Surgical management of childhood bronchiectasis due to infectious disease

AbstractBackgroundThe purpose of this study was to estimate operative risk and to identify indicators of adverse prognosis in patients undergoing resection for childhood bronchiectasis.MethodsFrom January 1985 to February 2001, patients undergoing resection for bronchiectasis were studied. The indications for operation were failure of medical therapy in 33 patients (94.2%) and hemoptysis in 2 (5.7%). The mean duration of symptoms was 4.2 years (range, 1-9 years). Surgical treatment included lobectomy in 17 patients (48.5%), pneumonectomy in 7 (20%), lobectomy plus segmentectomy in 5 (14.2%), bilobectomy in 2 (5.7%), and segmentectomy in 4 (11.4%).ResultsThe operative mortality rate was 2.8%, and the morbidity rate was 17.6%. The mean follow-up in 34 patients was 5.4 years (range, 1-12 years). Overall, 22 patients (64.7%) were asymptomatic after surgery. Clinical improvement was noticed in 8 patients (23.5%), and no improvement was noticed in 4 (11.7%). Complete resection resulted in a significantly better clinical outcome than incomplete resection (P < .05).ConclusionsSurgery for childhood bronchiectasis can be performed with low mortality and morbidity. Complete resection should be performed when possible

Incipient Separation in Shock Wave Boundary Layer Interactions as Induced by Sharp Fin

The incipient separation induced by the shock wave turbulent boundary layer interaction at the sharp fin is the subject of present study. Existing theories for the prediction of incipient separation, such as those put forward by McCabe (1966) and Dou and Deng (1992), can have thus far only predicting the direction of surface streamline and tend to over-predict the incipient separation condition based on the Stanbrook's criterion. In this paper, the incipient separation is firstly predicted with Dou and Deng (1992)'s theory and then compared with Lu and Settles (1990)' experimental data. The physical mechanism of the incipient separation as induced by the shock wave/turbulent boundary layer interactions at sharp fin is explained via the surface flow pattern analysis. Furthermore, the reason for the observed discrepancy between the predicted and experimental incipient separation conditions is clarified. It is found that when the wall limiting streamlines behind the shock wave becomes\ aligning with one ray from the virtual origin as the strength of shock wave increases, the incipient separation line is formed at which the wall limiting streamline becomes perpendicular to the local pressure gradient. The formation of this incipient separation line is the beginning of the separation process. The effects of Reynolds number and the Mach number on incipient separation are also discussed. Finally, a correlation for the correction of the incipient separation angle as predicted by the theory is also given.Comment: 34 pages; 9 figure

Shoulder-girdle strength after standard and lateral muscle-sparing thoracotomy

Background: There is no objective data in the literature to support the statement that shoulder-girdle strength can be preserved better after muscle-sparing thoracotomy compared with standard thoracotomy. The aim of this study is to determine the decrease on muscle strength with objective criteria by measuring the peak torque value produced by the shoulder girdle. Method: Peak torque values on abduction and adduction of entire shoulder range at the velocity of 60 and 120 degree per second were measured with an isokinetik dynomometer which was attached to a computer. The measurements were performed in 20 cases, all candidates for thoracotomy. Patients were randomised into 2 groups; muscle sparing thoracotomy was undertaken in group A,and standard thoracotomy in group B. The same measurements were repeated 3 months after the surgery. Results: The decrease in postoperative PT values between group A and B was statistically significant (p<0.003). The decrease on shoulder abduction and adduction was insignificant in group A (p=0.33 and p=0.13) and statistically significant in group B (p<0.0001 and p<0.001). Conclusion: These results confirm the statement that shoulder girdle strength is better preserved with muscle-sparing thoracotomy

Frequency analysis of oblique shock wave boundary layer interaction

Frequency analysis has been performed for the oblique shockwave boundary layer interaction (OSWBLI). Rainbow Schlieren Deflectometry (RSD) has been used to capture the flow data at 5000 frames per second. The experimental setup produces a free stream flow of Mach 3.1. This flow upon encountering a 12 degree isoceles traingular prism attached to the roof of the test section generate the required oblique shock in the test section

Study of shock wave boundary layer interaction phenonemon using color schlieren and snapshot Proper Orthogonal Decomposition

The flow structure of shockwave boundary layer interaction (SWBLI) has been studied using Rainbow Schlieren Deflectometry (RSD), Ensemble Averaging, Fast Fourier Transform (FFT), and snapshot Proper Orthogonal Decomposition (POD) techniques. The Mach number of the approach free-stream was Mach = 3. Shockwave was generated with a 12° wedge. The color schlieren pictures are used to determine the transverse ray deflections at each pixel of the pictures taken using a high speed camera. The interaction region structure is described statistically with the ensemble average and, root mean square deflections. FFT technique is used to determine the dominant frequencies at different regions of the flow field. Results indicate that low frequency oscillations dominate the flow field. The POD technique results complement the findings of the ensemble averaging technique and show that distinct regions contain most of the energy in the flow field. These distinct regions are located around the reflected shock, around the shock wave reaching into the approach boundary layer and around the separation region over the edge of the separation bubble. (Published By University of Alabama Libraries

Study of shock wave boundary layer interaction using modal decomposition

Snapshot Proper Orthogonal Decomposition (SPOD) and Dynamic Mode Decomposition (DMD) have been used to study the flow features of oblique S hockwave Boundary Layer Interaction ( SWBLI). Ra inbow Schlieren Deflectometry (RSD) has been used to capture the flow data at 30,000 frames per second. The experimental setup produces a free stream flow of Mach 3.1. A 12° isosceles triangular prism attached to the roof of the test section generates the required oblique shock in the test section. The RSD pictures were used for data analysis to determine the transverse ray deflections at each pixel of the pictures. The analysis focuses on obtaining dominant flow regions in the flow and the corresponding mo des at which they occur. This modal information is used to comment on the unsteadiness associated with the flo

Elective pneumonectomy for non-small cell lung cancer: Factors affecting early operative mortality and morbidity

WOS: 000242091700015PubMed: 17168268Background : The aim of this study was to investigate the factors influencing the morbidity and mortality of the non-small cell lung cancer (NSCLC) cases where pneumonectomy was performed. Material & methods: All 101 patients who had underwent a pneumonectomy for NSCLC between 1994-2001 in our hospital were included in the retrospective study. There were 97 males and 4 females with a mean age of 56 +/- 9.6. Factors affecting morbidity and mortality were analysed by univariate and multivariate analysis. Results: The morbidity rate was 53% and the mortality rate was 9%. Morbidity was related to cardiopulmonary complications in 40% of the cases. The risk factors for cardiopulmonary morbidity with univariate analysis were age >60 years (p = 0.004), FEV1 4 cm (p = 0.033), vital capacity ) (p = 0.012) and tumour size > 4 ern (p = 0.043). The risk factors mortality with univariate analysis were right pneumonectomy (p = 0.025), respiratory morbidity (p = 0.0001), cardiac morbidity (p = 0.002), cell type (Epidermoid CA) (0.047), tumour size > 6 cm (p = 0.036), fluid infusion (p = 0.009), forced vital capacity 42 mmHg (p = 0.023). Conclusion : Among the pneumonectomies performed for NSCLC, the causes of postoperative morbidity were multifactorial, however, multivariate analysis did not show any significant factor affecting the mortality, related to this procedure