Dilation behavior of normal strength concrete confined by FRP wire jackets

Nguyen, Hoan D.,Choi, Eunsoo,Park, Kyoungsoo Elsevier 2018 Construction & building materials Vol.190 No.-

<P><B>Abstract</B></P> <P>The introduction of confining pressure is an effective method to improve both ductility and strength of concrete. To confine concrete, recently, fiber reinforced polymer (FRP) wire has been employed because of several advantages, such as corrosion resistance, cost-effectiveness, and the ability to control the tightness of jackets during the installation process. In addition to experimental researches, confinement models need to be studied; in which, a factor affects directly to the accuracy of the models is dilation. This study aimed to investigate dilation behaviors and the effects of FRP wire jackets confinement on concrete. For this purpose, the uniaxial compression tests were conducted on twelve specimens by changing the number of FRP wire layers and the compressive strength of concrete. Experimental results illustrated that the FRP wire jackets provided higher confinement effects on concrete than FRP sheets. The dilation developed through three stages of compressive behaviors of confined concrete, i.e., the elastic, hardening, and damaged stages. Moreover, the test results indicated that the effects of the stiffness ratio for FRP wire jackets were different from these for FRP sheets. Additionally, to estimate the lateral-axial strain relation of concrete confined by FRP wire jackets, a dilation model was developed on the basis of a secant dilation ratio, which is the percentage of the lateral strain to axial strain. The experimental results and the model estimation demonstrated in a good agreement.</P> <P><B>Highlights</B></P> <P> <UL> <LI> The dilation ratio of concrete confined by FRP wire jackets is investigated. </LI> <LI> The FRP wire confinement is more effective than the FRP sheet confinement. </LI> <LI> The stiffness ratio of the FRP jackets affects behaviors of confined concrete. </LI> <LI> The proposed dilation model describes three stages of dilation behavior. </LI> <LI> The proposed model well captures behaviors of concrete confined by FRP wire jackets. </LI> </UL> </P>

위장관 ( 胃腸管 ) : 일차성 Achalasia 에서 풍선 확장술의 효과 판정 기준

나용호(Yong Ho Nah),이건화(Keon Hwa Lee),박옥규(Ock Kyu Park) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2

N/A Pneumatic dilation of the esophagus is an effective form of therapy to be available to achalasia. To evaluate the criteria predicting the therapeutic effects of pneumatic dilation, the manometric and radiographic appearances of the esophagus with achalasia were analyzed in 32 achalasia patients immediately following pneumatic dilation. A comparison of dysphagia grading and the parameters of the manometric and radiographic studies was made. 1) The pretreatment manometric findings of vigorous achalasia were associated with the significant irriprovement of dysphagia grading score and with high rate of reappearance of peristalsis after pneumatic dilatation. 2) The fall of LES pressure or intraesophageal pressure compare with pretreatment values noted no close relationship to the dysphagia grade after 6 months postdilation. 3) The level of barium fleck (no more than 1 cm) showed a close relationship to the dysphagia grade after pneumatic dilation. 4) The caliber of the esophagogastric channel (more than 8 mm) after dilation showed a close relationship to the dysphagia grade after pneumatic dilation. 5) Reduction of the diameter of the esophageal body was not well correlated with the dysphagia grade after pneumatic dilation. In conclusion, in predicting the clinical response of pneumatic dilation, the esophagogastric diameter or the level of barium fleck in the distal esophagus is the useful criteria to evaluate the effects of pneumatic dilation in achalasia.

Health-Care Utilization and Complications of Endoscopic Esophageal Dilation in a National Population

Abhinav Goyal,Kshitij Chatterjee,Sujani Yadlapati,Shailender Singh 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.4

Background/Aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown. Methods: We used National Inpatient Sample (NIS) database for 2007–2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures. Logistic regression was used to assess association between hospital/patient characteristics and utilization of esophageal dilation. Results: There were 591,187 hospitalizations involving esophageal stricture; 4.2% were malignant. Endoscopic dilation was performed in 28.7% cases. Dilation was more frequently utilized (odds ratio [OR], 1.36; p<0.001), had higher in-hospital mortality (3.1% vs. 1.4%, p<0.001), and resulted in longer hospital stays (5 days vs. 4 days, p=0.01), among cases of malignant strictures. Esophageal perforation was more common in the malignant group (0.9% vs. 0.5%, p=0.007). Patients with malignant compared to benign strictures undergoing dilation were more likely to require percutaneous endoscopic gastrostomy or jejunostomy (PEG/J) tube (14.1% vs. 4.5%, p<0.001). Palliative care services were utilized more frequently in malignant stricture cases not treated with dilation compared to those that were dilated. Conclusions: Inpatient endoscopic dilation was utilized in 29% cases of esophageal stricture. Esophageal perforation, although infrequent, is more common in malignant strictures.

Acute gastrointestinal dilation in laboratory rhesus monkeys in the Korea National Primate Research Center

Kyoung-Min Kim,Sang-Rae Lee,Kwon-Sik Chang,Yong-Hoon Lee,Sung-Woo Kim,Kang-Jin Jung,Youngjeon Lee,Doo Kim,Kyu-Tae Chang 한국실험동물학회 2012 Laboratory Animal Research Vol.28 No.3

Acute gastrointestinal dilation is a medical condition in which the stomach and intestine become overstretched by excessive gas content. In laboratory monkeys, cases of bloating involving gastrointestinal dilation are rarely seen, and the cause thereof is not clearly defined. Two rhesus monkeys in the Korea National Primate Research Center were found to suffer from acute gastrointestinal dilation. One of the monkeys showed severe gastric bloating after recovering from general anesthesia with isoflurane, where after it died suddenly. During necropsy, severe congestion of the lung was observed. The other monkey showed gastrointestinal dilation and died after treatment. During necropsy, severe dilation of the large intestine was observed. Severe congestion was detected in small and large intestines. Histopathologically, erythrocytes were found to fill the alveoli and alveolar capillaries of the lung. In stomach, epithelial cells were found to be sloughed from the mucosal layer, and erythrocytes were found to fill the blood vessels of the submucosal and mucosal layers. In small and large intestines, epithelial cells were also found to be sloughed from the mucosal layer, and inflammatory cells were found to have infiltrated in the submucosa (only large intestine) and mucosa. Microbiologically, Enterococcus faecalis and the pathogenic Staphylococcus haemolyticus, which do not form gas in the gastrointestinal tract, were detected in the gastrointestinal contents of both monkeys. These results suggest that the cause of the acute gastrointestinal dilation in these monkeys was not infection by gas-forming bacteria, but rather multiple factors such as diet, anesthesia, and excessive water consumption.

Long-term outcomes of balloon dilation versus botulinum toxin injection in patients with primary achalasia

( Ho Eun Jung ),( Joon Seong Lee ),( Tae Hee Lee ),( Jin Nyoung Kim ),( Su Jin Hong ),( Jin Oh Kim ),( Hyeon Geon Kim ),( Seong Ran Jeon ),( Joo Young Cho ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.6

Background/Aims: We compared the long-term outcomes of balloon dilation versus botulinum toxin injection in Korean patients with primary achalasia and identified factors predicting remission. Methods: We included 73 patients with achalasia newly diagnosed between January 1988 and January 2011. We ultimately enrolled 37 of 55 patients with primary achalasia through telephone interviews, who were observed for over 1 year. Shortterm outcomes were evaluated from the medical records based on symptom relief after 1 month of treatment. Long-term outcomes were evaluated in a telephone interview using a questionnaire. Results: Twenty-five patients were administered a botulinum toxin injection and 12 underwent balloon dilation. One month after the botulinum toxin injection, improvements were seen in chest pain (14 [56.0%] to 4 patients [16.0%]), regurgitation (16 [64.0%] to 4 [16.0%]), and dysphagia (25 [100.0%] to 5 [20.0%]). In the balloon dilation group, chest pain (8 [66.7%] to 1 [8.3%]), regurgitation (11 [91.7%] to 1 [8.3%]), and dysphagia (12 [100.0%] to 1 [8.3%]) had improved. A significant difference was observed in the mean remission duration between the botulinum toxin injection and balloon dilation groups (13 months [range, 1 to 70] vs. 29 months [range, 6 to 72], respectively; p = 0.036). Independent factors predicting long-term remission included treatment type (odds ratio [OR], 6.982; p = 0.036) and the difference in the lower esophageal sphincter pressure (OR, 7.198; p = 0.012). Conclusions: Balloon dilation may be more effi cacious than botulinum toxin for providing long-term remission in Korean patients with achalasia. Follow-up manometry may predict the long-term outcome.

양성 식도 수술 문합부 협착에 대한 확장 치료의 임상 결과

최철웅 ( Cheol Woong Choi ),강대환 ( Dae Hwan Kang ),김형욱 ( Hyung Wook Kim ),박수범 ( Su Bum Park ),김수진 ( Su Jin Kim ),남형석 ( Hyeong Seok Nam ),유대곤 ( Dae Gon Ryu ) 대한소화기학회 2017 대한소화기학회지 Vol.69 No.2

목적: 식도 절제술 후 발생하는 양성 식도 협착은 드물지 않은 합병증이다. 양성 식도 문합부 협착은 여러 번의 확장 치료가 필요하다고 알려져 있다. 본 연구에서는, 수술 후 발행한 식도 문합부 협착 환자에서 확장 치료(내시경 풍선 확장 또는 부우지 확장)의 임상 결과를 분석하고, 불응성 협착과 관련된 위험인자를 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2016년 5월까지, 식도 수술 문합부 협착으로 진단되어 확장 치료를 시행 받은 환자의 의무기록을 후향적으로 분석하였다. 결과: 연구 기간 동안에 21명의 양성 식도 문합부 협착 환자에 대해서 확장시술을 시행하였다. 환자의 성별은 남자가 17명(80.1%), 환자의 평균나이는 68.2±7.2세였다. 첫 진단 때, 협착의 직경은 협착 정도가 5 mm 미만인 경우가 10명(47.6%), 6-10 mm가 8명(38.1%), 11 mm 이상인 경우가 3명(14.3%)이었다. 협착의 길이는 평균 6.4 mm(표준편차 8.1mm)였다. 확장 치료 후 발생하는 중요 합병증은 없었다. 불응성 식도 협착은 7명(33.3%)이었고, 관련된 인자는 협착의 길이(>10 mm)와 당뇨였다. 결론: 양성 식도 수술 문합부 협착 환자에서 확장 치료는 안전한 치료법이며, 협착의 길이가 10 mm보다 작은 경우에 효과적이었다. Background/Aims: Benign esophageal stricture after esophagectomy is not an infrequent complication. Anastomotic esophageal stricture requires frequent multiple dilations. We aimed to evaluate the clinical outcomes of dilation therapies using an endoscopic balloon or bougie dilator and analyzed the risk factors associated with refractory stricture. Methods: Between January 2009 and May 2016, the medical records of 21 patients treated with endoscopic balloon dilation or bougie dilation for esophageal anastomotic strictures were retrospectively reviewed. Results: During the study periods, a total of 21 patients were diagnosed with esophageal anastomotic stricture and included for analysis (17 male; mean age, 68.2±7.2 years at the first procedure). The mean stricture length was 6.4±8.1 mm. The refractory stricture was found in 28.6% of patients, and successful relief of dysphagia was achieved in 71.4% of patients. The major complication associated with dilations was absent. Factors associated with refractory stricture were stricture length (> 10 mm, p<0.049) and diabetes mellitus (p=0.035). Additive bougie dilations achieved clinical success in 4 out of 7 patients. Conclusions: Dilation with endoscopic balloon or bougie dilator was an effective and safe procedure for benign anastomotic esophageal strictures of less than 10 mm in length. (Korean J Gastroenterol 2017;69:102-108)

고식적 풍선 확장에 불응성인 양성 담관 문합 협착이 있는 환자에서 구조요법으로 절단 풍선 확장

이종현,김동욱,한성용,김광하,서형일,홍승백,김석,김창원 대한췌장담도학회 2022 대한췌담도학회지 Vol.27 No.3

Percutaneous balloon dilation with or without placement of an external biliary drain is a nonoperative alternative method for treating benign bilioenteric anastomotic strictures. Although this procedure has a high technical success rate, outcomes are less optimal when attempting to dilate refractory tight strictures. For the stricture, cutting balloon can be an option. We present four patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation. To the patients, a peripheral cutting balloon over-the-wire system was inflated, following subsequent conventional non-compliant balloon dilation. After the balloon dilation treatment, an external drainage catheter was placed through the stricture site and maintained for up to 30 days. Technical and end-treatment success was achieved in all four patients. In conclusion, the use of cutting balloon dilation may appear to be a safe and effective alternative method of treatment in patients with benign bilioenteric anastomotic strictures refractory to conventional balloon dilation.

Endoscopy-Guided Balloon Dilation of Benign Anastomotic Strictures after Radical Gastrectomy for Gastric Cancer

( Hyun Jik Lee ),( Wan Park ),( Hyuk Lee ),( A Keun Ho Lee ),( Jun Chul Park ),( Sung Kwan Shin ),( Sang Kil Lee ),( Yong Chan Lee ),( Sung Hoon Noh ) 대한소화기학회 2014 Gut and Liver Vol.8 No.4

Background/Aims: The aim of this study was to evaluate the outcome of endoscopic dilation for benign anastomotic stricture after radical gastrectomy in gastric cancer patients. Methods: Gastric cancer patients who underwent endoscopic balloon dilation for benign anastomosis stricture after radical gastrectomy during a 6-year period were reviewed retrospectively. Results: Twenty-one patients developed benign strictures at the site of anastomosis. The majority of strictures occurred within 1 year after surgery (95.2%). The median duration to stenosis after surgery was 1.70 months (range, 0.17 to 23.97 months). The success rate of the first endoscopic dilation was 61.9%. Between the restenosis group (n=8) and the no restenosis group (n=13), there were no significant differences in the body mass index (22.82 kg/m2 vs 22.46 kg/m2), interval to symptom onset (73.9 days vs 109.3 days), interval to treatment (84.6 days vs 115.6 days), maximal balloon diameter (14.12 mm vs 15.62 mm), number of balloon dilation sessions (1.75 vs 1.31), location of gastric cancer or type of surgery. One patient required surgery because of stricture refractory to repeated dilation. Conclusions: Endoscopic dilation is a highly effective treatment for benign anastomotic strictures after radical gastrectomy for gastric cancer and should be considered a primary intervention prior to proceeding with surgical revision. (Gut Liver 2014;8:394-399)

Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture

Takafumi Mie,Takashi Sasaki,Takeshi Okamoto,Tsuyoshi Takeda,Chinatsu Mori,Yuto Yamada,Takaaki Furukawa,Akiyoshi Kasuga,Masato Matsuyama,Masato Ozaka,Naoki Sasahira 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2

Background/Aims: Hepaticojejunostomy anastomotic stricture (HJAS) is a feared adverse event associated with hepatopancreatobiliary surgery. Although balloon dilation for benign HJAS during endoscopic retrograde cholangiopancreatography with balloon-assisted enteroscopy has been reported to be useful, the treatment strategy remains controversial. Therefore, we evaluated the outcomes and risk factors of recurrent stenosis after balloon dilation alone for benign HJAS. Methods: We retrospectively analyzed consecutive patients who underwent balloon-assisted enteroscopy-endoscopic retrograde cholangiopancreatography for benign HJAS at our institution between July 2014 and December 2020. Results: Forty-six patients were included, 16 of whom had recurrent HJAS after balloon dilation. The patency rates at 1 and 2 years after balloon dilation were 76.8% and 64.2%, respectively. Presence of a residual balloon notch during balloon dilation was an independent predictor of recurrence (hazard ratio, 2.80; 95% confidence interval, 1.01–7.78; p=0.048), whereas HJAS within postoperative 1 year tended to be associated with recurrence (hazard ratio, 2.43; 95% confidence interval, 0.85–6.89; p=0.096). The patency rates in patients without a residual balloon notch were 82.1% and 73.1% after 1 and 2 years, respectively. Conclusions: Balloon dilation alone may be a viable option for patients with benign HJAS without residual balloon notches on fluoroscopy.

시각적 자극의 정서가와 정서강도에 따른 동공크기 변화

맹세호,정윤경,이중 한국심리학회 2013 한국심리학회지 일반 Vol.32 No.4

동공크기의 변화는 활성화된 심리적 상태, 혹은 정서적 각성을 측정하는데 유용하기 때문에 여러 연구자들에 의해 심리적 활동 과정을 이해하는 지표로 사용되었다. 본 연구는 시각적 자극의 긍정적, 부정적. 중립적 정서가(emotional valence)에 따른 동공크기의 차이를 탐색하고 자극의 객관적, 주관적 정서강도와 동공크기 사이의 관계를 살펴보기 위하여 설계되었다. 이를 위하여 성인 실험참가자 102명(남 28, 여 74)을 대상으로 International Affective Picture System(IAPS: Lang, Bradley, & Cuthbert, 2008)에 의해 평정된 정서자극을 제시하고 동공크기의 변화를 측정하고 각 자극의 강도에 대한 주관적 경험을 보고하도록 하였다. 연구 결과, 정서가에 따라 동공크기의 변화가 유의미한 것으로 나타났다. 사후검증 결과 부정적, 긍정적 정서가를 가진 자극과 중립적 자극 사이의 동공크기는 유의미한 차이를 나타냈으나 긍정적 자극과 부정적 자극 사이의 동공크기 변화는 유의미하지 않았다. 정서강도(객관적/주관적)와 동공크기의 상관분석 결과 자극의 객관적 정서강도와 주관적 정서강도가 동공크기와 정적관계를 가지는 것을 검증하여 정서적 자극에 대한 주관적 경험의 강도가 증가함에 따라 동공의 크기가 확장됨을 확인하였다. Pupillary dilation has been used for understanding the process of psychological activity by several researchers. The present study was aimed to find difference in pupillary dilation according to emotional valence of visual stimuli and to reveal relationship between emotional intensity and pupillary dilation. 102 subjects’(28 males, 74 females) pupil responses were measured while presenting 10 negative, 10 neutral and 10 positive pictures. The subjects also rated their subjective emotional intensity that they experienced while they were exposed to the stimuli. Our results showed that the amount of pupillary dilation was significantly different according to the valence of emotional stimuli. We found significant difference in pupillary dilation between neutral stimuli and stimuli with emotional valence(negative/positive). But there was no significant difference between positive and negative stimuli. Most importantly, there was significant positive relation between emotional intensity(objective/subjective) and pupillary dilation. These results suggests that pupillary dilation may indicate the level of emotional arousal that a subject experiences.