A case report on uterus didelphys with unilateral renal agenesis and crouzon syndrome

Uterus didelphys is a type of Müllerian duct anomaly where there is complete duplication of uterine horns and the cervix, with no communication between them, which can be associated with abnormalities of the renal system as seen in this case of a 17 year girl, who attained menarche at 13 years of age and had regular cycles presented with dysmenorrhea. Examination and imaging showed right ovarian cystic mass. Incidentally left unilateral solitary kidney was found. Physical examination showed features of Crouzon Syndrome which is an autosomal dominant genetic disorder also known as Branchial Arch Syndrome. She was admitted for treatment of the symptomatic right adnexal mass. Laparotomy was done. Findings were, a dense adherent mass of 6 × 6 cm in right iliac fossa, uterus didelphys with left uterine horn, normal left fallopian tube and ovary, right side hematosalphinx adherent to enlarged right uterine horn of 10 weeks size and right side chocolate cyst.  Appendix was elongated with faecolith. Adhesiolysis with removal of right non communicating horn with fallopian tube and ovary and appendicectomy was done

Laparoscopic sleeve gastrectomy using a synthetic bioabsorbable staple line reinforcement material: Post-operative complications and 6 year outcomes.

BACKGROUND: Gastric leak after laparoscopic sleeve gastrectomy (LSG) is a serious complication. Currently, the literature lacks long-term outcomes in LSG and leak rates after reinforcement of the staple line. The aims are two-fold: to present leak rates from using staple line reinforcement and six year outcomes of LSG in relation to resolution of obesity-related comorbidities and long-term weight loss. MATERIALS AND METHODS: This is a single-institution, retrospectively reviewed study of 204 patient case files. Data from all patients undergoing LSG between December 2007 and May 2013 was collected. RESULTS: The total complication rate was 6.9% (14/204), with no recorded staple line leaks. The mean postoperative Body Mass Index (BMI) at 1 year, 2 years, 3 years, 4 years, 5 years, and 6 years was 39.3 ± 8, 38.7 ± 8, 40.4 ± 9, 40.5 ± 10, 43.0 ± 10, and 42.4 ± 7, respectively. The mean % excess weight loss at 1 year, 3 years, and 6 years was 48.4 ± 19, 51.7 ± 28, and 41.0 ± 21, respectively. There were no significant differences between follow-ups at year 1 and 3 (p > 0.05), and between year 3 and 6 (p > 0.05) for the mean % excess weight loss. The resolution rates for all patients were 74%, 61%, 79%, and 90% for hypertension, hypercholesterolemia, diabetes mellitus type 2 and obstructive sleep apnea, respectively. CONCLUSION: The synthetic bioabsorbable reinforcement material shows no staple line leaks making it safe to use. LSG as a procedure had a high resolution of obesity-related comorbidities as well as sustainable long-term weight loss

Combustion Turbine (CT) Hot Section Coating Life Management

The integrity of coatings used in hot section components of combustion turbines is crucial to the reliability of the buckets. This project was initiated in recognition of the need for predicting the life of coatings analytically, and non-destructively; correspondingly, four principal tasks were established. Task 1, with the objective of analytically developing stress, strain and temperature distributions in the bucket and thereby predicting thermal fatigue (TMF) damage for various operating conditions; Task 2 with the objective of developing eddy current techniques to measure both TMF damage and general degradation of coatings and, Task 3 with the objective of developing mechanism based algorithms. Task 4 is aimed at verifying analytical predictions from Task 1 and the NDE predictions from Task 3 against field observations

An overview of applications of PEEK polymer in prosthodontics.

The rapid evolution of computer-aided design and computer-aided manufacturing (CAD-CAM) led to the introduction of newer materials that could be precisely milled for the fabrication of dental prostheses. PEEK (PolyEtherEtherKetone) has been explored for a number of applications for clinical dentistry, including removable dental prostheses, fixed dental prostheses, implant-supported prostheses, resin-bonded fixed dental prostheses and implant-retained overdentures. The major beneficial property of PEEK is its lower Young\u27s modulus, and as elastic as bone, providing a cushioning effect and reduction of stress transferred to abutment teeth. It is a material with high biocompatibility, good mechanical properties, high-temperature resistance, chemical stability, polishability, good wear resistance, and high bond strength with luting cements. Further, PEEK is also recommended for a wide range of CAD-CAM fabricated fixed and removable prostheses, fabrication of occlusal splints, intra-radicular posts, implant abutments and provisional restorations. PEEK material shows a property of radiolucency, which is advantageous for the evaluation of both osseointegration and tissue surrounding the implant on computed tomography. Considering these properties, PEEK is increasingly being used in implantology

Community-Based Approach to Assess Obstructive Respiratory Diseases and Risk in Urban African American Churches

Asthma, and chronic obstructive pulmonary disease (COPD) are significant health problems that have disparate effects on many Americans. Misdiagnosis and underdiagnosis are common and lead to ineffective treatment and management. This study assessed the feasibility of applying a two-step case-finding technique to identify both COPD and adult asthma cases in urban African American churches. We established a community-based partnership, administered a cross-sectional survey in step one of the case-finding technique and performed spirometry testing in step two. A total of 219 surveys were completed. Provider-diagnosed asthma and COPD were reported in 26% (50/193) and 9.6% (18/187) of the sample. Probable asthma (13.9%), probable COPD (23.1%), and COPD high-risk groups (31.9%) were reported. It is feasible to establish active case-finding within the African American church community using a two-step approach to successfully identify adult asthma and COPD probable cases for early detection and treatment to reduce disparate respiratory health outcomes

COMBUSTION TURBINE (CT) HOT SECTION COATING LIFE MANAGEMENT

The integrity of coatings used in hot section components of combustion turbines is crucial to the reliability of the buckets. This project was initiated in recognition of the need for predicting the life of coatings analytically, and non-destructively; correspondingly, four principal tasks were established. Task 1, with the objective of analytically developing stress, strain and temperature distributions in the bucket and thereby predicting thermal fatigue (TMF) damage for various operating conditions; Task 2 with the objective of developing eddy current techniques to measure both TMF damage and general degradation of coatings and, Task 3 with the objective of developing mechanism based algorithms. Task 4 is aimed at verifying analytical predictions from Task 1 and the NDE predictions from Task 3 against field observations

An unusual case of metastasis to the left side of the heart: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cardiac metastases are found in six to 20% of autopsies of patients with malignant neoplasm. The most common neoplasms that metastasize to the heart are malignant melanoma, lymphoma, and leukemia, but the relative numbers are greater with breast and lung cancers, reflecting the most common incidence of these cancers.</p> <p>Case presentation</p> <p>A 60-year-old Hispanic man presented to our hospital after being transferred from an outside hospital for workup and evaluation of an adrenal mass of the abdomen and pelvis, found on computed tomography. His chief complaint upon admission was altered mental status. Physical examination was unremarkable. He was alert and oriented and had a dry and non-erythematous oropharynx, and bilateral diffuse wheezing on lung examination. Computed tomography of the chest showed multiple hypodense lesions in the left ventricular myocardium, suggestive of metastases. There were also tiny sub-centimeter nodular densities in the right upper and lower lobes. Adrenal glands contained hypodense lesions, which showed characteristic adenocarcinomatous malignant cells.</p> <p>Conclusion</p> <p>Cancers which have metastasized to the heart are found in six to 20% of patients with malignant neoplasms. The right side of the heart is more commonly involved in metastasis. This study is unusual in that a tumor of an unknown primary origin had metastasized to the left side of the heart.</p

Computation Modeling and Assessment of Nanocoatings for Ultra Supercritical Boilers

Forced outages and boiler unavailability of coal-fired fossil plants is most often caused by fire-side corrosion of boiler waterwalls and tubing. Reliable coatings are required for Ultrasupercritical (USC) application to mitigate corrosion since these boilers will operate at a much higher temperatures and pressures than in supercritical (565 C {at} 24 MPa) boilers. Computational modeling efforts have been undertaken to design and assess potential Fe-Cr-Ni-Al systems to produce stable nanocrystalline coatings that form a protective, continuous scale of either Al{sub 2}O{sub 3} or Cr{sub 2}O{sub 3}. The computational modeling results identified a new series of Fe-25Cr-40Ni with or without 10 wt.% Al nanocrystalline coatings that maintain long-term stability by forming a diffusion barrier layer at the coating/substrate interface. The computational modeling predictions of microstructure, formation of continuous Al{sub 2}O{sub 3} scale, inward Al diffusion, grain growth, and sintering behavior were validated with experimental results. Advanced coatings, such as MCrAl (where M is Fe, Ni, or Co) nanocrystalline coatings, have been processed using different magnetron sputtering deposition techniques. Several coating trials were performed and among the processing methods evaluated, the DC pulsed magnetron sputtering technique produced the best quality coating with a minimum number of shallow defects and the results of multiple deposition trials showed that the process is repeatable. scale, inward Al diffusion, grain growth, and sintering behavior were validated with experimental results. The cyclic oxidation test results revealed that the nanocrystalline coatings offer better oxidation resistance, in terms of weight loss, localized oxidation, and formation of mixed oxides in the Al{sub 2}O{sub 3} scale, than widely used MCrAlY coatings. However, the ultra-fine grain structure in these coatings, consistent with the computational model predictions, resulted in accelerated Al diffusion from the coating into the substrate. An effective diffusion barrier interlayer coating was developed to prevent inward Al diffusion. The fire-side corrosion test results showed that the nanocrystalline coatings with a minimum number of defects have a great potential in providing corrosion protection. The coating tested in the most aggressive environment showed no evidence of coating spallation and/or corrosion attack after 1050 hours exposure. In contrast, evidence of coating spallation in isolated areas and corrosion attack of the base metal in the spalled areas were observed after 500 hours. These contrasting results after 500 and 1050 hours exposure suggest that the premature coating spallation in isolated areas may be related to the variation of defects in the coating between the samples. It is suspected that the cauliflower-type defects in the coating were presumably responsible for coating spallation in isolated areas. Thus, a defect free good quality coating is the key for the long-term durability of nanocrystalline coatings in corrosive environments. Thus, additional process optimization work is required to produce defect-free coatings prior to development of a coating application method for production parts

COMPUTATIONAL DESIGN OF CORROSION-RESISTANT FE-CR-NI-AL NANOCOATINGS FOR POWER GENERATION 1

ABSTRACT A computational approach has been undertaken to design and assess potential Fe-Cr-Ni-Al systems to produce stable nanostructured corrosion-resistant coatings that form a protective, continuous scale of alumina or chromia at elevated temperatures. Phase diagram computation was modeled using the Thermo-Calc ® software and database [1, 2] to generate pseudo-ternary Fe-Cr-Ni-Al phase diagrams to help identifying compositional ranges without undesirable brittle phases. Computational modeling of the grain growth process, sintering of voids, and interface toughness determination by indentation, assessed micro-structural stability and durability of the nanocoatings fabricated by a magnetron-sputtering process. Interdiffusion of Al, Cr, and Ni was performed using the DICTRA ® diffusion code [3] to maximize the long-term stability of the nanocoatings. The computational results identified a new series of Fe-Cr-NiAl coatings that maintain long-term stability and a fine-grained microstructure at elevated temperatures. The formation of brittle sigma phase in Fe-Cr-Ni-Al alloys is suppressed for Al contents in excess of 4 wt.%. Grain growth modeling indicated that the columnar-grained structure with a high percentage of low-angle grain boundaries is resistant to grain growth. Sintering modeling indicated that the initial relative density of as-processed magnetron-sputtered coatings could achieve full density after a short thermal exposure or heat-treatment. Interface toughness computation indicated that Fe-Cr-Ni-Al nanocoatings exhibit high interface toughness in the range of 52-366 J/m 2 . Interdiffusion modeling using the DICTRA software package indicated that inward diffusion could result in substantial to moderate Al and Cr losses from the nanocoating to the substrate during long-term thermal exposures

Effect of Silicon Content on Carbide Precipitation and Low-Temperature Toughness of Pressure Vessel Steels

Cr – Mn – Mo – Ni pressure vessel steels containing 0.54 and 1.55% Si are studied. Metallographic and fractographic analyses of the steels after tempering at 650 and 700°C are performed. The impact toughness at – 30°C and the hardness of the steels are determined. The mass fraction of the carbide phase in the steels is computed with the help of the J-MatPro 4.0 software