Search

Earthquake catastrophes continue to cause substantial damage and casualties in many parts of the world. Despite design codes and standards having succeeded in reducing life losses during earthquakes, the level of damage in buildings after severe earthquakes still cannot be precisely predicted. Code provisions focus on the safety of buildings with no consideration of the amount of damage expected after an event. Current U.S. guidelines designate three performance levels related to the inelastic rotational demands of RC shear walls––immediate occupancy, life safety, and collapse prevention. The damage corresponding to these performance levels is minor, moderate, and severe, respectively. In the current study, these performance limits were implemented, along with other recognized standards, in order to design four RC ductile shear wall buildings with different heights located in a high seismic hazard zone. Each building was designed based on Canadian building codes to reach the three designated performance levels. For each case, the quantities of the constitutive materials of the RC shear walls were estimated and compared. The impact of the targeted performance level on the building's gravity-load-resisting system was also investigated. The cost effectiveness of using moderately ductile shear walls in high seismic hazard zones was also examined. [ABSTRACT FROM AUTHOR]

Despite the reduction in perioperative mortality observed over the past two decades, the risk of performing cardiac surgery in patients with coronary artery disease and severe left ventricular dysfunction remains high, these risks have led to the appearance of several ways to provide better outcomes. These ways are either mechanical like intraaortic balloon pump (IABP) or using medical inotropic drugs either adrenergic (epinephrine, norepinephrine &dobutamine) or non-adrenergic (levosimendan) drugs. It is indicated for the short-term treatment of acutely. Patients and Method:Patients had collected, evaluated thorough the preoperative, intra-operative, postoperative period withpoor left ventricular function ejection less than or equal to 40%. Cases had allocated into two gatherings of 50 cases.cases had admitted to the cardiovascular intensive care unit (ICU) 24h before surgery, a peri-operative dose of continuous levosimendan infusion over a total of 24h in the other gathering, cases will be submitted to conventional inotropes only (non levosimendan gathering) according to their medical requirements. Objective: the aim of this study had to detect the outcome of clinical use of preioperative Levosemindan for cases undergoing coronary artery bypass grafting with poor left ventricular function, also comparing it with the conventional medications as catecholamines. Results: Gathering A included 38 cases received levosimendan as perioperative cardiac support Gathering B included 40 cases received conventional cardiac support. A critical difference between both gatherings regarding total operative time, total bypass time, failure of weaning from cardiobypass (C.P.B), the use of intraoperative I.A.B.P. There had a statistically critical difference between both gatherings in which C.V. P had lower in levosimendan. There had statistically critical difference regarding base critical in the levosimendan gathering. with high statistical difference for medical support, no difference for support. Conclusion: the use of levosimendan perioperatively decrease the operative time, cross clamp time, facilitate the weaning from cardiomachine decrease the need of conventional inotropic support, decrease the duration of postoperative ventilation, improve the tissue perfusion, cardiac output parameters, length of I.C.U, hospital stay with decreasing early postoperative mortality, it had high degree of drug safety, tolerability. [ABSTRACT FROM AUTHOR]

Background: Cardiac tamponade after heart surgery is of great concern. It increases perioperative mortality and morbidity. Late tamponade might be easily missed and difficult to be diagnosed clinically. It is thought that posterior pericardial window decreases the incidence of postoperative tamponade. Aim of the work: The aim of the study to evaluate the prophylactic role of posterior pericardial window (PPW) in preventing pericardial tamponade after heart valve surgery. Methods: Our prospective randomized comparative study included 640 patients collected by simple random sampling. All patients were admitted in cardiothoracic surgery department-Zagazig University hospitals-Egypt, from January 2020 to May 2022. They were divided into PPW group and non-PPW group and each group contains 320 patients. Results: There is statistical significant difference as regrading occurrence of late tamponade between both groups and also less developed new onset atrial fibrillation in PPW group. Conclusions: Pericardial window is easily to be performed technically. We recommend that procedure to prevent late pericardial effusion and tamponade as it provides a good drainage pathway between pericardial and pleural cavities. We consider that technique is valuable for patients with coagulation disorders. [ABSTRACT FROM AUTHOR]

Background: Approximately 20 to 30 percent of patients experience Ischemic Mitral regurgitation after MI, with extreme IMR occurring in more than 10 percent of patients. Guidelines for appropriate surgical modality, whether for reconstruction or replacement, are still under review. Aim of the study: To compare the outcome of patients with Ischemic mitral regurgitation who underwent CABG with either mitral valve replacement or repair in 2 years follow up. Methods: The selected patients with ischemic mitral regurgitation underwent CABG and mitral valve replacement or repair at the cardiothoracic surgery department, zagazgig university during the period from July 2016 to June 2018 with postoperative follow up of 2 years. Results: we found no signifi cant difference between patients of group 1(Mitral v replacement) 22 patients and group 2 (Mitral v repair) 24 patients regarding preoperative, operative characteristic,operative data and early postoperative follow up with significant difference between the 2 groups regarding recurrence of (mitral regurgitation) MR in which 25% of the patients of repair group developed significant MR at the end of 2 years the follow up period Conclusions: The best surgical solution is problematic due to minimal scientific data. According to existing research, the role of MV replacement tends to be warranted in patients with extreme IMR. [ABSTRACT FROM AUTHOR]

To assess the effect of regional anesthesia on the outcome of elbow arteriovenous fistula (AVF), prospectively studied consecutive patients with end-stage renal disease referred for permanent vascular access to the Vascular Unit of King Fahd University Hospital between September 2004 and September 2007. The patients were divided into 2 groups: Group 1: patients who underwent the construction of the AVF under regional anesthesia and Group 2: patients who were operated under general anesthesia, indicated by their preferences or failure of regional anesthesia. Data including patient characteristics and type of AVF were recorded. The internal diameter of the vein and the artery and intra-operative blood flow were measured. The complications of both types of anesthesia were recorded. The patients were followed up for three months. Eighty four cases were recruited in this study. Complete brachial plexus block was achieved in 57 (68%) patients. Seven patients were converted to general anesthesia and 20 patients had AVF under general anesthesia from the start. There were no significant differences between the 2 groups with regard to basic characteristics or operative data. There were no instances of systemic toxicity, hematomas, or nerve injury from the regional block. No major complications were reported from the general anesthesia. There was no significant difference between both groups regarding early failure of AVF (Group 1, 14% vs. Group2; 11%. P= 0.80). No significant advantage of regional over general anesthesia in terms of early outcome of AVF was seen in this study.

The aim of this study is to assess wind-induced torsional loads on low- and medium-rise buildings determined in accordance with the National Building Code of Canada (NBCC 2010). Two building models with the same horizontal dimensions but different gabled-roof angles (0 and 45) were tested at different full-scale equivalent eave heights (6,12, 20, 30, 40, 50, and 60 m) in open terrain exposure for several wind directions (every 15). Wind-induced measured pressures were numerically integrated over all building surfaces and results were obtained for along-wind force, across-wind force, and torsional moment. Torsion load case (i.e., maximum torsion and corresponding shear) and shear load case (i.e., maximum shear and corresponding torsion) were evaluated to reflect the maximum actual wind load effects in the two horizontal directions (i.e., ransverse and longitudinal). The evaluated torsion and shear load cases were also compared with the current torsion- and shear-- reltaed provisions in the NBCC 2010. The results demonstrated significant discrepancies between NBCC 2010 and the wind tunnel measurements regarding the evaluation of torsional wind loads on low- and medium-rise buildings. Finally, shear and torsion load cases were suggested for evaluating wind loads in the design of low- and medium-rise rectangular buildings. Key words: wind loads, torsion, shear, wind provisions, low-rise buildings, medium-rise buildings. La presente etude vise a evaluer les charges de torsion causees par le vent sur les immeubles de faible et de moyenne hauteur telles que determinees selon le Code national du batiment du Canada (CNB 2010). Deux modeles d'immeubles ayant les memes dimensions horizontales mais ayant des toits a deux versants d'angles differents (0 et 45) ont ete mis a l'epreuve a differentes hauteurs d'avant-toit equivalentes a pleine echelle (6,12, 20, 30, 40, 50 et 60 m) et exposes dans un terrain decouvert avec des vents soufflant de plusieurs directions (a tous les 15). Les pressions mesurees engendrees par les vents ont ete integrees de maniere numerique sur toutes les surfaces des immeubles; les resultats obtenus sont la force dans le sens du vent, la force perpendiculaire au vent et le moment de torsion. Un cas de charge de torsion (c.-a-d. torsion maximale et cisaillement correspondant) et un cas de charge de cisaillement (c.-a-d. cisaillement maximum et torsion correspondante) ont ete evalues pour faire ressortir les effets de la charge reelle due au vent dans les deux directions horizontales (c.-a-d. transversale et longitudinale). Les cas evalues de charges en torsion et en cisaillement ont aussi ete compares aux dispositions du CNB 2010. Les resultats ont montre de grandes differences entre le CNB 2010 et les mesures en soufflerie quant a l'evaluation des charges de torsion dues au vent sur des immeubles de faible et de moyenne hauteur. Finalement, des cas de charges en cisaillement et en torsion sont suggeres afin d'evaluer les charges dues au vent lors de la conception d'immeubles rectangulaires de faible et de moyenne hauteur. [Traduit par la Redaction] Mots-cles : charges dues au vent, torsion, cisaillement, dispositions quant au vent, immeubles de faible hauteur, immeubles de moyenne hauteur., 1. Introduction Proper building design against wind loads depends primarily on the adequacy of the provisions of codes of practice and wind load standards. During the past decades, much has [...]

This investigation carried out throughout two successive seasons 2016 and 2017, on six years-old Flame seedless grapevines in a private vineyard located at Km 93, Cairo, Alexandria desert road. Vines grown in sandy soil under drip irrigation system are trellised with Spanish (Paron) system and trained with quadrilateral cordon. The experiment included 10 treatments as follow:T1- Control (sprayed with water only), T2-Ethrel (ethephon) at 300 ppm, T3-Ascorbic acid (AA) at 500 ppm, T4 - Salicylic acid (SA) at 100 ppm, T5- ABA (Protone10% abscisic acid) at 400 ppm, T6-AA at 500 ppm + Ethrel (Eth) at 300 ppm, T7- SA at 100 ppm+ Eth at 300 ppm, T8-Eth at 300 ppm + ABA at 400 ppm, T9-AA at 500 ppm+ ABA at 400 ppm and T10-SA at 100 ppm+ ABA at 400 ppm. The foliar spray was used two times in the treatments from T2 to T5 but used once for every substance in the treatments from T6 to T10. The results cleared significantly effect of all treatments on yield, bunch, berry physical and chemical characteristics. Spraying with ascorbic acid (AA) or salicylic acid (SA) recorded highest values of 100-berry weight (g), berry firmness, attachment, berry length and width (cm) without significant differences with ABA in both seasons. The treatments of Ethrel (Eth), ABA and Eth+ ABA had maximum TSS (%), while Ethrel or Eth+ ABA had highest TSS/acid ratio and anthocyanin (%) in berries and also these treatments had least values of total acidity (%) in the two seasons. Spraying with ascorbic acid (AA) or salicylic acid (SA) or AA+ ABA or SA+ ABA recorded uppermost yield (kg/ vine) and bunch weight (g), followed by spraying Ethrel (Eth) or (Eth+ ABA). [ABSTRACT FROM AUTHOR]

Background: Management of traumatic hemothorax is an important problem in thoracic surgery. As an alternative to surgical treatment in patients who developed clotted hemothorax after trauma, intra-pleural fibrinolysis has been used with favorable results. This modality of treatment may reduce known morbidities secondary to surgical procedures and may result in significant medical cost savings. Aim of the study is to test the efficacy and safety of tissue plasminogen activator and Streptokinase for management of post traumatic clotted hemothorax. METHODS: our study included 40 patients presented with clotted hemothorax after chest trauma. Patients were divided into two groups each contains 20 patients. First group treated with intra-pleural Alteplase (tissue plasminogen activator) and the second group treated with streptokinase, both was instilled via an intercostal chest tube. Clinical and radiologic (chest radiographs (CXR) and chest computed tomography (CT) data used for evaluation of efficacy of both protocols. RESULTS: Alteplase give excellent results in clotted hemothorax, it showed dramatic improvement in both chest tube drain and pleural thickness without bleeding complications. Streptokinase protocol showed only improvement of chest tube drain. CONCLUSIONS: Intra pleural Alteplase is safe and more efficient than Streptokinase as a chemical modality in treating patients presented with post traumatic clotted hemothorax. [ABSTRACT FROM AUTHOR]

Background: Management of an early empyema is an important problem in thoracic surgery. As an alternative to surgical treatment empyema is in patients who developed early empyema, intra-pleural fibrinolysis has been used with favorable results. This modality of treatment may reduce known morbidities secondary to surgical procedures and may result in significant medical cost savings. Our study aim is to test the efficacy and safety of tissue plasminogen activator and Streptokinase for management of early empyema. Methods: Our study included 48 patients presented with complicated parapneumonic effusion and early empyema. Patients were divided into two groups each contains 24 patients. First group treated with intra-pleural Alteplase (tissue plasminogen activator) and the second group treated with streptokinase, both were instilled via an intercostal chest tube. Clinical and radiologic (chest radiographs (CXR) and chest computed tomography (CT) data used for evaluation of efficacy of both protocols. Results: Tissue plasminogen activator give excellent results in early empyema, it showed success rate 100%, dramatic improvement in both chest tube drain and pleural thickness with no need for further surgical intervention, Streptokinase showed success rate 83.4% in comparison to TPA. Conclusion: Intrapleural tissue plasminogen activator is safe and more efficient than Streptokinase as a chemical modality in treating patients presented with complicated pleural effusion and early empyema. [ABSTRACT FROM AUTHOR]

Handlebar hernias are abdominal wall hernias resulting from direct trauma to the anterior abdominal wall. They usually result at weak anatomic locations of the abdominal wall. Such traumatic hernias are rare, requiring a high index of suspicion for a clinical diagnosis. We report the case of a handlebar hernia resulting from an injury sustained during a vehicular injury, and discuss the management of such injuries.

This study aims at the investigation of GNSS-PP method to determine the dynamic characteristics of structures. Cantilever steel bars having lengths of 70, 100 and 120 cm were tested under dynamic excitation. The GNSS was used to measure the natural frequencies and damping values of all the tested cantilever structures. The GNSS data were processed using relative GNSS positioning and PPP methods. The results obtained using these two methods were also compared with the dynamic characteristics obtained by applying the theoretical and finite element (FE) methods. Furthermore, it is investigated the impact of the stable data length before oscillation events on kinematic PPP. The study showed that the maximum difference among the experimental results in terms of natural frequencies proceeded using PPP is 0.08 Hz when compared with the theoretical and FE results. Furthermore, there is no difference between the PPP and relative GNSS positioning in determining the dynamic behaviour of structures eventhough roving GNSS antenna remains motionless for short-time, such as a few-minutes, before an event occurred. [ABSTRACT FROM AUTHOR]