Clinical Phenomenon Research Articles

Trunnions and Modularity in Total Hip Arthroplasty: A Historical Review With Current Clinical Implications.

Trunnion in total hip arthroplasty refers to the interface between the neck of a femoral stem and the femoral head. Clinical complications arising from damage to this junction, whether it be due to mechanical wear, corrosion, or a combination, are referred to as mechanically assisted crevice corrosion (MACC), also commonly known as trunnionosis. With the use of modular hip prostheses, which help customize offset and leg length to an individual patient's anatomy, the incidence of MACC and revision due to MACC has increased in recent years. Although the cause of MACC is multifactorial, with patient factors and technique factors contributing to this condition, taper design and geometry, metallurgical properties of implants, and size mismatch of the bearing couple are some of the implant factors that have also been implicated in this clinical phenomenon. Understanding the history of taper design and geometry, the track record of older implants, and the rationale behind the development of current prostheses can help surgeons choose the right implants for their patients and accurately assess the pros and cons of new implants being introduced to the market each year.

Recurrent implantation failure: A comprehensive summary from etiology to treatment.

Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing in vitro fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.

Using Buddhist Meditation-informed Hypnotic Techniques to Manage Rumination: Two Case Illustrations

ABSTRACT Rumination is a clinical phenomenon that causes significant distress in clients who suffer from various psychological and physical disorders. It also has a deleterious impact on both therapeutic process and outcome. One approach that holds promise to manage rumination is mindfulness meditation in combination with clinical hypnosis. This article: (1) reviews the concept of and techniques to manage rumination in the Buddhist psychological framework, (2) introduces 2 simple mindfulness-based techniques to deal with rumination, i.e., mindful thought detachment and mindful dereflection, and (3) describes 2 case studies in which these strategies were applied successfully. Hypnosis-informed clinicians are encouraged to integrate these approaches in their practices.

Acute ischemic colitis associated with oral decongestant use: a systematic review

Acute ischemic colitis (IC) has been linked with the use of oral decongestants. However, clinical evidence on this association remains limited. We aim to evaluate the occurrence and clinical outcomes of acute IC following over-the-counter (OTC) use of pseudoephedrine and phenylephrine.We conducted a systematic review of the MEDLINE, Google Scholar, Scopus, and Embase databases between inception and July 20, 2022. Specific search terms were used. The inclusion criteria consisted of English-language articles describing acute IC secondary to pseudoephedrine or phenylephrine.A total of 18 case reports (level of clinical evidence: IV) fulfilled our inclusion criteria. The mean age of patients was 51.6 ± 15.3 years, with 14 (77.8%) cases reported in women. The clinical presentation was mainly related to abdominal pain 16 (88.9%), hematochezia 15 (83.3%), and/or abdominal tenderness 10 (55.6%). The medical background showed that 5 (27.8%) patients were previously healthy. In the 13 (72.2%) patients with comorbidities, hypertension 6 (46.2%), a history of tobacco use 5 (38.5%), and psychiatric illnesses 4 (30.8%) were commonly reported. Leukocytosis was encountered in 13 (72.2%) patients. Diagnostic investigations included a combination of computed tomography scan and colonoscopy in 10 (55.6%), colonoscopy alone in 6 (33.3%), and flexible sigmoidoscopy in 1 (5.6%) patient. Colonoscopic biopsy was the mainstay of diagnosis in 15 (83.3%) patients. Treatment was based on supportive care in 18 (100%), concurrent antibiotic use in 2 (11.1%), and surgical intervention in 1 (5.6%) patient. Recurrent episodes of IC occurred in 4 (22.2%) patients.Acute IC secondary to oral decongestants remains a rare but important clinical phenomenon. Clinical suspicion and imaging findings are important for the early diagnosis.In unexplained cases of IC, clinicians should specifically inquire about oral decongestants since they are OTC and patients commonly fail to reveal their usage. These drugs should be avoided for transient cold symptoms, especially in women.

Deceptive Appearances - Spastic Paretic Hemifacial Contractures in Cases of Seventh Nerve Involvement 'Inside' and 'Outside' the Brainstem.

Spastic paretic hemifacial contracture (SPHC) is a rare clinical phenomenon characterized by facial weakness and simultaneous well-sustained contraction of the unilateral half of the face, mimicking a paresis of the normal contralateral side on casual inspection. We present three cases with such phenomenon and have postulated the underlying mechanisms. One patient had intrinsic brainstem glioma, and the others were operated for extra-axial lesions compressing the pons. The former presented with SPHC, whereas the latter two gradually developed this phenomenon following postoperative facial paresis. This condition is possibly due to denervation hyper-excitability of the facial supranuclear pathway or an aberrant regeneration secondary to nerve injury leading to functional facial-nerve nuclear reorganization. SPHC occurrence is not limited to intra-axial lesions but can also be seen after partial injury to the facial nerve beyond its exit from the brainstem.

The debatable role of immune checkpoint blockade therapy in lung adenocarcinoma-oriented liver metastatic malignant lesions.

The use of anti-PD-1 or PD-L1 inhibitors in combination with other anti-cancer agents was a priority for treating advanced non-small cell lung cancer (NSCLC) patients with considerable PD-L1 expression. However, studies seldom show the progression of liver metastases after using immune checkpoint inhibitors (ICIs). Data were obtained from the Department of Pulmonary and Critical Care of Medicine, the First Affiliated Hospital of the Air Force Military Medical University. In the present study, we analyzed five non-small cell lung cancer (NSCLC) patients who had liver metastases after they were treated with pembrolizumab between 2019 and 2021. All of them had both stable primary lesions and liver progression with pembrolizumab intervention. Blood laboratory tests and imaging examinations were performed regularly during the treatment to assess the tumor responses of patients. All patients displayed reduction or stability in the initial lesions as a result, but they also experienced the emergence of metastatic liver locations, which were regularly detected throughout immunotherapy. Additionally, the appearance of liver metastasis weakened their liver function gradually with the escalation of carcinoembryonic antigen, regarded as a predictor for evaluating the progression of tumors. These individuals were highly distinctive with hyper-progressive diseases associated with immunotherapy. We drew individualized intervention schemes for metastatic lesions in each patient and found that their life expectancy shared no significance given the restricting subjected population. Our study indicated a clinical phenomenon after using immune checkpoint inhibitors and presented a necessity for implementing large scales clinical studies to manage NSCLC-oriented liver metastasis.

The YTHDF1–TRAF6 pathway regulates the neuroinflammatory response and contributes to morphine tolerance and hyperalgesia in the periaqueductal gray

Long-term use of opioids such as morphine has negative side effects, such as morphine analgesic tolerance and morphine-induced hyperalgesia (MIH). These side effects limit the clinical use and analgesic efficacy of morphine. Elucidation of the mechanisms and identification of feasible and effective methods or treatment targets to solve this clinical phenomenon are important. Here, we discovered that YTHDF1 and TNF receptor-associated factor 6 (TRAF6) are crucial for morphine analgesic tolerance and MIH. The m6A reader YTHDF1 positively regulated the translation of TRAF6 mRNA, and chronic morphine treatments enhanced the m6A modification of TRAF6 mRNA. TRAF6 protein expression was drastically reduced by YTHDF1 knockdown, although TRAF6 mRNA levels were unaffected. By reducing inflammatory markers such as IL-1β, IL-6, TNF-α and NF-κB, targeted reduction of YTHDF1 or suppression of TRAF6 activity in ventrolateral periaqueductal gray (vlPAG) slows the development of morphine analgesic tolerance and MIH. Our findings provide new insights into the mechanism of morphine analgesic tolerance and MIH indicating that YTHDF1 regulates inflammatory factors such as IL-1β, IL-6, TNF-α and NF-κB by enhancing TRAF6 protein expression.

Neuroinflammation in Huntington's disease: From animal models to clinical therapeutics.

Huntington's disease (HD) is a progressive neurodegenerative disease characterized by preferential loss of neurons in the striatum in patients, which leads to motor and cognitive impairments and death that often occurs 10-15 years after the onset of symptoms. The expansion of a glutamine repeat (>36 glutamines) in the N-terminal region of huntingtin (HTT) has been defined as the cause of HD, but the mechanism underlying neuronal death remains unclear. Multiple mechanisms, including inflammation, may jointly contribute to HD pathogenesis. Altered inflammation response is evident even before the onset of classical symptoms of HD. In this review, we summarize the current evidence on immune and inflammatory changes, from HD animal models to clinical phenomenon of patients with HD. The understanding of the impact of inflammation on HD would help develop novel strategies to treat HD.

Local Anesthetic Efficacy in Marijuana Users and Nonusers: A Pilot Study.

Despite the common clinical impression that patients with a history of drug use are challenging to anesthetize with local anesthesia, literature on this clinical phenomenon is sparse. The objective of this pilot study was to assess if differences in local anesthetic efficacy for dental treatment exist between marijuana users and nonusers. Subjects were healthy adult males and females who qualified as either chronic marijuana users or nonusers. All subjects had an asymptomatic, vital maxillary lateral incisor that responded to an electric pulp test (EPT). A standard maxillary infiltration injection technique was employed using 1.7 mL 2% lidocaine with 1:100,000 epinephrine over the test tooth, and the tooth was tested with an EPT at 3-minute intervals. A total of 88% of nonusers (15/17) and 61% of users (11/18) were successfully anesthetized, defined as anesthesia onset within 10 minutes and lasting at least 15 minutes. The difference in the proportion of anesthetized subjects was not statistically significant (P = .073). For subjects with successful anesthesia, there was no significant difference between nonusers and users in the onset or duration of anesthesia. No significant differences in local anesthetic efficacy with respect to local anesthetic success, onset, or duration of action were found between chronic marijuana users and nonusers. However, larger studies are likely needed to provide more definitive evidence.

Pharmacokinetic mechanisms underlying clinical cases of valproic acid autoinduction: A review

• Autoinduction is a frequent clinical phenomenon with antiepileptic drugs. • Clinical cases of valproic acid autoinduction may be underreported. • Multiple complex pharmacokinetic mechanisms underlie valproic acid autoinduction. • Free fraction levels are useful to diagnose and mange valproic acid autoinduction. Although enzyme induction by valproic acid (VPA) has been documented in several case reports, clinical reports of VPA autoinduction are rare. In contrast, other antiepileptic drugs (AED) and/or mood stabilizers, such as carbamazepine and phenytoin, are well-documented to increase other drugs' metabolism as well as their own. This review analyzes data from published case reports of VPA autoinduction to elucidate plausible mechanisms underlying VPA autoinduction to enhance clinicians' awareness of VPA autoinduction and its management. A literature search using the following search terms: (('valproic acid' OR 'valproate' OR 'VPA') AND ('autoinduction' OR 'auto-induction' OR 'induction' OR 'inducibility')) revealed 14 records. However, only three papers described clinical cases of VPA autoinduction, with one research paper investigating the role of β-oxidation in VPA autoinduction without a clinical case description. As shown in Table 1, VPA autoinduction in c ase 1 was primarily formulation-based, cases 2-4 were dose-related, and case 5 involved protein displacement reaction with co-prescribed ibuprofen. All reviewed cases were Caucasian males, with a mean age (SD) of 44.0±14.88, receiving a VPA formulation with different diagnoses, including bipolar disorder, schizophrenia, tuberous sclerosis, and traumatic brain injury. All VPA levels were trough levels obtained at the steady-state and analyzed by the same laboratories for each case. This review utilizes clinical data from a few published cases to present the complexities of pharmacokinetic mechanisms underlying VPA autoinduction. Nevertheless, clinicians should consider requesting free fraction along with the total VPA levels to diagnose and manage VPA autoinduction, particularly in clinically challenging patients.

Analysis Of Bilirubin and Hemoglobin in Newborn Infants

One of the causes of infant death outside the womb is hyperbilirubinemia. This hyperbilirubinemia is a clinical phenomenon often found in newborns in the first week of life. In laboratory examination, the determination of hemoglobin level is an indicator that is widely used to determine the prevalence of anemia. This study uses an observation method with a descriptive approach. The data collection of this research was carried out at RSIA Pertiwi Makassar City in May 2021. The sample in this study was secondary data for all newborns. The results of this study were obtained from 40 newborns (85%) who had hyperbilirubinemia. As many as 6 newborns (15%) did not have hyperbilirubinemia while from 25 newborns, 9 newborns (36%) had anemia, and as many as 16 newborns. Born (64%) did not have anemia. Keywords: Bilirubin, Hemoglobin, And Newborn

Recurrent bacterial meningitis with cerebrospinal fluid rhinorrhea

Introduction: Recurrent bacterial meningitis is a rare clinical phenomenon, but a telltale sign of a mysterious foe. It is an occurrence of two or more episodes of bacterial meningitis by different organisms, or with the same organism and the episodes separated by an interval of at least three weeks. Case Report: We present a case of a 29-year-old gentleman who presented with acute pyogenic meningitis due to Streptococcus pneumoniae. This is the second episode of confirmed bacterial meningitis in two years with another episode of meningitis ten years ago, which was treated as tuberculous. History of rhinorrhea was elicited on direct questioning and cerebrospinal fluid leak through cribriform plate was confirmed on magnetic resonance imaging. The current episode of meningitis was successfully treated with intravenous high dose cephalosporin and short course dexamethasone. The patient was referred to a neurosurgeon for closure of cerebrospinal fluid leak. Conclusion: This case highlights the importance of a thorough clinical history and awareness of a seemingly unimportant symptom which can be an important diagnostic clue.

A faulty compass: Why do some people choose situations that are not good for them?

Why do some people seem to be drawn to situations that are not good for them? While we all regularly end up in situations that we would have preferred to avoid, we tend to not choose situations or other people that are not good for us, and with time most of us get better at recognizing and avoiding these situations. However, it is a well-known clinical phenomenon that some people have a faulty compass when it comes to these situations, increasing the likelihood of repeated exposure to negative experiences and even trauma. In this paper, we reflect on the relationship between adverse experiences early in development and dysfunctional choices in adulthood, with the aim to reinvigorate interest in this clinically important phenomenon, which is in need of rigorous empirical study. Based on the literature and clinical observations, we distill four categories of hypotheses: people make dysfunctional choices 1) to process or master previous trauma, 2) out of habit and because of preferences for what is familiar, 3) to maintain a coherent view of themselves and the world, and 4) to avoid difficult emotions. We end with concrete questions that can help narrow down the heterogenous set of observations and explanations, providing a first step towards a better conceptualisation and systematic documentation of (factors contributing to) maladaptive situation selection. We dedicate this essay to Jack Rachman, who was a great inspirator for the field of experimental psychopathology with his essays highlighting phenomena that were overlooked and drawing attention to fresh ideas.

Inter-subject prediction of pediatric emergence delirium using feature selection and classification from spontaneous EEG signals

Pediatric emergence delirium is a troublesome clinical phenomenon, which may cause serious safety problems and sequelae. Predicting pediatric emergence delirium before pediatric patients regain consciousness can provide early warning for timely treatment, which helps to reduce the occurrence of adverse events. In this paper, we proposed a feature selection and classification method fusing marine predator algorithm and k-nearest neighbors, named MPA-KNN-FSC, to achieve inter-subject pediatric emergence delirium prediction from spontaneous electroencephalogram (EEG) signals. Firstly, 64-channel spontaneous EEG signals were collected from 20 pediatric patients after anesthetic surgery, and processed to extract 1792 features containing time domain, frequency domain, time–frequency domain and nonlinear features. The marine predator algorithm was then exploited to search the optimal feature subset and hyperparameters of the k-nearest neighbors, which was employed for predicting pediatric emergence delirium. To resolve the sample imbalance problem, the fitness function of the marine predator algorithm was constructed with the area under the receiver operating characteristic curve (AUROC) obtained by the k-nearest neighbors classifier. The proposed AUROC-based MPA-KNN-FSC method achieved the best inter-subject pediatric emergence delirium prediction accuracy (77.90 ± 2.59 %) and AUROC (0.871 ± 0.017), compared to the feature selection and classification methods with ten metaheuristic algorithms and the accuracy-based MPA-KNN-FSC method. These results demonstrate the feasibility, effectiveness and generalizability of the proposed AUROC-based MPA-KNN-FSC method for automatic and unsupervised physiological monitoring of pediatric patients.

Endoscopic submucosal tunnel dissection for early esophageal squamous cell carcinoma in patients with cirrhosis: A propensity score analysis.

Although early esophageal squamous cell carcinoma (EESCC) with cirrhosis is a relatively rare clinical phenomenon, the management of EESCC in cirrhotic patients continues to be a challenge. To evaluate the feasibility, safety, efficacy and long-term survival outcomes of endoscopic submucosal tunnel dissection (ESTD) for treating EESCC in patients with cirrhosis. This was a single-center retrospective cohort study. We examined 590 EESCC patients who underwent ESTD between July 14, 2014, and May 26, 2021, from a large-scale tertiary hospital. After excluding 25 patients with unclear lesion areas or pathological results, the remaining 565 patients were matched at a ratio of 1:3 by using propensity score matching. A total of 25 EESCC patients with comorbid liver cirrhosis and 75 matched EESCC patients were ultimately included in the analysis. Parametric and nonparametric statistical methods were used to compare the differences between the two groups. The Kaplan-Meier method was used to create survival curves, and differences in survival curves were compared by the log-rank test. Among 25 patients with liver cirrhosis and 75 matched noncirrhotic patients, there were no significant differences in intraoperative bleeding (P = 0.234), 30-d post-ESTD bleeding (P = 0.099), disease-specific survival (P = 0.075), or recurrence-free survival (P = 0.8196). The mean hospitalization time and costs were significantly longer (P = 0.007) and higher (P = 0.023) in the cirrhosis group than in the noncirrhosis group. The overall survival rate was significantly lower in the cirrhosis group (P = 0.001). ESTD is technically feasible, safe, and effective for patients with EESCC and liver cirrhosis. EESCC patients with Child-Pugh A disease seem to be good candidates for ESTD.

What is the incidence of septic arthritis in patients with infective endocarditis? A systematic review

• Incidence of osteoarticular infection in infective endocarditis was unknown. • Evaluation of the limited, available evidence to date would suggest septic arthritis occurs in 3.5–3.9% of cases. • Early identification of septic arthritis is shown to be of vital importance. • Predictive factors are herein identified to assist clinicians in diagnosis and management. The clinical scenario of a hospital inpatient receiving treatment for infective endocarditis who suddenly develops a painful joint will probably be familiar to most. Arthralgia and myalgia are common manifestations of acute, severe infection, and of systemic disease in general. Nevertheless a proportion of patients with infective endocarditis will develop secondary osteoarticular infections. These may be a focus for life-threatening sepsis and in the case of septic arthritis can result in irreversible and massively disabling destruction of major synovial joints. The aim of this systematic review is to establish the incidence of this clinical phenomenon based on the available literature, and to aid physicians in its identification and management by means of a proposed guidance summary. A targeted literature review was produced using appropriate medical subject heading terms to search the PUBMED database for pertinent studies. Dual author consensus was reached following independent assessment of the papers using a critical appraisal tool. 6 papers in total were found to have met the inclusion criteria and were included for review, ranging in study dates from 1992 to 2020. The reported incidence rates varied from 2.5% to 10.6%. However detailed analysis of methodologies and study populations facilitated more precise figures to be reached when focusing on those studies whose participants were felt to more closely reflect a modern European/North American case-mix. Although the quality of the available data does not allow for firm conclusions to be drawn in terms of an exact incidence, evaluation of the largest and most recent case-series available on this subject would indicate that the rate of patients with IE developing synchronous SA is in the region of 3.5–3.9%. This review also highlights the poor outcomes associated with such phenomena, and a proposed clinical guidance summary is also included in order to aid clinicians in its early identification and appropriate management.

Understanding lived experiences of nurse managers about managerial ethics.

Expressions of Managerial ethics as a clinical phenomenon in Nursing Ethics as expressed by nurse managers were investigated. A coherence could be detected between the concepts and phenomena of Managerial ethics and nurse managers as a context. Managerial ethics as a new approach has emerged in the perspective and by prioritizing ethics in the organization has provided the basis for creating and promoting individual and organizational effectiveness. Managers' and staff's adherence to professional ethics helps hospitals to achieve their intended goals. The present study aimed to explain nurse managers' experience of managerial ethics. This qualitative study was conducted based on a phenomenological design in 2022. The participants included 20 nurse managers working in hospitals in Arak, Iran. They were selected by the purposive sampling method which continued until data saturation. Data were collected through semi-structured individual interviews (30-90min); subsequently, the obtained results were analyzed using the Van Manen six-step approach. The confidentiality and the right of participants to take part or withdraw from the study were observed during this research. The results of the present study were able to demonstrate nurse managers' lived experience of managerial ethics in the form of five themes of professional ethics, people-oriented management, professional empowerment, excellencism, and patient-centered care. As evidenced by the obtained results, nurse managers held a positive view of managerial ethics. They were striving to strongly adhere to ethical principles in nursing management since they contribute greatly to the improved quality of nursing services in care and health settings. Therefore, appropriate policy-making and planning for managerial ethics training are indispensable for all nurses and nursing students.

Anaesthetic emergence agitation after cardiac surgery: An intensive care staff survey

BackgroundAnecdotal reports suggest that during emergence from anaesthesia, some post–cardiac surgery patients exhibit signs of agitation with concerning clinical features, including hypoxaemia, ventilation dysynchrony, and haemodynamic instability. This clinical phenomenon has not been described in the published literature. ObjectiveWe aimed to investigate the perceptions and practice of intensive care unit staff members who have managed adult patients after cardiac surgery regarding emergence agitation, its clinical features, and treatment. MethodsA descriptive survey was conducted from December 2020 to January 2021 in two metropolitan hospitals. Items included Likert scale, multiple-item selection, and free-text responses. ResultsThere were 144 respondents (response rate: 55%). Post–cardiac surgery emergence agitation was witnessed by 143 respondents (99%). Fifty-seven (40%) reported encountering this clinical problem often. Clinical concerns included instabilities with airway or ventilation (347 items selected), cardiovascular system (189 items selected), and patient treatment interference, such as pulling tubes (229 items selected). Overall, 143 (99%) respondents re-sedated patients with emergence agitation, 138 (96%) added a narcotic bolus, and 121 respondents reported use of mechanical restraints (84%). Twenty-four respondents (2%) recalled receiving any formal anaesthetic emergence education, including after cardiac surgery. ConclusionAnaesthetic emergence agitation following cardiac surgery is a concerning clinical problem. Clinical management of emergence agitation was influenced more by clinical experience than research evidence. Further observational research is required to investigate clinical characteristics and inform evidence-based management practices and education.

Tailored Direct Oral Anticoagulation in Patients with Atrial Fibrillation: The Future of Oral Anticoagulation?

Direct oral anticoagulants (DOAC) are currently the drug of choice for drug prevention of stroke or systemic embolism in patients with atrial fibrillation (AF). However, repeated ischemic stroke or systemic embolism and bleeding while on DOAC is still a challenging clinical phenomenon in the management of future long-term anticoagulation. It is not known whether tailoring the DOAC therapy to achieve optimal therapeutic drug levels could improve the clinical course of DOAC therapy. To be able to tailor the therapy, it is necessary to have a valid laboratory method for DOAC level assessment, to be aware of factors influencing DOAC levels and to have clinical options to tailor the treatment. Furthermore, the data regarding clinical efficacy/safety of tailored DOAC regimes are still lacking. This article reviews the current data on tailored direct oral anticoagulation in patients with AF.

Mechanisms of the ascites volume differences between patients receiving a left or right hemi-liver graft liver transplantation: From biofluidic analysis

Background and objectivePost-transplant refractory ascites (RA) is common in patients receiving living donor liver transplantation (LDLT) using a left hemi-liver graft than in those using a right hemi-liver graft. However, there is currently no clear mechanism explaining the effect of grafts on ascites drainage. The purpose of this study is to analyze the values of blood flow parameters in the portal vein under different grafts using computational fluid dynamics (CFD) to interpret the relationship between portal pressure values with ascites drainage. MethodsIn this work, ascites drainage was counted in 30 patients who underwent left-sided liver transplantation and 26 patients who underwent right-sided liver transplantation. The portal vein flow models of the transplanted liver under different flow rates were established based on computed tomography (CT) images and finite element theory. Ascites drainage and blood flow parameters were qualitatively compared. ResultsThe results show that the ascites drained from patients who received LDLT with a left hemi-liver is three times as that with a right hemi-liver. The simulation results show that the coefficient of the pressure-velocity curve of the left-liver is 1.7 times of the right-liver under the same hydrodynamic conditions, which qualitatively agrees with the clinical data. Moreover, the streamline of the transplanted left liver shows more vortexes compared with the right liver, which is a major reason for the left liver's higher pressure value. ConclusionThis clinical phenomenon is reproduced and comprehensively explained by the hemodynamic parameters of the portal vein. This work establishes the relationship between portal pressure values and floating water drainage, and offers a new way for physicians to predict postoperative risks intuitively.