Side Of Cavity Research Articles

Numerical analysis of additional heat loss induced by air cavities between insulation boards due to non-ideality

This study uses the numerical steady-state three-dimensional CFD calculation method to assess parametrically the thermal transmittance of a building envelope with partially and fully penetrating air cavities within 20 cm thick layer of insulation. Heat flux measurements from climate chamber experiment were used to validate numerical model and estimated heat flux at different height of penetrating air cavity. Focus is on the effect of different cavity geometry and cavity location within a building envelope, including the effect of temperature difference across the building envelope. Fully penetrating horizontal air cavities in the wall construction and vertical air cavities inside the floor construction were found to have an insignificant effect on thermal transmittance. The vertical air cavities in the wall and the roof construction significantly increase the convective heat transfer through the insulation layer, well over the normative correction levels defined by EN ISO 6946. The effect is strongly dependent on the temperature difference and cavity thickness. At 40 K temperature difference, the penetrating air cavities with 5, 10 and 20 mm thickness will increase the thermal transmittance up to 10, 33 and 59% respectively; the simplified procedure in EN ISO 6946 was unable to describe this effect adequately. For an upward heat flow in the roof construction, the effect was even more adverse. Using dual layer insulation with rebate, tongue and groove edge or expanding montage foam to tighten the external side of the air cavity, additional heat loss is reduced roughly by half and the dependency of additional heat loss on the temperature difference between internal and external environments is decreased.

Penetrating Ocular Injury Management in Intraocular Foreign Body (IOFB) and Traumatic Cataract

Highlight: The management of penetrating ocular injury with IOFB and traumatic cataracts needs a thorough examination of the mechanism of injury, location, size, and composition of IOFB. Endophthalmitis, retinal detachment, and development of PVR are potentially vision-threatment. Abstract: Most IOFB are metallic and found in males of productive age as a consequence of work-related accidents. A 45-year-old man complained of sudden blurred vision in the left eye (3/60 pinhole 5/12) after getting hit by a foreign body when cutting grass with a lawn mower. Anterior segment examination revealed a 10 mm long, one-plane, straight, full thickness, already sutured inferonasal corneal laceration, inferonasal traumatic iridectomy size 3x7 mm, and opaque lens. Head CT-scan revealed opacity with metallic density intraocularly. Ultrasonography revealed an echogenic lesion, particle-shaped with 100% RCS complex density, located at the inferonasal of the vitreous cavity. Focal laser photocoagulation was performed preoperatively because there was a tear at the superonasal of the retina. The patient underwent cataract extraction, intraocular lens implantation, vitrectomy, and IOFB extraction in a one-step procedure. IOFB was found at the inferonasal side of a vitreous cavity with size 3 x 1 mm, metallic, and not attached to the retina. Silicon oil tamponade was used as a precaution because there were retinal tears. Postoperatively, the left eye's visualacuity was 5/20. After 6 months, the silicon oil was evacuated and the visual acuity became 5/8.5.

Oral Lipoma: A Case Report

Lipomas are the most frequent benign neoplasms of mesenchymal origin, and they mostly occur in various anatomical sites, including the palate, lip, buccal mucosa and vestibule, tongue, and floor of the mouth. Lipomas have a low incidence between 1 to 4% of benign oral cavity lesions. The clinical presentation of lipomas is generally characterized as a neoformation with well-demarcated borders. In this clinical case report, a 66-year-old female patient presented with pain and an inflamed region in the oral cavity. In intraoral clinical examination, a neoformation of 1 centimeter in diameter was observed and located in the jugal mucosa of the right side of the oral cavity. Furthermore, an excisional biopsy was chosen as the treatment method, and a postoperative histopathological study was conducted. Surgical excision is the treatment of choice for preventing recurrence in patients with oral lipomas.

Comparison of Eustachian Tube Function Before and After Septoplasty: A Systematic Review and Meta-Analysis

Background and Objectives The middle ear, eustachian tube, and nasal cavity are anatomically adjacent, so the middle ear pressure (MEP), eustachian tube function (ETF), and nasal cavity condition are highly correlated. In this study, the effect of nasal septal deviation (NSD) on ETF and the effects of septoplasty on ETF and MEP were meta-analyzed using the results of tympanogram.Subjects and Method A systematic search was conducted using the PubMed, Embase, the Web of Science, and the Cochrane Central Register of Controlled Trials. The MEP and ETF were compared before and after septoplasty. We also compared eustachian tube dysfunction observed from the deviated side and from the non-deviated side of the ear. Heterogeneity was analyzed within the subgroups.Results Eustachian tube dysfunction was about twice as high in the narrowed side of NSD patients than in other patients. The tympanogram results did not show any significant difference when subgroups were observed before, within 1 month after, or 3 months after septoplasty. Eustachian tube dysfunction before septoplasty was about 4.5 times higher than after septoplasty (when followed up for more than 1 month). From the subgroup analysis of deviated and non-deviated sides, MEP before septoplasty was significantly lower than after septoplasty and eustachian tube dysfunction was approximately 4 times higher in the narrowed nasal cavity.Conclusion The narrowed side of the nasal cavity in NSD can be related to eustachian tube dysfunction. Septoplasty may help restore ETF in the ears of narrowed side of the nasal cavity.

Chemical Scalpel: An Experimental Collagenase-Based Treatment for Peritoneal Adhesions.

Simple SummaryIntraperitoneal adhesions are bands of scar tissue that occur frequently after abdominal surgery. These scars bind the abdominal organs together, producing symptoms such as intestinal obstruction, infertility, chronic pain, and a greater risk of injury in subsequent surgery. Currently, the only treatment approach for this disease is a risky surgical intervention that may cause additional adhesions or other complications. In this article we propose the use of collagenase in the peritoneal cavity to facilitate adhesion disruption. Using a simple experimental rat model, we produced an array of adhesions resembling those presented in humans. We demonstrate that the application of collagenase at the concentration and time described is safe and facilitates the disruption of adhesions with no organ damage due to contact with collagenase. The further development of this therapy and application route, published for the first time in this article, may improve the quality of life of patients with this disease.(1) Background: Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2) Methods: We generated an adhesion model with intraperitoneal polypropylene meshes. Four months later, we evaluated the efficacy of the treatment in blinded form, i.e., 0.05% collagenase vs. placebo at 37 °C for 20 min. Protocol 1: Ten rats with ten mesh fragments, in which an attempt was made to remove the maximum number of meshes in a 5-min period. Protocol 2: Six rats with four mesh fragments in the sides of the abdominal cavity in which adhesiolysis was performed using a device that measures burst pressure. (3) Results: Protocol 1: 42% efficacy in the collagenase group versus 8% in the control group (p < 0.013). Protocol 2: 188.25 mmHg (SD 69.65) in the collagenase group vs. 325.76 mmHg (SD 50.25) in the control group (p < 0.001). (4) Conclusions: Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.

Determination of Dimensions of Glenoid Cavity from other Scapular Parameters

Background: Different pathological conditions are associated with the anatomical variations in glenoid cavity. For getting insights into these variations the anthropometric parameters knowledge is highly required. Objective: The purpose of the study was the determination of the anthropometric relationship present between the left and right side of the glenoid cavity of the scapula and the application of the obtained knowledge in the forensic medicine. Place and Duration: In the department of anatomy, Multan Medical and Dental College and Bacha Khan Medical Complex Swabi for six months duration, from January 2021 to June 2021. Material and Methods: The data of 190 patients included in the study, was collected from the anatomy department of our institute. The sample was withdrawn from the non-deformed and well macerated scapulae bone of the 190 patients. The calibrated sliding digital caliper was used to measure the anthropometric parameters of glenoid cavity. The glenoid height, width and index were calculated by SPSS software. Results: The 34.8±4.0 (R=38 ± 4.98 and L=27.9-46.78) and 24.9 ±3.90 (R=27.2 ± 3.43 and L=20.1- 36) was the calculated mean standard deviation of Maximum glenoid height (MGH) and Maximum glenoid width (MGW) respectively. The statistically significant and greater values of MGH and MGW on the right side were obtained by using ANOVA and t-test. While calculated values of glenoid Index (GI) was smaller on the right side as compared to the left. Conclusion: The kinanthropological applications of the scapula are indicated by the study that which side can be more commonly used. This study provides with in-depth knowledge of biological profiling and develops better understanding required during reconstruction of the damaged skeleton. Keywords: Glenoid cavity, Maximum glenoid height (MGH), Maximum glenoid width (MGW).

Double-diffusive convection of two rods in a novel cavity saturated by porous media and suspended by nano-encapsulated phase change materials

The double-diffusive convection of two rotating rods inside an infinite-shaped saturated porous cavity filled by a suspension of nano-encapsulated phase change material was investigated numerically using the (ISPH) method. The cavity includes two rotating rods, (NEPCM) particles, and porous media. The inner left and right rods are located inside the left and right sides of an infinite-shaped cavity. In the present work, two types of boundary conditions between the inner rods and outer boundary walls of the cavity are considered. The results were produced for the dimensionless fusion temperature (0.05 ≤ ≤ 0.95), the length of the inner rotating rods (0.2 ≤ LR ≤ 0.6), the buoyancy ratio number (−2 ≤ N ≤ 2), the solid volume fraction (0.01 ≤ ϕ ≤ 0.05), the dimensionless time (0 ≤ ≤ 0.3) and Darcy number (10−2 ≤ Da ≤ 10−5). But, the Lewis and Stefan numbers were considered fixed at (Le = 10) and (Ste = 0.2), respectively. The effects of several parameters on the melting-solidification zones, temperature, concentration, and velocity fields were also investigated. It was found that the location and the strength of the melting-solidification zone are influenced significantly by the variation of the boundary conditions. The average Nusselt and Sherwood numbers are influenced clearly by the variation of the boundary conditions for rods and cavity walls and by increasing the length of the inner rods.

Parametric Study of Lightweight Wooden Wall Assemblies for Cold and Subarctic Climates Using External Insulation

While externally insulated wall assemblies are widely recognized for their hygrothermal performance, few research projects have focused on the impact of shifting the entire wall insulation to the exterior side of a structural cavity in cold or subarctic climates or its effectiveness in terms of acoustic performance and airtightness. The objective of this study was to propose fully externally insulated assemblies that could be used in cold and subarctic climates by assessing the benefits of the hygrothermal performance of these assemblies and by achieving a comparable airtightness and sound transmission performance to the modern assemblies that are currently built in North America. The results suggested that the externally insulated assemblies limited the risk of condensation occurring inside structural cavities and allowed for faster drying than the modern assemblies when exposed to water infiltration or high water contents in all climates that were tested. The assemblies with external airtight insulation boards were more airtight than assemblies with air barrier membranes and, in addition, assemblies with external soundproof insulation were shown to be necessary to achieve a comparable sound transmission loss to that of a modern assembly.

The Hammock Proposal: A Modification of Loma Linda Pouch Technique

Introduction: A technique, the "Loma Linda pouch," is introduced for repairing the perforated maxillary sinus membrane during sinus grafting procedures. The collagen membrane is then folded along the lateral access window to form a pouch that surrounds and isolates the graft material. In this review, we planned to devise a modification to the “Loma Linda pouch technique”. This ‘‘hammock’’ approach immobilizes the collagen membrane as far as possible, promotes greater blood supply, thereby increasing vital bone formation. Case presentation: When perforation occurs during elevation of the Schneiderian membrane, elevation of the membrane from the internal sinus walls must be completed. In this approach, plasma rich in growth factors is used as a graft carrier to achieve a more compact and homogeneous bone graft and to avoid particle dispersion. The rest of the procedure follows the classic sinus augmentation approach. Discussion: Ranges of techniques involve repairing perforations that range in size from 2 mm to 1.5 cm. For larger perforations (≥1.5mm), the only reported possibility is the use of a resorbable collagen membrane. Displacement of the collagen membrane is one of the most frequent complications. For this reason, perfect immobilization of the membrane is the key to success. Compared with other methods, this modified approach enhances the fixation of the collagen membrane not only on the buccal side but also on the palatal side of the sinus cavity. Conclusion: This technique achieves stable immobilization of the collagen membrane and, with it, better treatment predictability in future.

Sphingosine Kinase 2 Inhibitors: Rigid Aliphatic Tail Derivatives Deliver Potent and Selective Analogues.

Sphingosine 1-phosphate (S1P) is a pleiotropic signaling molecule that interacts with five native G-protein coupled receptors (S1P1–5) to regulate cell growth, survival, and proliferation. S1P has been implicated in a variety of pathologies including cancer, kidney fibrosis, and multiple sclerosis. As key mediators in the synthesis of S1P, sphingosine kinase (SphK) isoforms 1 and 2 have attracted attention as viable targets for pharmacologic intervention. In this report, we describe the design, synthesis, and biological evaluation of sphingosine kinase 2 (SphK2) inhibitors with a focus on systematically introducing rigid structures in the aliphatic lipid tail present in existing SphK2 inhibitors. Experimental as well as molecular modeling studies suggest that conformationally restricted “lipophilic tail” analogues bearing a bulky terminal moiety or an internal phenyl ring are useful to complement the “J”-shaped sphingosine binding pocket of SphK2. We identified 14c (SLP9101555) as a potent SphK2 inhibitor (Ki = 90 nM) with 200-fold selectivity over SphK1. Molecular docking studies indicated key interactions: the cyclohexyl ring binding in the cleft deep in the pocket, a trifluoromethyl group fitting in a small side cavity, and a hydrogen bond between the guanidino group and Asp308 (amino acid numbering refers to human SphK2 (isoform c) orthologue). In vitro studies using U937 human histiocytic lymphoma cells showed marked decreases in extracellular S1P levels in response to our SphK2 inhibitors. Administration of 14c (dose: 5 mg/kg) to mice resulted in a sustained increase of circulating S1P levels, suggesting target engagement.

Analyses of the spatial and temporal features of the blade pressure‐side cavitation in a pump‐turbine runner in the pump mode

AbstractIn the pump mode of pump‐turbine, cavitation usually happens in runners because of the local pressure drop on the blade leading‐edge. At over‐load, pressure drop and cavitation occur on the runner blade pressure side. In conventional studies, the spatial and temporal features of the blade pressure‐side cavitation are difficult to understand. In this study, the runner blade pressure‐side cavitation is studied in a pump‐turbine in pump mode at over‐load. Local low pressure and cavitation are found on runner blade pressure‐side at leading‐edge near shroud. Moreover, small‐scale gathering cavitation is also observed on the blade suction‐side with connecting the large‐scale pressure side cavity. As a breakthrough in flow analysis, the pulsation tracking network (PTN) method is applied to track the spatial and temporal features of cavitation. The time‐accumulated intensity, pulsation amplitude, frequency, and phase are analyzed for cavitation based on PTN. The stably‐gathering strong‐intensity cavitation sites are indicated by time‐accumulated intensity. Based on the pulsation amplitude contour, strong pulsating cavitation is found on the edges of the gathering strong cavities. Frequency and phase analyses indicate the cavitation propagation along the blade‐to‐blade direction and reveal the reason of the connecting cavitation phenomenon. The spatial and temporal features of cavitation is well investigated.

Activation-induced pyroptosis contributes to the loss of MAIT cells in chronic HIV-1 infected patients

BackgroundMucosal-associated invariant T (MAIT) cells are systemically depleted in human immunodeficiency virus type 1 (HIV-1) infected patients and are not replenished even after successful combined antiretroviral therapy (cART). This study aimed to identify the mechanism underlying MAIT cell depletion.MethodsIn the present study, we applied flow cytometry, single-cell RNA sequencing and immunohistochemical staining to evaluate the characteristics of pyroptotic MAIT cells in a total of 127 HIV-1 infected individuals, including 69 treatment-naive patients, 28 complete responders, 15 immunological non-responders, and 15 elite controllers, at the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.ResultsSingle-cell transcriptomic profiles revealed that circulating MAIT cells from HIV-1 infected subjects were highly activated, with upregulation of pyroptosis-related genes. Further analysis revealed that increased frequencies of pyroptotic MAIT cells correlated with markers of systemic T-cell activation, microbial translocation, and intestinal damage in cART-naive patients and poor CD4+ T-cell recovery in long-term cART patients. Immunohistochemical staining revealed that MAIT cells in the gut mucosa of HIV-1 infected patients exhibited a strong active gasdermin-D (GSDMD, marker of pyroptosis) signal near the cavity side, suggesting that these MAIT cells underwent active pyroptosis in the colorectal mucosa. Increased levels of the proinflammatory cytokines interleukin-12 (IL-12) and IL-18 were observed in HIV-1 infected patients. In addition, activated MAIT cells exhibited an increased pyroptotic phenotype after being triggered by HIV-1 virions, T-cell receptor signals, IL-12 plus IL-18, and combinations of these factors, in vitro.ConclusionsActivation-induced MAIT cell pyroptosis contributes to the loss of MAIT cells in HIV-1 infected patients, which could potentiate disease progression and poor immune reconstitution.

A Novel Technique With Ileal Mesentery to Reconstruct the Pelvic Peritoneum After Pelvic Dissection With End Colostomy for Rectal Cancer.

After abdominoperineal resection, low anterior resection, and end colostomy for lower rectal cancer, it is necessary to reconstruct the pelvic peritoneum to avoid small bowel obstruction, perineal hernia, and radiation enteritis in patients for whom postoperative radiotherapy is planned. However, pelvic peritoneal closure is technically difficult in patients who lack enough peritoneum to cover the defect or have received neoadjuvant radiation and have a rigid pelvis. The impact of this innovation is to reconstruct the pelvic peritoneum with the distal ileal mesentery laparoscopically. After removal of the tumor, the distal ileal mesentery was selected to completely cover the defect. Subsequently, suturing of the ileal mesentery to the posterior wall of the urinary bladder and all sides of the pelvic cavity was performed. Finally, the patients were returned to the headfirst supine position to ensure that there was no small bowel falling into the pelvic dead space. All surgical procedures were successfully performed laparoscopically from January 2019 to April 2021. No perineal complications or intestinal obstructions occurred during the follow-up period. This novel technique was found to be safe and effective. Moreover, it provided an economical method for the reconstruction of the pelvic peritoneum using autologous material, which could preserve the small intestine in the abdomen to avoid related complications. Additional larger series of patients with longer follow-up are needed to validate the safety and feasibility of this method.

Capsule endoscopy with retention of 4years: A case report.

Introduction and importanceCapsule endoscopy has been widely used in the diagnosis of small bowel diseases. Most CE can be smoothly excreted through the digestive tract. However, very few retention of CE may happen.Case presentationA 64-year-old man had been suffering from intermittent abdominal pain for 10 years. Capsule endoscopy was performed in local hospital 4 years ago. He was initially diagnosed with Crohn's disease and started on treatment. CTE and X-ray film of abdomen showed a suspected capsule endoscopy on the right side of pelvic cavity. Surgery was performed to remove the capsule. After the surgical treatment, no gastrointestinal symptoms relapsed for 9 months.Clinical discussionIt isn't uncommon for capsule endoscopy to be detained in Crohn's disease, because Strictures are the commonest complication of Crohn's disease. In order to prevent intestinal retention of capsule endoscopy, risk assessment should be carried out before capsule endoscopy. If detained CE isn't removed successfully by drug therapy and endoscopic therapy, surgery treatment has to be considered.ConclusionIn the present case, capsule endoscopy was found in the small intestine after 4 years, and the reason is worth pondering. We strongly recommend performing routine CTE, MRE and patency capsule examination before capsule endoscopy for patients suspected of stenosis. Routine abdominal X-ray film after examination is also useful for timely detection of capsule retention.

Research on the Modified Mathematical Prediction Model of Impeller Cover Side Cavity Liquid Pressure for Centrifugal Pumps

Accurate calculation of pressure distribution in the impeller cover side cavity is the key to predict the axial force of centrifugal pump. The existing calculation models almost does not involve the prediction of cavity pressure when the radial clearances of different sealing rings are matched with the diameter of different balance holes. On the basis of the original prediction model of pump cavity pressure, a mathematical model of pressure distribution of impeller cover side cavity with different radial clearance of sealing ring and the diameter of balance hole was established by introducing potential head correction coefficient and flow proportional coefficient. In order to improve the calculation accuracy of rotation coefficient for rear pump cavity, the balance aperture length ratio and the rotation undetermined coefficient were introduced in the calculation equation of original rotation coefficient. A test bed for pressure and leakage was designed and established, and the pressure of impeller cover side cavity and balance hole leakage was systematically tested when the radial clearance of sealing ring and the diameter of balance hole were different. Experimental results showed that the radial clearance of rear sealing ring and the diameter of balance hole had different effects on the radial pressure gradient of pump cavity. The diameter of balance hole had little effects on the pressure of the front pump cavity. When the clearance of the front and rear sealing rings were the same, the pressure of rear pump cavity was generally higher than that of the front pump cavity. For the equilibrium chamber liquid, increasing the diameter of balance hole could relieve the pressure, and increasing the radial clearance of sealing ring could increase the pressure. Combined with the test data, the potential head correction coefficient, the rotation undetermined coefficient and the flow proportional coefficient of different specific areas were calibrated, with a specific solution equation. In this study, the reliability of the proposed pressure mathematical model for impeller cover side cavity was verified by three cases. The results showed that the theoretical prediction value was more consistent with the actual measured value, proving that the proposed mathematical model had high accuracy and universality.

ACTIVE DECOMPRESSION AND DISTRACTION SUGOSTEOGENESIS AS A NOVEL TREATMENT FOR ODONTOGENIC KERATOCYST: A CASE REPORT

The Odontogenic Keratocyst is a rare but benign developmental cyst of the oral cavity that arises from cell rests of dental lamina; it is aggressive and typically appears during the second and third decades of life. It is usually detected incidentally or by asymptomatic swelling; 50% of them are commonly located in the posterior body and lower ramus of the mandible. <b>Objective:</b> present the effectiveness of a novel treatment for cyst decompression and distraction sugosteogenesis.<b>Clinical presentation:</b> A 59-year-old female was referred to clinic due to painless swelling in her posterior left side of the oral cavity with one year of evolution. The mass measured 2cmx2cm. After biopsy, a diagnosis of Odontogenic Keratocyst was determined. Radiographical evaluation showed a mass that started at the middle of the ramus and extended to the roots of the second molar, cortical bone from inferior border of the mandible was compromised.<b>Intervention and Outcome:</b> Active decompression of the cyst was elected as the treatment path. The application of negative pressure to osseous cells produces a stretching that creates mechanical cues that trigger signaling pathways, promote fluid flow, and enhance angiogenesis.²Two bone windows were performed on the buccal aspect of the cyst, and a tube was placed into each one of them. One tube was connected to a saline bag, and the other tube was connected to a Hemovac device. For one month, the patient manually irrigated with saline the inside of the cyst through one of the tubes, and manually used the Hemovac pump to aspirate the water out of the cavity. This procedure was performed three times daily.<b>Results:</b> After three months, radiographic evaluation showed remarkable cyst decompression.<b>Conclusions:</b> After three months of device use, we believe it has the potential to remarkably reduce the size of cystic lesions through distraction sugosteogenesis.

Multiscale analysis of craniomaxillofacial bone repair: A preclinical mini-pig study.

The rate of reparative osteogenesis controls when an implant is sufficiently stable as to allow functional loading. Using a mini pig model, the rate of reparative osteogenesis in two types of implant sites for example, an osteotomy versus a fresh extraction socket were compared. Eight adult mini pigs were used for the study. In phase I, three premolars were extracted on one side of the oral cavity; 12weeks later, in phase II, osteotomies were produced in healed extraction sites, and contralateral premolars were extracted. Animals were sacrificed 1, 5, and 12weeks after phase II. Bone repair and remodeling were evaluated using quantitative micro-computed tomographic imaging, histology, and histochemical assays coupled with quantitative dynamic histomorphometry. One week after surgery, extraction sockets and osteotomy sites exhibited similar patterns of new bone deposition. Five weeks after surgery, mineral apposition rates (MARs) were elevated at the injury sites relative to intact bone. Twelve weeks after surgery, the density of new bone in both injury sites was equivalent to intact bone but quantitative dynamic histomorphometry and cellular activity assays demonstrated bone remodeling was still underway. The mechanisms and rates of reparative osteogenesis were equivalent between fresh extraction sockets and osteotomies. The volume of new bone required to fill a socket, however, was significantly greater than the volume required to fill an osteotomy. These data provide a framework for estimating the rate of reparative osteogenesis and the time to loading of implants placed in healed sites versus fresh extraction sockets.

Chronic ACE-Inhibitor Induced Angioedema Requiring Emergent Nasotracheal Intubation: A Case Report

ACE-inhibitor induced angioedema is a rare, potentially life-threatening phenomenon with unpredictable symptoms. With advanced angioedema, orotracheal intubation may not be possible necessitating nasotracheal intubation or cricothyroidotomy. This case describes a 76-year-old male with a history of hypertension controlled with lisinopril-hydrochlorothiazide who developed sudden-onset angioedema. Additionally, this case was complicated by the patient’s anticoagulation after recent abdominal aortic aneurysm repair. The patient’s acute respiratory distress was managed with nasotracheal intubation because of severe edema of the oral cavity including at the base of the tongue without improvement with epinephrine, a corticosteroid, or an antihistamine. He was extubated the following day, but mild edema of the oral cavity and left side of face persisted at discharge 4 days after presentation. When presenting to the emergency room with angioedema mediated via ACE-inhibitor use, time is of the essence to avoid cardiopulmonary arrest secondary to hypoxemia. Rapid identification and management of this condition is key to improve outcomes. After acute management, patients should be advised to avoid all ACE-inhibitors in the future.

Cover Image

The cover image is based on the Research Article Human study on cancer diagnostic probe (CDP) for real-time excising of breast positive cavity side margins based on tracing hypoxia glycolysis; checking diagnostic accuracy in non-neoadjuvant cases by Mohammad Abdolahad et al., https://doi.org/10.1002/cam4.4503.

Research and Test on Mathematical Model of Pressure in Pump Cavity and Balance Cavity of Centrifugal Pump

The pressure distribution law and calculation of impeller side cavity is one of the important topics in the pump industry, but there is no more accurate calculation method at present. On this basis, a mathematical model of pump cavity pressure distribution and balance cavity pressure under design conditions was derived in this paper. By changing the radial clearance of front and back sealing rings and the diameter of the balance hole on the same impeller, the pressure distribution of front and rear cavities and the balance cavity pressure of the pump were systematically tested by a specially designed device. In the test, the curve of pressure loss coefficient and relative radius of pump cavity under different sealing ring radial clearance was obtained, which could solve the calculation problem of the pressure distribution of front and rear pump cavities. The test curve of the relationship between flow coefficient ratio and specific surface area essentially reflected the coupling regulation effect of balance holes and the rear sealing ring on the balance cavity pressure, which could not only solve the calculation problem of the balance cavity pressure, but also provide the theoretical basis for controlling the pressure and cover force of balance cavity and select different combinations of the radial clearance of the rear sealing ring and the diameter of balance holes. The results showed that the theoretical prediction value was more consistent with the actual measured value, which proved that the proposed mathematical model has high accuracy and universality. This study provides a new way to more accurately calculate the pump cavity pressure distribution and balance cavity pressure and laid a theoretical basis for the study of impeller cover force with significant academic and application value.