Management of Patients with Ischemic Heart Disease in Spine Surgery

In ischemic heart disease (IHD), the myocardium does not receive enough blood and oxygen. Although the IHD-related mortality rate is decreasing, the risk remains and is a major predictor of cardiac complications following noncardiac surgery. Given the increase in the older population, the number of patients with spinal diseases requiring surgery is increasing. Among these patients, those with underlying IHD or a high risk of cardiac complications before and after surgery are also increasing. Given that cardiac complications following spinal surgery are associated with delayed patient recovery and even death, spinal surgeons should be knowledgeable about overall patient management, including medication therapy in those at high risk of developing perioperative cardiac complications for successful patient care. Before surgery, the underlying medical conditions of patients should be evaluated. Patients with a history of myocardial infarction should be checked for a history of surgical treatments, and the anticoagulant dose should be controlled depending on the surgery type. In addition, the functional status of patients must be examined before surgery. Functional status can be assessed according to the metabolic equivalent of task (MET). More preoperative cardiac examinations are needed for patients who are unable to perform four METs in daily because of the high risk of postoperative cardiac complications. Patients with a history of IHD require appropriate preoperative management and further postoperative evaluation. When considering surgery, spinal surgeons should be knowledgeable about patient care before and after surgery

Development And Application Of A Shallow Water Flow Model HDM-2D

In this study, an unsteady 2D depth-averaged flow model, HDM-2D was developed by employing the finite element algorithm. The shallow water equations were weighted by SU/PG test function of which the shape is deformed by the current direction to introduce balancing diffusion only in the flow direction. The nonlinearity of the discretized momentum equations was linearized by Newton-Raphson method. Triangular or rectangular element with C0 interpolation function can be mixed together in the construction of geometry and the linear set of equations was solved by frontal method. The HDM-2D features (1) the incorporation of secondary current effect by dispersion stresses; (2) the reproduction of convection-dominated or supercritical flow by SU/PG scheme; (3) the adjustment of the internal wall velocity by Navier-slip condition; (4) the imposition of skewed inflow velocity profiles by beta function; (5) the provision of eddy viscosity by constant, parabolic, and Smagorinsky turbulence models; (6) the inclusion of bottom shear stress by either quadratic Manning’s law or bed friction factor; and (7) the representation of wetting and drying by flux blocking method, which can be extended into inundation analysis model. To increase the applicability and user convenience, the HDM-2D was coupled to a 2D advection-dispersion model, CTM-2D to consider the flow and the transport phenomenon. The flow and transport models were combined into a software suite RAMS (River Analysis and Modeling System) to interface the solvers with the pre- and post-processor. Therefore, RAMS supports the mesh generation, the model control, the result view, and the exportation to SMS geometry or Tecplot data files. Several applications of HDM-2D in RAMS environment have shown that the HDM-2D gives accurate prediction of the flow characteristics in a variety of free surface problems and expected to be served as a useful tool for practical design

Multi-Player Virtual Ping-Pong Game

In this paper we show how a motion capture system and feedback mechanism can be integrated into a virtual ping-pong game to create a multi-player platform. To trace the motion of each player, optical markers are attached to dif-ferent places on each player’s paddle. For tactile feedback, we designed a controller for a DC (Direct Current) mo-tor, which is also attached to the paddle. This controller communicates with the game server through wireless Blue-tooth technology. When the game server detects a collision between the paddle and ball, the controller receives the message from the game server and then triggers one of the respective paddle’s DC motors to vibrate depending on the position of the impact on the paddle. During an exhibition many people positively responded to the game

A Case of Successful Treatment of Stomal Variceal Bleeding with Transjugular Intrahepatic Portosystemic Shunt and Coil Embolization

Variceal bleeding from enterostomy site is an unusual complication of portal hypertension. The bleeding, however, is often recurrent and may be fatal. The hemorrhage can be managed with local measures in most patients, but when these fail, surgical interventions or portosystemic shunt may be required. Herein, we report a case in which recurrent bleeding from stomal varices, developed after a colectomy for rectal cancer, was successfully treated by placement of transjugular intrahepatic portosystemic shunt (TIPS) with coil embolization. Although several treatment options are available for this entity, we consider that TIPS with coil embolization offers minimally invasive and definitive treatment