Horizontal Part Research Articles

Three-dimensional structure of the basal lamella of the middle turbinate

The middle turbinate’s basal lamella (3BL) is a variable landmark which needs to be understood in endoscopic transnasal skull base surgery. It comprises an anterior frontal and a posterior horizontal part and appears in its simplest depiction to be “L”-shaped, when viewed laterally. In this study we analyzed its 3D morphology and variations focusing on a precise and systematic description of the anatomy. CBCTs of 25 adults, 19 cadavers and 6 skulls (total: 100 sides) were investigated with the 3DSlicer software, creating 3D models of the 3BL. We introduced a novel geometrical classification of the 3BL’s shape, based on segments. We analyzed their parameters and relationship to neighboring structures. When viewed laterally, there was no consistent “L”-shaped appearance of the 3BL, as it is frequently quoted. A classification of 9 segment types was used to describe the 3BL. The 3BLs had in average of 2.95 ± 0.70 segments (median: 3), the most frequent was the horizontal plate (23.05% of all segments), next a concave/convex plate (22.71%), then a sigma plate (22.37%). Further types were rare. We identified a horizontal plate in 68% of all lateral views whilst 32% of the 3BLs were vertical. A sigma–concave/convex–horizontal trisegmental 3BL was the most common phenotype (27%). Globally, the sigma–concave/convex pattern was present in 42%. The 3BL adhered the ethmoidal bulla in 87%. The segmenting method is eligible to describe the 3BL’s sophisticated morphology.

Compound usage of L shaped fin and Nano-particles for the acceleration of the solidification process inside a vertical enclosure (A comparison with ordinary double rectangular fin)

Performance enhancement of energy storing unite is a very important issue in renewable energy systems. In the present investigation, L shaped fins with two different orientations and various geometrical properties were considered to enhance the solidification performance inside a vertical enclosure. Furthermore, effect of two types of Nano-particles with different concentrations were evaluated. It was found that the application of downward L shaped fin is better than upward form in solidification process. Also, results revealed that case with same length in vertical and horizontal part of L shaped fin has best performance. Furthermore, results presented that there is no need to use high cost Nano-particles of Cu because low cost Nano-particles of Al2O3 have better performance in considered issue. Best performance was related to case 3 which had 12.3% enhancement in the solidification time. Also, between the downward fins, the best case was related to case 8 which provided about 21.5% reduction in the solidification time. Furthermore, it was found that the application of AL2O3 with concertation of 2% and case 8, provided about 27% improvement in the total melting time when compared to the Base case.

高度貧血を契機に診断されたステントグラフト内挿術後腹部大動脈瘤：十二指腸瘻の1例(Secondary aorto–duodenal fistula following endovascular abdominal aortic aneurysm repair diagnosed by severe anemia)

要旨腹部大動脈ステントグラフト（EVAR）は腹部大動脈瘤（AAA）に対する主な治療として位置づけられ，とくに開腹歴をもつ症例群に対する加療として，低侵襲性の観点で積極的に施行されている。EVAR後に発生するエンドリークは，治療にも関わらず瘤径拡大の主原因であり，周囲臓器との瘻孔や瘤破裂の発生などEVAR関連合併症が発生しうる。EVAR後の大動脈腸管瘻（AEF）の発生は非常に稀であるが，致命的な合併症として知られる。我々は，大腸癌で開腹歴をもつ70歳代女性の拡大傾向のある嚢状AAA対してEVARを施行したが，瘤拡大が持続し十二指腸に穿破した症例を経験した。EVAR術後6か月，16か月後にそれぞれエンドリークによる瘤径拡大に対する追加加療を行ったが，瘤径の制御が困難であった。術後20か月後に高度貧血に対する精査のために施行された上部消化管内視鏡検査の結果，AAAが十二指腸水平脚と交通し出血している所見を認め，AEFの診断となり緊急手術を行った。周術期死亡率の高い本症において，手術侵襲が大きくなることが予想される症例に対して，ステントグラフトを抜去せず瘤縫縮術を選択した1例を報告した。EVAR後の瘤拡大関連イベントに救急医が関わるケースが増えてくることが予想され，AEFの合併を念頭に置くべきである。

Anatomical observation of the right retroperitoneal fascia and its clinical significance in complete mesocolic excision for right colon cancer

Objective: To investigate the anatomic characteristics of the right retroperitoneal fascia and its surgical implementation while performing complete mesocolic excision (CME) for right colon cancer. Methods: A descriptive study was carried out. (1) Clinicopathological data and surgical videos of 17 non-consecutive patients undergoing laparoscopic right hemicolectomy (extended right hemicolectomy) with CME for right colon cancer at Department of Colorectal Surgery of Union Hospital, Fujian Medical University between January 2020 and October 2020 were retrospectively collected. The construction of right retroperitoneal fascia was observed from caudal dorsal direction and caudal ventral direction. (2) Three postoperative specimens from 3 cases undergoing laparoscopic right hemicolectomy with CME for right colon cancer in June 2020 were prospectively included to observe anatomy and examine histology. (3) Five abdominal cadaver specimens from the Department of Anatomy of Fujian Medical University were enrolled, including 3 males and 2 females. Anatomical observation and histological studies were performed from the cranial approach and the caudal dorsal approach. Masson staining was used to examine the histology. Results: (1) Surgical video observation: The typical structure of right retroperitoneal fascia could be observed in all the 17 patients. The fascia was a rigid barrier between the posterior space of the ascending colon and the anterior pancreaticoduodenal space behind the transverse colon. The right retroperitoneal fascia should be sharply cut to communicate between the two spaces to avoid entering the right mesocolon by mistake. The severed ventral stump of the right retroperitoneal fascia ran along the dorsal side of the right hemicolon to the lateral side, and the dorsal stump covered the level of the duodenum caudally, and continued to move downward, covering the surface of Gerota's fascia. (2) Observation of 3 surgical specimens: The dorsal side of the right mesocolon was smooth and intact, which could be anchored in the corresponding area of the lateral edge of the duodenum. The ventral stump of the right retroperitoneal fascia could be seen, which attached to the dorsal side of the right mesocolon semi-circularly. Masson staining observation: The ventral stump of the right retroperitoneal fascia ran cephalad, fused with the dorsal side of the right mesocolon tightly and curled. The caudal side of confluence and the dorsal side of the right mesocolon presented a bilobed structure. (3) Anatomy of 5 cadaveric specimens: The right retroperitoneal fascia was a thin fascia structure, which was a rigid barrier between the anterior pancreaticoduodenal space behind the transverse colon and the posterior space of the ascending colon. The ventral stump of the right retroperitoneal fascia (including the dorsal side of the right mesocolon), the dorsal stump of the right retroperitoneal fascia (including part of the duodenal wall) and the dorsal side of the right mesocolon were retrieved for histological examination. The ventral stump of the right retroperitoneal fascia fused with the dorsal side of the right mesocolon by the cephalic side, and the dorsal side of the right hemi-mesocolon on the fusion level by caudal side gradually separated into a double-layer loose fascial structure. The dorsal stump of the right retroperitoneal fascia covered the surface of the duodenum level, moved on from the ventral side to the surface of the prerenal fascia, and continued to the caudal side. Conclusions: The right retroperitoneal fascia is a rigid barrier between the anterior pancreaticoduodenal space behind the transverse colon and the posterior space of the ascending colon. The Toldt fascia formed by fusion with the dorsal lobe of the right colon travels to the edge of the descending and horizontal part of the duodenum and separates again. The right retroperitoneal fascia is attached to the edge of the duodenum, reversing and running on the surface of the prerenal fascia, while the dorsal lobe of the right colon runs in front of the pancreas and duodenum, and shifts to the pancreaticoduodenal fascia. During the operation, this fascia should be identified and cut to penetrate the anterior pancreaticoduodenal space behind the transverse colon and the posterior ascending colon space, which helps to ensure the integrity of the dorsal side of the right hemi-mesocolon.

Determination of the Loading of a Flat Rack Container during Operating Modes

This research deals with determination of the loading of an open container during operating modes. The special feature of this container is its convex walls. This engineering solution increases the useful capacity of a container by 8% in comparison to that of the prototype. The elastic elements in the bearing structure of a container were introduced to decrease the dynamic loads. The dynamic loads in the vertical plane were dumped by means of the dry friction forces between the components of the cross bearers of the container’s base. The dynamic loads in the longitudinal plane were dumped by means of the dry friction forces between the horizontal parts of fittings and fixed lashing components. This study presents the modelling of the dynamic loading of a container in a vertical plane. The dynamic loads of a container in the longitudinal plane were determined with a mathematical model. The authors determined the basic strength characteristics of the bearing structure of a container; and found that the maximum stresses to a container were about 200 MPa, concentrated near the front fittings. The maximum displacements were recorded in the cross bearers of the base and amounted to about 4 mm.

The traditional approximation of rotation for rapidly rotating stars and planets

Context. The traditional approximation of rotation (TAR) is a treatment of the hydrodynamic equations of rotating and stably stratified fluids in which the action of the Coriolis acceleration along the direction of the entropy and chemical stratifications is neglected because it is weak in comparison with the buoyancy Archimedean force. This leads to the neglect of the horizontal projection of the rotation vector in the equations for the dynamics of gravito-inertial waves (GIWs). The dependent variables in those equations then become separable into radial and horizontal parts as in the non-rotating case. The TAR is built on the assumptions that the star is spherical (i.e., its centrifugal deformation is neglected) and uniformly rotating. However, it has recently been generalised to include the effects of a moderate centrifugal deformation using a perturbative approach. Aims. We study the feasibility of carrying out a new generalisation to account for the centrifugal acceleration in the case of strongly deformed uniformly and rapidly rotating stars (and planets), and to identify the validity domain of this approximation. Methods. We built a complete formalism analytically that allows the study of the dynamics of GIWs in spheroidal coordinates which take the flattening of uniformly and rapidly rotating stars into account by assuming the hierarchies of frequencies adopted within the TAR in the spherical case. Results. Using 2D stellar models, we determine the validity domain of the generalised TAR as a function of the rotation rate of the star normalised by its critical angular velocity and its pseudo-radius. Assuming the anelastic and the two-dimensional Jeffreys-Wentzel-Kramers-Brillouin approximations, we derive a generalised Laplace tidal equation for the horizontal eigenfunctions of the GIWs and their asymptotic wave periods, which can be used to probe the structure and dynamics of rotating deformed stars with asteroseismology. The generalised TAR where the centrifugal deformation of a star (or planet) is taken into account non-perturbatively allows us to identify, within the framework of 2D Evolution STEllaire en Rotation models, the validity domain of this approximation which is reduced by increasing the rate of rotation. We can affirm with a level of confidence of 90% that the TAR remains applicable in all the space domain of deformed stars rotating at a rotation rate lower than 20% of the critical rotation rate. Conclusions. A new generalisation of the TAR, which takes the centrifugal acceleration into account in a non-perturbative way, is derived. This generalisation allows us to study the detectability and the signature of the centrifugal effects on GIWs in rapidly rotating deformed stars (and planets). We found that the effects of the centrifugal acceleration in rapidly rotating early-type stars on GIWs are theoretically detectable in modern space photometry using observations from Kepler. We found also, by comparing the period spacing pattern computed with the standard and the generalised TAR, that the centrifugal acceleration affects the period spacing by increasing its values for low radial orders and by decreasing them slightly for high radial orders.

What's your name again? A review of the superior longitudinal and arcuate fasciculus evolving nomenclature.

Studies of the superior longitudinal fasciculus (SLF) have multiplied in recent decades owing to methodological advances, but the absence of a convention for nomenclature remains a source of confusion. Here, we have reviewed existing nomenclatures in the context of the research studies that generated them and we have identified their agreements and disagreements. A literature search was conducted using PubMed/MEDLINE, Web-of-Science, Embase, and a review of seminal publications, without restrictions regarding publication date. Our search revealed that diffusion imaging, autoradiography, and fiber dissection have been the main methods contributing to tract designation. The first two have been particularly influential in systematizing the horizontal elements distant from the lateral sulcus. Twelve approaches to naming were identified, eight of them differing considerably from each other. The terms SLF and arcuate fasciculus (AF) were often used as synonyms until the second half of the 20th century. During the last 15 years, this has ceased to be the case in a growing number of publications. The term AF has been used to refer to the assembly of three different segments, or exclusively to long frontotemporal fibers. Similarly, the term SLF has been employed to denote the whole superior longitudinal associative system, or only the horizontal frontoparietal parts. As only partial correspondence can be identified among the available nomenclatures, and in the absence of an official designation of all anatomical structures that can be encountered in clinical practice, a high level of vigilance regarding the effectiveness of every oral or written act of communication is mandatory.

Utility of observation of the horizontal part of the duodenum by upper gastrointestinal endoscopy combined with manual compression of the umbilical region

Observation of the horizontal part of the duodenum by upper gastrointestinal endoscopy is not routinely performed due to the physical burden to patients. Determining in which patients observation of the horizontal part of the duodenum by upper gastrointestinal endoscopy should be attempted remains a challenge. We actively observe the horizontal part of the duodenum by upper gastrointestinal endoscopy in cases in which balloon-assisted endoscopy is considered. We report two patients in whom the horizontal part of the duodenum could be observed by upper gastrointestinal endoscopy combined with manual compression of the umbilical region.

Экспериментальное исследование процессов эвакуации и спасения людей при пожаре с этажерки технологической линии газоперерабатывающего завода

To meet the requirements of Federal Law № 123-FZ dated July 22, 2008 «Technical Regulations on fire safety requirements», it is required to determine the estimated time of people evacuation and rescue from the hazardous production facility. To solve this problem, an experimental study of the processes of people evacuation and rescue from the structure of the real gas processing plant was conducted. Evacuation and rescue were carried out from the sections of the pipe rack most remote from the exits from it. The ways for the evacuation and rescue included both horizontal parts and stairs. Rescue was carried out using special stretchers, in which there was a dummy imitating an injured person. The time of evacuation and rescue was determined when moving both down and up, which can take place at the enterprises of the oil and gas industry. The time of movement in different sections was determined by the stopwatches. Based on the measured time and the parameters of the sections along which the movement took place, the movement speeds during evacuation and rescue were found. The evacuation experiments involved untrained people, while the rescue experiments involved professional rescuers. The average movement speeds in the evacuation simulation were as follows: down the stair — 100 m/min, up — 44 m/min, along the horizontal section — 193 m/min. The average movement speeds with a victim during the simulation of rescue were the following: down the stair —22 m/min, up —16 m/min, along the horizontal path — 102 m/min.

Correlations between Low Doses of Zearalenone, Its Carryover Factor and Estrogen Receptor Expression in Different Segments of the Intestines in Pre-Pubertal Gilts-A Study Protocol.

Plant materials can be contaminated with Fusarium mycotoxins and their derivatives, whose toxic effects on humans and animals may remain subclinical. Zearalenone (ZEN), a low-molecular-weight compound, is produced by molds in crop plants as a secondary metabolite. The objective of this study will be to analyze the in vivo correlations between very low monotonic doses of ZEN (5, 10, and 15 μg ZEN/kg body weight—BW for 42 days) and the carryover of this mycotoxin and its selected metabolites from the intestinal contents to the intestinal walls, the mRNA expression of estrogen receptor alfa (ERα) and estrogen receptor beta (ERβ) genes, and the mRNA expression of genes modulating selected colon enzymes (CYP1A1 and GSTP1) in the intestinal mucosa of pre-pubertal gilts. An in vivo experiment will be performed on 60 clinically healthy animals with initial BW of 14.5 ± 2 kg. The gilts will be randomly divided into a control group (group C, n = 15) and three experimental groups (group ZEN5, group ZEN10, and group ZEN15; n = 15). Group ZEN5 will be administered per os 5 μg ZEN/kg BW (MABEL), group ZEN10—10 μg ZEN/kg BW (NOAEL), and group ZEN15—15 µg ZEN/kg BW (low LOAEL). In each group, five animals will be euthanized on analytical dates 1 (exposure day 7), 2 (exposure day 21), and 3 (exposure day 42). Samples for in vitro analyses will be collected from an intestinal segment resected from the following regions: the third (horizontal) part of the duodenum, jejunum, ileum, cecum, ascending colon, transverse colon, and descending colon. The experimental material will be collected under special conditions, and it will be transported to specialist laboratories where samples will be obtained for further analyses.

Skin landmarks to main cerebral structures: how to identify the main cerebral sulci? An anatomical study.

Neuronavigation is used in neurosurgical practice to locate the cortical structures. If this tool is unavailable, basic anatomical knowledge should be used. Craniometry has been rarely detailed in recent literature, systematically using bony landmarks. The aim of this study is to describe skin landmarks for neurosurgical practice. Dissection of 10 hemispheres with insertion of radio-opaque markers within the limits of lateral sulcus, central and pre-central sulci, and preoccipital notch. Computed tomography was performed in all cases and multiplanar reconstructions were performed. Maximal intensity projection (MIP) fusion images were used for measurements between known skin landmarks and sulci of interests. The Anterior Sylvian Point is measured 31.8 ± 2.8mm behind the orbital wall, 36.9 ± 3mm above the zygomatic arch. The horizontal part of the lateral sulcus is measured 59 ± 6mm above the tragus. The Superior Rolandic Point is measured 190.7 ± 4.5mm behind the nasion. The Pre-occipital Notch is measured 37.0 ± 6.9mm above the tragus and 67.1 ± 6.4mm behind. The Ideal Entry Points (IEP) for ventricular punctures are measured 120.2 ± 7mm behind the nasion and 33.8 ± 3mm laterally for the frontal IEP, and 61.3mm ± 2.5mm above and 64.7 ± 6.8mm behind the tragus for the parieto-occipital IEP. In this study, we described simple skin landmarks for lateral sulcus, central sulcus, preoccipital notch, and an IEP for ventricular drainage. Precise knowledge of brain sulcal anatomy will guide patient's positioning, skin incision, and craniotomies; and permits checking of imaging data provided by neuronavigation systems.

Estimations of edge plasma and impurity performance on HL-2M with EMC3-EIRENE modelling

The three-dimensional edge transport code EMC3-EIRENE has been employed to investigate the edge plasma behavior and carbon impurity transport in the HuanLiuqi-2M (HL-2M) tokamak. It is found that the outboard divertor target has a narrower flux deposition width and therefore undergoes more intense peak heat flux than the inboard one. Detailed analyses of carbon impurity have been performed to obtain deeper insights into the mechanisms of edge impurity transport and mitigation of heat loads. As the increment in upstream density, a larger region in the intrinsic friction force dominant regime has been achieved in divertor region, while less impurity ionization source locates in the thermal force dominant region, and hence a better impurity screening has been obtained. The total power loss induced by carbon impurity shows no significant differences as the upstream density increases when it is higher than 1.5 × 1019 m−3, even though the total number of carbon ions in space obviously decreases. Further study on impacts of the impurity source locations has been performed. The carbon impurity eroded from the vertical part of the outboard target is likely to leak out into the upstream, which is attributed to that the region where the intrinsic friction force dominates is thin. On the other hand, the carbon impurity eroded from the inboard target and the horizontal part of the outboard target is under good control due to the wider region in the intrinsic friction force dominant regime.

Experimental realisation of build orientation effects on the mechanical properties of truly as-built Ti-6Al-4V SLM parts

Studying the mechanical properties of Selective Laser Melting (SLM) fabricated titanium parts built in a horizontal direction, parallel to the substrate, in a truly as-built condition, has always been a challenge. The problem is mainly related to the stress relaxation of horizontal parts after removal from the substrate, which causes a noticeable level of distortion when compared with vertically printed parts with no observable distortion. In this study, a novel design has been developed that enables fabrication of straight undistorted horizontal parts via an SLM route with no post-processing steps, and thus the mechanical properties of horizontal Ti-6Al-4 V (Ti64) samples in their truly as-built condition have been reported and compared with their vertically built counterparts. The study reveals that the vertical samples suffer from premature fracture in their truly as-built condition, while the horizontal parts perform similarly to post-treated samples. The analysis of the tensile test results shows that the fracture stress (maximum stress) of the truly as-built vertical parts is below the yield stress (YS) of the horizontal parts in their truly as-built condition, i.e. nearly 38 % of the Ultimate Tensile Strength (UTS). In addition to the truly as-built condition, the effect of machining was also studied to further highlight the effect of as-built surface removal on the mechanical properties of both vertically and horizontally deposited Ti-6Al-4 V(Ti64) SLM parts.

First results of endonasal balloon dacryoplasty use in recurrence after dacryocystorhinostomy

Background. In recurrent dacryocystitis after dacryocystorhinostomy, a re-operation is indicated. In recent years, some publications appeared concerning endonasal dacryoplasty using 9 mm-balloon in treatment of patients with recurrent dacryocystitis.
 Purpose to evaluate the possibility of using endonasal balloon dacryoplasty in recurrence after dacryocystorhinostomy.
 Materials and methods. Into the study, 6 patients (6 cases) were included who underwent endonasal endoscopic dacryocystorhinostomy for dacryocystitis 1-3 years before. In all patients, evaluation of Munks scores for epiphora, optical coherence tomography (OCT) based lacrimal meniscometry, dye disappearance test, lacrimal drainage system syringing and probing of its horizontal part, nasal endoscopy, multispiral computed tomography of lacrimal drainage system with contrast enhancement. In all patients, endonasal dacryoplasty using a balloon with 6 mm diameter was carried out. The follow-up period after surgery was 6 months.
 Results. In 4 patients, recovery was achieved, in 1 patient improvement was obtained, in 1 patient there was dacryostoma cicatrization.
 Conclusion. Preliminary results received in this study of the balloon dacryoplasty performed in 6 patients afford ground to consider it possible to use this method in patients with dacryocystitis recurrence after dacryocystorhinostomy. The matter of the prospects when using this method may be solved after further research aimed to increase the number of clinical observations to enhance the possibility of adequate statistical processing of obtained results, to extend the postoperative follow-up period, to develop the indications for this procedure, and to investigate the necessity in additional manipulations improving the effectiveness of endonasal balloon dacryoplasty.

STRESS STATE STUDY DURING ROLLING IN A BOX CALIBER WITH A CHILLED SURFACE

The article deals with the influence of the uneven distribution of the temperature field of the billet on the stress state of the strip when rolling in a box-shaped caliber for the production of pipe billets. Until recently, in the study of deformed and stressed state there were problems ones related to the accounting accuracy of the non-uniformity of deformation in the caliber itself, which when rolling in box-shaped calibers is significant due to the fact that the studied deformation zone has signs of a high zone. In addition, the shape of the caliber imposes its own imprint on the flow of the metal. It leads to the fact that in reality the deformation zone is much more complicated than it is represented. Therefore, a complex variation of the velocity field is formed during rolling along the length of the deformation zone consequently; a complex stress field is formed. The situation is even more complicated when trying to account for the influence of temperature fields on the metal flow and stress state. The studies were carried out for the modes and deformation schemes existing in production line. The finite element method for approximation of metal flow velocity fields and the variation principle of continuum mechanics were used as a mathematical apparatus. The occurrence of the zone of tensile transverse stresses is shown in the part of the strip under the horizontal contact surface. The reason for the occurrence of this zone is that when the length is reduced of a part of the strip heavily crimp by sides of the caliber, it tends to widen. Naturally, metal particles tend to flow not towards the vertical axis of symmetry of the caliber, but in the opposite direction. In addition, the central part of the strip tends to broaden itself. This leads to compressive transverse stresses at the side parts and tensile stresses at the contact center part. It is shown that from the point of view of defect formation, the most severe stress state pattern arises in places corresponding to the horizontal part of the contact surface of the strip after the strip leaves the rolls and the zone of the lateral surface located slightly below the corners of the workpiece.

十二指腸後腹膜穿通が疑われ非手術的加療を行った十二指腸水平脚憩室症の1例(A case of duodenal diverticulosis in the horizontal part suspected as duodenal retroperitoneal penetration treated with non–operative management)

要旨十二指腸憩室症自体は結腸憩室に次ぐ頻度で珍しい疾患ではないとされているが，報告例の多くが下行脚または傍乳頭憩室であり，水平脚の報告は限定される。いずれの部位でも無症状で特別な治療を要することは少なく経過観察されることが多いが，有症状時には部位によって鑑別に苦慮することがある。十二指腸後腹膜穿通と誤認した十二指腸水平脚憩室症の1例を経験したため，文献的考察を加えて報告する。症例は50歳代の女性。突然発症した腹痛を主訴に前医に救急搬送され十二指腸後腹膜穿通の診断にて入院となった。しかし，緊急手術となった際に対応が不能とのことで翌日に当院へ転院となった。来院後，消化性潰瘍による十二指腸後腹膜穿通と診断したが，病変は限局していたため非手術的に加療を開始した。臨床経過は順調に経過したが，2週間経過しても消化管造影にて十二指腸壁外への造影剤漏出と考えられる所見が消失せず，十二指腸後腹膜穿通ではない可能性を強く疑った。以前に画像検査を施行した医療機関にCTデータの送付を依頼し確認したところ，その時から十二指腸後面に見える部分にガス像を認めており，十二指腸憩室症と診断できた。十二指腸水平脚部の憩室は比較的稀であるが，有症状時には後腹膜穿通と鑑別が困難で，侵襲的処置が選択されてしまう可能性があり注意を要する。

A Sensorimotor Numerosity System.

Incoming sensory input provides information for the planning and execution of actions, which yield motor outcomes that are themselves sensory inputs. One dimension where action and perception strongly interact is numerosity perception. Many non-human animals can estimate approximately the number of external elements as well as their own actions, and neurons have been identified that respond to both. Recent psychophysical adaptation studies on humans also provide evidence for neural mechanisms responding to both the number of externally generated events and self-produced actions. Here we advance the idea that these strong connections may arise from dedicated sensorimotor mechanisms in the brain, part of a more generalized system interfacing action with the processing of other quantitative magnitudes such as space and time.

Description of the Vascular Anatomy of Livers with Absence of the Portal Bifurcation.

The absence of the portal bifurcation (APB) is a rare anatomic variation, in which the horizontal part of the left portal vein (PV) is missing. The aim of this study was to identify the vascular architecture in livers with APB. Computed tomography data for 17,651 patients were reviewed; five patients (0.03%) were found to present with APB. The liver volume and anatomy of APB patients were compared with those of 30 patients with normal livers. All the APB patients exhibited an independent posterior branch of the PV. The intrahepatic left PV (LPV) ran through either the ventral (n = 2, 40%) or dorsal side (n = 3, 60%) of the middle hepatic vein. The frequency of medial branches diverging from the LPV was higher in patients with APB than in normal patients (p < 0.001). The left hepatic duct (LHD) ran through the inside of the left lobe along the left PV in 40% of the patients with APB, whereas in the remaining 60% of the patients with APB, the LHD ran on the outside of the liver separately from the left PV and joined the right hepatic duct. The liver volume of the left lateral section was significantly smaller (p = 0.014), and the posterior section was significantly larger (p = 0.014) in patients with APB than in patients with normal livers. The unique anatomical characteristics and the positional relation of the vessels should be considered preoperatively in patients with APB.

The Effect of Small Density Differences at River Confluences

Remarkable 3D flow structures occur at river confluences with small density differences due to differences in sediment concentration or temperature. We explain these by comparing numerical simulations for an idealized confluence with aerial photographs of several river confluences where color differences express the pattern of density differences at the surface. We analyzed numerical simulations of the Rio Negro–Solimões confluence near Manaus, Brazil, in more detail. The numerical model of the idealized confluence showed that the dense water flowed under the light water and the light water over the dense water in a spiraling motion, distorting the interface between the two waters. The horizontal part of this interface moves upwards in downstream direction. Constraining of the spiraling motion in a narrow river downstream of the confluence can cause local up- and downwelling near the banks. A mixing layer can develop when the flow velocities of the two tributaries differ, but strong spiraling motion due to the density differences can suppress this development. The aerial photographs and all numerical simulations showed similar density patterns at the water surface. Even small density differences can have a significant impact and hence need to be considered when analyzing and modeling 3D flow at confluences.

Establishing patterns in the dynamic loading on the body of a semi­wagon with an elastic middle part of the girder beam

To reduce the dynamic loading and prolong the service life of a semi-wagon's girder beam by improving its fatigue strength, it has been proposed to improve its design. A special feature of the girder beam is that its middle part (the distance between the rear supports of auto-couplings) consists of a U-shaped profile, covered with a horizontal sheet above which an I-beam is located. Elastic elements are placed between the horizontal part of the U-shaped profile's shelf and the sheet. Mathematical modeling was performed to substantiate the proposed technical solution. A mathematical model has been constructed describing the fluctuations of the bouncing wagon. It has been established that the maximum vertical acceleration of the body is about 1.8 m/s 2 (0.18 g), and of the bogie ‒ about 9.0 m/s 2 (0.9 g). Based on our calculations, we can conclude that a wagon's movement is assessed as excellent. In this case, the use of the girder beam with elastic links makes it possible to reduce the dynamic load on a wagon, in comparison with the prototype, by almost 35 %. The main indicators of the strength of the improved load-bearing structure of a wagon have been determined. The maximum equivalent strains occur, in this case, in the upper horizontal sheet of the girder beam, and are 136.0 MPa, which are lower, by 20 %, than those of the prototype wagon. The results of the modal analysis of the load-bearing structure of a semi-wagon taking into consideration the improvement measures have demonstrated that their natural frequencies of oscillations are within the permissible limits. Our research could help reduce the dynamic loading on the load-bearing structures of wagons in operation, as well as design the innovative structures of rolling stock