract of guinea pigs.Methods: Standard microelectrode cell...Objective: To investigate the electrophysiology effects and mechanism of iron overload on the slow response autorhythmic cells in the left ventricular outflow tract of guinea pigs.Methods: Standard microelectrode cell recording techniques were adopted to observe the electrophysiological effects of different concentrations of Fe^(2+)(100 μmol/L, 200 μmol/L) on the left ventricular outflow tract autorhythmic cells.Heart tissues were perfused with FeSO_4(200 μmol/L) combing with CaCl_2(4.2 mmol/L), Verapamil,(1 μmol/L), and nickel chloride(200μmol/L) respectively to observe the influences of these contents on electrophysiology of FeSO_4(200μmol/L) on the left ventricular outflow tract autorhythmic cells.Results: Fe^(2+)at both 100 μmol/L and 200 μmol/L could change the electrophysiological parameters of the slow response autorhythmic cells of the left ventricular outflow tract in a concentrationdependent manner resulting into decrease in Vmax, APA and MDP, slower RPF and VDD, and prolonged APD_(50) and APD_(90)(P all <0.05).Besides, perfusion of increased Ca^(2+) concentration could partially offset the electrophysiological effects of Fe^(2+)(200 μmol/L).The L-type calcium channel(LTCC) blocker Verapamil(1 μmol/L) could block the electrophysiological effects of Fe^(2+)(200 μmol/L).But the T-type calcium channel(TTCC) blocker nickel chloride(NiCl_2, 200 μmol/L) could not block the electrophysiological effects of Fe^(2+)(200 μmol/L).Conclusions: Fe^(2+) can directly change the electrophysiological characteristics of the slow response autorhythmic cells of the left ventricular outflow tract probably through the L-type calcium channel.展开更多
Esophagogastric junction outflow obstruction(EGJOO) is a major motility disorder based on the Chicago Classification of esophageal motility disorders.This entity involves a heterogenous group of underlying etiologies....Esophagogastric junction outflow obstruction(EGJOO) is a major motility disorder based on the Chicago Classification of esophageal motility disorders.This entity involves a heterogenous group of underlying etiologies. The diagnosis is reached by performing high-resolution manometry. This reveals evidence of obstruction at the esophagogastric junction, manifested by an elevated integrated relaxation pressure(IRP) above a cutoff value(IRP threshold varies by the manometric technology and catheter used), with preserved peristalsis. Further tests like endoscopy, timed barium esophagram, and cross-sectional imaging can help further elucidate the underlying etiology and rule out mechanical causes.Treatment is tailored to the underlying cause. Similar to achalasia, treatment targeting lower esophageal sphincter disruption like pneumatic dilation, peroral endoscopic myotomy, and botulinum injection are used in patients with functional EGJOO and persistent symptoms.展开更多
In this article, we are concerned with the stability of stationary solution for outflow problem on the Navier-Stokes-Poisson system. We obtain the unique existence and the asymptotic stability of stationary solution. ...In this article, we are concerned with the stability of stationary solution for outflow problem on the Navier-Stokes-Poisson system. We obtain the unique existence and the asymptotic stability of stationary solution. Moreover, the convergence rate of solution towards stationary solution is obtained. Precisely, if an initial perturbation decays with the algebraic or the exponential rate in space, the solution converges to the corresponding stationary solution as time tends to infinity with the algebraic or the exponential rate in time. The proof is based on the weighted energy method by taking into account the effect of the self-consistent electric field on the viscous compressible fluid.展开更多
AIM To assess the efficacy and safety of balloon dilatation for the treatment of hepatic venous outflow obstruction(HVOO) following pediatric liver transplantation.METHODS A total of 246 pediatric patients underwent l...AIM To assess the efficacy and safety of balloon dilatation for the treatment of hepatic venous outflow obstruction(HVOO) following pediatric liver transplantation.METHODS A total of 246 pediatric patients underwent liver transplantation at our hospital between June 2013 and September 2016. Among these patients, five were ultimately diagnosed with HVOO. Seven procedures(two patients underwent two balloon dilatation procedures) were included in this analysis. The demographic data,types of donor and liver transplant, interventional examination and therapeutic outcomes of these five children were analyzed. The median interval time between pediatric liver transplantation and balloon dilatation procedures was 9.8 mo(range: 1-32).RESULTS Five children with HVOO were successfully treated by balloon angioplasty without stent placement, with seven procedures performed for six stenotic lesions. All children underwent successful percutaneous intervention. Among these five patients, four were treated by single balloon angioplasty, and these patients did not develop recurrent stenosis. In seven episodes of balloon angioplasty across the stenosis, the pressure gradient was 12.0 ± 8.8 mm Hg before balloon dilatation and 1.1 ± 1.5 mm Hg after the procedures, which revealed a statistically significant reduction(P < 0.05). The overall technical success rate among these seven procedures was 100%(7/7), and clinical success was achieved in all five patients(100%). The patients were followed for 4-33 mo(median: 15 mo). No significant procedural complications or procedurerelated deaths occurred.CONCLUSION Balloon dilatation is an effective and safe therapeutic option for HVOO in children undergoing pediatric liver transplantation. Venous angioplasty is also recommended in cases with recurrent HVOO.展开更多
Summary： Lead placement for ventricular pacing variably impacts the physiological benefit of the pa- tient. This study evaluated the ventricular lead performance and safety of right ventricular outflow tract septal p...Summary： Lead placement for ventricular pacing variably impacts the physiological benefit of the pa- tient. This study evaluated the ventricular lead performance and safety of right ventricular outflow tract septal pacing in patients with bradyarrhythmia in South China over 60-month follow-up. Totally, 192 patients （108 males, and 84 females, 63-4-21 years old） with bradyarrhythmia were randomly divided into two groups. The right ventricular outflow tract septum （RVOTs） group had lead placement near the sep- tum （n=97）, while the right ventricular apex （RVA） group had a traditional apical placement （n=95）. RV septal lead positioning was achieved with a specialized stylet and confirmed using fluoroscopic projec- tion. All patients were followed up for 60 months. Follow-up assessment included stimulation threshold, R-wave sensing, lead impedance and lead complications. The time of electrode implantation in both the ROVTs and RVA groups were significantly different （4.29±0.61 vs. 2.16±0.22 min; P=0.009）. No dif- ferences were identified in threshold, impedance or R-wave sensing between the two groups at 1 st, 12th, 36th and 60th month during the follow-up period. No occurrence of electrode displacement, increased pacing threshold or inadequate sensing was found. The long-term active fixation ventricular electrode performance in RVOTs group was similar to that in RVA group. RVOTs pacing near the septum using active fixation electrodes may provide stability during long-term follow-up period.展开更多
OBJECTIVE: To summarize the experience in modified reconstruction of the hepatic outflow tract during piggyback liver transplantation at our hospital. METHODS: The clinical data on 67 patients undergoing piggyback liv...OBJECTIVE: To summarize the experience in modified reconstruction of the hepatic outflow tract during piggyback liver transplantation at our hospital. METHODS: The clinical data on 67 patients undergoing piggyback liver transplantation with modified hepatic outflow tract reconstruction from January 1999 to October 2002 were analyzed retrospectively. RESULTS: In this group, 7 patients (10. 45%) died perioperatively. Complications included: pulmonary infection (38 patients); multiple organ system failure (10), intraperitoneal bleeding (6), acute respiratory distress syndrome (14), thrombosis of the hepatie artery (1), and bile leakage (1). No hepatic outflow occluded. Two recipients survived for over 3 years, 8 over 2 years, and 19 over a year. CONCLUSION: Modified hepatic outflow reconstruction in piggyback live transplantation may increase the success rate of liver transplantation and decrease technical complications.展开更多
The performance of hepatic surgery without a parenchyma-sparing strategy carries significant risks for patient survival because of the not negligible occurrence of postoperative liver failure.The key factor of modern ...The performance of hepatic surgery without a parenchyma-sparing strategy carries significant risks for patient survival because of the not negligible occurrence of postoperative liver failure.The key factor of modern hepatic surgery is the use of the intraoperative ultrasound(IOUS),not only to stage the disease,but more importantly to guide resection with the specific aim to maximize the sparing of the functional parenchyma.Whether in patients with hepatocellular carcinoma and underlying liver cirrhosis,or in patients with colorectal liver metastasis,IOUS allows the performance of the so-called "radical but conservative surgery",which is the pivotal factor to offer a chance of cure to an increasing proportion of patients,who until few years ago were considered only for palliative care.Using some new IOUS-guided surgical maneuvers,which are based on the liver inflow and outflow modulations,more precise anatomically subsegmental-and segmentaloriented resections can be effectively performed.The present work describes the rationale and the surgical technique for a precise tailoring of the area of hepatic resection using the most recent attainments in IOUS.Such important technical achievements should be a fundamental part of the surgical armamentarium of the modern liver surgeon.展开更多
Hepatic venous outflow obstruction after piggyback liver transplantation is a very rare complication. An unusual mechanism aggravating it is reported. A 33-year-old man with end-stage hepatitis B liver cirrhosis under...Hepatic venous outflow obstruction after piggyback liver transplantation is a very rare complication. An unusual mechanism aggravating it is reported. A 33-year-old man with end-stage hepatitis B liver cirrhosis underwent a piggyback orthotopic liver transplantation using a full-size cadaveric graft. Two months after transplantation, he developed gross ascites refractory to maximal diuretic therapy. Doppler ultrasound showed patent portal and hepatic veins. Serial computed tomography scans revealed a hypoperfused right posterior segment of the liver which subsequently underwent atrophy. Hepatic venography demonstrated a high-grade stenosis with an element of torsion of venous drainage at the anastomosis. The stenosis was successfully treated with repeated percutaneous balloon angioplasty. The patient remained asymptomatic six months afterwards with complete resolution of ascites and peripheral edema. We postulate that liver allograft segmental hypoperfusion and atrophy may aggravate or result in a hepatic venous outflow problem by the mechanism of torsion effect. Percutaneous balloon angioplasty is a safe and effective treatment modality for anastomotic stenosis.展开更多
BACKGROUND Esophagogastric junction outflow obstruction(EGJOO) is a rare syndrome,characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations i...BACKGROUND Esophagogastric junction outflow obstruction(EGJOO) is a rare syndrome,characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations in esophageal motility that may lead to the criteria for achalasia. We were unable to find any prior report of the combination of Heller myotomy with anterior partial fundoplication(Dor) as the treatment for EGJOO. We herein report a case of EGJOO treated with laparoscopic Heller myotomy combined with Dor fundoplication.CASE SUMMARY A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He was treated with oral nifedipine, isosorbide, and omeprazole,without resolution of symptoms. An upper gastrointestinal series(barium swallow) revealed a "bird's beak" sign. Esophagogastroduodenoscopy was positive for Los Angeles grade A peptic esophagitis. High-resolution esophageal manometry was compatible with EGJOO. Esophageal pH monitoring showed pathological acid reflux both in orthostatic and decubitus position. An 8-cm laparoscopic Heller myotomy combined with an anterior 220° Dor fundoplication was performed. Solid diet was introduced on postoperative day 2, and the patient was discharged home the same day. At 17-mo follow-up, he reported no symptoms. Barium swallow was compatible with complete radiologic resolution.Both esophageal manometry and upper endoscopy showed normal findings 9 mo after the operation.CONCLUSION Surgical treatment with Heller myotomy and Dor fundoplication is a potential treatment option for EGJOO refractory to medical treatment.展开更多
The reconstruction of the vascular outflow tract of partial liver grafts has received considerable attention in the past, especially in the setting of right liver grafts with undrained segments. Hepatic venous outflow...The reconstruction of the vascular outflow tract of partial liver grafts has received considerable attention in the past, especially in the setting of right liver grafts with undrained segments. Hepatic venous outflow reconstruction is an important factor for successful living donor liver transplantation outcome. However, in presence of undrained anterior sector and presence of multiple short hepatic veins that drain substantial portions of liver, outflow reconstruction without backtable venoplasty may lead to severe graft congestion and subsequent graft dysfunction. Various backtable venoplasty techniques in presence of multiple hepatic veins that can be used in either right- or leftlobe liver transplantation are devised to ensure a single, wide outflow channel. In this overview, various techniques to overcome the hepatic venous variations of liver allograft and outflow reconstruction are discussed.展开更多
The main objective of the present study is to introduce new empirical equations for the determination of breach geometrical dimensions and peak outflow discharge(Q_(p)).Therefore,a historic failure database of 109 emb...The main objective of the present study is to introduce new empirical equations for the determination of breach geometrical dimensions and peak outflow discharge(Q_(p)).Therefore,a historic failure database of 109 embankments was collected and examined.The most important factors that affect the breach evolution,including grading size,hydraulic,and outflow characteristics are also studied.Some of the parameters used for the determination of Q_(p) and average breach width(Bave)have a significant effect on the erosion process,but they are less reflected in the technical literature.To study the behavior of noncohesive soils during overtopping,15 physical tests were performed at the laboratory,and the effects of interfering parameters were investigated.The experimental output hydrograph was used to simulate the hydrographs resulting from the failure of real dams,and recent artificial intelligence techniques along with linear and nonlinear regression models were employed.The area-time analysis of the laboratory hydrographs shows that the soil particle size and the characteristics of reservoir-basin significantly affect the rate of breach formation and outflow discharge.New relationships are introduced,based on the breach characteristics,by a combination of historical and experimental data,as well as case studies conducted on the hypothetical failure of 10 operational dams.The mathematical model is also used to simulate the process of breach evaluation.Based on statistical indices,comparison of the results,and sensitivity analysis,the developed equations can better express the susceptibility of materials to erosion and their application can minimize downstream vulnerabilities.展开更多
Sea ice outflow through Fram Strait is a vital component of the sea ice mass balance of the Arctic Ocean.Previous studies have examined the role of large-scale modes of atmospheric circulation variability such as the ...Sea ice outflow through Fram Strait is a vital component of the sea ice mass balance of the Arctic Ocean.Previous studies have examined the role of large-scale modes of atmospheric circulation variability such as the Arctic Oscillation,North Atlantic Oscillation,and Dipole Anomaly in the movement of sea ice.This review emphasizes the distinct impacts of synoptic weather on sea ice export as well as on other relevant fields(i.e.,sea ice concentration and sea ice drift).We identify deficiencies in previous studies that should be addressed,and we summarize potential research subjects that should be investigated to further our understanding of the relationship between synoptic weather and sea ice export via Fram Strait.For example,the connection between summertime anticyclones and weakened potential vorticity related to the observed extensive spring Eurasian snow and Siberian Ocean sea ice loss is of considerable interest.In-depth exploration of this type of geophysical mechanism will be particularly useful in assessment of the robustness of such linkages inferred through statistical analyses.展开更多
Pyrolysis gas jets out from the surface of a solid fuel particle when heated. This study experimentally observes the occurrence of gas jets?from heated solid fuel particles. Results reveal a local gas jet occurs from ...Pyrolysis gas jets out from the surface of a solid fuel particle when heated. This study experimentally observes the occurrence of gas jets?from heated solid fuel particles. Results reveal a local gas jet occurs from the particle’s surface when its temperature reaches the point at which a pyrolysis reaction occurs. To investigate the influence of the gas jet on particle motion, a numerical simulation of the uniform flow around a spherical particle with a nonuniform outflow or high surface temperature is conducted, and the drag force acting on the spherical particle is estimated. In the numerical study, the magnitude of the outflow velocity, direction of outflow, and Rayleigh number,?i.e., particle surface temperature, are altered, and outflow velocities and the Rayleigh number are set based on the experiment. The drag coefficient is found to decrease when an outflow occurs in the direction against the mainstream;this drag coefficient at a higher Rayleigh number is slightly higher than that at a Rayleigh number of zero.展开更多
基金supported by the National Natural Science Foundation of China[grant numbers 42192553 and 61827091]。
文摘This study employs the self-organizing map method to investigate the upper-tropospheric outflow patterns of tropical cyclones(TCs)over the western North Pacific from 1979 to 2019,using the 200 hPa horizontal wind fields from the ERA5 reanalysis datasets.According to the number and orientation of TC outflow channels,as well as the wind speed,the outflow patterns are classified into five categories:southwestward single-channel pattern S1(26.1%);northwestward single-channel pattern S2(23.6%);northeastward single-channel pattern S3(23.6%);double-channel outflow pattern D(20.8%);and high latitude outflow pattern H(6.0%).Composite analysis shows that the orientations of the TC outflow channels are aligned with the direction of the environmental vertical wind shear and closely related to the distribution of the environmental inertial instability,upper-level divergence,and inner-core convective activities.TC intensity and intensity changes for different outflow patterns are also significantly different.Patterns S1 and S2 usually appear in the development phase and are thus prone to TC intensification,while patterns S3 and H usually occur in the weakening phase and are thus prone to TC weakening.The double-channel pattern(D)has the largest mean intensity and accounts for more than 60%of super-typhoon samples.
文摘BACKGROUND Hepatic venous outflow obstruction(HVOO)is a rare but serious complication of liver transplantation,particularly in piggyback liver transplantation techniques where the inferior vena cava(IVC)is preserved.CASE SUMMARY A transplanted liver patient underwent retransplantation due to hepatic artery thrombosis and subsequently developed HVOO caused by graft compression of the IVC.A novel approach using a retrohepatic tissue expander effectively relieved the IVC compression,restored venous outflow,and stabilized hemodynamics.We discuss this case in the context of current treatment options and advances in HVOO management,from endovascular interventions such as balloon dilation and stenting to innovative surgical solutions such as graft repositioning and retrohepatic implants.CONCLUSION This case shows how important personalized treatments are for managing HVOO and how tissue expanders can be an adjustable and less invasive option.
文摘In situ inflow and outflow permeability tests with the BAT probe at SarapuíII soft clay test site are presented.A description of the BAT permeability test is provided,discussing its advantages and shortcomings,especially in the case of very soft clays under low stresses.Pore pressures were monitored during probe installation and were found to be slightly lower than piezocone u2 pore pressures,consistent with the position of the filter.The role of filter tip saturation was investigated after the usual saturation procedure provided an unsatisfactory pore pressure response during probe installation.Results show that the vacuum saturation procedure provides adequate response during installation and increases the reliability of the coefficient of permeability determination in early measurements.Both inflow and outflow tests yielded similar results,indicating that careful execution of the test can lead to good test repeatability regardless of the loading condition.Various sequences of alternated inflow and outflow tests have yielded similar results,indicating that soil reconsolidation and filter clogging were negligible in the tests performed.Data are presented concerning the relationship between index parameters and the in situ coefficient of permeability for SarapuíII clay,which plot outside the range of existing databases.
文摘BACKGROUND Postoperative complications like remnant hepatic vein(HV)outflow block and liver torsion can occur after right hepatectomy.Hepatic falciform ligament fixation is typically used to prevent liver torsion.We report a novel procedure to manage outflow block.CASE SUMMARY An 80-year-old man developed HV outflow block after remnant right hepatectomy,despite liver fixation and intraoperative HV flow check.He had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and choledojejunostomy.The falciform ligament fixation was inadequate to maintain liver position.Emergency surgery was performed,using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal adhesion.His postoperative course was uneventful.CONCLUSION This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.
基金supported by the Republic of South Africa's National Research Foundation
文摘This paper is part of a series on the Azimuthally Symmetric Theory of Gravitation （ASTG）. This theory is built on Laplace-Poisson＇s well known equation and it has been shown that the ASTG is capable of explaining, from a purely classical physics standpoint, the precession of the perihelion of solar planets as a consequence of the azimuthal symmetry emerging from the spin of the Sun. This symmetry has and must have an influence on the emergent gravitational field. We show herein that the emergent equations from the ASTG, under some critical conditions determined by the spin, do possess repulsive gravitational fields in the polar regions of the gravitating body in question. This places the ASTG on an interesting pedestal to infer the origins of outflows as a repulsive gravitational phenomenon. Outflows are a ubiquitous phenomenon found in star forming systems and their true origin is a question yet to be settled. Given the current thinking on their origin, the direction that the present paper takes is nothing short of an asymptotic break from conventional wisdom; at the very least, it is a complete paradigm shift because gravitation is not at all associated with this process, but rather it is thought to be an all-attractive force that only tries to squash matter together onto a single point. Additionally, we show that the emergent Azimuthally Symmetric Gravitational Field from the ASTG strongly suggests a solution to the supposed Radiation Problem that is thought to be faced by massive stars in their process of formation. That is, at ,- 8-10M⊙, radiation from the nascent star is expected to halt the accretion of matter. We show that in-falling material will fall onto the equatorial disk and from there, this material will be channeled onto the forming star via the equatorial plane, thus accretion of mass continues well past the value of - 8-10M⊙, albeit via the disk. Along the equatorial plane, the net force （with the radiation force included） on any material there-on right up to the surface of the star is directed toward the forming star, hence accretion of mass by the nascent star is un-hampered.
文摘Aim： To explore the interaction between bladder compliance （BC） and bladder outflow obstruction （BOO） in men with benign prostatic hyperplasia （BPH） using cross-sectional and longitudinal studies. Methods： A total of 181 men with BPH were recruited, and 100 of them were followed for one year. Cystometry was performed in a standing or a sitting position with 30 mL/min infusion. BC was manually corrected and defined. Obstruction coefficient （OCO）, linear passive urethral resistance relation and international continence society （ICS） nomogram were used to diagnose BOO. The obstructed parameters were compared between the reduced BC group and the non-reduced group. BC was compared between the first investigation at the beginning of study and the second investigation at the end of study during the one-year follow-up period. Results： The group with reduced BC had increased OCO and linear passive urethral resistance relation. BC was significantly lower in the obstructed group （55.7 mL/cm water） than that in unobstructed and equivocal one （74.9 mL/cm water, P 〈 0.01）. BC gradually reduced with the increased obstructed grade. There was a significantly weak negative correlation between BC and OCO （r = - 0.132, P 〈 0.01）. Over the one-year follow-up period in the longitudinal study, BC for all men changed from 54.4 to 48.8 mL/cm water （P 〉 0.05）, and BC for the group with BOO fell from 58.4 ± 70.1 to 46.5 ± 38.7 mL/cm water （P 〉 0.05）. Conclusion： In men with BPH, a significant systematic decrease occurred in BC in the obstructed group and a significant systematic increase with urethral resistance occurred in the low BC group. A longitudinal study of the tendency of BC reduction in a group with BOO is necessary in the future.
基金supported by Zhangjiakou Project of Science and Technology Studies and Development Planning(Grand No.1321078D)
文摘Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.
基金supported by Zhangjiakou Project of Science and Technology Studies and Development Planning(Grand No.1321078D)
文摘Objective: To investigate the electrophysiology effects and mechanism of iron overload on the slow response autorhythmic cells in the left ventricular outflow tract of guinea pigs.Methods: Standard microelectrode cell recording techniques were adopted to observe the electrophysiological effects of different concentrations of Fe^(2+)(100 μmol/L, 200 μmol/L) on the left ventricular outflow tract autorhythmic cells.Heart tissues were perfused with FeSO_4(200 μmol/L) combing with CaCl_2(4.2 mmol/L), Verapamil,(1 μmol/L), and nickel chloride(200μmol/L) respectively to observe the influences of these contents on electrophysiology of FeSO_4(200μmol/L) on the left ventricular outflow tract autorhythmic cells.Results: Fe^(2+)at both 100 μmol/L and 200 μmol/L could change the electrophysiological parameters of the slow response autorhythmic cells of the left ventricular outflow tract in a concentrationdependent manner resulting into decrease in Vmax, APA and MDP, slower RPF and VDD, and prolonged APD_(50) and APD_(90)(P all <0.05).Besides, perfusion of increased Ca^(2+) concentration could partially offset the electrophysiological effects of Fe^(2+)(200 μmol/L).The L-type calcium channel(LTCC) blocker Verapamil(1 μmol/L) could block the electrophysiological effects of Fe^(2+)(200 μmol/L).But the T-type calcium channel(TTCC) blocker nickel chloride(NiCl_2, 200 μmol/L) could not block the electrophysiological effects of Fe^(2+)(200 μmol/L).Conclusions: Fe^(2+) can directly change the electrophysiological characteristics of the slow response autorhythmic cells of the left ventricular outflow tract probably through the L-type calcium channel.
文摘Esophagogastric junction outflow obstruction(EGJOO) is a major motility disorder based on the Chicago Classification of esophageal motility disorders.This entity involves a heterogenous group of underlying etiologies. The diagnosis is reached by performing high-resolution manometry. This reveals evidence of obstruction at the esophagogastric junction, manifested by an elevated integrated relaxation pressure(IRP) above a cutoff value(IRP threshold varies by the manometric technology and catheter used), with preserved peristalsis. Further tests like endoscopy, timed barium esophagram, and cross-sectional imaging can help further elucidate the underlying etiology and rule out mechanical causes.Treatment is tailored to the underlying cause. Similar to achalasia, treatment targeting lower esophageal sphincter disruption like pneumatic dilation, peroral endoscopic myotomy, and botulinum injection are used in patients with functional EGJOO and persistent symptoms.
基金supported by the National Natural Science Foundation of China(11331005,11471134)the Program for Changjiang Scholars and Innovative Research Team in University(IRT13066)the Scientific Research Funds of Huaqiao University(15BS201,15BS309)
文摘In this article, we are concerned with the stability of stationary solution for outflow problem on the Navier-Stokes-Poisson system. We obtain the unique existence and the asymptotic stability of stationary solution. Moreover, the convergence rate of solution towards stationary solution is obtained. Precisely, if an initial perturbation decays with the algebraic or the exponential rate in space, the solution converges to the corresponding stationary solution as time tends to infinity with the algebraic or the exponential rate in time. The proof is based on the weighted energy method by taking into account the effect of the self-consistent electric field on the viscous compressible fluid.
文摘AIM To assess the efficacy and safety of balloon dilatation for the treatment of hepatic venous outflow obstruction(HVOO) following pediatric liver transplantation.METHODS A total of 246 pediatric patients underwent liver transplantation at our hospital between June 2013 and September 2016. Among these patients, five were ultimately diagnosed with HVOO. Seven procedures(two patients underwent two balloon dilatation procedures) were included in this analysis. The demographic data,types of donor and liver transplant, interventional examination and therapeutic outcomes of these five children were analyzed. The median interval time between pediatric liver transplantation and balloon dilatation procedures was 9.8 mo(range: 1-32).RESULTS Five children with HVOO were successfully treated by balloon angioplasty without stent placement, with seven procedures performed for six stenotic lesions. All children underwent successful percutaneous intervention. Among these five patients, four were treated by single balloon angioplasty, and these patients did not develop recurrent stenosis. In seven episodes of balloon angioplasty across the stenosis, the pressure gradient was 12.0 ± 8.8 mm Hg before balloon dilatation and 1.1 ± 1.5 mm Hg after the procedures, which revealed a statistically significant reduction(P < 0.05). The overall technical success rate among these seven procedures was 100%(7/7), and clinical success was achieved in all five patients(100%). The patients were followed for 4-33 mo(median: 15 mo). No significant procedural complications or procedurerelated deaths occurred.CONCLUSION Balloon dilatation is an effective and safe therapeutic option for HVOO in children undergoing pediatric liver transplantation. Venous angioplasty is also recommended in cases with recurrent HVOO.
基金supported in part by grants from the Science and Technology Key Foundation of Guangdong Province(No.2010B031600166)the Science and Technology Foundation of Guangdong Province(No.2011B061300072)
文摘Summary： Lead placement for ventricular pacing variably impacts the physiological benefit of the pa- tient. This study evaluated the ventricular lead performance and safety of right ventricular outflow tract septal pacing in patients with bradyarrhythmia in South China over 60-month follow-up. Totally, 192 patients （108 males, and 84 females, 63-4-21 years old） with bradyarrhythmia were randomly divided into two groups. The right ventricular outflow tract septum （RVOTs） group had lead placement near the sep- tum （n=97）, while the right ventricular apex （RVA） group had a traditional apical placement （n=95）. RV septal lead positioning was achieved with a specialized stylet and confirmed using fluoroscopic projec- tion. All patients were followed up for 60 months. Follow-up assessment included stimulation threshold, R-wave sensing, lead impedance and lead complications. The time of electrode implantation in both the ROVTs and RVA groups were significantly different （4.29±0.61 vs. 2.16±0.22 min; P=0.009）. No dif- ferences were identified in threshold, impedance or R-wave sensing between the two groups at 1 st, 12th, 36th and 60th month during the follow-up period. No occurrence of electrode displacement, increased pacing threshold or inadequate sensing was found. The long-term active fixation ventricular electrode performance in RVOTs group was similar to that in RVA group. RVOTs pacing near the septum using active fixation electrodes may provide stability during long-term follow-up period.
文摘OBJECTIVE: To summarize the experience in modified reconstruction of the hepatic outflow tract during piggyback liver transplantation at our hospital. METHODS: The clinical data on 67 patients undergoing piggyback liver transplantation with modified hepatic outflow tract reconstruction from January 1999 to October 2002 were analyzed retrospectively. RESULTS: In this group, 7 patients (10. 45%) died perioperatively. Complications included: pulmonary infection (38 patients); multiple organ system failure (10), intraperitoneal bleeding (6), acute respiratory distress syndrome (14), thrombosis of the hepatie artery (1), and bile leakage (1). No hepatic outflow occluded. Two recipients survived for over 3 years, 8 over 2 years, and 19 over a year. CONCLUSION: Modified hepatic outflow reconstruction in piggyback live transplantation may increase the success rate of liver transplantation and decrease technical complications.
文摘The performance of hepatic surgery without a parenchyma-sparing strategy carries significant risks for patient survival because of the not negligible occurrence of postoperative liver failure.The key factor of modern hepatic surgery is the use of the intraoperative ultrasound(IOUS),not only to stage the disease,but more importantly to guide resection with the specific aim to maximize the sparing of the functional parenchyma.Whether in patients with hepatocellular carcinoma and underlying liver cirrhosis,or in patients with colorectal liver metastasis,IOUS allows the performance of the so-called "radical but conservative surgery",which is the pivotal factor to offer a chance of cure to an increasing proportion of patients,who until few years ago were considered only for palliative care.Using some new IOUS-guided surgical maneuvers,which are based on the liver inflow and outflow modulations,more precise anatomically subsegmental-and segmentaloriented resections can be effectively performed.The present work describes the rationale and the surgical technique for a precise tailoring of the area of hepatic resection using the most recent attainments in IOUS.Such important technical achievements should be a fundamental part of the surgical armamentarium of the modern liver surgeon.
文摘Hepatic venous outflow obstruction after piggyback liver transplantation is a very rare complication. An unusual mechanism aggravating it is reported. A 33-year-old man with end-stage hepatitis B liver cirrhosis underwent a piggyback orthotopic liver transplantation using a full-size cadaveric graft. Two months after transplantation, he developed gross ascites refractory to maximal diuretic therapy. Doppler ultrasound showed patent portal and hepatic veins. Serial computed tomography scans revealed a hypoperfused right posterior segment of the liver which subsequently underwent atrophy. Hepatic venography demonstrated a high-grade stenosis with an element of torsion of venous drainage at the anastomosis. The stenosis was successfully treated with repeated percutaneous balloon angioplasty. The patient remained asymptomatic six months afterwards with complete resolution of ascites and peripheral edema. We postulate that liver allograft segmental hypoperfusion and atrophy may aggravate or result in a hepatic venous outflow problem by the mechanism of torsion effect. Percutaneous balloon angioplasty is a safe and effective treatment modality for anastomotic stenosis.
基金Supported by Research and Events Support Fund at Hospital de Clínicas de Porto Alegre
文摘BACKGROUND Esophagogastric junction outflow obstruction(EGJOO) is a rare syndrome,characterized by an elevation of the integrated relaxation pressure of the lower esophageal sphincter, not accompanied by alterations in esophageal motility that may lead to the criteria for achalasia. We were unable to find any prior report of the combination of Heller myotomy with anterior partial fundoplication(Dor) as the treatment for EGJOO. We herein report a case of EGJOO treated with laparoscopic Heller myotomy combined with Dor fundoplication.CASE SUMMARY A 26-year-old man presented with a 3-year history of solid dysphagia and a 30-kg weight loss. He was treated with oral nifedipine, isosorbide, and omeprazole,without resolution of symptoms. An upper gastrointestinal series(barium swallow) revealed a "bird's beak" sign. Esophagogastroduodenoscopy was positive for Los Angeles grade A peptic esophagitis. High-resolution esophageal manometry was compatible with EGJOO. Esophageal pH monitoring showed pathological acid reflux both in orthostatic and decubitus position. An 8-cm laparoscopic Heller myotomy combined with an anterior 220° Dor fundoplication was performed. Solid diet was introduced on postoperative day 2, and the patient was discharged home the same day. At 17-mo follow-up, he reported no symptoms. Barium swallow was compatible with complete radiologic resolution.Both esophageal manometry and upper endoscopy showed normal findings 9 mo after the operation.CONCLUSION Surgical treatment with Heller myotomy and Dor fundoplication is a potential treatment option for EGJOO refractory to medical treatment.
文摘The reconstruction of the vascular outflow tract of partial liver grafts has received considerable attention in the past, especially in the setting of right liver grafts with undrained segments. Hepatic venous outflow reconstruction is an important factor for successful living donor liver transplantation outcome. However, in presence of undrained anterior sector and presence of multiple short hepatic veins that drain substantial portions of liver, outflow reconstruction without backtable venoplasty may lead to severe graft congestion and subsequent graft dysfunction. Various backtable venoplasty techniques in presence of multiple hepatic veins that can be used in either right- or leftlobe liver transplantation are devised to ensure a single, wide outflow channel. In this overview, various techniques to overcome the hepatic venous variations of liver allograft and outflow reconstruction are discussed.
文摘The main objective of the present study is to introduce new empirical equations for the determination of breach geometrical dimensions and peak outflow discharge(Q_(p)).Therefore,a historic failure database of 109 embankments was collected and examined.The most important factors that affect the breach evolution,including grading size,hydraulic,and outflow characteristics are also studied.Some of the parameters used for the determination of Q_(p) and average breach width(Bave)have a significant effect on the erosion process,but they are less reflected in the technical literature.To study the behavior of noncohesive soils during overtopping,15 physical tests were performed at the laboratory,and the effects of interfering parameters were investigated.The experimental output hydrograph was used to simulate the hydrographs resulting from the failure of real dams,and recent artificial intelligence techniques along with linear and nonlinear regression models were employed.The area-time analysis of the laboratory hydrographs shows that the soil particle size and the characteristics of reservoir-basin significantly affect the rate of breach formation and outflow discharge.New relationships are introduced,based on the breach characteristics,by a combination of historical and experimental data,as well as case studies conducted on the hypothetical failure of 10 operational dams.The mathematical model is also used to simulate the process of breach evaluation.Based on statistical indices,comparison of the results,and sensitivity analysis,the developed equations can better express the susceptibility of materials to erosion and their application can minimize downstream vulnerabilities.
基金This work was funded by the Natural Science Foundation of China(Grant no.41406215)The authors thank the two anonymous reviewers for their constructive comments.
文摘Sea ice outflow through Fram Strait is a vital component of the sea ice mass balance of the Arctic Ocean.Previous studies have examined the role of large-scale modes of atmospheric circulation variability such as the Arctic Oscillation,North Atlantic Oscillation,and Dipole Anomaly in the movement of sea ice.This review emphasizes the distinct impacts of synoptic weather on sea ice export as well as on other relevant fields(i.e.,sea ice concentration and sea ice drift).We identify deficiencies in previous studies that should be addressed,and we summarize potential research subjects that should be investigated to further our understanding of the relationship between synoptic weather and sea ice export via Fram Strait.For example,the connection between summertime anticyclones and weakened potential vorticity related to the observed extensive spring Eurasian snow and Siberian Ocean sea ice loss is of considerable interest.In-depth exploration of this type of geophysical mechanism will be particularly useful in assessment of the robustness of such linkages inferred through statistical analyses.
文摘Pyrolysis gas jets out from the surface of a solid fuel particle when heated. This study experimentally observes the occurrence of gas jets?from heated solid fuel particles. Results reveal a local gas jet occurs from the particle’s surface when its temperature reaches the point at which a pyrolysis reaction occurs. To investigate the influence of the gas jet on particle motion, a numerical simulation of the uniform flow around a spherical particle with a nonuniform outflow or high surface temperature is conducted, and the drag force acting on the spherical particle is estimated. In the numerical study, the magnitude of the outflow velocity, direction of outflow, and Rayleigh number,?i.e., particle surface temperature, are altered, and outflow velocities and the Rayleigh number are set based on the experiment. The drag coefficient is found to decrease when an outflow occurs in the direction against the mainstream;this drag coefficient at a higher Rayleigh number is slightly higher than that at a Rayleigh number of zero.
