Destructive Procedures Research Articles

La répétition d’un geste de destruction endométriale permet-elle d’améliorer les symptômes de ménométrorragie, et diminue-t-elle le taux de réintervention par hystérectomie ?

Hysteroscopic endometrial resection or destruction in the indication of abnormal uterine bleeding or post-menopausal bleeding represents an alternative to hysterectomy, as it carries a lower morbidity rate. In case of failure of such procedure though, hysterectomy will most often be proposed as a second line of treatment. The place of the repetition of an endometrial destruction procedure has not yet been evaluated. The aim of our study is to evaluate the efficiency and the satisfaction after two consecutive techniques of endometrial destruction in case of abnormal uterine bleeding or post-menopausal bleeding. Nineteen patients presenting with recurring abnormal uterine bleeding after one procedure of endometrial destruction, underwent in our department, between 2004and 2011, a second conservative endometrial procedure. No complication occurred during the repeated procedure. Sixteen of the nineteen patients (84.2%) included answered a questionnaire. The mean delay since the second procedure was 27months [25; 29]. Eight patients (i.e. 50%) later underwent a hysterectomy, with 5of them (31.25% of all 16patients) being directly attributed to treatment failure. Patients said to be satisfied with the management of their condition in 68.75% of cases, and 93.75% of them would recommend it to a friend. Our results suggest that a second conservative management in case of recurrence of AUB is effective. Hysterectomy could be avoided in 50% of cases. A second conservative treatment could be an interesting option for patients with medical contra-indication for heavier surgery, as well as for patients willing to keep their uterus.

Extracellular matrix‐associated proteome changes during non‐host resistance in citrus–Xanthomonas interactions

Non-host resistance (NHR) is a most durable broad-spectrum resistance employed by the plants to restrict majority of pathogens. Plant extracellular matrix (ECM) is a critical defense barrier. Understanding ECM responses during interaction with non-host pathogen will provide insights into molecular events of NHR. In this study, the ECM-associated proteome was compared during interaction of citrus with pathogen Xanthomonas axonopodis pv. citri (Xac) and non-host pathogen Xanthomonas oryzae pv. oryzae (Xoo) at 8, 16, 24 and 48 h post inoculation. Comprehensive analysis of ECM-associated proteins was performed by extracting wall-bound and soluble ECM components using both destructive and non-destructive procedures. A total of 53 proteins was differentially expressed in citrus-Xanthomonas host and non-host interaction, out of which 44 were identified by mass spectrometry. The differentially expressed proteins were related to (1) defense-response (5 pathogenesis-related proteins, 3 miraculin-like proteins (MIR, MIR1 and MIR2) and 2 proteases); (2) enzymes of reactive oxygen species (ROS) metabolism [Cu/Zn superoxide dismutase (SOD), Fe-SOD, ascorbate peroxidase and 2-cysteine-peroxiredoxin]; (3) signaling (lectin, curculin-like lectin and concanavalin A-like lectin kinase); and (4) cell-wall modification (α-xylosidase, glucan 1, 3 β-glucosidase, xyloglucan endotransglucosylase/hydrolase). The decrease in ascorbate peroxidase and cysteine-peroxiredoxin could be involved in maintenance of ROS levels. Increase in defense, cell-wall remodeling and signaling proteins in citrus-Xoo interaction suggests an active involvement of ECM in execution of NHR. Partially compromised NHR in citrus against Xoo, upon Brefeldin A pre-treatment supported the role of non-classical secretory proteins in this phenomenon.

An effective iterated greedy algorithm for the mixed no-idle permutation flowshop scheduling problem

In the no-idle flowshop, machines cannot be idle after finishing one job and before starting the next one. Therefore, start times of jobs must be delayed to guarantee this constraint. In practice machines show this behavior as it might be technically unfeasible or uneconomical to stop a machine in between jobs. This has important ramifications in the modern industry including fiber glass processing, foundries, production of integrated circuits and the steel making industry, among others. However, to assume that all machines in the shop have this no-idle constraint is not realistic. To the best of our knowledge, this is the first paper to study the mixed no-idle extension where only some machines have the no-idle constraint. We present a mixed integer programming model for this new problem and the equations to calculate the makespan. We also propose a set of formulas to accelerate the calculation of insertions that is used both in heuristics as well as in the local search procedures. An effective iterated greedy (IG) algorithm is proposed. We use an NEH-based heuristic to construct a high quality initial solution. A local search using the proposed accelerations is employed to emphasize intensification and exploration in the IG. A new destruction and construction procedure is also shown. To evaluate the proposed algorithm, we present several adaptations of other well-known and recent metaheuristics for the problem and conduct a comprehensive set of computational and statistical experiments with a total of 1750 instances. The results show that the proposed IG algorithm outperforms existing methods in the no-idle and in the mixed no-idle scenarios by a significant margin.

Circumspinal decompression and fusion through a posterior midline incision to treat central calcified thoracolumbar disc herniation: a minimal 2-year follow-up study with reconstruction CT

PurposeThere have been several surgical approaches used in the treatment of thoracolumbar disc herniation (TLDH) from T10/11 to L1/2. However, central calcified TLDH cases are still challenging to spine surgeons. The anterior transthoracic approaches and lateral/posterolateral approaches are all essentially performed from one side; thus, the compressive lesion and the dura matter on the other side of the spinal canal are not clearly visualized, predisposing the procedure to incomplete decompression or inadvertent cord manipulation. Moreover, a number of these approaches are technically demanding and require entry into the chest. The purpose of this study was to introduce a new surgical procedure—circumspinal decompression and fusion through a posterior midline incision—for the treatment of central calcified TLDH and to evaluate its surgical outcome.MethodsIn this study, 22 patients (15 males and 7 females; mean age 49 years) with central calcified TLDH underwent this procedure between April 2008 and April 2011. Altogether, 26 discs were excised, with two discs at T10/11, eight discs at T11/12, nine discs at T12/L1 and seven discs at L1/2. Of these patients, 16 returned for final follow-up, with a mean follow-up period of 41 months (range 24–57 months). Clinical outcomes, including operative time, blood loss, perioperative complications, post-operative time of hospitalization, neurological status improvement, extent of decompression, back pain, local spinal curvature and fusion, were investigated. The patients’ neurological status was evaluated by a modified Japanese Orthopedic Association scoring system of 11 points. Fusion and the extent of decompression were evaluated by reconstruction CT at final follow-up.ResultsThe mean operative time was 185 min, the mean blood loss was 896 ml and the mean post-operative hospitalization time was 8 days. Four patients suffered perioperative complications, but only two were related to dura violation and none involved the respiratory system. All of the 16 patients who returned for the final follow-up showed improvement, and evidence of improvement was found in five of the other six patients who did not return for final follow-up through telephone interview or earlier follow-up evaluations. Complete decompression was achieved in 12 of the 16 patients who returned for final follow-up. In the 16 patients who returned for final follow-up, back pain was significantly reduced and local spinal curvature remained unaltered. In addition, based on reconstruction CT images, solid fusion was observed in 15 of the 16 patients who returned for final follow-up.ConclusionsThe circumspinal decompression and fusion through a posterior midline incision procedure can be used to treat central calcified TLDH patients with neurological deficits. This method’s greatest advantage is that it is a highly effective and safe procedure for decompression. Although it is a major and destructive procedure, spinal stability was well maintained in most of the cases. In this era when minimally invasive spine surgeries like thoracoscopy have been in an upward trajectory, spine surgeons still should be made aware of this procedure.

Introduction: Intractable pain

The problem of surgical pain management remains one of the most daunting in our specialty. Traditionally, we divide the surgical approaches into the more historic destructive procedures (“ablative”) and the more contemporary modulatory ones (stimulation or intrathecal agents). The advent of “evidence-based medicine” has caused us to reanalyze the evidentiary basis of everything we do in neurosurgery, and pain procedures are no exception. What this has taught us is that the evidence to support destructive procedures is almost uniformly absent, although reanalysis using contemporary standards has shown that procedures, such as anterolateral cordotomy, may have a justifiable role in pain control, especially for pain associated with cancer. These same standards of evidence have also revealed weakness in the data supporting neuromodulation, particularly neurostimulation. There is some qualified support for spinal cord stimulation based on reasonably conducted prospective trials, although even these studies are flawed. There is almost no indication that deep brain stimulation was ever effective for pain control, as indicated by a structured review using modern criteria. Peripheral nerve stimulation seems to be flourishing in pain centers worldwide, and yet the data to support this method for a variety of diagnoses are lacking. We are currently in an era in which high-quality evidence to support our surgical endeavors will be increasingly important. With this evidence, it is likely that certain procedures, and perhaps whole fields, will disappear. Our hope is that this issue of Neurosurgical Focus will highlight some of the innovative work that is going on in our field and address some of the challenges of gathering and analyzing the data that will keep the area of pain surgery a vibrant and compelling practice for the future. We are grateful to all of the authors for their contributions to this issue as well as the editors and staff of Neurosurgical Focus for their diligent efforts in support of this cause. (http://thejns.org/doi/abs/10.3171/2013.7.FOCUS13277)

Research of Data Destruction System in Marine Environmental Monitoring Buoy

To solve the problem how to prevent the marine environment monitoring feature data from leaking when an emergency occurs, a destruction of data used in marine environment monitoring buoy system is researched. The architecture design of the system is introduced; a data overwrite algorithm based on the data secret level of the marine work is proposed; through data overwrite technology and the high-pressure circuit to achieve the safe destruction of data elements in marine environmental monitoring. The study shows the data destruction system can trigger data destruction procedures in real time, it can solve data security issues for marine environmental monitoring buoy in the out of control situation, and the destroyed data is unrecoverable, thus preventing data loss and leakage.

Neoformations on stony materials of modern building works

Stony materials applied in the built environment interact with diverse pollutants and can originate INORGANIC neoformations that can contribute to depreciation of these materials.Microscopy studies help to characterize the chemical and textural features of these neoformations hence contributing to the understanding of the decay processes. In a study of diverse modern constructions in towns of Northern and Central Portugal were identified diverse neoformation substances in stony materials that were sampled and subjected to scanning electron microscopy (SEM) studies. While, in a strict perspective, implying destructive procedures that require the removal of a sample, microscopy techniques require minute amounts and can study occurrences of neoformations that can be detected at the macroscopic level. Products clearly resulting of metals corrosion were not considered in this study.The dominant inorganic coatings and stains in the studied constructions are carbonate-rich whitish ones that can present diverse morphological features. Some of these carbonate-rich coatings have showed textural features defining a kind of urban travertine and the existence of several layers suggesting diverse episodes of solutions circulation and crystals precipitation, indicating the recurrence of the neoformation processes. Phosphates aggregates were also detected in several built surfaces, including indoor areas (Figure 1a,b). Another relatively common occurrence are efflorescences of more soluble salts, dominated by alkaline sulphates and carbonates (especially sodium sulphate) but were other salts such as alkaline nitrates (Figure 1c,d) and chlorides and magnesium sulphates have also been occasionally found. In some buildings it was possible to observe black crusts resulting from the fixation of atmospheric particles by gypsum aggregates. A very rare neoformation are silica-rich stains that in the situation presented in Figure 1e,f occur associate with calcium carbonate stains and metal corrosion products. The observed neoformations show a great geochemical and textural diversity in the surfaces of stony materials of modern built works, being evidences of diverse possible pollution sources that can interact under variable environmental conditions. Besides an important role that seems to be attributable to mortars materials (namely in relation to calcium carbonates and alkaline sulphates but that might also be the case for the phosphates in inside portions), there are also possible contributions from atmospheric pollutions (in the case of the black crusts) and the presence of alkaline nitrates could be indicative of organic sources as this connection is well established in older works. It has been admitted that alkaline nitrates in these modern works could either represent the persistence of contamination conditions from the past in the soils or the recurrence of the same polluting conditions. Also of particular interest are the textural informations indicating recurrence of neoformation episodes (relevant for possible cleaning interventions) and the chemical associations observed even in some very small samples.The author acknowledges the support of the Fundação para a Ciência e Tecnologia (PEST-OE/CTE/UI0697/2011, funding by the national budget of the Portuguese Republic).

Dynamic characterization of satellite assembly for responsive space applications

The rapid deployment of satellites for responsive space surveillance applications is hindered by the need to flight-qualify their components and the resulting mechanical assembly. Conventional methods for qualification testing of satellite components are costly and time consuming. Furthermore, full-scale vehicles must be subjected to simulated launch loads during testing, and this harsh testing environment increases the risk of damage to satellite components during qualification. This work focuses on replacing this potentially destructive testing procedure with a non-destructive structural health monitoring (SHM)-based technique while maintaining the same level of confidence in the testing procedure's ability to qualify the satellite for flight. We focus on assessing the performance of SHM techniques to replace the high-cost qualification procedure and to localize faults introduced by improper assembly. The goal of this work is to create a dual-use system that can both assist in the process of qualifying the satellite for launch, as well as provide continuous structural integrity monitoring during manufacture, transport, launch and deployment. SHM techniques were applied on a small-scale structure representative of a responsive satellite. The test structure consisted of an extruded aluminum space-frame covered with aluminum shear plates assembled using bolted joints. Multiple piezoelectric transducers were bonded to the test structure and acted as combined actuators and sensors. Piezoelectric active-sensing based techniques, including measurements of low-frequency global frequency response functions and high-frequency wave propagation techniques, were employed. Using these methods in conjunction with finite element modeling, the dynamic properties of the test structure were established and areas of potential damage could be identified and localized. A procedure for guiding the effective placement of the sensors and actuators is also outlined.

Characterization of Natural Dyes and Traditional Korean Silk Fabric by Surface Analytical Techniques.

Time-of-flight secondary ion mass spectrometry (TOF-SIMS) and X-ray photoelectron spectroscopy (XPS) are well established surface techniques that provide both elemental and organic information from several monolayers of a sample surface, while also allowing depth profiling or image mapping to be carried out. The static TOF-SIMS with improved performances has expanded the application of TOF-SIMS to the study of a variety of organic, polymeric and biological materials. In this work, TOF-SIMS, XPS and Fourier Transform Infrared (FTIR) measurements were used to characterize commercial natural dyes and traditional silk fabric dyed with plant extracts dyes avoiding the time-consuming and destructive extraction procedures necessary for the spectrophotometric and chromatographic methods previously used. Silk textiles dyed with plant extracts were then analyzed for chemical and functional group identification of their dye components and mordants. TOF-SIMS spectra for the dyed silk fabric showed element ions from metallic mordants, specific fragment ions and molecular ions from plant-extracted dyes. The results of TOF-SIMS, XPS and FTIR are very useful as a reference database for comparison with data about traditional Korean silk fabric and to provide an understanding of traditional dyeing materials. Therefore, this study shows that surface techniques are useful for micro-destructive analysis of plant-extracted dyes and Korean dyed silk fabric.

Accounting for Soil Spatial Variability in Soil Water Capacitance Probe Calibration

For long‐term studies on spatiotemporal processes of soil water focusing on spatial variability at the field scale, appropriate calibration techniques for capacitance sensors are lacking. In an ideal case, soil water content samples would need to be taken in the close vicinity of the access tube, that is, within the physical sphere of influence, for sensor calibration. This destructive sampling procedure is prohibitive because the measurement site of that particular access tube would be destroyed for any further capacitance probe measurements. On the other hand, despite the advantage of controlled boundary conditions, it is difficult or impossible to conduct a lab calibration of the sensor that would be valid for the site specific conditions in a heterogeneous field soil. The objective of this study was to propose a sampling and data processing procedure to compare six calibration scenarios with respect to the RMSE values of their associated calibration functions and to describe the spatial series of calibration parameters in an autoregressive state‐space model. All scenarios were based on a data set obtained during the installation of access tubes and four subsequent soil sampling campaigns in the vicinity of 1‐m radius around the tube. Site‐ and depth‐specific calibration yielded the best calibration results, ranging among the best calibration results presented in the literature. Layer‐specific stratification of measurement points according to the soil clay content yielded RMSE values approximately twice as high as the site‐ and layer‐specific calibration and ranged among many other published studies. The presented sampling and data‐processing procedure in combination with site‐ and layer‐specific calibration are critically discussed and show a promising way for field‐scale studies focused on spatiotemporal processes of soil water content and underlying calibration parameters. This study shows that the spatial range of representativity can substantially exceed the small physical sphere of influence of the capacitance sensor and supports its calibration.

Intermediate-Term Results Following First Metatarsal Cheilectomy

Hallux rigidus is a term describing degenerative joint disease (DJD) to the first metatarsal phalangeal joint (MTPJ). It is the most common DJD encountered in the foot and is the second most common pathology of the great toe behind hallux valgus. The goal of a cheilectomy is to relieve pain and increase MTPJ motion. Critical evaluation of the cheilectomy must include longevity of desired results. The primary goal of this study was to determine how long a cheilectomy can be expected to last before an arthrodesis or joint destructive procedure is performed, if ever. We examined 189 cheilectomies with a mean radiographic follow-up of 235 days and mean chart review follow-up of 1184 days (3.2 years). Analysis showed 5 repeat cheilectomies, 1 interpositional arthroplasty, and only 2 arthrodeses subsequently performed. This retrospective study provides intermediate term evidence that cheilectomy is an appropriate procedure for stages 1, 2, and 3 first MTPJ DJD with reliable, lasting results.

Thomas Stephen Szasz: Psychiatric Critic, Prophet, American Humanist

Born: April 15, 1929, Budapest, HungaryDied: September 8, 2012, Syracuse, New YorkOn October 28, 2012, in Los Angeles, Thomas Szasz was the honored guest and keynote speaker at the International Society for Ethical Psychology and Psychia- try 14th Annual Conference.Having authored more than 600 papers and 35 books, having received perhaps 50 pres- tigious awards including Humanist of the Year in 1973, after receiving a standing ovation by a packed audience, he took the podium with both a twinkle in his eye and a sly smile: "Well I hope you like me as much after my presentation as you do before." This was not false modesty or just a cute joke. In his presentation he told us:The first task of the psychiatric critic worth his salt is to repudiate this psychiatrized politics: He must oppose the use of psychiatric force and fraud; reject the idea of mental illness; eschew psychi- atric language and condemn its journalistic and professional use. Most psychiatric critics, past and present, fail miserably to pass this elementary test. Or, more precisely, they regard the principle as benevolent and support the therapeutic state. (This term, "therapeutic state," was coined by Szasz in 1963. See Law, Liberty, and Psychiatry, Syracuse University Press, 1989.) He went on: The historical evidence compels us to conclude that, after more than 200 years of psychiatric criticism, we have made no progress in unshackling the psychiatric slave from his psychiatric master.You see, this man of diminutive physical stature with both gigantic intellect and force of character was there not just to critique the status quo but to critique those of us who fancy ourselves "reformers" of the system. Szasz ivas not a reformer. He was an abolition- ist. Together with colleagues George ]. Alexander and Erving Goffman, he founded in 1970 die American Association for die Abolition of Involuntary Mental Hospitalization, which actually published a magazine called The Abolitionist.So, even as we honored him, he remained our potent critic. David Cohen said, "Szasz is the most self-actualized person I've ever met." He never wavered: Humans "acted" out of free will, did not "function" like machines or "behave" like animals. He was not going to let us off die hook. Not-so-subtly, he was poking fun at us and criticizing our conference which offered "Alternatives to Biological Psychiatry: If we don't medicate, what do we do?" Yes, Szasz mocked the obsessive use of pharmaceuticals-"Throw diem all into the ocean-bad for the fish, good for us"-and decried the destructive procedures of lobotomy and electroconvulsive therapy, but he was not there to debate what was good or bad "treat- ment." For Szasz-the libertarian, atheist, historian, anthropologist, and linguist-there was one and only one core belief "worth its salt" and that was a belief in human freedom and self-responsibility.No, the kind of treatment one sought out, as long as it was voluntary, was of second- ary concern to him. Coercive treatment (see Psychiatric Slavery, 1998) was always die primary target of Szasz's sharp wit, controlled anger, and incisive criticism. Szasz came to America to escape despotism. …

CHARACTERISTIC AND CORRELATION BETWEEN TIME AND COMPLICATION AFTER DESTRUCTIVE EYE PROCEDURE PATIENT AT PLASTIC AND RECONSTRUCTION DIVISION SANGLAH HOSPITAL’S EYE CLINIC BALI-INDONESIA

Destructive eye procedure can be carried out by enucleation, evisceration and excenteration. Some efforts have been developed to reduce the complications, but it still occur within several years after the operation. This research aims to find out the characteristic and correlation between time and complications in patient after destructive eye procedure at Plastic and Reconstruction Division Sanglah Hospital’s Eye Clinic. For addition, characteristic of other patients in plastic and reconstruction also provided. This report is an analytical cross sectional study. Data were collected retrospectively from medical report of patients with history of destructive eye procedure in Sanglah Hospital’s eye clinic from January 1st until December 31st 2010. Patient’s characteristics were presented as frequency, percentage, mean, and standard deviation. Correlations between variables were statistically analyzed with Correlation of Lambda. Eye trauma, anophthalmic socket and nasolacrimal duct obstruction were the most common diagnosis at plastic and reconstruction division Sanglah Hospital’s eye clinic. There were 17 patients with history of destructive eye procedure in this report, including 76.5% male and 23.5% female. There is 58.8% destructive eye procedure held in age 13-50 year, mean 30.75 (SD 19.81). Infection (35.3%), trauma (23.5%) and tumor (11.8%) were the most common cause of destructive eye procedure in this study. Complications of destructive eye procedure occur in 70.6% of patient with contracted socket was the most common complication (58.3%). There was medium correlation between time and complication after the procedure, but the correlation was not statistically significant (r = 0.40; p > 0.05). In conclusion, from this study we obtained that there was medium correlation between time and complication after the procedure, but the correlation was not statistically significant.

The increased but non-predominant expression of Th17- and Th1-specific cytokines in Hashimoto’s thyroiditis but not in Graves’ disease

Hashimoto's thyroiditis (HT) is considered to be mediated mainly by Th1 cells, but it is not known whether Graves' disease (GD) is associated with Th1 or Th2 predominance. Th17 cells, a novel subset of Th cells, play a crucial role in the pathogenesis of various autoimmune disorders. In the present study, the expression of IL-17A and IFN-γ was investigated in patients with HT or GD. mRNA expression of IL-17A and IFN-γ in peripheral blood mononuclear cells (PBMC) from 43 patients with autoimmune thyroid disease (AITD) and in thyroid tissues from 40 AITD patients were measured by real-time quantitative PCR. The protein expression of IL-17A and IL-23p19 was examined by immunohistochemistry in thyroid tissues from 28 AITD patients. The mRNA levels of IL-17A and IFN-γ were higher in both PBMC and thyroid tissues of HT patients than in controls (mRNA levels are reported as the cytokine/β-actin ratio: IL-17 = 13.58- and 2.88-fold change and IFN-γ = 16.54- and 2.74-fold change, respectively, P < 0.05). Also, the mRNA levels of IL-17A and IFN-γ did not differ significantly in GD patients (P > 0.05). The high protein expression of IL-17A (IOD = 15.17 ± 4.8) and IL-23p19 (IOD = 16.84 ± 7.87) in HT was confirmed by immunohistochemistry (P < 0.05). The similar high levels of IL-17A and IFN-γ suggest a mixed response of Th17 and Th1 in HT, where both cells may play important roles in the destruction procedure by cell-mediated cytotoxicity.

An iterated greedy algorithm for the single-machine total weighted tardiness problem with sequence-dependent setup times

This article presents an enhanced iterated greedy (EIG) algorithm that searches both insert and swap neighbourhoods for the single-machine total weighted tardiness problem with sequence-dependent setup times. Novel elimination rules and speed-ups are proposed for the swap move to make the employment of swap neighbourhood worthwhile due to its reduced computational expense. Moreover, a perturbation operator is newly designed as a substitute for the existing destruction and construction procedures to prevent the search from being attracted to local optima. To validate the proposed algorithm, computational experiments are conducted on a benchmark set from the literature. The results show that the EIG outperforms the existing state-of-the-art algorithms for the considered problem.

Double-balloon cervical ripening catheter works well as an intrauterine balloon tamponade in post-abortion massive hemorrhage

ObjectiveClinical experience in the management of post-abortion hemorrhage is limited. Case ReportsTwo women with severe post-abortion hemorrhage were reported. One case occurred after methotrexate treatment of Cesarean scar pregnancy and the other occurred after abortion surgery. Both patients were successfully treated with a double-balloon cervical ripening catheter inducing intrauterine balloon tamponade. ConclusionUse of a double-balloon cervical ripening catheter either before or after systemic methotrexate treatment is one of the choices in the management of severe post-abortion hemorrhage and can prevent the use of more invasive and/or destructive procedures.

초임계 CO2에 의한 셰일 및 사암의 물성변화 및 스웰링에 관한 연구

<TEX>$CO_2$</TEX> 저장에 따른 암반 물성의 변화 분석은 지중저장소 정밀 모니터링을 위해 필수적인 요소로서 이에 대한 다양한 각도의 시험 수행과 모델링이 요구된다. 하지만 국내의 경우는 대부분 모델링 연구에 집중되고 있으며, 수치모델에서 필요로 하는 입력자료 대부분이 문헌에 기반을 둔 가정치를 사용하고 있다. 따라서 본 연구에서는 실험실 규모의 <TEX>$CO_2$</TEX> 주입 환경을 모사하는 기술을 고안하고, 초임계 <TEX>$CO_2$</TEX>와 반응하는 저류층 암반의 거동 분석을 위해 암석 시료를 이용한 역학적 물성 변화 위주의 실험실 시험을 실시하였다. 시험 대상은 저류층 내에서 덮개암 및 저장층 역할을 하는 셰일 및 사암으로 하였으며, 층간 결합력이 약해 팽창성이 높은 것으로 보고된 셰일에 대해서는 추가적으로 초임계 <TEX>$CO_2$</TEX>에 의한 팽창성을 검토 하고자 하였다. 반응 전 후의 변형 거동과 물성변화 관찰을 위해 파괴 및 비파괴 분석 시험을 실시하였다. 단축압축시험 결과 분석을 위해 균열닫힘, 균열개시, 불안정한 균열 성장 구간을 찾아서 검토하였으며, 선형탄성 구간에서의 탄성계수 및 포아송비를 비교 분석하였다. 그리고 비파괴 시험 중 탄성파 속도 측정 시험을 통하여 초임계 <TEX>$CO_2$</TEX>에 의한 암석 내부물성변화를 추정하였다. 실험결과, 초임계 <TEX>$CO_2$</TEX> 및 염수, 물 등 반응 조건이 변화함에 따라 암석의 변형거동 양상은 크게 달랐으며 물성 변화도 관측되었다. 덮개암 역할을 하는 셰일의 경우 사암에 비해 반응조건에 따라 물성이 민감하게 변화하였는데 셰일의 이와 같은 특성은 저류층의 안정성에 영향을 미칠 것으로 판단되었다. 본 연구의 결과는 앞으로 추가 실험을 통해 저류층의 지중저장 능력 및 안정성에 영향을 미치는 주요변수들의 상호관계를 규명하는데 기초적인 자료로 활용될 수 있을 것이다. In this study, a method is devised to implement a supercritical <TEX>$CO_2$</TEX> (<TEX>$scCO_2$</TEX>) injection environment on a laboratory scale and to investigate the effects of <TEX>$scCO_2$</TEX> on the properties of rock specimens. Specimens of shale and sandstone normally constituting the cap rock and reservoir rock, respectively, were kept in a laboratory reactor chamber with <TEX>$scCO_2$</TEX> for two weeks. From this stage, a chemical reaction between rock surface and the <TEX>$scCO_2$</TEX> was induced. The effect of saline water was also investigated by comparing three conditions (<TEX>$scCO_2$</TEX>-rock, <TEX>$scCO_2-H_2O$</TEX>-rock and <TEX>$scCO_2$</TEX>-brine(1M)-rock). Finally, we checked the changes in the properties before and after the reaction by destructive and nondestructive testing procedures. The swelling of shale was a main concern in this case. The experimental results suggested that <TEX>$scCO_2$</TEX> has a greater effect on the swelling of the shale than pure water and brine. It was also observed that the largest swelling displacement of shale occurred after a reaction with the <TEX>$H_2O-scCO_2$</TEX> solution. The results of a series of the destructive and nondestructive tests indicate that although each of the property changes of the rock differed depending on the reaction conditions, the <TEX>$H_2O-scCO_2$</TEX> solution had the greatest effect. In this study, shale was highly sensitive to the reaction conditions. These results provide fundamental information pertaining to the stability of <TEX>$CO_2$</TEX> storage sites due to physical and chemical reactions between the rocks in these sites and <TEX>$scCO_2$</TEX>.

Hinged External Fixation Distraction for Treatment of First Metatarsophalangeal Joint Arthritis

Treatment for hallux rigidus varies from joint preservation to joint destructive procedures. The objective of the present study was to report an alternative method of treatment of hallux rigidus using hinged external fixation distraction of the first metatarsophalangeal joint and to present our surgical technique. Ten distractions were performed in 9 patients (9 female feet [90%] and 1 male foot [10%]). The mean age at surgery was 41.0 (range 20 to 64) years. All patients had stage II or III hallux rigidus on the Regnauld classification system for hallux rigidus. The patients were evaluated clinically and radiographically before and after the distraction treatment. The mean period of fixation was 16.40 (range 7 to 21) weeks. Six of the patients (60%) with distraction experienced pin tract infections that were treated with oral antibiotics. The reported mean preoperative categorical pain score in 7 patients (7 feet) was 8.2 (range 5 to 10), and the postoperative score was 0.83 (range 0 to 2; p = .001). Of the 6 patients (6 feet) who responded to the remaining portion of the survey, 4 (66.67%) were very satisfied with their results, and 2 (33.33%) were satisfied with their surgical result. None of the patients required additional surgical treatment during the mean 2.2 (range 1.2 to 3.3) years of follow-up. Hinged first metatarsophalangeal joint distraction with external fixation has been shown to be a viable treatment option for joint preservation for stage II and III hallux rigidus in the short term.

In-situ study of the structure and dynamics of thermo-responsive PNIPAAm grafted on a cotton fabric

Stimuli-responsive polymeric materials can adapt to various surrounding environments, converting chemical and biochemical changes into optical, electrical and thermal signals, or changing wettability and adhesion properties upon external stimuli. Herein we report a cotton fabric modified with a thermo-responsive polymer, Poly(N-isopropylacrylamide) (PNIPAAm). 1H solid-state NMR techniques were used to characterize the molecular structure and dynamics of the PNIPAAm brushes, while still grafted on the cotton fabric surfaces, avoiding un-grafting destructive procedures. The results demonstrate that the motion of the grafted PNIPAAm brushes is restricted as the temperature rises above the low critical solution temperature (LCST), which was estimated to be ∼34 °C. Variable temperature (VT) experiments were used to investigate the nature of the hydrophilic-hydrophobic transitions of the grafted polymer. The 1H solid-state NMR techniques used proved to be an extremely sensitive and precise way to probe in-situ the LCST transition of the PNIPAAm brushes, while still grafted on cotton fibres.This work presents a high potential synthesis and analysis route towards stimuli-responsive cotton fibres which can find exceptional applications as novel intelligent fabrics for the textile related industries.

Diagnostic challenges of hemihematocolpos and dysmenorrhea in adolescents: obstructed hemivagina, didelphys or bicornuate uterus and renal aplasia is a rare female genital malformation

To develop a clear diagnostic and therapeutic strategy for adolescents presenting with abdominal pain and vaginal tumor caused by congenital female genital anomalies, such as blind hemivagina and uterine anomalies, as the lack of the correct diagnosis of the underlying anatomical genitourinary malformation frequently leads to destructive surgical procedures. Retrospective study, study group: patients with double/bicornuate uterus, blind hemivagina and hematocolpos (n=13), controls: patients with uterine malformation and complete vertical vaginal septum (n=11), analysis for: menarche, age at onset of symptoms, type of malformation, symptoms leading to admission and diagnostic/surgical techniques applied. Median age at diagnosis study group 19.85 (SD±6.23, range 13-23years) versus controls 26.09years (SD±7.44, 16-36years); predominance of imperforated hemivagina: 69.2% right-sided versus 30.8% left-sided septum; renal agenesis ipsilateral to imperforate hemivagina 100% study group versus 9.1% controls; 84.6% previous surgical interventions in the study group, such as partial removal of the septum and re-obliteration, unilateral salpingo-ovarectomy and vaginal drainage of pyometra. We used a single transvaginal surgical procedure, including removal of the obstructed vaginal septum and marsupialization of the blind hemivagina. A diagnostic and therapeutic algorithm for young women presenting with progressive dysmenorrhea and abdominal pain and/or vaginal tumor reduces destructive interventions.