Location Of Fenestration Research Articles

HOW TO MAXIMIZE DAYLIGHT IN COMMERCIAL BUILDING WITHOUT INCREASING HEAT GAIN

To reduce heat in commercial buildings in daylight, you can use shades, blinds, and curtains. On hot days, draw the curtains or shades to keep the sun out. Well-designed sun control and shading devices can dramatically reduce building peak heat gain and cooling requirements and improve the natural lighting quality of building interiors. Depending on the amount and location of fenestration, reductions in annual cooling energy consumption of 5% to 15% have been reported. Horizontal slat-type blinds can also be adjusted to block and reflect direct sunlight onto a light-colored ceiling. When completely closed and lowered on a sunny window, highly reflective blinds can reduce heat gain. External blinds can be installed to more effectively prevent heat from coming into your house. Honeycomb blinds consist of little cells that retain pockets of air. In addition to the most common ways to reduce heat impact, such as shading devices and green roofs, there are also new ways to reduce heat impact such as tensile structures, brise soleil, mashrabiya, and sunbreak.Working with qualified engineers and installers can help to ensure that the best possible choices are made for the building. Keywords Reduce heat impact, Energy savings, Shading devices, Accessories, Skylights

Cerebral arterial fenestration associated with stroke and other cerebrovascular diseases.

Cerebral arterial fenestration is a rare vascular malformation that has not been fully understood. Whether it is related to cerebrovascular diseases remains to be determined. In this study, we aimed to investigate the imaging characteristics of cerebral fenestrations, the clinical characteristics of fenestrations complicated with cerebrovascular diseases, and the correlation between fenestrations and cerebrovascular diseases. We reviewed the magnetic resonance imaging and computed tomography (CT) imaging findings of patients with cerebrovascular fenestrations in the Third Affiliated Hospital of Soochow University from January 2016 to December 2020, mainly focused on the shape and location of fenestrations. According to the location of fenestrated arteries, patients were divided into the internal carotid arterial system (ICAS) group and the vertebrobasilar arterial system (VAS) group. For patients complicated with cerebrovascular diseases, detailed data about the demographics and clinical characteristics were recorded. Stroke patients with injured lesions located in the territories of fenestrated arteries were further screened out and analyzed. Moreover, the proportions of cerebrovascular diseases including stroke between the ICAS group and the VAS group were compared. A total of 280 cerebrovascular fenestrations were found in 274 patients (six patients had two fenestrations). The most frequently involved vessels were the anterior cerebral artery (123/280), the basilar artery (76/280) and the vertebral artery (35/280). As to the shape of fenestrations, slit-like fenestrations accounted for 63.2% (177/280), followed by convex-lens-like type 26.1% (73/280) and duplicated type 10.7% (30/280). A total of 70 patients were complicated with cerebrovascular diseases, including ischemic stroke 64.3% (45/70), hemorrhagic stroke 22.9% (16/70), aneurysm 10% (7/70), arteriovenous malformation 1.4% (1/70) and cavernous hemangioma 1.4% (1/70). There were no significant differences between the ICAS group and the VAS group in terms of the demographics and clinical characteristics. Furthermore, among the 61 patients complicated with stroke, 16 patients' stroke lesions were located in the territories of fenestrated arteries, including 12.5% (2/16) in the ICAS and 87.5% (14/16) in the VAS. In addition, compared with the ICAS group, the proportions of cerebrovascular diseases including stroke in patients with fenestrations were higher in the VAS group (P < 0.05). Cerebral arterial fenestrations are most commonly found in the anterior cerebral artery, the basilar artery and the vertebral artery. Vertebrobasilar fenestrations are more related to cerebrovascular diseases, especially stroke.

Hemodynamic effects of size and location of basilar artery fenestrations associated to pathological implications.

Fenestration is a rare congenital abnormality that refers to a segmental duplication of arteries. It is still not clear about the role of fenestrations in the etiology and pathological evolution of vascular diseases. This study aims to investigate the hemodynamic influence brought by various sizes and locations of fenestration in basilar artery models. A series presumptive fenestration models were established based on a normal basilar artery model with various sizes and locations. Identical boundary conditions were utilized in the computational fluid dynamics simulations and different flow patterns in the fenestration and bifurcation regions were comprehensively analyzed. Wall shear stress (WSS)-related parameters such as oscillatory shear index (OSI) and aneurysm formation index (AFI) were computed and compared. The value of WSS on fenestration increased by the fenestration's tortuosity, and nearly-circular fenestration suffered higher WSS than narrow-strips one. Also, high OSI and low AFI value mainly occurred in the bifurcation region, indicating a high level of turbulence and high risk of aneurysm formation. The location of fenestration mainly changed the impact force of blood flow on the bifurcation and the disorder characteristics of blood flow, while the size of fenestration changed the WSS distribution on the proximal inner wall and bifurcation region of fenestration. In summary, the nearly-circular fenestration should be stratified carefully which may results in a high risk inducing unfavorable vascular wall remodeling.

On the optimization of energy efficient fenestration for small commercial buildings in the United States

Currently, commercial buildings consume almost 18% of the total primary energy in the US and this is bound to increase with time due to population and economic growth. Small commercial buildings are those with less than 50,000 ft2 of conditioned area and represent 94% of total commercial buildings in the U.S. Since windows are responsible for 34% of commercial space conditioning energy use, windows in small commercial buildings should be given considerable attention. Besides the window material, selecting an optimum window dimension and location has played an important role in building energy performance. Since different weather conditions and sun angles impact on determining the optimum window dimensions and location, the goal of this study is to identify the optimum window design parameters in seven US climate zones in order to minimize building energy use.In this study, an optimization model using a genetic algorithm is developed and coupled with EnergyPlus software to identify the optimum window design parameters including a window to wall ratio, aspect ratio, and fenestration location. A double-story commercial building model, as a case study, is designed using DesignBuilder software to illustrate the application of the model. Identifying the optimum window dimensions and location in different locations would help engineers and designers to reduce building energy consumption in the early stages of the design. The results show that selecting optimum window dimensions and locations can reduce the total building energy consumption by 2 and 15% in cold and hot climate zones respectively.

Dynamics of Bone Loss in Cases with Acute or Chronic Apical Abscess

IntroductionAcute and chronic apical abscesses are 2 dramatic ways that periradicular tissues may react to pulpal infection and necrosis. Although both of these clinical states are the response to pulpal infection, their clinical manifestations are significantly different. It is not clear why the body responds to root canal infection in one way or another. The objective of this study was to evaluate the size and pattern of bone loss in patients with acute apical abscess (AAA) and chronic apical abscess (CAA) using cone-beam computed tomographic images. MethodsTwenty-three cone-beam computed tomographic images of cases with AAA and 25 cases with CAA were selected and evaluated. The presence and location of fenestration and the volume and pattern of the periradicular lesions were recorded and compared between the 2 groups using the Fisher exact and Mann-Whitney U tests. ResultsOne hundred percent of cases with CAA had cortical fenestration, but only 47% of cases with AAA had cortical fenestration (P < .05). The median volume of the lesions was 233 mm3 in the CAA group and 109 mm3 in the AAA group (P > .05). CAA cases, in comparison with the AAA group, had a relatively larger cortical disruptions. ConclusionsCortical fenestration is fundamental for the development of CAA. However, periradicular lesions without evident cortical fenestration can still cause AAA and fascial space involvement.

Plaque Distribution of Basilar Artery Fenestration by 3D High-Resolution MR Vessel Wall Imaging

The association between fenestrations and neurovascular pathology is not well defined. The morphology of vessel wall plays an important role in the development of neurovascular pathology. We sought to explore the plaque distribution around basilar artery fenestration (BAF) by three-dimensional high-resolution MR vessel wall imaging (3D HRMRI). Patients with BAF on 3D HRMRI images were enrolled. All cross-sectional slices of basilar arteries were assessed and categorized based on the location of fenestration as proximal segment, in-bifurcation segment, and distal segment. Furthermore, plaques in the in-bifurcation segment were classified according to their orientation being centered on the lateral, interior, dorsal, or ventral wall of the vessel. In all, 12 cases with BAF involving 661 cross-sectional image slices in entire basilar arteries were included. Plaques were found in 190 image slices, with the distribution of 41 slices in the proximal segment, 144 slices in the in-bifurcation segment and 67 slices in the distal segment. Plaques were found more frequently in the proximal and in-bifurcation segments than in the distal segment (P < 0.001), but there was no statistical difference between the proximal and in-bifurcation segment (P = 0.11). In the in-bifurcation segment, plaques were more frequently located at the lateral (50.0%) than other interior (16.0%), dorsal (21.0%), and ventral (13.0%) wall (P < 0.001).Plaques of BAF tend to locate in the proximal and in-bifurcation segments, especially at the lateral wall of the in-bifurcation segment.

Detection of Bone Defects Using CBCT Exam in an Italian Population.

Background The aim of this study was to evaluate the in vivo incidence and the location of fenestrations in a young Italian population by using CBCT. Materials and Methods Fifty patients who had previously performed CBCT for planning third molar extraction or orthodontic therapy were selected for the study. No previous dental treatment had been performed on these patients. Overall, 1,395 teeth were evaluated. Root fenestrations were identified according to the definition of Davies and the American Association of Endodontists. Data was collected and statistically analyzed. Results Fenestrations were observed in 159 teeth out of 1,395 (11% of teeth). In the lower jaw, we found 68 fenestrations (5%) and 91 in the maxilla (6,5%). Incisors were the teeth with the highest incidence of fenestrations. Conclusion The relative common finding (11%) of fenestration supports the need for CBCT exams before any surgical/implant treatment to avoid complications related to the initial presence of fenestrations. CBCT was found to be an effective and convenient tool for diagnosing fenestration.

1E46 生理機能を考慮したFontan手術血流動態のFenestration位置依存性

1E46 生理機能を考慮したFontan手術血流動態のFenestration位置依存性

Fenestrations of intracranial arteries.

Few data are available on the frequency and location distribution of fenestrations of intracranial arteries. We used 3D rotational angiography of all intracranial arteries in a cohort of 179 patients with suspected intracranial aneurysms to assess the prevalence and location of fenestrations and the relation of fenestrations to aneurysms. Of 179 patients with subarachnoid hemorrhage admitted between March 2013 and June 2014, 140 had 3D rotational angiography of all cerebral vessels. The presence and location of aneurysms and fenestrations were assessed. In patients with both aneurysms and fenestrations, we classified the relation of the location of the aneurysm as remote from the fenestration or on the fenestration. In 140 patients, 210 aneurysms were present. In 33 of 140 patients (24%; 95% confidence interval, 17.2%-31.3%), 45 fenestrations were detected with the following locations: anterior communicating artery in 31 (69%), A1 segment of the anterior cerebral artery in 4 (9%), middle cerebral artery in 4 (9%), basilar artery in 4 (9%), vertebral artery in 1 (2%), and anterior inferior cerebellar artery in 1 (2%). Of 56 patients with anterior communicating artery aneurysms, 14 had a fenestration on the anterior communicating artery complex. The remaining 31 fenestrations had no anatomic relation to aneurysms. In 140 patients with 210 aneurysms, 14 aneurysms (7%) were located on a fenestration and 196 were not. In patients with a suspected ruptured aneurysm, fenestrations of intracranial arteries were detected in 24% (33 of 140). Most fenestrations were located on the anterior communicating artery. Of 45 fenestrations, 14 (31%) were related to an aneurysm.

J0210102 Fontan手術における3次元血流動態のFenestration位置依存性

J0210102 Fontan手術における3次元血流動態のFenestration位置依存性

Arterial fenestrations and their association with cerebral aneurysms

Fenestrations of intracranial arteries and associated aneurysms are rare. The significance of these fenestrations in relation to aneurysms remains unclear. We present four patients with fenestration-associated aneurysms and a comprehensive review of associations with aneurysms and other vascular lesions. A PubMed search of the literature was conducted from 1970–2012 reporting cases of intracranial aneurysms associated with arterial fenestration or duplications. Data were collected on patient presentation, sex, age, aneurysm and fenestration location, aneurysm treatment, and presence of other vascular lesions. We performed a retrospective review of four patients with intracranial fenestrations associated with aneurysms at our institution from 2012–2013. There were 59 cases of fenestrations and associated aneurysms in the literature. Aneurysms were reported as either arising from (n=50) or adjacent to but distinct from (n=13) fenestrations. The most common single fenestration location was at the basilar artery (n=23, 36.5%); however the majority of fenestrations were in the carotid circulation (n=34, 54.0%). The majority of patients with aneurysms and fenestrations at all locations except those at the anterior communicating artery (70.5%) presented with subarachnoid hemorrhage. Patients with aneurysms arising from a fenestration or adjacent to a fenestration presented with an additional intracranial vascular lesion in 38% and 31% of cases, respectively. The majority of all aneurysms were treated with microsurgical clipping. Aneurysms associated with cerebral arterial fenestrations are most commonly discovered after subarachnoid hemorrhage and are most often located in the carotid circulation. A high index of suspicion must be maintained for an associated vascular lesion if an intracranial fenestration is discovered.

Fenestration of the basilar artery in a 13-year-old boy detected in magnetic resonance

Control magnetic resonance (MR) imaging of the brain in a 13-year-old boy with epilepsy confirmed a non-expansive focal parenchymal lesion in the white matter of the left frontal lobe, coressponding to heterotopic grey matter revealed two years before. MR scans did not show new lesions in the brain parenchyma. The axial T2-weighted image showed double flow voids (Fig. 1a), while the coronal T2-weighted image showed a small loss of signal intensity (Fig. 1b) in the proximal part of the basilar artery (BA), which wasn't detected on the first exam. MR angiography showed a type 3 (classification according to the location of fenestration introduced by Tanaka et al. in 2006), medium size, slit-like fenestration at the proximal segment of the BA, without evidence of aneurysm, thrombus or dissection (Fig. 2, 3). The fenestration window was 3.6 mm; the right anterior inferior cerebellar artery (AICA) arose from the fenestrated trunk

A Novel Cautery Instrument for On-Site Fenestration of Aortic Stent-Grafts: A Feasibility Study of 18 Patients

To report the bench-top evaluation and initial clinical use of an instrument for on-site fenestration of aortic stent-grafts. A stainless steel thermal cautery instrument was designed to create circular stent-graft fenestrations from 3 to 10 mm in diameter. Three operators independently bench-tested the instrument on thoracic stent-graft samples to evaluate size, shape, location, and quality of fenestrations created. For clinical use, on-site fenestration was performed 2 days before the endovascular procedure in a sterile room without access to supplemental oxygen. A fenestrator 1 or 2 mm smaller in diameter than the target vessel was used; the edges of the fenestrations were strengthened using flexible radiopaque nitinol wire. The aortic stent-graft was then re-sheathed and sterilized for added safety. Eighteen patients (17 men; mean age 51 years, range 18-80) with a variety of thoracic and juxtarenal pathologies were treated using Zenith TX2, Valiant Captivia, Zenith AAA, and Endurant stent-grafts modified in this manner. After successful bench testing, the instrument was used to create 34 fenestrations in aortic stent-grafts deployed in the 18 patients. Size and location of fenestrations obtained were as desired. Subsequent catheterization of the fenestration/target vessel and covered stent deployment were successfully achieved in 31 (91%) fenestrations; 2 fenestrations had type III endoleaks and 1 fenestration was unused. There was no perioperative mortality, stroke, embolization, vessel dissection, renal failure, or graft infection. Follow-up to 1 year in the majority of patients has revealed no new fenestration-related problems. This simple-to-use instrument makes on-site creation of aortic stent-graft fenestrations easy, accurate, and precise. The instrument is inexpensive, robust, and easily sterilized.

Fenestrations accompanied by intracranial aneurysms assessed with magnetic resonance angiography

The aim of this study was to evaluate the anatomical changes and investigate the prevalence in intracranial aneurysm with fenestrations using magnetic resonance angiography (MRA). Between June 2008 and October 2010, 4652 patients (aged 23-73 years) with suspected intracranial aneurysm or other cerebrovascular diseases underwent MRA examination. MRA was performed using a three-dimensional time-of-flight technique (3D-TOF) with volume rendering (VR) and maximum intensity projection reconstruction methods. The presence and location of fenestrations and aneurysms was reviewed. When fenestrations were present in combination with aneurysms, we noted the relationship of the locations. The classification of fenestration accompanied by intracranial aneurysm was divided into three types according to the anatomical relationship as follows: Type I, aneurysm adjacent to but not on a fenestration; Type II, aneurysm located on the fenestration; type III, aneurysm located at a position remote from a fenestration. Among the 4652 patients examined, 409 patients were defined with 412 intracranial aneurysms, and the prevalence of aneurysms was 8.8%. One hundred and forty-one patients were identified with fenestrations; 24 of these patients were confirmed with intracranial aneurysms. Seven cases were classified as type I, three as type II and 14 as type III. The prevalence of intracranial aneurysm with fenestrations was 17.0%, with significant statistical difference compared with aneurysms unaccompanied with fenestrations (P=0.0064). The anatomical relationship between fenestrations and intracranial aneurysms was visualized by MRA with VR, which displayed pathologies with sufficient clarity to enable diagnosis. Furthermore, the results of this study suggest that physicians should be alerted to the occurrence of intracranial aneurysm following the detection of fenestrations by MRA.

Fenestrations of Intracranial Arteries Detected with 3D Rotational Angiography

Fenestrations of intracranial arteries are variants resulting from incomplete fusion of primitive vessels. An association with aneurysms is suggested in many studies. On conventional angiography, fenestrations are rarely visible. 3D rotational angiography (3DRA) provides improved visualization of cerebral vessels from any desired angle. We used 3DRA to assess the frequency and location of fenestrations of intracranial arteries and a possible relationship with aneurysms. In 208 patients with suspected intracranial aneurysms, 3DRA of 1, 2, or 3 cerebral vessels (in 143, 16, and 49 patients) was reviewed for the presence and location of fenestrations and aneurysms. When fenestrations were present in combination with aneurysms, we noted the relationship of the locations. In 59 of 208 patients, 61 fenestrations were detected (28%). Fenestrations were more frequent in the anterior than in the posterior circulation (23% versus 7%), and the most common location was the anterior communicating artery (AcomA) (43 of 61, 70%). The frequency of fenestrations in 185 patients with aneurysms was not different from the frequency in 23 patients without aneurysms. Of 220 aneurysms present in 208 patients, 10 aneurysms (4.5%) were located on a fenestration. Of 61 fenestrations, 51 (84%) were not associated with an aneurysm. With 3DRA, fenestrations were found in 28% of patients. In our study, fenestrations occurred more often in the anterior than in the posterior circulation, and the most common location was the AcomA. A definite relationship between fenestrations and aneurysms cannot be concluded from our data.

Use of Stents to Maintain Atrial Defects and Fontan Fenestrations in Congenital Heart Disease

Maintaining patent atrial septal communications or fenestrations can be vital in conditions requiring adequate decompression of the atria or Fontan baffle. We have recently deployed stents for this purpose, and the aim of this retrospective analysis is to describe our experience. All 26 patients undergoing such stent placement were retrospectively studied and for neonates with hypoplastic left heart syndrome (HLHS) and patients with Fontan fenestrations, their data were compared to controls undergoing transseptal static balloon dilation during the same time period. All 7 stented neonates with HLHS survived to their Norwood procedure and 57% survived to hospital discharge, similar to those who had static balloon dilation. Complications occurred in both HLHS groups but transient complete heart block was only seen in the control group, which also had larger balloons used (10.3 mm vs 7 mm, P=0.002). The success rate for patients undergoing stent placement in Fontan fenestrations was 64% compared to 76% with dilation alone. Complications were seen in 64% of the Fontan stented group compared to 39% for controls. There were 5 other patients with complex lesions (3 of whom were on the Extracorporeal Membrane Oxygenator) in whom stent placement successfully maintained atrial communication patency. Atrial septal stent placement in neonates with HLHS with restrictive defects is effective and appears at least as safe as static balloon dilation. On the other hand, initial fenestration stent placement is indicated only after extracardiac Fontan procedures in which the previous fenestration location cannot be found.

Duration of patency of laser-assisted tympanic membrane fenestration.

Laser-assisted tympanic membrane fenestration (LTMF) provides intermediate-duration middle ear ventilation, which benefits selected children with acute otitis media (AOM) and otitis media with effusion (OME). To evaluate clinical and technical factors that may affect duration of LTMF patency. Prospective clinical cohort effectiveness trial. Four tertiary care children's hospitals. Volunteer sample of 251 children (430 ears) followed up at 1, 2, 3, 4, 8, and 12 weeks; time to fenestration closure was evaluable in 201 ears, and assessment of cure at study conclusion was evaluable in 128 ears. Laser-assisted tympanic membrane fenestration for prospectively defined AOM or OME. The surgeon determined spot size, wattage, and concurrent adenoidectomy based on clinical judgment. Cure of AOM/OME with effusion at 90 days and duration of LTMF patency relative to spot size (1.8-2.8 mm), fenestration location on tympanic membrane, power (7-22 W), concurrent adenoidectomy, age, diagnosis (AOM vs OME), type of effusion, and preoperative tympanogram characteristics. Results are based on the number of ears that could be evaluated at each data collection interval. Fenestrations remained patent for 2 to 4 weeks (mean = 2.52, median = 2.0, SD = 1.4, n = 201); 97.4% were closed at 6-week follow-up. Spot sizes of 2.4 and 2.6 mm had a higher rate of patency than 2.0-mm spot size at 3 weeks following LTMF. Cure at 90 days was related to duration of patency for all patients combined and for patients treated for AOM and OME, but not for those undergoing adjunctive adenoidectomy. Cure at 90 days was related to larger spot size for all patients combined and those treated for AOM. Other investigated factors did not achieve statistical significance. Spot size of 2.4 mm or greater results in improved duration of LTMF patency, persisting for up to 3 weeks after LTMF, especially for treatment of AOM. Increased duration of LTMF patency correlates with greater incidence of cure of middle ear effusion at 90 days. Additional investigation is indicated to determine optimum spot size and optimum duration of patency for disease- severity-adjusted populations.

Daylighting with windows, skylights, and clerestories

This paper examines the impact of several fenestration options on building space heating, cooling, and lighting loads. The use of skylights, windows, and clerestories is evaluated for a single floor commercial building, using the NBSLD-2 building energy analysis computer program, which possesses a fully integrated daylight model (DALITE). The evaluation focuses on: 1. (a) the impact of daylighting on heating and cooling energy and equipment sizing; 2. (b) the potential reduction in electric lighting energy requirements through daylight utilization; 3. (c) the relative daylighting and thermal performance of skylights, clerestories, and windows; and 4. (d) the effect of building orientation on fenestration optimization and selection. The NBSLD-2 computer procedure performs a dynamic simulation of hour-by-hour building thermal performance and energy requirements for a one-year period. The thermal and daylighting characteristics of each fenestration aperture are modeled to enable evaluation of the trade-offs associated with the use of each fenestration type. The results are correlated in the form of design guidelines to enable the preliminary design decisions to be made regarding fenestration location, type, configuration, and size. The energy calculations are presented as functions of fenestration characteristics, so that the potential energy advantages can be estimated for different fenestration designs.