Emergent Orthotopic Liver Transplantation for Hemorrhage from a Giant Cavernous Hepatic Hemangioma: Case Report and Review

IntroductionCavernous hemangiomas represent the most common benign primary hepatic neoplasm, often being incidentally detected. Although the majority of hepatic hemangiomas remain asymptomatic, symptomatic hepatic hemangiomas can present with abdominal pain, hemorrhage, biliary compression, or a consumptive coagulopathy. The optimal surgical management of symptomatic hepatic hemangiomas remains controversial, with resection, enucleation, and both deceased donor and living donor liver transplantation having been reported.Case reportWe report the case of a patient found to have a unique syndrome of multiorgan cavernous hemangiomatosis involving the liver, lung, omentum, and spleen without cutaneous involvement. Sixteen years following her initial diagnosis, the patient suffered from intra-abdominal hemorrhage due to her giant cavernous hepatic hemangioma. Evidence of continued bleeding, in the setting of Kasabach-Merritt Syndrome and worsening abdominal compartment syndrome, prompted MELD exemption listing. The patient subsequently underwent emergent liver transplantation without complication.ConclusionAlthough cavernous hemangiomas represent the most common benign primary hepatic neoplasm, hepatic hemangioma rupture remains a rare presentation in these patients. Management at a center with expertise in liver transplantation is warranted for those patients presenting with worsening DIC or hemorrhage, given the potential for rapid clinical decompensation

Wearability Map

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Design for Wearability

Digital Technology is constantly improving as information becomes wireless. These advances demand more wearable and mobile form factors for products that access information. A product that is wearable should have wear- ability. This paper explores the concept of dynamic wearability through design research. Wearability is defined as the interaction between the human body and the wearable object. Dynamic wearability extends that definition to include the human body in motion. Our research has been to locate, understand, and define the spaces on the human body where solid and flexible forms can rest -- without interfering with fluid human movement. The result is a set of design guidelines embodied in a set of wearable forms. These wearable forms describe the three dimensional spaces on the body best suited for comfortable and unobtrusive wearability by design

Benchmarking an interdisciplinary concurrent design methodology for electronic/mechanical design

The paper describes the evolution of an Interdisciplinary Concurrent Design Methodology (ICDM) and the metrics used to compare four generations of wearable computer artifacts produced by the methodology at each stage of ICDM’s growth. The product cycle is defined, its phases, and the design information representation for each phase. Six generic axes of design activity are defined, and the concept of benchmarking a complete design methodology using these axes is introduced. In addition an approach for measuring design complexity is proposed. When applied to the four generations of the CMU wearable computers, the ICDM has demonstrated two orders of magnitude increase in design and efficiency. I

Why the upper arm? factors contributing to the design of an accurate and comfortable, wearable body monitor

Abstract⎯Wearable and ambulatory body monitors hold many obvious benefits for the future of public health. At the heart of the healthcare industry lies the unmet need for consumers, researchers and clinicians to continuously and accurately monitor physiological states of the body. This paper discusses in-depth the challenges and reasoning for the specific positioning and design of the SenseWear TM Armband and how the important and contradictory requirements of comfort and accuracy were reconciled in order to create a product that can collect continuous and accurate data for extended periods of time, outside of labs and hospitals. Index Terms⎯Ambulatory body monitors, SenseWear Armband, sensor array, energy expenditure, sleep state, physical activity level