Clinical significance of large decompressive craniectomy to control intractable increased intracranial pressure in patients with traumatic brain injury

Objective To investigate the role of decompressive craniectomy (DC) to decrease intractable intracranial hypertension(ICH) due to diffuse brain swelling and / or cerebral edema after severe traumatic brain injury and the time window of DC to affect on prognosis. Methods The clinical record of 132 patients who underwent DC for posttraumatic intractable ICH in our hospital from July 2003 to

Combined ab-interno trabeculectomy and cataract surgery induces comparable intraocular pressure reduction in supine and sitting positions

AIM:To analyze the therapeutic effect of combined abinterno trabeculectomy and cataract surgery on intraocular pressure(IOP)levels in supine and sitting postures during a 24-hour IOP profile.METHODS:Twenty-six eyes of twenty-six patients receiving ab-interno trabeculectomy using electroablation of the trabecular meshwork combined with cataract surgery or stand-alone were included in this retrospective analysis.IOP change during 24-hour IOP profiles within two years postoperatively were analyzed for eyes receiving surgery(“study eyes”)and compared to fellow eyes,which had not received surgery.Clinical data including mean sitting IOP(siIOP),mean supine IOP(su IOP)and the number of topical antiglaucomatous medications(TAM)were extracted from patients’files.RESULTS:Preoperatively,si IOP was 17.6±5.3 mm Hg in study and 17.1±4.7 mm Hg in fellow eyes(P=0.347).Patients were treated with an average of 2.8±1.0 TAM.Best corrected visual acuity(BCVA)was significantly worse in study eyes(P<0.001),visual field function was marginally not significantly dif ferent(P=0.057).Af ter surger y 9.6±6.8 mo,study eyes had a mean si IOP of 14.5±3.6 mm Hg(IOP reduction:-3.2 mm Hg,P=0.009),a mean su IOP of 18.0±3.5 mm Hg,and an average of 1.3±1.34 TAM(P<0.001),while in fellow eyes,mean si IOP was 16.2±3.4 mm Hg and mean su IOP was 20.5±5.1 mm Hg.Postoperatively,the relative IOP increase between sitting and supine postures was approximately 30%in both study and fellow eyes(P=0.99).CONCLUSION:IOP after ab-interno trabeculectomy shows a comparable relative reduction in both supine and sitting position.Classical trabeculectomy is known to lower su IOP overproportionally.

Preparation and Characterization of Phenolic Prepolymer Impregnated Chinese Fir by Cyclic Increasing-Pressure Method with Green and Efficient

The Chinese fir wood was impregnated using a cyclic increasingpressure method(CIPM)with phenolic prepolymers as the impregnating modifier.Unmodified Chinese fir and progressive increasing-pressure method(PIPM)impregnated Chinese fir were used as reference samples and were compared and analyzed.The product’s chemical structure,internal morphology,crystal structure,and heat resistance were characterized.The transversal and longitudinal sections showed better filling effects,so that it bore greater external loading and reduced the water storage space.CIPM infused more phenolic prepolymer into the Chinese fir.Not only producing more physical filling but also forming more hydrogen bond associations and chemical bond combinations.Compared with PIPM and unmodi-fied Chinese fir,the CIPM impregnated Chinese fir had better mechanical strength and water resistance.The cellulose chains in CIPM impregnated Chinese fir were more closely linked and their crystallinity were clearly improved.Changes in internal morphology and crystal structure explained the reason why the mechanical properties and water resistance of CIPM impregnated Chinese fir were improved significantly.This Chinese fir had lower thermal decomposition rates,higher decomposition residual rates,and smaller combustion flames,which confirmed that it possessed improved heat and fire resistance.

Increasing Pressure:Impacts of Migration on Cities:

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Study on "fracturing-sealing" integration technology based on high-energy gas fracturing in single seam with high gas and low air permeability

To improve the gas extraction efficiency of single seam with high gas and low air permeability,we developed the"fracturing-sealing"integration technology,and carried out the engineering experiment in the3305 Tunliu mine.In the experiment,coal seams can achieve the aim of antireflection effect through the following process:First,project main cracks with the high energy pulse jet.Second,break the coal body by delaying the propellant blasting.Next,destroy the dense structure of the hard coal body,and form loose slit rings around the holes.Finally,seal the boreholes with the"strong-weak-strong"pressurized sealing technology.The results are as follows:The average concentration of gas extraction increases from8.3%to 39.5%.The average discharge of gas extraction increases from 0.02 to 0.10 m^3/min.The tunneling speeds up from 49.5 to 130 m/month.And the permeability of coal seams improves nearly tenfold.Under the same conditions,the technology is much more efficient in depressurization and antireflection than common methods.In other words,it will provide a more effective way for the gas extraction of single seam with high gas and low air permeability.

Atypical clinical and pathological findings in a patient with isolated cortical vein thrombosis

Isolated cortical vein thrombosis often produces a focal lesion. Because of the rapid development of collateral circulation, increased intracranial pressure has never been reported in a patient with isolated cortical vein thrombosis. The diagnosis of isolated cortical vein thrombosis is based mainly on MRI, catheter digital subtraction angiography, and histological findings, but may be challenging. We report a patient who presented with intermittent seizures and left-sided limb weakness. Her symptoms gradually progressed, and she eventually developed signs of increased intracranial pressure. Imaging studies showed a space-occupying lesion in the right frontal lobe of the brain. As we could not diagnose isolated cortical vein thrombosis based on the preoperative findings, surgical excision of the lesion was performed under general anesthesia. Histological examination showed destruction of the brain parenchyma with infiltration of macrophages, proliferation of reactive astrocytes and small vessels, and foci of hemorrhage. Further examination found that a number of small vessels in both the subarachnoid space and brain parenchyma were filled with thrombus, some of which was organized. Elastic fiber staining showed that the obstructed vessels were veins. We diagnosed isolated cortical vein thrombosis with atypical clinical features.

PRESSURE CHARACTERISTICS OF CAVITATION CONTROL BY AERATION

This experimental investigation was systernatically conducted with the aid of a non-circulating water tunnel in the Hydraulics Laboratory at Zhejiang University of Tech nology in China, The test velocity is between 20m/s and 40m/ s. The least air concentration to prevent cavitation erosion lies between 1. 7% and 4. 5%. Pressure waveforms with and without aeration in cavitation and cavitation erosion regions were measured. Time-averaged pressure profiles with and without aeration were compared. Pressure characteristics cotresponding to least air concentration to prevent cavitation erosion in cavitation and cavitation erosion regions were analyzed.