Assuntos
Ponte de Artéria Coronária , Doença da Artéria Coronariana , Humanos , Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/terapia , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Valor Preditivo dos Testes , Angiografia por Tomografia Computadorizada , Tomada de Decisão Clínica , Angiografia Coronária , Fatores de Risco , Resultado do Tratamento , Seleção de Pacientes , Procedimentos Desnecessários , Intervenção Coronária Percutânea/efeitos adversosRESUMO
Steam-assisted gravity drainage (SAGD), the leading commercial in situ bitumen recovery process, involves the underground injection of steam and produces at the well head a hot fluid containing water, hydrocarbons, and sand. This fluid is subjected to separation by diluent addition and gravity in several parallel treaters. Occasionally, the separation may be disrupted in one or few treaters by the occurrence of an unresolved interface or "rag layer" while continuing without disruption in the rest of the treaters. In the current study, we investigate "rag layer" occurrence based on the quantification of laboratory-scale and SAGD field tests and imaging of the "rag layer" morphology. The quantification results show that the formation and volume of the "rag layer" are affected by solids, mixing speed, and solvent addition. The microscopic images demonstrate the presence of both water-in-oil or oil-in water emulsions with a distinct transition between the continuous phases. The visual detection boundaries of the "rag layer" are defined as the threshold between the agglomerated and individual droplet layers. The extent of agglomeration increases in the proximity to the oil-water interface. The contribution of hydrophobic fine inorganic solids (less than 10 µm) to forming a "rag layer" is supported by their accumulation observed at the treaters' oil-water interface, compared to the feed. In well-controlled field operations, the perceived randomness of "rag layer" occurrence could be associated with the fluctuation of fine solid contents in the feed.
RESUMO
BACKGROUND: In post-coronavirus disease-19 (post-COVID-19) conditions (long COVID), systemic vascular dysfunction is implicated, but the mechanisms are uncertain, and the treatment is imprecise. METHODS AND RESULTS: Patients convalescing after hospitalization for COVID-19 and risk factor matched controls underwent multisystem phenotyping using blood biomarkers, cardiorenal and pulmonary imaging, and gluteal subcutaneous biopsy (NCT04403607). Small resistance arteries were isolated and examined using wire myography, histopathology, immunohistochemistry, and spatial transcriptomics. Endothelium-independent (sodium nitroprusside) and -dependent (acetylcholine) vasorelaxation and vasoconstriction to the thromboxane A2 receptor agonist, U46619, and endothelin-1 (ET-1) in the presence or absence of a RhoA/Rho-kinase inhibitor (fasudil), were investigated. Thirty-seven patients, including 27 (mean age 57 years, 48% women, 41% cardiovascular disease) 3 months post-COVID-19 and 10 controls (mean age 57 years, 20% women, 30% cardiovascular disease), were included. Compared with control responses, U46619-induced constriction was increased (P = 0.002) and endothelium-independent vasorelaxation was reduced in arteries from COVID-19 patients (P < 0.001). This difference was abolished by fasudil. Histopathology revealed greater collagen abundance in COVID-19 arteries {Masson's trichrome (MT) 69.7% [95% confidence interval (CI): 67.8-71.7]; picrosirius red 68.6% [95% CI: 64.4-72.8]} vs. controls [MT 64.9% (95% CI: 59.4-70.3) (P = 0.028); picrosirius red 60.1% (95% CI: 55.4-64.8), (P = 0.029)]. Greater phosphorylated myosin light chain antibody-positive staining in vascular smooth muscle cells was observed in COVID-19 arteries (40.1%; 95% CI: 30.9-49.3) vs. controls (10.0%; 95% CI: 4.4-15.6) (P < 0.001). In proof-of-concept studies, gene pathways associated with extracellular matrix alteration, proteoglycan synthesis, and viral mRNA replication appeared to be upregulated. CONCLUSION: Patients with post-COVID-19 conditions have enhanced vascular fibrosis and myosin light change phosphorylation. Rho-kinase activation represents a novel therapeutic target for clinical trials.