Large Amounts Of Fluid Research Articles

Peningkatan Kadar Troponin-I Paska Resusitasi Cairan pada Sus Scrofa Sebagai Model Hewan Coba Renjatan

Provision large amounts of fluids in a short period is known can cause hypervolemia. Therefore, an examination is needed to find out that the fluid resuscitation being administered does not cause hypervolemia. The purpose of this study is to assess the effect of hypervolemic resuscitation on cardiac contractility. The study was conducted on 10 male Sus Scrofa aged 6-8 weeks, as shocked animal models. There are 3 types of resuscitation treatments : normovolemic, hypervolemic-1, and hypervolemic-2. Cardiac contractility was assessed using DPmax and troponin-i levels. There was an increase in troponin-i levels after hypervolemic fluid resuscitation (p = 0.05). There is a decrease in cardiac contractility after hypervolemic resuscitation. Decreased cardiac contractility is associated with increased troponin-i (r = 0.720; p = 0.020). Based on the results, we conclude hypervolemic resuscitation causes changes in troponin-i levels, which reflect changes in cardiac contractility.

Monitoring fluid reservoir in an enhanced geothermal system using magnetotellurics

Geothermal exploration plays an increasing role worldwide and in Australia in order to meet carbon emission targets and to provide green and renewable energy alternatives to coal. In Australia, EGS systems are widely used to extract geothermal energy from the subsurface. Initially, the stimulation process involves pumping large amount of fluids into the subsurface at depths of reasonable temperature to ensure a maximum energy output. The high-pressured fluids penetrate from the borehole into the surrounding sedimentary rocks and increase the permeability of the system until the stimulation is finished. Subsequently, a second borehole is put in place to extract the heated fluids.

Genetic relationship between fenitized ores and hosting dolomite carbonatite of the Bayan Obo REE deposit, Inner Mongolia, China

The Bayan Obo deposit is the largest rare-earth element (REE) deposit in the world. In this deposit, ore bodies are hosted in fine-grained ore-bearing dolomite marbles, known as the H8 dolomite marble. The H8 dolomite marble has been considered as part of the Bayan Obo Group composed Paleoproterozoic sedimentary rocks. However, the H8 dolomite marble can be younger than the Bayan Obo Group, and thus, the genesis of the dolomite marble should be re-examined. In this paper, we describe petrography and compositions of the H8 dolomite marble. The dolomite marbles generally have high FeO, MnO and SrO contents, different from sedimentary limestone or dolostone but similar to dolomite carbonatites. In composition, they can be grouped into magnesio-carbonatite and ferro-carbonatite. Texturally they are porphyritic and comprise originally hypabyssal intrusions. It is thus proposed that carbonatitic magmas injected slowly into a magma chamber where they have undergone fractionation to produce evolved dolomite-carbonatite magmas rich in alkali, REE, Fe and volatile components. Such evolved, metal-rich magmas were consequently injected along the contact zone between the early dolomite carbonatite sill and other layer of the Bayan Obo Group, and produced an large fenitization aureole enclosing ores rich in Fe, Nb, REE, F and alkali metals. Changes in CO2/H2O ratios, oxygen fugacity and halogen content of fluids were responsible for the formation of different types of ore, including massive magnetite-rich, aegirine-rich and Na-amphibole-rich ores. Considering the fact that the ore bodies are located at the place where dolomite carbonatites are relatively thick and the fenitization is relatively extensive, we speculate that the ore formation was genetically related to extensive fenitization involving exsolution of large amounts of fluids and subsequently extensive metasomatism. It is concluded that carbonatitic magmas played a major role in the formation of the REE mineralization in the Bayan Obo deposit.

Perioperative Fluid Accumulation Impairs Intestinal Contractility to a Similar Extent as Peritonitis and Endotoxemia.

Perioperative resuscitation with large amounts of fluid may cause tissue edema, especially in the gut, and thereby impairing its functions. This is especially relevant in sepsis where capillaries become leaky and fluid rapidly escapes to the pericapillary tissue. We assessed the effects of endotoxemia and peritonitis, and the use of high and moderate volume fluid resuscitation on jejunal contractility. We hypothesized that both endotoxemia and peritonitis impair jejunum contractility and relaxation, and that this effect is aggravated in peritonitis and with high fluid administration. Pigs were randomized to endotoxin (n = 16), peritonitis (n = 16), or sham operation (n = 16), and either high (20 mL/kg/h) or moderate volume (10 mL/kg/h) fluid resuscitation for 24 h or until death. At the end of the experiment, jejunal contractility and relaxation were measured in vitro using acetylcholine and sodium nitroprusside reactivity, and the effect of nitric oxide synthase inhibition (NOS-I) was assessed. Mortality in the respective groups was 88% (peritonitis high), 75% (endotoxemia high), 50% (peritonitis moderate), 13% (endotoxemia moderate and sham operation high), and 0% (sham operation moderate volume resuscitation). Although gut perfusion was preserved in all groups, jejunal contractility was impaired in the two peritonitis and two endotoxemia groups, and similarly also in the sham operation group treated with high but not with moderate volume fluid resuscitation (model-fluid-contraction-interaction, P = 0.036; maximal contractility 136 ± 28% [average of both peritonitis, both endotoxemia and sham operation high-volume groups) vs. 170 ± 74% of baseline [sham operation moderate-volume group]). NOS-I reduced contractility (contraction-inhibition-interaction, P = 0.011) without significant differences between groups and relaxation was affected neither by peritonitis and endotoxemia nor by the fluid regimen. Intestinal contractility is similarly impaired during peritonitis and during endotoxemia. Moreover, perioperative high-volume fluid resuscitation in sham-operated animals also decreases intestinal contractility. This may have consequences for postoperative recovery.

Endoscopic Ultrasound-Guided Drainage of a Walled-Off Pancreatic Necrosis via Cystoesophagostomy

A 45-year-old woman with a history of recurrent necrotizing pancreatitis presented with severe abdominal pain and nausea for ten days. A CT scan of the abdomen and pelvis revealed an organized fluid collection measuring 14.6 x 10.2 cm in the subcapsular spleen and 5.0 x 3.8 cm in the pancreatic tail consistent with walled off pancreatic necrosis (WOPN; Image 1). Endoscopic ultrasound (EUS)-guided drainage was subsequently pursued. On EGD, extrinsic compression was noted in the superior portion of the gastric fundus near the cardia. A 14-cm fluid collection with internal debris was identified via EUS (Image 2). Under endosonographic guidance, a 19-gauge FNA needed was used to puncture the fluid collection. A cautery-enhanced, lumen-apposing metal stent (LAMS) was deployed into the fluid cavity. After deployment of the proximal phlange, the stent was noted to be at the level of the squamo-columnar junction. A large amount of fluid and debris drained spontaneously from the stent, confirming appropriate stent position. The patient was treated with antibiotics and her pain significantly improved. Eight days after stent deployment, repeat CT scan demonstrated near complete resolution of the WOPN (Image 3). An EGD was performed the following day and the stent was noted at the level of the squamocolumnar junction and removed. EUS-guided transmural drainage is currently the main modality for management of WOPN. Typically, a cystgastrostomy or cystduodenostomy is performed in which a fistula is created between the abscess and the stomach wall or the bowel wall, respectively. Success rates for these procedures are reported at 82%-100% and mortality rates less than 1%. Here, we describe the first case of a successful drainage of a WOPN via cystoesophagostomy. The atypical location of the WOPN, posterior to the junction of the cardia and fundus, allowed for trans-mural stent placement at the level of the distal esophagus. Our case demonstrates that WOPN in the proximal stomach can safely be drained via transmural drainage at the level of the squamocolumnar junction.2107_A Figure 1. CT Abdomen/Pelvis with contrast showing a lesion measuring 14.6-cm x 10.2-cm in the subcapsular spleen and 5.0-cm x 3.8-cm in the pancreatic tail2107_B Figure 2. EUS showing a 14-cm lesion compressing the superior portion of the gastric fundus2107_C Figure 3. CT Abdomen/Pelvis without contrast showing near resolution of the previously described lesion

Metamorphism and fluid evolution of the Sumdo eclogite, Tibet: Constraints from mineral chemistry, fluid inclusions and oxygen isotopes

The Sumdo metamorphic belt, located in the Lhasa terrane of Tibet, is a key area for unraveling the Paleo-Tethys evolution. In order to identify the fluid evolution in oceanic subduction zones, eclogite from the Sumdo metamorphic belt, has been investigated in a combined study of petrography, mineral chemistry, fluid inclusions and oxygen isotopes. On the basis of petrography and mineral chemistry, two kinds of garnet were distinguished. The core part of Grt-I shows increasing grossular content and contains prograde mineral inclusions, suggesting that it grew during prograde metamorphism, while the rim of Grt-I shows varying grossular and pyrope contents, representing subsequent overgrowth. Grt-II displays a composition comparable with the outermost part of Grt-I, indicating that Grt-II grew at the peak or initial retrograde stage. Garnet trace element zoning patterns and P-T estimates suggest that the Sumdo eclogite experienced a heating stage during an initial exhumation after the peak metamorphic event.Based on textural criteria and host minerals, three types of fluid inclusions were distinguished: Type-I are primary NaCl dominated intermediate to high-salinity (10–22 wt% NaCl) fluid inclusions hosted by omphacite, which were most likely released during dehydration of the subducting oceanic crust and reflect the composition of eclogite-facies fluids; Type-II are defined as primary low-salinity (1–6 wt% NaCl) fluid inclusions hosted by epidote/clinozoisite, representing fluids that evolved towards low-salinity during uplift; Type-III are secondary low-salinity (0–7 wt% NaCl) fluid inclusions hosted by matrix quartz (i.e., minerals other than the mineral inclusions) and rarely by omphacite and must have formed at a very late stage. In addition, the eclogite displays δ18O values (δ18O = +5.0 to +8.9‰) similar to its protolith, low-temperature altered oceanic crust (δ18O = +4.9 to +12.7‰). The equilibrium oxygen isotope fractionations (Δ18OQtz-Min) between quartz and garnet/omphacite suggest isotopic equilibrium and a closed fluid system during eclogite facies metamorphism. Our data indicate that the Sumdo eclogite experienced “hot” exhumation, during which large amounts of fluids were released by dehydration. Fluids in the Sumdo eclogite were typically aqueous fluids of varying salinities and now preserved as fluid inclusions in HP metamorphic minerals. In comparison with continental subduction zones, we confirm previous conclusion that the fluid regime in oceanic subduction zones is relatively simple (i.e. mainly NaCl bearing brines) with seawater-altered slabs as the dominant source.

Significance of OH, F and Cl content in biotite during metamorphism of the Western Adamello contact aureole

The hydroxyl (O(4)) site composition of biotite can in principle be used to retrieve information about fluid composition during fluid–rock interaction; however, due to low F and Cl content, as well as difficulties involved with analyzing the H2O content using in situ techniques, measuring these species in biotite has remained an elusive goal. Here we present high-precision secondary ion mass spectrometry (SIMS) OH–F–Cl measurements from biotite within metapelites from the Western Adamello Tonalite (WAT) contact aureole, Northern Italy. Fluorine, chlorine and hydrogen are analyzed on the SIMS sequentially by peak-hopping at the same biotite spot; H2O, F and Cl content were measured with a precision (1σ) οφ 0.06 ωτ%, 50 ανδ 5 ππµ, ρeσπeχτιϖeλψ. The compositions of isolated biotite crystals in andalusite are compared with that of biotite in the matrix, documenting that halogens and H2O behave refractory in biotite during the time scale of contact metamorphism. The H2O and halogen contents of biotite are mostly locked in during the prograde to peak formation of biotite, and are not reset during further heating or cooling, unless significant biotite recrystallization occurs. It also appears that both Ti content and XMg of the biotite from the Western Adamello contact aureole were not significantly reset during cooling. The concentration of F and Cl does not vary systematically with metamorphic grade, which indicates that these species reflect initial compositions. No significant Rayleigh fractionation behavior was observed for these elements. H2O variations in the biotite from samples throughout the Western Adamello contact aureole suggest that Al-oxy substitution partially controls the variations in OH content through charge balance of the type R2+,VI + OH− = Al3+,VI + O2− + H2, while the Ti-oxy substitution does not seem to influence the O(4) site occupation. The main titanium substitution appears to be the Ti-vacancy ( $${\text{2}}{{\text{R}}^{{\text{2}}+}}~=~{\text{T}}{{\text{i}}^{{\text{4}}+}}~+\,{\square ^{{\text{VI}}}}$$ ) exchange. Variations in H2O and halogen concentrations in biotite define sub mm-scale areas of localized equilibration, even for biotite recrystallized during dehydration reactions that produced large amounts of fluid (chlorite or muscovite breakdown). Similar systematics were observed for Ti4+ and Al3+. These findings further support the increasing number of observations that kinetics control much of the mineralogical reactions occurring in contact aureoles, and hence care is advised in using equilibrium thermodynamics in this environment.

Fluidoterapia nos pacientes em choque séptico: revisão de literatura

Sepse, definida pela Síndrome da Resposta Inflamatória Sistêmica (SRIS) secundária a um agente infeccioso, é uma afecção comum em cães e gatos e está relacionada a altos índices de morbidade e mortalidade nestas espécies. Sua patogenia é complexa e multifatorial, mas a instabilidade hemodinâmica tem sido apontada como fator relevante para o alto índice de óbito nos pacientes, pois gera hipóxia e subsequente disfunção de múltiplos órgãos. O tratamento é baseado na terapia guiada por metas e tem como objetivo restaurar o equilíbrio circulatório pela infusão de grandes quantidades de fluido, sendo que a escolha da fluidoterapia adequada é ainda muito controversa. Assim, esta revisão descreve a fisiopatogenia da sepse e compara resultados do uso de coloides e cristaloides apresentados nos periódicos consultados.

Design of a Biomimetic Hydrogel Nanocomposite Material for Responsive Wound Management

Current wound management technology can inhibit the healing process due to poor adhesion to the wound surface, low uptake of exudate, and lack of inherent antimicrobial properties. Alternatives to traditional wound dressings include hydrogels, which are supramolecular matrices, stabilized by non-covalent interactions that absorb large amounts of fluid and exhibit flexible behavior. This research uses an amino acid-calcium complex to crosslink an alginate hydrogel which is further functionalized with metal (Ag, Au) nanoparticles. Previous research has shown that amino acids such as tryptophan and serine have increased the non-covalent interactions within the network, resulting in greater gel strength. The hydrodynamic radius and structural diversity of the amino acid has also been shown to exhibit an inverse relationship between the gels ability to swell and its tensile strength. To harness the porosity and swelling capacity of the hydrogel, conductive polymers polyaniline (PANI) or polypyrrole (PPy) can be layered onto the biomimetic hydrogel to yield a responsive wound dressing. As wound secretions diffuse through the hydrogel and into the electroactive layer, the conductivity of the matrix increases and induces an electrochemical signal. The efficacy of the composite is characterized by simultaneously measuring swellability and the increase in conductivity, indicating the point of saturation. Initial results showed that after 150 minutes in a simulated wound environment, the composite swelled upwards of 150% and increased in conductivity up to 20%.

Fluid and carbon flux estimation of regional metamorphic fluid flow in Glen Esk, SE Scottish Highlands: The role of hydrodynamic dispersion for broadening of an isotopic front

During metamorphism, large quantities of fluids are mobilized and transported through the crust. Such fluids may interact with surrounding rock and serve as a medium for chemical transport. In this study, we use coupled carbonation and oxygen isotope fronts to estimate fluid and carbon fluxes for metamorphic fluid flow in vein pathways in the Dalradian metasediments that crop out in Glen Esk, SE Scottish Highlands. Comparison of wall rock and vein oxygen isotope ratios indicate that the Barrovian sequence in Glen Esk was infiltrated by at least two separate fluid flow events, where fluid flow from the North Esk Fault overprints an earlier fluid flow event, for which the syn-metamorphic magmatic intrusions north of Glen Esk are a probable fluid source. Advection is the dominating mode of fluid transportation in veins. By advection-dispersion and advection-diffusion modeling, we estimate a time-averaged fluid flux of 0.0005 to 0.0135 m3 · m−2 · yr−1 and a carbon flux of 0.04 to 0.71 mol C · m−2 · yr−1for fluid flow from the North Esk fault into the Dalradian metasediments. The duration of this fluid flow event is estimated to between 11 and 230 kyr. Our results also indicate that hydrodynamic dispersion was the main reason for broadening of the oxygen isotope front.

Nanofluid as coolant for grinding process: An overview

This paper reviews the recent progress and applications of nanoparticles in lubricants as a coolant (cutting fluid) for grinding process. The role of grinding machining in manufacturing and the importance of lubrication fluids during material removal are discussed. In grinding process, coolants are used to improve the surface finish, wheel wear, flush the chips and to reduce the work-piece thermal deformation. The conventional cooling technique, i.e., flood cooling delivers a large amount of fluid and mist which hazardous to the environment and humans. Industries are actively looking for possible ways to reduce the volume of coolants used in metal removing operations due to the economical and ecological impacts. Thus as an alternative, an advanced cooling technique known as Minimum Quantity Lubrication (MQL) has been introduced to the enhance the surface finish, minimize the cost, to reduce the environmental impacts and to reduce the metal cutting fluid consumptions. Nanofluid is a new-fangled class of fluids engineered by dispersing nanometre-size solid particles into base fluids such as water, lubrication oils to further improve the properties of the lubricant or coolant. In addition to advanced cooling technique review, this paper also reviews the application of various nanoparticles and their performance in grinding operations. The performance of nanoparticles related to the cutting forces, surface finish, tool wear, and temperature at the cutting zone are briefly reviewed. The study reveals that the excellent properties of the nanofluid can be beneficial in cooling and lubricating application in the manufacturing process.

Fluid Migration in a Subducting Viscoelastic Slab

AbstractMetamorphic dehydration reactions in a subducting slab release fluids that trigger arc volcanism and are thought to be responsible for intermediate‐depth seismicity. The fluid flow from the source is controlled by buoyancy and compaction pressure which is modified by viscous and elastic effects. In this paper, we investigate how fluid migrates in viscoelastic slab by using 2‐D and 3‐D numerical models based on a theory of two‐phase flow. When bulk viscosity is sufficiently low, viscosity plays a dominant role and fluid goes up almost vertically soon after its release producing porosity waves. When a higher bulk viscosity is assumed, a large amount of fluid is trapped in a high porosity region produced by the fluid source and migrates along the source except for a case where the ratio of permeability (K) to fluid viscosity (μ) is relatively low. We also find that porosity increases in the deeper part of the fluid source in cases with intermediate and low values of . In 3‐D, fluid focusing occurs where the slab bends away from the trench causing a local increase in porosity and compaction pressure. These findings may help us explain several types of observations in subduction zones including slow earthquakes at the plate interface, low seismic wave velocities in the oceanic crust, double seismic zones in the slab, and shallow subduction angle at the bend of the slab.

Small intestinal herniation through the broad ligament in a mare outside of the gestation period – a case report

A Furioso-North Star mare, aged 8 years, was examined for colic signs. The mare had a history of dystocia and post partum vaginal lacerations, acute endometritis and laminitis approximately one year before the admission for colic. Signs of persistent abdominal pain, moderate distended abdomen, non-passage of manure, fever, tachycardia, tachypnoea, congested mucus membranes, and “toxic line” were recorded. No intestinal borborygmi were present in the four quarters of the abdomen. On rectal examination, the colon, the ventral band of the caecum, the right ovary and the uterine horn were palpated on the right side of the abdomen. The spleen, the nephrosplenic ligament, the left ovary and a firm, distended and painful small intestine (SI) loop were palpated on the left side. The left uterine horn and the adjacent broad ligament were not detectable. Percutaneous abdominal ultrasound evaluation revealed a large amount of fluid in the abdominal cavity, SI distention and absence of peristalsis. Abdominocentesis yielded approximately 20 ml of red-tinged peritoneal fluid with increased mean protein concentration (5.2 mg/dl), white blood cell count (12,550 cells/μl), and lactate (14 mmol/dl). A presumptive diagnosis of SI strangulation was made. Surgical resection of the affected intestinal loops was recommended. Due to poor prognosis and financial limitations, the mare was euthanized. Post mortem macroscopic diagnosis was a herniation of 3 metres of the mid-jejunum through the left mesometrium, resulting in a complete and complicated strangulation. To prevent this type of SI strangulation, we recommend transrectal palpation of the urogenital tract (including the broad ligament) after foaling. If a defect is identified, we recommend flank laparoscopy for correction.

Distribution of slab-derived fluids around the edge of the Philippine Sea Plate from Central to Northeast Japan

Marginal parts of a plate and subducting slab can play important roles in geodynamics. This is because in areas where a plate interacts with other plates or with the mantle thermal, geochemical, and mechanical interactions are expected. The Philippine Sea (PHS) slab that subducts beneath the Japan arcs has such an edge. To examine the relationship between arc magmatism and the slab edge in the transition zone from Northeast Japan to Central Japan, we investigated isotopic systematics of the regional volcanic rocks, incorporating data from literature and new data for five isotopic ratios of Sr, Nd, and Pb. The new data included major element compositions of 22 samples from the back-arc area, and 5 isotopic ratios for 6 samples selected from Pleistocene to early Quaternary epochs. Consequently, several findings were determined based on the spatial variation of the isotopic ratios and the estimated amount of slab-derived fluid: (1) the amount of fluid derived from the two subducting slabs (i.e., the Pacific slab and the PHS slab) decreases northward from a significantly high value (~5wt% fluid added to the source mantle), away from the seismically determined edge of the PHS slab; (2) the proportion of the PHS component in the total slab-derived fluid also decays northward; and (3) the PHS component spreads to the north beyond the seismically determined edge of the PHS slab. These observations strongly suggest that the existence of an aseismic PHS slab beneath southernmost parts of Northeast Japan delivers the PHS component to the arc magmatism. As was indicated by previous geodynamical studies, subduction of the PHS and PAC slabs may generate suction force towards the corner of mantle wedge, which might account for the large amount of fluid near the seismically determined slab edge as described in (1) above.

Multi-element isotopic evolution of magmatic rocks from Caviahue-Copahue Volcanic Complex (Chile-Argentina): Involvement of mature slab recycled materials

In the Southern Volcanic Zone (Chile-Argentina), the active Caviahue-Copahue Volcanic Complex (CCVC) is approximately 30km east of the main N-S trending volcanic front, where the Nazca Plate subducts under the South American Plate. CCVC activity includes three major stages: the 5–4Ma old Ante-Caviahue series, the 2.6Ma old Caviahue series, and Copahue volcano that has been active since 1.2Ma ago. CCVC volcanism results from extension and slab steepening since 2.6Ma ago that produces the asthenospheric influx under Copahue. Here we investigate the link between the geochemical and multi-element (He, Li, N, Sr, Nd, Hf, and Pb) isotopic composition of CCVC magmas and evolution of the subduction regime since 5Ma ago. The CCVC magmatic source is characterized by a mid-ocean ridge basalt-like mantle signature (high 3He/4He=8 Ra) and a high δ15N (+5.8‰) related to subducted sediments. These data suggest a significant degree of N recycling, but low 4He recycling over time. Trace element and isotope modeling indicates that the influence of sediments is strongest in Copahue magmatism, whereas the mantle wedge contribution was strongest in Caviahue and Ante-Caviahue magmatism. The light rare earth element-enriched nature of Copahue rocks (compared to Caviahue and Ante-Caviahue rocks) is more likely due to incorporation of sediments from the slab rather than a very low degree of partial melting. The low δ7Li (0.44±0.31‰ to 1.42±0.17‰) of Copahue and Caviahue magmas indicates the contribution of a mature slab depleted in 7Li during previous dehydration events. Conversely, Ante-Caviahue rocks have a moderate δ7Li value (2.63‰), suggesting input from a less-dehydrated slab. This is consistent with trace element data, showing that the Copahue (and Caviahue) source is less enriched in fluid-mobile elements (low Ba/Th and U/Th ratios). We propose that the geochemical and isotopic evolution of CCVC magmas records the evolution of the subduction regime under the CCVC. Ante-Caviahue magmas were produced in an arc front extensional regime in which the shallow, extensively dehydrating slab delivered large amounts of fluids to the melting zone. Later slab steepening caused the volcanic front to migrate west of the CCVC, probably due to the beginning of subduction in the Mocha fault zone (south of CCVC) 2.5–5Ma ago. Crustal attenuation and asthenospheric influx under the CCVC produced Caviahue magmatism. Further progressive slab steepening and successive dehydration events produced a mature slab and dry mantle wedge that explain the particular signature of Copahue magmas.

Fluid distribution in ankle and midfoot joints: MR findings in asymptomatic volunteers.

The purpose of this study is to assess the amount of fluid in the joints of the ankle and midfoot on MR imaging in asymptomatic volunteers. Twenty-one healthy asymptomatic volunteers (42 ankles) were evaluated with MRI imaging. There were 13 men and 8 women. The mean age was 24.7years (19-42years). MR imaging was performed on a 3T MR system using proton density weighted images with fat saturation (TR 2969, TE 30ms, NA 2, slice thickness 2.5mm). Images were obtained in three orthogonal planes. The images were interpreted by two radiologistsin two sessions. The maximum size of the joint effusion was measured in one plane. Descriptive statistics and variation between interpretation sessions were calculated. Fluid in the anterior tibiotalar joint had a mean size of 2.0mm (0.0-5.5mm), in the posterior tibiotalar joint 3.1mm (0.0-6.3mm), in the talonavicular joint 0.7mm (0.0-2.9mm), and in the anterolateral recess 2.0mm (0.0-4.3mm). Fluid in the posterior aspect of the posterior subtalar joint had a mean size of 2.6mm (0.0-9.4mm), in the anterior aspect of the posterior subtalar joint 1.9mm (0.0-6.6mm), at the middle subtalar joint 0.1mm (0.0-1.7mm), and at the anterior subtalar joint 1.6mm (0.0-6.0mm). Fluid in the tibiofibular joint had a mean height of 8.1mm (0.0-16.4mm). In asymptomatic volunteers, moderate to large amounts of fluid were common in all joint recessesof ankle and midfoot, and most pronounced in the anterior and posterior tibiotalar joint, anterolateral recess, and posterior subtalar joint. This should not be mistaken for evidence of a pathological condition.

Advances in Endoscopic Procedures: Large Pancreatic Fluid Collection Drained Utilizing Endoscopic Cystgastrostomy

Recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) can result in the formation of fluid-filled pseudocysts communicating with the pancreas, a complication which occurs in 20-40% of patients. Advances in both interventional radiology and endoscopy have made it possible to perform therapeutic, non-invasive cystgastrostomy. We report a case of pancreatic pseudocyst treated endoscopically via cystgastrostomy with drainage of an extremely large amount of fluid. A 54-year-old alcoholic man with a recent hospitalization for acute pancreatitis presented to an outside facility after experiencing abdominal distention associated with generalized weakness for 2 weeks. Upon transfer to our institution for further management of a large fluid collection found on CT (> 22 cm), endoscopic ultrasound (EUS) showed it to be a large pseudocyst. Laboratory results were significant for a Hgb of 8.0 g/dL, MCV of 78 fL, INR of 1.4, and an albumin of 2.9 g/dL. Cystgastrostomy via EUS utilizing a lumen apposing metal stent drained 4.75 L of fluid. After a hospital course complicated by MRSA pneumonia, the patient was transferred to a long-term acute care facility. EGD with necrosectomy was performed 2 weeks later, but he was then hospitalized for continuing fevers, undergoing laparotomy with necrosectomy and closure of gastrostomy with drain placement. The patient was transferred to a skilled nursing facility for continued management 6 weeks later. Cautery assisted Lumen Apposing Metal Stents (LAMS), while not familiar to many physicians, offers a safe, cost effective, method of drainage of pancreatic pseudocysts. It has a similar success rate when compared to surgical or interventional radiology approaches, specifically when the patient has progressed clinically to pseudocyst containing necrotic debris. In our patient, the size of the cyst and the severity of his pancreatitis made initial surgery a difficult proposition due to potential morbidity, and IR drainage unfavorable due to possible fistula formation. Over time, pseudocysts can spontaneously resolve if the circumstances are right. The size and amount of fluid present in this pseudocyst made our patient an unlikely candidate for spontaneous resolution of his pseudocyst, thus making drainage an acceptable option. Endoscopic guided cystgastrostomy, when available, is quickly becoming the preferred method of fluid drainage.Figure: Endoscopic ultrasound showing fluid consistent with a pancreatic pseudocyst.Figure: Endoscopic view of the gastric lumen as fluid (arrow) is being drained via a lumen apposing metal stent.

Seismicity at Lusi and the adjacent volcanic complex, Java, Indonesia

We study the local seismicity in East Java around the Arjuno-Welirang volcanic complex that is connected via the Watukosek Fault System, to the spectacular Lusi eruption site. Lusi is a sediment-hosted hydrothermal system which has been erupting since 2006. It is fed by both mantellic and hydrothermal fluids, rising and mixing with the thermogenic gases and other fluids from shallower sedimentary formations. During a period of 24 months, we observe 156 micro-seismic earthquakes with local magnitudes ranging from ML0.5 to ML1.9, within our network. The events predominantly nucleate at depths of 8–13 km below the Arjuno-Welirang volcanic complex. Despite the geological evidence of active tectonic deformation and faulting observed at the surface, practically no seismicity is observed in the sedimentary basin hosting Lusi. Although we cannot entirely rule out artifacts due to an increased detection threshold in the sedimentary basin, the deficit in significant seismicity suggests aseismic deformation beneath Lusi due to the large amount of fluids that may lubricate the fault system. An analysis of focal mechanisms of nine selected events around the Arjuno-Welirang volcanic complex indicates predominantly strike-slip faulting activity in the region SW of Lusi. This type of activity is consistent with observable features such as fault escarpment, river deviation and railroad deformation; suggesting that the Watukosek fault system extends from the volcanic complex towards the NE of Java. Our results point out that the tectonic deformation of the region is characterized by a segmented fault system being part of a broader damage zone, rather than localized along a distinct fault plane.

Pediatric Orbeez Ingestions Reported to Texas Poison Centers

There is concern that ingestion of superabsorbent polymer toys, which can absorb large amounts of fluid and increase greatly in volume, may pose a risk if swallowed by children.The intent of this study was to characterize pediatric Orbeez ingestions reported to a statewide poison center system. Cases were Orbeez ingestions among patients 19 years or younger reported to Texas poison centers during January 2011 to June 2016. The distribution by various demographic and clinical factors was determined. Of 110 total cases, 56% were female and 55% were 5 years or younger. Eighty-six percent of the ingestions were unintentional. Sixty-nine percent occurred at the patient's home and 28% at school. Seventy-eight percent of the patients were managed on site. The reported adverse effects were vomiting (4%), abdominal pain (3%), constipation (1%), diarrhea (1%), and fever (1%). The reported treatments were dilution (42%), food or snack (16%), other emetics (1%), whole bowel irrigation (1%), antihistamines (1%), and intravenous fluids (1%). Pediatric Orbeez ingestions tended to involve younger children, were unintentional, and occurred at the child's home or school. Most ingestions were managed outside of a healthcare facility. This study provides further evidence that ingestion of Orbeez by children is not likely to result in serious problems, such as intestinal obstruction. The information in this investigation may assist in prevention and education activities.

Grain-scale modelling of swelling granular materials; application to super absorbent polymers

Swelling is an important process in many natural materials and industrial products, such as swelling clays, paper, and Super Absorbent Polymer (SAP) particles in hygienic products. SAP particles are capable to absorb large amounts of fluid. Each grain of SAP can absorb water 30 to 1000 times its initial mass, depending on the water composition.To gain insight in the swelling behaviour of a bed of SAP particles, we have developed a grain-scale model and have tested it by comparing it to experiments. The grain-scale model is based on a combination of the Discrete Element Method (DEM) and the Pore Finite Volume (PFV) method, which we have extended to account for the swelling of individual SAP particles. Using this model, we can simulate the behaviour of individual particles inside a water-saturated bed of swelling SAP particles while taking into account the hydro-mechanical effect arising from the presence of pore water. The model input includes physical parameters such as particle stiffness and friction angle, which were found in the literature, as well as particle size distribution and diffusion coefficients, which were measured experimentally. A swelling rate equation was developed to simulate the swelling of individual particles based on water diffusion into a spherical particle. We performed experiments to measure the rise of the surface of a bed of initially dry SAP particles, which were put inside a glass beaker that contained sufficient amount of water for the SAP particles to swell and to remain saturated at all times. We used our model to simulate the swelling of that SAP particle bed as a function of time. Simulations show that the numerical model is in accordance with the experimental data. We have also verified the model with Terzaghi's analytical solution for a small swelling event. Finally, a sensitivity analysis was performed to study the effects of main grain-scale parameters on the larger-scale behaviour of a bed of particles.