Uretroplastia de sustitución con doble injerto de mucosa oral como opción terapéutica para pacientes con estenosis de uretra bulbar asociada a UroLume®

ResumenEl UroLume® o endoprótesis uretral fue concebido como un dispositivo de fácil colocación para pacientes con estenosis uretral bulbar recurrente. Con el paso del tiempo se demostró que ocasionaba más complicaciones que beneficios por lo que se abandonó su uso. Sin embargo, se generó un grupo de pacientes con estenosis uretral compleja que necesitaban múltiples tratamientos quirúrgicos con resultados poco favorecedores. Con la divulgación a finales de la década de los 90 del uso de injertos de mucosa oral para el tratamiento de estenosis uretral se inició una nueva etapa en la búsqueda de un tratamiento definitivo para este tipo de pacientes. El objetivo del artículo es presentar una técnica quirúrgica no descrita en la literatura para el tratamiento de estenosis uretral bulbar asociada a UroLume®. Se describe el caso de un paciente masculino de 71 años de edad con estenosis uretral bulbar secundaria a resección transuretral de próstata al cual le fue colocado un UroLume® hace 8 años presentando reestenosis uretral, tratado con múltiples dilataciones uretrales. Mediante un abordaje perineal se retiró la endoprótesis en su totalidad, en base a las características locales de los tejidos se decidió colocar un doble injerto de mucosa oral dorsal inlay y ventral onlay con resultados exitosos a 6 meses de seguimiento.AbstractUroLume®, or urethral endoprosthesis, was conceived as an easy placement device for patients with recurrent bulbar urethral stricture. With the passage of time, it was shown to cause more complications than benefits and its use was discontinued. However, it created a group of patients with complex urethral stricture that required multiple surgical treatments with unsatisfactory results. The widespread use at the end of the 1990s of buccal mucosa grafts for the treatment of urethral stricture began a new stage in the search for a definitive treatment for this type of patient.The aim of our article was to present a surgical technique for the treatment of UroLume®-associated bulbar urethral stricture that has not been described in the literature.A 71-year-old man presented with bulbar urethral stricture secondary to transurethral resection of the prostate who, 8 years ago, had UroLume® placement. He presented with another urethral stricture and was treated with numerous urethral dilations. Through the perineal approach, the endoprosthesis was completely removed, and based on the local tissue characteristics, a dorsal inlay and ventral onlay double buccal mucosa graft was placed with successful results at the 6th month of follow-up

Scoping assessment of free-field vibrations due to railway traffic

The number of railway lines both operational and under construction is growing rapidly, leading to an increase in the number of buildings adversely affected by ground-borne vibration (e.g. shaking and indoor noise). Post-construction mitigation measures are expensive, thus driving the need for early stage prediction, during project planning/development phases. To achieve this, scoping models (i.e. desktop studies) are used to assess long stretches of track quickly, in absence of detailed design information. This paper presents a new, highly customisable scoping model, which can analyse the effect of detailed changes to train, track and soil on ground vibration levels. The methodology considers soil stiffness and the combination of both the dynamic and static forces generated due to train passage. It has low computational cost and can predict free-field vibration levels in accordance with the most common international standards. The model uses the direct stiffness method to compute the soil Green's function, and a novel two-and-a-half dimensional (2.5D) finite element strategy for train-track interaction. The soil Green's function is modulated using a neural network (NN) procedure to remove the need for the time consuming computation of track-soil coupling. This modulation factor combined with the new train-track approach results in a large reduction in computational time. The proposed model is validated by comparing track receptance, free-field mobility and soil vibration with both field experiments and a more comprehensive 2.5D combined finite element-boundary element (FEM-BEM) model. A sensitivity analysis is undertaken and it is shown that track type, soil properties and train speed have a dominant effect on ground vibration levels. Finally, the possibility of using average shear wave velocity introduced for seismic site response analysis to predict vibration levels is investigated and shown to be reasonable for certain smooth stratigraphy's.Ministerio de Economía y Competitividad - BIA2016-75042-C2-1-

Scoping methodology to asses induced vibration by railway traffic in buildings

This work presents a scoping model to predict ground-borne railway vibration levels within buildings considering soil-structure interaction (SSI). It can predict the response of arbitrarily complex buildings in a fraction of the time typically required to analyse a complex SSI problem, and thus provides a practical tool to rapidly analyse the vibration response of numerous structures near railway lines. The tool is designed for use in cases where the ground-borne vibration is known, and thus can be used as model input. Therefore in practice, for the case of a new line, the ground motion can be computed numerically, or alternatively, for the case of new buildings to be constructed near an existing line, it can be recorded directly (e.g. using accelerometers) and used as model input. To achieve these large reductions in computational time, the model discretises the ground-borne vibration in the free field into a frequency range corresponding to the modes that characterize the dynamic building response. After the ground-borne response spectra that corresponds with the incident wave field is estimated, structural vibration levels are computed using modal superposition, thus avoiding intensive soil-structure interaction computations. The model is validated using a SSI problem and by comparing results against a more complex finite element-boundary element model. Finally, the new scoping model is then used to analyse structural-borne vibration. The results show that the scoping model provides a powerful tool for use during the early design stages of a railway system when a large number of structures require analysis

Nuclear masses and the number of valence nucleons

An improved version of the liquid drop model is presented. The addition of two terms, linear and quadratic in the total number of valence nucleons (particles or holes), improves the description of atomic masses, which can be fitted with an r.m.s. error of 1.2 MeV. Predictions are analysed an compared with those of established models. (c) 2007 Elsevier B.V. All rights reserved

Surface shape resonances in lamellar metallic gratings

The specular reflectivity of lamellar gratings of gold with grooves 0.5 microns wide separated by a distance of 3.5 microns was measured on the 2000 cm$^{-1}$ - 7000 cm$^{-1}$ spectral range for p-polarized light. For the first time, experimental evidence of the excitation of electromagnetic surface shape resonances for optical frequencies is given. In these resonances the electric field is highly localized inside the grooves and is almost zero in all other regions. For grooves of depth equal to 0.6 microns, we have analyzed one of these modes whose wavelength (3.3 microns) is much greater than the lateral dimension of the grooves.Comment: 4 pages (LaTex), 5 postscript figures, to be published in Physical Review Letter

A transfer function method to predict building vibration and its application to railway defects

This work presents a simplified method to evaluate building shaking due to arbitrary base excitations, and an example application to railway problems. The model requires minimal computational effort and can be applied to a wide range of footing shapes, thus making it attractive for scoping-type analysis. It uses the soil excitation spectrum at the building footing location as it’s input, and computes the building response at any arbitrary location within it’s 3D structure. To show an application of the model versatility, it is used to compute building response due to a variety of singular railway defects (e.g. switches/crossings). It is however suitable for more general applications including railway problems without defects. The approach is novel because current railway scoping models do not use soil-structure transfer functions combined with free-field response to estimate building vibration by railway defects. First the soil-structure interaction approach is outlined for both rigid and flexible footings. Then it is validated by comparing results against a comprehensive fully-coupled 3D FEM-BEM model. Finally, it is used to analyse the effect of a variety of variables related to railway defects on building response. Local track defects are shown to have a strong influence on building vibrations. Further, vibration levels close to the threshold of human comfort are found in buildings close to the railway line. Overall the new approach allows for the computation of building vibrations accounting for soil-structure interaction, floor amplification and the measured/computed free-field response due to railway traffic using minimal computational effort

Image reconstruction techniques applied to nuclear mass models

A new procedure is presented that combines well-known nuclear models with image reconstruction techniques. A color-coded image is built by taking the differences between measured masses and the predictions given by the different theoretical models. This image is viewed as part of a larger array in the (N,Z) plane, where unknown nuclear masses are hidden, covered by a "mask." We apply a suitably adapted deconvolution algorithm, used in astronomical observations, to "open the window" and see the rest of the pattern. We show that it is possible to improve significantly mass predictions in regions not too far from measured nuclear masses

Dynamic equivalence between atomic and colloidal liquids

We show that the kinetic-theoretical self-diffusion coefficient of an atomic fluid plays the same role as the short-time self-diffusion coefficient D_S in a colloidal liquid, in the sense that the dynamic properties of the former, at times much longer than the mean free time, and properly scaled with D_S, will indistinguishable from those of a colloidal liquid with the same interaction potential. One important consequence of such dynamic equivalence is that the ratio D_L/ D_S of the long-time to the short-time self-diffusion coefficients must then be the same for both, an atomic and a colloidal system characterized by the same inter-particle interactions. This naturally extends to atomic fluids a well-known dynamic criterion for freezing of colloidal liquids[Phys. Rev. Lett. 70, 1557 (1993)]. We corroborate these predictions by comparing molecular and Brownian dynamics simulations on (soft- and hard-sphere) model systems, representative of what we may refer to as the "hard-sphere" dynamic universality class

Management of a ruptured epidural catheter, an anesthesiologist's dilemma: a case report

Epidural anesthesia is a widely used anesthetic technique in lower extremity surgeries although it is a relatively safe procedure, it can have complications, such as rupture of the epidural catheter. This is a 69-year-old male patient with a diagnosis of Wagner IV diabetic foot is presented, which was scheduled for left supracondylar amputation in which after epidural block, retention of the catheter tip in the epidural space at level L2-L3 was seen, so hemi laminectomy was performed in a second surgical stage in L2 and removal of the epidural catheter. Ideally a broken needle should be removed as soon as possible