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Experimental study on concrete filled square hollow sections
Dennis Lam,Christopher A. Williams 국제구조공학회 2004 Steel and Composite Structures, An International J Vol.4 No.2
A series of tests was performed to consider the behaviour of short composite columns under axial compressive loading, covering a range of S275 and S355 grade steel square hollow section filled with normal and high strength concrete. The interaction between the steel and the concrete component is considered and the results show that concrete shrinkage has an effect on the axial strength of the column. Comparisons between Eurocode 4, ACI-318 and the Australian Standards with the findings of this research were made. Result showed the equation used by the ACI-318 and the proposed Australian Standards gave better predication for the axial capacity of concrete filled SHS columns than the Eurocode 4.
Role of PCSK9 Inhibitors in Patients with Familial Hypercholesterolemia
Brian Tomlinson,Nivritti Gajanan Patil,Manson Fok,Christopher Wai Kei Lam 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.2
Patients with familial hypercholesterolemia (FH) are at high or very high risk for cardiovascular disease. Those with heterozygousFH (HeFH) often do not reach low-density lipoprotein cholesterol (LDL-C) targets with statin and ezetimibe therapy, and those withhomozygous FH (HoFH) usually require additional lipid-modifying therapies. Drugs that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) offer a novel approach to reduce LDL-C. The monoclonal antibodies, alirocumab and evolocumab, given bysubcutaneous injection every 2 or 4 weeks produce reductions in LDL-C of 50% to 60% in patients with HeFH, allowing many ofthem to achieve their LDL-C goals. Patients with HoFH show a reduced and more variable LDL-C response, which appears to depend on residual LDL receptor activity, and those with receptor-negative mutations may show no response. Inclisiran is a long-actingsmall interfering RNA therapeutic agent that inhibits the synthesis of PCSK9. Subcutaneous doses of 300 mg can reduce LDL-C bymore than 50% for at least 6 months and the responses in HeFH and HoFH patients are similar to those achieved with monoclonalantibodies. These PCSK9 inhibitors are generally well tolerated and they provide a new opportunity for effective treatment for themajority of patients with FH.
Pablo Caro-Dominguez,Rajiv Chaturvedi,Govind Chavhan,Simon C. Ling,Deane Yim,Prashob Porayette,Christopher Z Lam,Tae Kyoung Kim,Mike Seed,Lars Grosse-Wortmann,Shi-Joon Yoo 대한영상의학회 2019 Korean Journal of Radiology Vol.20 No.7
Objective: To investigate the regional flow distribution in patients with Fontan circulation by using magnetic resonance imaging (MRI). Materials and Methods: We identified 39 children (18 females and 21 males; mean age, 9.3 years; age range, 3.3–17.0 years) with Fontan circulation in whom flow volumes across the thoracic and abdominal arteries and veins were measured by using MRI. The patients were divided into three groups: fenestrated Fontan circulation group with MRI performed under general anesthesia (GA) (Group 1, 15 patients; average age, 5.9 years), completed Fontan circulation group with MRI performed under GA (Group 2, 6 patients; average age, 8.7 years), and completed Fontan circulation group with MRI performed without GA (Group 3, 18 patients; average age, 12.5 years). The patient data were compared with the reference ranges in healthy controls. Results: In comparison with the controls, Group 1 showed normal cardiac output (3.92 ± 0.40 vs. 3.72 ± 0.69 L/min/m2, p = 0.30), while Group 3 showed decreased cardiac output (3.24 ± 0.71 vs. 3.96 ± 0.64 L/min/m2, p = 0.003). Groups 1 and 3 showed reduced abdominal flow (1.21 ± 0.28 vs. 2.37 ± 0.45 L/min/m2, p < 0.001 and 1.89 ± 0.39 vs. 2.64 ± 0.38 L/min/m2, p < 0.001, respectively), which was mainly due to the diversion of the cardiac output to the aortopulmonary collaterals in Group 1 and the reduced cardiac output in Group 3. Superior mesenteric and portal venous flows were more severely reduced in Group 3 than in Group 1 (ratios between the flow volumes of the patients and healthy controls was 0.26 and 0.37 in Group 3 and 0.63 and 0.53 in Group 1, respectively). Hepatic arterial flow was decreased in Group 1 (0.11 ± 0.22 vs. 0.34 ± 0.38 L/min/m2, p = 0.04) and markedly increased in Group 3 (0.38 ± 0.22 vs. -0.08 ± 0.29 L/min/m2, p < 0.0001). Group 2 showed a mixture of the patterns seen in Groups 1 and 3. Conclusion: Fontan circulation is associated with reduced abdominal flow, which can be attributed to reduced cardiac output and portal venous return in completed Fontan circulation, and diversion of the cardiac output to the aortopulmonary collaterals in fenestrated Fontan circulation.