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Watchi Michael,Quintard Hervé,Bijlenga Philippe,Pugin Jérôme,Negro Tommaso Rochat 대한신경집중치료학회 2022 대한신경집중치료학회지 Vol.15 No.2
Background: Sinking skin flap syndrome (SSFS) is a rare complication of decompressive craniectomy (DC) and causes a wide range of neurological deficits. Its pathophysiology remains debatable, however cranioplasty may decrease the symptoms of SSFS by reducing the direct effect of atmospheric pressure on the brain and allowing the correction of cerebral blood flow (CBF) and cerebral metabolism.Case Report: A 36-year-old woman underwent DC for a right frontal hematoma and signs of increased intracranial pressure following the resection of a right frontal arteriovenous malformation. Subsequently, she developed SSFS, altered neurological status with a Glasgow Coma Scale (GCS) score of 8/15, and bacterial-resistant meningitis. We applied a custom-shaped negative pressure helmet on the bone defect and used invasive and noninvasive techniques to measure the changes in intracranial pressure, CBF and cerebral oxygen saturation. Despite improvements in the cerebral physiological parameters, the neurological status did not improve (GCS score, 8/15).Conclusions: To our knowledge, this is the first reported case of SSFS treated with a negative-pressure helmet and subsequent changes in cerebral parameters that were monitored invasively and noninvasively.
Quality of CFD Models for Jet Flow Analysis for the Design of Burners and Boilers
Marias, F.,Puiggali, J.R.,Quintard, M.,Pit, F. 한국화학공학회 2002 Korean Journal of Chemical Engineering Vol.19 No.1
CFD models are increasingly used for the design and optimisation of boiler combustion chambers. Numerous commercial codes are available, and the user is confronted with making a proper choice for a particular application. In this paper, the accuracy and effectiveness of the popular code FLUENT^TM is investigated in terms of the different turbulence models and numerical schemes that are bundled in the software. The tests are performed for different simple experiments, involving classical hydrodynamic conditions with no combustion. The conclusion of these tests involves also the additional criterion of the computational time required for achieving a reasonable accuracy.
Unexpected epileptogenic effect of lethal doses of pentobarbital: a case report
Giudicelli-Bailly Amélie,Badia Chiara Della,Augsburger Marc,Quintard Hervé,Giraud Raphaël,De Stefano Pia 대한신경집중치료학회 2023 대한신경집중치료학회지 Vol.16 No.1
Background: Barbiturate poisoning is rare but potentially fatal. Case Report: We reported a case of barbiturate poisoning in a 28-year-old woman who recovered from lethal pentobarbital deliberate self-poisoning. The initial blood pentobarbital concentration was 61 mg/L, corresponding to a potentially lethal dose. Despite the ingestion of a high dose of pentobarbital, the electroencephalogram revealed an unattended pattern compatible with possible nonconvulsive status epilepticus. Following resuscitation maneuvers, appropriate care, and antiseizure medication, the patient awakened after 7 days. The evolution was excellent without neurological deficits at 2 months.Conclusion: Despite the expected and known effects of high-dose pentobarbital in reducing and suppressing cortical activity in the brain, the present case demonstrates that lethal dose of pentobarbital may have an epileptogenic effect. Our hypothesis was that the mechanism of the origin of such a picture is a relatively abrupt decrease in toxic doses of pentobarbital, resulting in a withdrawal phenomenon.