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Paravertebral block: anatomy and relevant safety issues
Alberto E Ardon,Justin Lee,Carlo D. Franco,Kevin T. Riutort,Roy A. Greengrass 대한마취통증의학회 2020 Korean Journal of Anesthesiology Vol.73 No.5
Paravertebral block, especially thoracic paravertebral block, is an effective regional anesthetic technique that can provide significant analgesia for numerous surgical procedures, including breast surgery, pulmonary surgery, and herniorrhaphy. The technique, although straightforward, is not devoid of potential adverse effects. Proper anatomic knowledge and adequate technique may help decrease the risk of these effects. In this brief discourse, we discuss the anatomy and technical aspects of paravertebral blocks and emphasize the importance of appropriate needle manipulation in order to minimize the risk of complications. We propose that, when using a landmark-based approach, limiting medial and lateral needle orientation and implementing caudal (rather than cephalad) needle redirection may provide an extra margin of safety when performing this technique. Likewise, recognizing a target that is not in close proximity to the neurovascular bundle when using ultrasound guidance may be beneficial.
Impact Behavior of Carbon Fiber/Epoxy Composites and Fiber Metal Laminates with Open Holes
Carlos Rubio-González,Fabiola Chávez,Eduardo José-Trujillo,Julio A. Rodríguez-González,Alberto Ruiz 한국섬유공학회 2021 Fibers and polymers Vol.22 No.3
This paper describes an experimental investigation performed to evaluate the low-velocity impact behavior ofprepreg-based carbon fiber reinforced polymers (CFRPs) and fiber metal laminates (FMLs) with and without open holessubjected to different impact energies. The laminates were made of carbon fiber/epoxy prepregs and aluminum layers andmanufactured by using autoclave. The impact responses of these laminates were experimentally obtained using a drop-weighttower at impact energies of 15, 20 and 30 J. After testing, the impact damage area of tested specimens was quantified from Cscanultrasonic technique. In addition, an X-ray tomography analysis was performed to assess the through-thicknessdistribution of damage in FMLs with and without open holes. The results showed that the woven FMLs exhibit the highestimpact peak force compared to that of CFRP plates due to the presence of aluminum layers, which induce a higherdeformation capability to the laminates. The presence of open holes in laminates tends to augment their damage extensionand decreases their impact peak force due to the local stress concentration effect. Nevertheless, it was observed by C-scanultrasonic images that the aluminum layers reduce the extent of delamination of laminates during the impact event. Postimpactevaluation using X-ray computed tomography showed that impact causes a severe damage to the laminates aroundtheir impact point and confirmed that matrix cracking and delamination are the principal damage mechanisms induced on thethrough-thickness direction of the FML plates. In specific, the results confirm that the aluminum layers provide good impactproperties and damage resistance when they are added to the CFRPs.
Liver transplantation for hepatocellular carcinoma at Centro Médico Nacional 20 de Noviembre-México
Alberto DE JESUS-FLORES,Carlos FLOREZ-ZORRILLA,Ricardo CERON-CASTILLO,Carlos VAZQUEZ-SALINAS,Nadia ROMERO-BEYER,Aczel SANCHEZ-CEDILLO,Miguel CHARCO-CRUZ 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.-
Carlos Alberto Nogueira-de-Almeida,Elza Daniel de Mello 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.1
Purpose: to compare cut off points corrected for age and gender (COOP) with fixed cut off points (FCOP) for fasting plasma insulin and Homeostatic model assessment-insulin resistance (HOMA-IR) for the diagnosis of IR in obese children and adolescents and their correlation with dyslipidemia.Methods: A multicenter, cross-sectional study including 383 subjects aged 7 to 18 years, evaluating fasting blood glucose, plasma insulin, and lipid profile. Subjects with high insulin levels and/or HOMA-IR were considered as having IR, based on two defining criteria: FCOP or CCOP. The frequency of metabolic abnormalities, the presence of IR, and the presence of dyslipidemia in relation to FCOP or CCOP were analyzed using Fisher and Mann-Whitney exact tests.Results: Using HOMA-IR, IR was diagnosed in 155 (40.5%) and 215 (56.1%) patients and, using fasting insulin, 150 (39.2%) and 221 (57.7%), respectively applying FCOP and CCOP. The use of CCOP resulted in lower insulin and HOMA-IR values than FCOP. Dyslipidemia was not related to FCOP or CCOP. Blood glucose remained within normal limits in all patients with IR. There was no difference in the frequency of IR identified by plasma insulin or HOMA-IR, both for FCOP and CCOP.Conclusion: The CCOP of plasma insulin or of HOMA-IR detected more cases of IR as compared to the FCOP, but were not associated with the frequency of dyslipidemia. As blood glucose has almost no fluctuation in this age group, even in the presence of IR, fasting plasma insulin detected the same cases of IR that would be detected by HOMA-IR.
Fuzzy Linguistic Recommender Systems for the Selective Diffusion of Information in Digital Libraries
( Carlos Porcel ),( Alberto Ching-lpez ),( Juan Bernabe-moreno ),( Alvaro Tejeda-lorente ),( Enrique Herrera-viedma ) 한국정보처리학회 2017 Journal of information processing systems Vol.13 No.4
The significant advances in information and communication technologies are changing the process of how information is accessed. The internet is a very important source of information and it influences the development of other media. Furthermore, the growth of digital content is a big problem for academic digital libraries, so that similar tools can be applied in this scope to provide users with access to the information. Given the importance of this, we have reviewed and analyzed several proposals that improve the processes of disseminating information in these university digital libraries and that promote access to information of interest. These proposals manage to adapt a user`s access to information according to his or her needs and preferences. As seen in the literature one of the techniques with the best results, is the application of recommender systems. These are tools whose objective is to evaluate and filter the vast amount of digital information that is accessible online in order to help users in their processes of accessing information. In particular, we are focused on the analysis of the fuzzy linguistic recommender systems (i.e., recommender systems that use fuzzy linguistic modeling tools to manage the user`s preferences and the uncertainty of the system in a qualitative way). Thus, in this work, we analyzed some proposals based on fuzzy linguistic recommender systems to help researchers, students, and teachers access resources of interest and thus, improve and complement the services provided by academic digital libraries.
Unusual and nondescript type of distal clavicular fracture
Alberto Izquierdo Fernandez,Jose Carlos Minarro 대한견주관절의학회 2021 대한견주관절의학회지 Vol.24 No.2
Displaced fracture of the distal third of the clavicle usually occurs after direct trauma to the shoulder and typically results in superior displacement of the proximal fragment. We report a previously undescribed case of downward displacement of the clavicle caused by a fall on an outstretched hand, and we suggest the mechanism of injury.
Effect of Laser Microcutting on Thermo-Mechanical Properties of NiTiCu Shape Memory Alloy
Carlo Alberto Biff,Paola Bassani,Marco Carnevale,Nora Lecis,Antonietta Loconte,Barbara Previtali,Ausonio Tuissi 대한금속·재료학회 2014 METALS AND MATERIALS International Vol.20 No.1
The machining of shape memory alloys (SMAs), such as NiTi based alloys, is a very interesting and rele-vant topic for several industrial applications in the biomedical, sensor and actuator fields. Laser technology isone of the most suitable methods for the manufacturing of products in the aforementioned fields, mainlywhen small and precise features have to be included. Due to the thermal nature of this process, study of itseffect on the functional properties of these materials is needed. Except for binary NiTi, few results on thelaser machining of NiTi based alloys are available in the literature. In this work, thin sheets of Ni40Ti50Cu10(at.%) were processed by a fibre laser and the effect of process speed on the material properties was analy-sed. Scanning electronic microscopy was adopted for observation of the laser cut edges’ morphology. Chemi-cal composition of the processed material was evaluated by energy dispersion spectroscopy and nanohardnessmeasurements were used to estimate the heat affected zone. SMA functional properties were studied on bothbase and laser machined material. These characteristics are affected by laser machining for the presence ofmelted material; this effect can be minimised by increasing the laser process speed.
Torsion modulus using the technique of mechanical spectroscopy in biomaterials
Carlos Alberto Fonzar Pintão,Diego R. N. Correa,Carlos R. Grandini 대한기계학회 2017 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.31 No.5
This work presents a new alternative to studying and determining the shear or torsion modulus, G. For this purpose, a measuring system was constructed with a rotational motion sensor coupled to a torsion pendulum that allowed the determination of the angular position as a function of time. Through an equation derived from studies of mechanical spectroscopy and the theory of relaxation of materials, G was calculated, and experiments were focused on validating it. The advantage of this technique, compared to other dynamical methods, is that it is not necessary to know the Poisson's ratio of the sample.
Measurement of the rotational inertia of bodies by using mechanical spectroscopy
Carlos Alberto Fonzar Pintão 대한기계학회 2014 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.28 No.10
In this paper, mechanical spectroscopy was used to study the rotational inertia of bodies. In order to verify and show its importance inrelation to other techniques, measurements of the internal friction and rotational inertia of a body with liquid or sand inside were carriedout. For a solid without axes and planes of symmetry, properties such as the matrix, directions and principal moments of inertia, variationof the rotational inertia for each of the coordinate planes, and the ellipsoid of inertia were determined. Force sensors and rotational motionwere used in the measurements taken in an arrangement that was specifically designed for this type of measure.