The investigation of ship maneuvering with hydrodynamic effects between ships in curved narrow channel

AbstractThe hydrodynamic interaction between two large vessels can't be neglected when two large vessels are closed to each other in restricted waterways such as in a harbor or narrow channel. This paper is mainly concerned with the ship maneuvering motion based on the hydrodynamic interaction effects between two large vessels moving each other in curved narrow channel. In this research, the characteristic features of the hydrodynamic interaction forces between two large vessels are described and illustrated, and the effects of velocity ratio and the spacing between two vessels are summarized and discussed. Also, the Inchon outer harbor area through the PALMI island channel in Korea was selected, and the ship maneuvering simulation was carried out to propose an appropriate safe speed and distance between two ships, which is required to avoid sea accident in confined waters. From the inspection of this investigation, it indicates the following result. Under the condition of SP12≤0.5L, it may encounter a dangerous tendency of grounding or collision due to the combined effect of the interaction between ships and external forces. Also considering the interaction and wind effect as a parameter, an overtaken and overtaking vessel in narrow channel can navigate while keeping its own original course under the following conditions; the lateral separation between two ships is about kept at 0.6 times of ship length and 15 degrees of range in maximum rudder angle. On the other hand, two ships while overtaking in curved narrow channel such as Inchon outer harbor in Korea should be navigated under the following conditions; SP12 is about kept at 1.0 times of ship length and the wind velocity should not be stronger than 10 m/s

Effect of beraprost sodium on arterial stiffness in patients with type 2 diabetic nephropathy

Trial registration : ClinicalTrials.gov number NCT01796418Background : Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD). Cardiovascular (CV) complications are the most common cause of death among ESRD patients. Beraprost sodium (BPS) is a prostacyclin analog with vasodilatory and antiplatelet effects. Methods : This is a multicenter prospective, randomized, double-blind, placebo-controlled trial to determine whether treatment with BPS improves arterial stiffness in patients with type 2 diabetic nephropathy. A total of 102 participants with type 2 diabetic nephropathy will be screened, enrolled, and randomly assigned to receive either 80 μg BPS or placebo daily for 12 weeks. The primary outcome is the change in brachial-ankle pulse wave velocity between baseline and after 12 weeks of medication use. The secondary outcomes will include changes in the ankle-brachial index, the urine albumin to creatinine ratio, the estimated glomerular filtration rate, lipid profiles, and blood pressure from baseline to after treatment. Discussion : This clinical trial is the first to investigate the effects of BPS on changes in CV biomarkers, albuminuria, renal function, and lipid profiles in patients with diabetic nephropathy.Peer Reviewe

Association between the Delta Estimated Glomerular Filtration Rate and the Prevalence of Monoclonal Gammopathy of Undetermined Significance in Korean Males

Background. We investigated the association between the reduction in the estimated glomerular filtration rate (eGFR) and the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in Korean males. Methods. We enrolled 723 healthy Korean males. Serum creatinine concentration, serum electrophoresis, serum immunofixation, and the serum free light chain assay were performed. We calculated delta eGFR per year (ΔeGFR/yr). The prevalence of MGUS was compared based on the ΔeGFR/yr and age group. Results. Thirteen (1.8%) of 723 participants exhibited the monoclonal band on serum immunofixation. Prevalence of MGUS by age group was 0.00% (0/172 for 40 years), 1.63% (6/367 for 60 years), and 3.80% (7/184 for >60 years). The median decrease in ΔeGFR/yr was 5.3%. The prevalence of MGUS in participants in their 50s with >5.3% decline in ΔeGFR/yr was significantly higher than those with <5.3% decrease in ΔeGFR/yr (3.16% versus 0.00%; = 0.049). The prevalence of MGUS in participants in their 50s with >5.3% decrease in ΔeGFR/yr was similar to that of healthy males in their 60s. Conclusion. Using the rate of reduction in ΔeGFR/yr in healthy Korean males who had their serum creatinine level checked regularly may increase the MGUS detection rate in clinical practice

Factors affecting the long-term outcomes of idiopathic membranous nephropathy

Abstract Background We attempted to describe the clinical features and determine the factors associated with renal survival in idiopathic membranous nephropathy (iMN) patients with nephrotic syndrome (NS) and to determine the factors associated with spontaneous complete remission (sCR) and progression to NS in iMN patients with subnephrotic proteinuria. Methods This retrospective study involved 166 iMN patients with NS and 65 patients with subnephrotic proteinuria. The primary end point was a doubling of serum creatinine or initiation of dialysis. In patients with subnephrotic proteinuria, we determined the factors associated with sCR and factors associated with progression to NS. Results Remission of NS was achieved in 125 out of 166 patients (75.3%). Of those who reached remission, 26 patients (20.8%) experienced relapse that was followed by second remission. The relapse or persistence of proteinuria was associated with the primary end points (hazard ratio [HR] = 12.40, P = 0.037, HR = 173, P < 0.001, respectively). In patients with subnephrotic proteinuria, sCR occurred in 35.4% of the patients. The patients with sCR had lower proteinuria and serum creatinine levels and higher serum albumin concentrations at baseline. The serum albumin level at diagnosis was a prognostic factor for progression to NS (Odds ratio [OR] = 0.015, P < 0.001). Conclusions The occurrence of relapse or persistence of proteinuria had negative effects on renal survival in iMN patients with NS, and low serum albumin levels at baseline were associated with non-achievement of sCR and progression to NS

Hong Kong dentists' preparedness for medical emergency in dental clinics

Aim: The aim of this study was to investigate the Hong Kong dentists’ and dental clinics’ preparedness for medical emergency in the dental clinic. Methods: Two custom designed questionnaires were developed, one for dentists and another for dental clinics, to collect the required information. The sampling frame for participants was the list of registered dentists published by the Hong Kong Dental Council on its website in January 2016. A total of 434 dentists and 143 dental clinics were selected from the list by systematic random sampling. The latter sample was supplemented by 10 randomly selected government dental clinics. The questionnaires were mailed the selected dentists together with a cover letter and a stamped return envelope. A reminder letter and another copy of the questionnaire were sent out two weeks after the first mailing. Results: 167 (38%) completed dentist questionnaires and 53 (35%) clinic questionnaires were collected. Most of the respondent dentists had some deficient knowledge on basic life support (BLS), their mean score was 3.5 out of a maximum of 5. Most (>60%) of the respondents thought they were competent in performing medical emergency procedures except giving intravenous injection. Moreover, most (>60%) of them held positive attitude towards having immediate availability of essential medical emergency equipment and drugs in their clinic. Dentists who were more recent graduates, those with postgraduate qualifications, and those who work with accompaniment generally had higher mean BLS knowledge scores. In the dental clinics, the most commonly kept medical emergency equipment/drug was instant glucose (70%) and followed by antihistamine (62%). Only a quarter of the clinics were equipped with AED, and 45% were equipped with oxygen cylinder. For 8 out of the 11 items, a higher proportion of the bigger clinics (>2 dental chairs) than the smaller clinics had the medical emergency equipment/drug available (Chi-square test, p<0.05). Conclusion: Hong Kong dentists have a moderate level of knowledge on BLS which should be enhanced through regular attendance at CE courses. Their knowledge level is affected by a number of their background and professional activities factors. Most dental clinics in Hong Kong have only few of the essential medical emergency equipment and drugs while the larger clinics are better equipped than the smaller clinics.published_or_final_versio

Recurrent Occlusion of Laser Iridotomy Sites After Posterior Chamber Phakic IOL Implantation

We report a case of recurrent occlusion of laser iridotomy (LI) sites after a Visian ICL (Implantable contact lens version 4, Staar Surgical AG, Nidau, Switzerland) implantation. A 45-year-old woman had bilateral ICL implantation after placement of two peripheral LI sites in each eye to prevent pupillary block. At one month after the operation, severe narrowing or occlusion of four LI sites occurred. After this, although she received four additional LIs at postoperative months 1, 6, 9 and 10 in both eyes, the narrowing or occlusion recurred. Mild chronic anterior chamber inflammation was observed intermittently throughout the follow-up period. We performed clear lens extraction in both eyes (at postoperative month 11 in the left eye and month 26 in the right eye) due to recurrent occlusion of the LI sites and excess trabecular meshwork pigment deposition presumably caused by the four repeated LIs. Recurrent obstruction of LI sites can occur after ICL implantation. These problems were unresolvable despite four repeated laser iridotomies. The risks associated with anterior uveitis must be considered when planning an ICL implantation

The Association between Intraocular Pressure and Predictors of Coronary Heart Disease Risk in Koreans

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucomatous visual field defects. Each individual systemic risk factor of coronary heart disease (CHD) is associated with elevated IOP, although no reports have argued for a correlation between the risk factors for CHD and IOP after a comprehensive or collective analysis. The National Cholesterol Education Program Adult Treatment Panel III presented the Framingham projection, which can predict the risk of CHD quantitatively. We investigated the association between IOP and the Framingham projection in 16,383 Korean subjects. The Framingham projection was applied using the indicated risk factors. The associations between the Framingham projection and IOP and the influences of the risk factors on the IOP were examined. The Framingham projection was correlated with the mean IOP in women (p<0.05). The relationship between IOP and systemic variables other than smoking was significant (p<0.05). The mean IOP was significantly higher in the high-risk CHD group than in the low-risk group based on the Framingham projection (p<0.05). Because an elevated IOP was associated with cardiovascular risk factors, subjects with a high CHD risk based on the Framingham projection need continuous monitoring for IOP to prevent glaucomatous visual field defects

Isolated Double-Chambered Right Ventricle in a Young Adult

Double-chambered right ventricle (DCRV) is a rare congenital heart disorder in which the right ventricle is divided by an anomalous muscle bundle into a high pressure inlet portion and a low pressure outlet portion. We report a case of isolated DCRV without symptoms in adulthood, diagnosed through echocardiography, cardiac catheterization and cardiac magnetic resonance imaging

Cleavage of Cdc6 by caspase-3 promotes ATM/ATR kinase–mediated apoptosis of HeLa cells

We show that caspase-3 cleaves Cdc6 at D290/S and D442/G sites, producing p32-tCdc6 (truncated Cdc6) and p49-tCdc6, respectively, during etoposide- or tumor necrosis factor (TNF)-α–induced apoptosis. The expression of these tCdc6 proteins, p32- and p49-tCdc6, promotes etoposide-induced apoptosis. The expression of tCdc6 perturbs the loading of Mcm2 but not Orc2 onto chromatin and activates ataxia telangiectasia mutated (ATM) and ATM and Rad-3 related (ATR) kinase activities with kinetics similar to that of the phosphorylation of Chk1/2. The activation kinetics are consistent with elevated cellular levels of p53 and mitochondrial levels of Bax. The tCdc6-induced effects are all suppressed to control levels by expressing a Cdc6 mutant that cannot be cleaved by caspase-3 (Cdc6-UM). Cdc6-UM expression attenuates the TNF-α–induced activation of ATM and caspase-3 activities. When ATM or ATR is down-expressed by using the small interfering RNA technique, the TNF-α– or tCdc6-induced activation of caspase-3 activities is suppressed in the cells. These results suggest that tCdc6 proteins act as dominant-negative inhibitors of replication initiation and that they disrupt chromatin structure and/or induce DNA damage, leading to the activation of ATM/ATR kinase activation and p53–Bax-mediated apoptosis