RESUMO
OBJECTIVE: Bulb suction drains have long been used in various surgical procedures. The purpose of this study was to evaluate 4 commonly used bulb suction devices in vitro to explore the nonlinear changes in draining ability and efficiency along with the conformation changes of the device throughout the draining processes. METHODS: Under a designed simulated scenario using pure water as the desired draining substance, the relative function of the J-VAC 100 cc (JV100) (Ethicon, Inc, Somerville, USA); the EVACUATOR 125cc (EP125) (Pacific Hospital Supply, Taiwan); the Bulb Reservoir 150 cc (BH150) (Hosmed, Inc, Miami, FL); and the HemoVac 400 cc (HV400) (Zimmer, Inc, Warsaw, IN) drains were compared. The maximum collection capacities and the dead space at maximum compression of each bulb drain were recorded and compared. The collected fluid weight was recorded along with time, and collection speeds were calculated and compared. RESULTS: The maximum collected weight of the 4 drains were 110.07 ± 0.54 g (JV100), 122.7 ± 06.51 g (EP125), 140.8 ± 03.78 g (BH150), and 335.07 ± 04.24 g (HV400). The dead spaces under maximum compression were 15.63 ± 01.32 ml, 19.80 ± 03.37 ml, 34.23 ± 06.77 ml, and 82.83 ± 05.51 ml, respectively. The collecting speed-volume curves were generated from the authors' tested devices. Although slightly different individually, typical characteristics, such as tendency to reach maximum collection speed at the very beginning of the collection phase; rapid decline to about 65% of peak collection speed when approximately 30% of the total collection volume had been achieved; and inefficient collection speed in the later collection phase were noted. CONCLUSIONS: Among all the bulb drains tested in this study, all of them performed well in vitro. Although using bulb drains continues to be an effective and economic draining method after operation, clinicians should be aware of the nonlinear features of suction efficiency during the drainage process to avoid unexpected function deterioration. .
RESUMO
The San Andreas Fault (SAF) showcases the breadth of possible earthquake sizes and occurrence behavior; in particular, the central SAF is a microcosm of such diversity. This section also exhibits the spectrum of fault coupling from locked to creeping. Here, we show that the observations of aseismic slip, temporal clustering of seismicity, and spatial variations in earthquake size distributions are tightly connected. Specifically, the creep rate along the central SAF is shown to be directly proportional to the fraction of nonclustered earthquakes for the period 1984-2020. This relationship provides a unified perspective of earthquake phenomenology along the SAF, where lower coupling manifests in weaker temporal clustering, with repeating earthquakes as an end-member. This new paradigm provides additional justification for characterizing the northwest â¼75 kilometers of the creeping segment as a transition zone, with potential implications for seismic hazard.
RESUMO
Intracranial arachnoid cysts are believed to be congenital; they can become symptomatic in pediatric patients. Chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury a few months prior to the onset of symptoms. However, these two distinct clinical entities sporadically occur together in relatively young patients. We report a 29-year-old man who presented with headache and dizziness of 2 months' duration. Brain computed tomography revealed a huge chronic subdural hematoma over the left frontoparietal lobe, with an incidental finding of an arachnoid cyst over the left sylvian fissure. In light of a literature review, we discuss arachnoid cysts as a possible risk factor for subdural hematoma, especially in young adults.
Assuntos
Cistos Aracnóideos/complicações , Hematoma Subdural/etiologia , Adulto , Doença Crônica , Humanos , Masculino , Tomografia Computadorizada por Raios XAssuntos
Fossa Craniana Média/patologia , Neoplasias da Base do Crânio/diagnóstico , Sinovite Pigmentada Vilonodular/diagnóstico , Transtornos da Articulação Temporomandibular/diagnóstico , Craniotomia , Diagnóstico Diferencial , Orelha Média/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética/métodos , Processo Mastoide/diagnóstico por imagem , Pessoa de Meia-Idade , Radioterapia Adjuvante , Neoplasias da Base do Crânio/patologia , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodosRESUMO
Spinal epidural lipomatosis (SEL), an abnormal localized or tumor-like accumulation of fat in the epidural space, is an infrequent complication of chronic steroid usage and an uncommon cause of spinal cord compression. During the period of 1990 to 2006, we have two cases of medically heath SEL patients without history of steroid administration. Their initial clinical manifestations were low back pain, progressive lower extremities weakness, numbness, followed by rapid deterioration of neurogenic intermittent claudication. They were misdiagnosed and treated as degenerative spinal disease for a long time. Due to prominent neurological deficit, lumbar magnetic resonance image (MRI) was obtained and showed SEL. These 2 patients all underwent laminectomy and removal of epidural fat. Postoperatively, they both showed improvement. We reviewed the literature and discussed the current concept in the management of SEL.