Search results for: penile duplex sonography
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 87

Search results for: penile duplex sonography

87 Management of Caverno-Venous Leakage: A Series of 133 Patients with Symptoms, Hemodynamic Workup, and Results of Surgery

Authors: Allaire Eric, Hauet Pascal, Floresco Jean, Beley Sebastien, Sussman Helene, Virag Ronald

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Background: Caverno-venous leakage (CVL) is devastating, although barely known disease, the first cause of major physical impairment in men under 25, and responsible for 50% of resistances to phosphodiesterase 5-inhibitors (PDE5-I), affecting 30 to 40% of users in this medication class. In this condition, too early blood drainage from corpora cavernosa prevents penile rigidity and penetration during sexual intercourse. The role of conservative surgery in this disease remains controversial. Aim: Assess complications and results of combined open surgery and embolization for CVL. Method: Between June 2016 and September 2021, 133 consecutive patients underwent surgery in our institution for CVL, causing severe erectile dysfunction (ED) resistance to oral medical treatment. Procedures combined vein embolization and ligation with microsurgical techniques. We performed a pre-and post-operative clinical (Erection Harness Scale: EHS) hemodynamic evaluation by duplex sonography in all patients. Before surgery, the CVL network was visualized by computed tomography cavernography. Penile EMG was performed in case of diabetes or suspected other neurological conditions. All patients were optimized for hormonal status—data we prospectively recorded. Results: Clinical signs suggesting CVL were ED since age lower than 25, loss of erection when changing position, penile rigidity varying according to the position. Main complications were minor pulmonary embolism in 2 patients, one after airline travel, one with Factor V Leiden heterozygote mutation, one infection and three hematomas requiring reoperation, one decreased gland sensitivity lasting for more than one year. Mean pre-operative pharmacologic EHS was 2.37+/-0.64, mean pharmacologic post-operative EHS was 3.21+/-0.60, p<0.0001 (paired t-test). The mean EHS variation was 0.87+/-0.74. After surgery, 81.5% of patients had a pharmacologic EHS equal to or over 3, allowing for intercourse with penetration. Three patients (2.2%) experienced lower post-operative EHS. The main cause of failure was leakage from the deep dorsal aspect of the corpus cavernosa. In a 14 months follow-up, 83.2% of patients had a clinical EHS equal to or over 3, allowing for sexual intercourse with penetration, one-third of them without any medication. 5 patients had a penile implant after unsuccessful conservative surgery. Conclusion: Open surgery combined with embolization for CVL is an efficient approach to CVL causing severe erectile dysfunction.

Keywords: erectile dysfunction, cavernovenous leakage, surgery, embolization, treatment, result, complications, penile duplex sonography

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86 Effect of Natural Molecular Crowding on the Structure and Stability of DNA Duplex

Authors: Chaudhari S. G., Saxena, S.

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We systematically and quantitatively investigated the effect of glucose as a model of natural molecular crowding agent on the structure and thermodynamics of Watson-Crick base paired three duplexes (named as D1, D2 and D3) of different base compositions and lengths. Structural analyses demonstrated that duplexes (D1 and D2) folded into B-form with different cations in the absence and presence of glucose while duplex (D3) folded into mixed A and B-form. Moreover, we demonstrated that the duplex was more stable in the absence of glucose, and marginally destabilized in its presence because glucose act as a weak structure breaker on the tetrahedral network of water. In the absence of glucose, the values of ΔG°25 for duplex (D1) were -13.56, -13.76, -12.46, and -12.36 kcal/mol, for duplex (D2) were -13.64, -12.93, -12.86, and -12.30 kcal/mol, for duplex (D3) were -10.05, -11.76, -9.91, -9.70 kcal/mol in the presence of Na+, K+, Na+ + Mg++ and K+ + Mg++ respectively. At high concentration of glucose (1:10000), there was increase in ΔG°25 for duplex (D1) -12.47, -12.37, -11.96, -11.55 kcal/mol, for duplex (D2) -12.37, -11.47, -11.98, -11.01 kcal/mol and for duplex (D3) -8.47, -9.17, -9.16, -8.66 kcal/mol. Our results provide the information that structure and stability of DNA duplex depends on the structure of molecular crowding agent present in its close vicinity. In this study, I have taken the hydration of simple sugar as an essential model for understanding interactions between hydrophilic groups and interfacial water molecules and its effect on hydrogen bonded DNA duplexes. On the basis of these relatively simple building blocks I hope to gain some insights for understanding more generally the properties of sugar–water–salt systems with DNA duplexes.

Keywords: natural molecular crowding, DNA Duplex, structure of DNA, bioengineering and life sciences

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85 Corrosion Behavior of Induced Stress Duplex Stainless Steel in Chloride Environment

Authors: Serge Mudinga Lemika, Samuel Olukayode Akinwamide, Aribo Sunday, Babatunde Abiodun Obadele, Peter Apata Olubambi

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Use of Duplex stainless steel has become predominant in applications where excellent corrosion resistance is of utmost importance. Corrosion behavior of duplex stainless steel induced with varying stress in a chloride media were studied. Characterization of as received 2205 duplex stainless steels were carried out to reveal its structure and properties tensile sample produced from duplex stainless steel was initially subjected to tensile test to obtain the yield strength. Stresses obtained by various percentages (20, 40, 60 and 80%) of the yield strength was induced in DSS samples. Corrosion tests were carried out in magnesium chloride solution at room temperature. Morphologies of cracks observed with optical and scanning electron microscope showed that samples induced with higher stress had its austenite and ferrite grains affected by pitting.

Keywords: duplex stainless steel, hardness, nanoceramics, spark plasma sintering

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84 Thermal Stabilisation of Poly(a)•Poly(U) by TMPyP4 and Zn(X)TMPyP4 Derivatives in Aqueous Solutions

Authors: A. Kudrev

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The duplex Poly(A)-Poly(U) denaturation in an aqueous solutions in mixtures with the tetracationic MeTMPyP4 (Me = 2H, Zn(II); TMPyP4 is 5,10,15,20-tetrakis(N-methylpyridinium-4-yl)porphyrin), was investigated by monitoring the changes in the UV-Vis absorbance spectrum with increasing temperatures from 20°С to 70°С (рН 7.0, I=0.15M). The absorbance data matrices were analyzed with a versatile chemometric procedure that provides the melting profile (distribution of species) and the pure spectrum for each chemical species present along the heating experiment. As revealed by the increase of Tm, the duplex structure was stabilized by these porphyrins. The values of stabilization temperature ΔTm in the presence of these porphyrins are relatively large, 1.2-8.4 °C, indicating that the porphyrins contribute differently in stabilizing the duplex Poly(A)-Poly(U) structure. Remarkable is the fact that the porphyrin TMPyP4 was less effective in the stabilization of the duplex structure than the metalloporphyrin Zn(X)TMPyP4 which suggests that metallization play an important role in porphyrin-RNA binding. Molecular Dynamics Simulations has been used to illustrate melting of the duplex dsRNA bound with a porphyrin molecule.

Keywords: melting, Poly(A)-Poly(U), TMPyP4, Zn(X)TMPyP4

Procedia PDF Downloads 116
83 Diagnostic Accuracy in the Detection of Cervical Lymph Node Metastases in Head and Neck Squamous Cell Carcinoma Patients: A Comparison of Sonography, CT, PET/CT and MRI

Authors: Di Luo, Maria Buchberger, Anja Pickhard

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Objectives: The purpose of this study was to assess and compare the diagnostic accuracy of four common morphological approaches, including sonography, computed tomography (CT), positron emission tomography/computed tomography (PET/CT), and magnetic resonance imaging (MRI) for the evaluation of cervical lymph node metastases in head and neck squamous cell carcinoma (HNSCC) patients. Material and Methods: Included in this retrospective study were 26 patients diagnosed with HNSCC between 2010 and 2011 who all underwent sonography, CT, PET/CT, and MRI imaging before neck dissection. Morphological data were compared to the corresponding histopathological results. Statistical analysis was performed with SPSS statistic software (version 26.0), calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for detection of cervical lymph node metastases. Results: The 5-year survival rate of the patient collective was 55.5%.Risk factors for survival included initial primary tumor stage, initial lymph node stage, initial metastasis status, and therapeutic approaches. Cox regression showed initial metastasis status(HR 8.671, 95%CI 1.316-57.123, p=0.025) and therapeutic approaches(HR 6.699, 95%CI 1.746-25.700, p=0.006)to be independent predictive risk factors for survival. Sensitivity was highest for MRI (96% compared to 85% for sonography and 89% for CT and PET/CT). Specificity was comparable with 95 % for CT and 98 % for sonography and PET/CT, but only 68% for MRI. While the MRI showed the least PPV (34%) compared to all other methods (85% for sonography,75% for CT, and 86% for PET/CT), the NPV was comparable in all methods(98-99%). The overall accuracy of cervical lymph node metastases detection was comparable for sonography, CT, and PET/CT with 96%,97%,94%, respectively, while MRI had only 72% accuracy. Conclusion: Since the initial status of metastasis is an independent predictive risk factor for patients’ survival, efficient detection is crucial to plan adequate therapeutic approaches. Sonography, CT, and PET/CT have better diagnostic accuracy than MRI for the evaluation of cervical lymph node metastases in HNSCC patients.

Keywords: cervical lymph node metastases, diagnostic accuracy, head and neck squamous carcinoma, risk factors, survival

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82 Austenite Transformation in Duplex Stainless Steels under Fast Cooling Rates

Authors: L. O. Luengas, E. V. Morales, L. F. G. De Souza, I. S. Bott

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Duplex Stainless Steels are well known for its good mechanical properties, and corrosion resistance. However, when submitted to heating, these features can be lost since the good properties are strongly dependent on the austenite-ferrite phase ratio which has to be approximately 1:1 to keep the phase balance. In a welded joint, the transformation kinetics at the heat affected zone (HAZ) is a function of the cooling rates applied which in turn are dependent on the heat input. The HAZ is usually ferritized at these temperatures, and it has been argued that small variations of the chemical composition can play a role in the solid state transformation sequence of ferrite to austenite during cooling. The δ → γ transformation has been reported to be massive and diffusionless due to the fast cooling rate, but it is also considered a diffusion controlled transformation. The aim of this work is to evaluate the effect of different heat inputs on the HAZ of two duplex stainless steels UNS S32304 and S32750, obtained by physical simulation.

Keywords: duplex stainless steels, HAZ, microstructural characterization, physical simulation

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81 A Retrospective Study of Pain Management Strategies for Pediatric Hypospadias Surgery in a Tertiary Care Hospital in Western Rajasthan

Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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80 The Austenite Role in Duplex Stainless Steel Performance

Authors: Farej Ahmed Emhmmed Alhegagi

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Duplex stainless steels are attractive material for apparatus working with sea water, petroleum, refineries, chemical plants,vessels, and pipes operating at high temperatures and/or pressures. The role of austenite phase in duplex stainless steels performance was investigated. Zeron 100, stainless steels with 50/50 ferrite / austenite %, specimens were tested for strength, toughness, embrittlement susceptibility, and assisted environmental cracking (AEC) resistance. Specimens were heat treated at 475°C for different times and loaded to well- selected values of load. The load values were chosen to be within the range of higher / lower than the expected toughness. Sodium chloride solution 3.5wt% environment with polarity of -900mV / SCE was used to investigate the material susceptibility to (AEC). Results showed important effect of austenite on specimens overall mechanical properties. Strength was affected by the ductile nature of austenite phase leading to plastic deformation accommodated by austenite slip system. Austenite embrittlement, either by decomposition or nucleation and growth process, was not observed to take place during specimens heat treatment. Cracking due to (AEC) took place in the ferrite grains and avoided the austenite phase. Specimens showed the austenite to act as a crack arrestor during (AEC) of duplex stainless steels.

Keywords: austenite phase, mechanical properties, embrittlement susceptibility, duplex stainless steels

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79 Effect of Heat Treatment on the Corrosion Behavior of Stainless Steel

Authors: Altoumi Alndalusi

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The work examines the aqueous corrosion behavior of grades of stain less steel which are used as corrosion resistant castings for applications such as valve and pump bodies. The corrosion behavior of steels in the as-cast condition has been examined using potentiostatic studies to illustrate the need for correct thermal treatment. A metallurgical examination and chemical analysis were carried out to establish the morphology of the steel structure. Heat treatment was carried out in order to compare damage in relation to microstructure. Optical and scanning electron microscopy examinations confirmed that the austenitic steels suffers from severe localized inter-dendritic pitting attack, while non homogenized castings highly alloyed duplex steels gave inferior corrosion resistance. Through the heat treatment conditions a significant of phase transformation of the duplex steel C were occurred (from ferrite to austenite and sigma plus carbides) and were gave reduction resistance.

Keywords: cast, corrosion, duplex stainless, heat treatment, material, steel

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78 Determination of Stress-Strain Curve of Duplex Stainless Steel Welds

Authors: Carolina Payares-Asprino

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Dual-phase duplex stainless steel comprised of ferrite and austenite has shown high strength and corrosion resistance in many aggressive environments. Joining duplex alloys is challenging due to several embrittling precipitates and metallurgical changes during the welding process. The welding parameters strongly influence the quality of a weld joint. Therefore, it is necessary to quantify the weld bead’s integral properties as a function of welding parameters, especially when part of the weld bead is removed through a machining process due to aesthetic reasons or to couple the elements in the in-service structure. The present study uses the existing stress-strain model to predict the stress-strain curves for duplex stainless-steel welds under different welding conditions. Having mathematical expressions that predict the shape of the stress-strain curve is advantageous since it reduces the experimental work in obtaining the tensile test. In analysis and design, such stress-strain modeling simplifies the time of operations by being integrated into calculation tools, such as the finite element program codes. The elastic zone and the plastic zone of the curve can be defined by specific parameters, generating expressions that simulate the curve with great precision. There are empirical equations that describe the stress-strain curves. However, they only refer to the stress-strain curve for the stainless steel, but not when the material is under the welding process. It is a significant contribution to the applications of duplex stainless steel welds. For this study, a 3x3 matrix with a low, medium, and high level for each of the welding parameters were applied, giving a total of 27 weld bead plates. Two tensile specimens were manufactured from each welded plate, resulting in 54 tensile specimens for testing. When evaluating the four models used to predict the stress-strain curve in the welded specimens, only one model (Rasmussen) presented a good correlation in predicting the strain stress curve.

Keywords: duplex stainless steels, modeling, stress-stress curve, tensile test, welding

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77 Duplex Real-Time Loop-Mediated Isothermal Amplification Assay for Simultaneous Detection of Beef and Pork

Authors: Mi-Ju Kim, Hae-Yeong Kim

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Product mislabeling and adulteration have been increasing the concerns in processed meat products. Relatively inexpensive pork meat compared to meat such as beef was adulterated for economic benefit. These food fraud incidents related to pork were concerned due to economic, religious and health reasons. In this study, a rapid on-site detection method using loop-mediated isothermal amplification (LAMP) was developed for the simultaneous identification of beef and pork. Each specific LAMP primer for beef and pork was designed targeting on mitochondrial D-loop region. The LAMP assay reaction was performed at 65 ℃ for 40 min. The specificity of each primer for beef and pork was evaluated using DNAs extracted from 13 animal species including beef and pork. The sensitivity of duplex LAMP assay was examined by serial dilution of beef and pork DNAs, and reference binary mixtures. This assay was applied to processed meat products including beef and pork meat for monitoring. Each set of primers amplified only the targeted species with no cross-reactivity with animal species. The limit of detection of duplex real-time LAMP was 1 pg for each DNA of beef and pork and 1% pork in a beef-meat mixture. Commercial meat products that declared the presence of beef and/or pork meat on the label showed positive results for those species. This method was successfully applied to detect simultaneous beef and pork meats in processed meat products. The optimized duplex LAMP assay can identify simultaneously beef and pork meat within less than 40 min. A portable real-time fluorescence device used in this study is applicable for on-site detection of beef and pork in processed meat products. Thus, this developed assay was considered to be an efficient tool for monitoring meat products.

Keywords: beef, duplex real-time LAMP, meat identification, pork

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76 Ultrasonography of Low Extremities Veins Before and After Replacement of Knee Joint by Endoprosthesis

Authors: A. V. Alabut, V. D. Sikilinda, N. J. Nelasov, O. L. Eroshenko, M. N. Morgunov, I. V. Koroleva

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We have analyzed the results of treatment of 204 patients with knee prosthetic arthroplasty. For the purpose of active delineation of vascular pathology triplex sonography of arterial and venous vessels of low extremities was performed in all cases in the preoperative period. When it was necessary, reconstructive vascular surgery was implemented to improve peripheral circulation and reduce the hazard of thrombosis after knee replacement. The combination of specific and nonspecific methods of thromboprophylaxis was used in perioperative period. On 7-10 day and 2.5-3 month after prosthetic arthroplasty, all patients iteratively underwent triple sonography. In case of detection of floating thrombus, urgent venous ligation was performed. Active diagnostics of venous thrombosis gave the opportunity to avoid fatal pulmonary embolism.

Keywords: knee replacement, venous thrombosis, pulmonary embolism, vascular surgery

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75 Aging Effect on Mechanical Behavior of Duplex Stainless Steel

Authors: Jeonho Moon, Tae Kwon Ha

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In the present study, the effect of Si, Al, Ti, Zr, and Nb addition on the microstructure and hot workability of cast M42 tool steels, basically consisting of 1.0 C, 0.2 Mn, 3.8 Cr, 1.5 W, 8.5 Co, 9.2 Mo, and 1.0 V in weight percent has been investigated. Tool steels containing Si of 0.25 and 0.5 wt.%, Al of 0.06 and 0.12 wt.%, Ti of 0.3 wt.%, Zr of 0.3 wt.%, and Nb of 0.3wt.% were cast into ingots of 140 mm x 140 mm x 330 mm by vacuum induction melting. After solution treatment at 1150 °C for 1.5 hr followed by furnace cooling, hot rolling at 1180 °C was conducted on the ingots. Addition of titanium, zirconium and niobium was found to retard the decomposition of the eutectic carbides and result in the deterioration of hot workability of the tool steels, while addition of aluminum and silicon showed relatively well decomposed carbide structure and resulted in sound hot rolled plates.

Keywords: duplex stainless steel, alloying elements, eutectic carbides, microstructure, hot workability

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74 Investigation of Optimal Parameter Settings in Super Duplex Stainless Steel Welding Welding

Authors: R. M. Chandima Ratnayake, Daniel Dyakov

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Super steel materials play vital role in construction and fabrication of structural, piping and pipeline components. They enable to minimize the life cycle costs in assuring the integrity of onshore and offshore operating systems. In this context, Duplex stainless steel (DSS) material related welding on constructions and fabrications play a significant role in maintaining and assuring integrity at an optimal expenditure over the life cycle of production and process systems as well as associated structures. In DSS welding, the factors such as gap geometry, shielding gas supply rate, welding current, and type of the welding process play a vital role on the final joint performance. Hence, an experimental investigation has been performed using engineering robust design approach (ERDA) to investigate the optimal settings that generate optimal super DSS (i.e. UNS S32750) joint performance. This manuscript illustrates the mathematical approach and experimental design, optimal parameter settings and results of verification experiment.

Keywords: duplex stainless steel welding, engineering robust design, mathematical framework, optimal parameter settings

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73 Partial Triphallia: The First Case Report of External and Internal Penile Triplication in a Cadaver

Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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72 Correlation of Clinical and Sonographic Findings with Cytohistology for Diagnosis of Ovarian Tumours

Authors: Meenakshi Barsaul Chauhan, Aastha Chauhan, Shilpa Hurmade, Rajeev Sen, Jyotsna Sen, Monika Dalal

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Introduction: Ovarian masses are common forms of neoplasm in women and represent 2/3rd of gynaecological malignancies. A pre-operative suggestion of malignancy can guide the gynecologist to refer women with suspected pelvic mass to a gynecological oncologist for appropriate therapy and optimized treatment, which can improve survival. In the younger age group preoperative differentiation into benign or malignant pathology can decide for conservative or radical surgery. Imaging modalities have a definite role in establishing the diagnosis. By using International Ovarian Tumor Analysis (IOTA) classification with sonography, costly radiological methods like Magnetic Resonance Imaging (MRI) / computed tomography (CT) scan can be reduced, especially in developing countries like India. Thus, this study is being undertaken to evaluate the role of clinical methods and sonography for diagnosis of the nature of the ovarian tumor. Material And Methods: This prospective observational study was conducted on 40 patients presenting with ovarian masses, in the Department of Obstetrics and Gynaecology, at a tertiary care center in northern India. Functional cysts were excluded. Ultrasonography and color Doppler were performed on all the cases.IOTA rules were applied, which take into account locularity, size, presence of solid components, acoustic shadow, dopper flow etc . Magnetic Resonance Imaging (MRI) / computed tomography (CT) scans abdomen and pelvis were done in cases where sonography was inconclusive. In inoperable cases, Fine needle aspiration cytology (FNAC) was done. The histopathology report after surgery and cytology report after FNAC was correlated statistically with the pre-operative diagnosis made clinically and sonographically using IOTA rules. Statistical Analysis: Descriptive measures were analyzed by using mean and standard deviation and the Student t-test was applied and the proportion was analyzed by applying the chi-square test. Inferential measures were analyzed by sensitivity, specificity, negative predictive value, and positive predictive value. Results: Provisional diagnosis of the benign tumor was made in 16(42.5%) and of the malignant tumor was made in 24(57.5%) patients on the basis of clinical findings. With IOTA simple rules on sonography, 15(37.5%) were found to be benign, while 23 (57.5%) were found to be malignant and findings were inconclusive in 2 patients (5%). FNAC/Histopathology reported that benign ovarian tumors were 14 (35%) and 26(65%) were malignant, which was taken as the gold standard. The clinical finding alone was found to have a sensitivity of 66.6% and a specificity of 90.9%. USG alone had a sensitivity of 86% and a specificity of 80%. When clinical findings and IOTA simple rules of sonography were combined (excluding inconclusive masses), the sensitivity and specificity were 83.3% and 92.3%, respectively. While including inconclusive masses, sensitivity came out to be 91.6% and specificity was 89.2. Conclusion: IOTA's simple sonography rules are highly sensitive and specific in the prediction of ovarian malignancy and also easy to use and easily reproducible. Thus, combining clinical examination with USG will help in the better management of patients in terms of time, cost and better prognosis. This will also avoid the need for costlier modalities like CT, and MRI.

Keywords: benign, international ovarian tumor analysis classification, malignant, ovarian tumours, sonography

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71 The Influence of C Element on the Phase Transformation in Weldment of Complex Stainless Steels 2507/316/316L

Authors: Lin Dong-Yih, Yang S. M., Huang B. W., Lian J. A.

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Super duplex stainless steel has excellent mechanical properties and corrosion resistance. It becomes important structural material as its application has been extended to the fields such as renewable energy and the chemical industry because of its excellent properties. As examples are offshore wind power, solar cell machinery, and pipes in the chemical industry. The mechanical properties and corrosion resistance of super duplex stainless steel can be eliminated by welding due to the precipitation of the hard and brittle σ phase, which is rich of chromium, and molybdenum elements. This paper studies the influence of carbon element on the phase transformation of -ferrite and σ phase in 2507 super duplex stainless steel. The 2507 will be under argon gas protection welded with 316 and 316L extra low carbon stainless steel separately. The microstructural phases of stainless steels before and after welding, in fusion, heat affected zones, and base material will be studied via X-ray, OM, SEM, EPMA i.e. their quantity, size, distribution, and morphology. The influences of diffusion by carbon element will be compared according to the microstructures, hardness, and corrosion tests.

Keywords: complex stainless steel, welding, phase formation, carbon element, sigma phase, delta ferrite

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70 Analysis of Rectangular Concrete-Filled Double Skin Tubular Short Columns with External Stainless Steel Tubes

Authors: Omnia F. Kharoob, Nashwa M. Yossef

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Concrete-filled double skin steel tubular (CFDST) columns could be utilized in structures such as bridges, high-rise buildings, viaducts, and electricity transmission towers due to its great structural performance. Alternatively, lean duplex stainless steel has recently gained significant interest for its high structural performance, similar corrosion resistance and lower cost compared to the austenitic steel grade. Hence, this paper presents the nonlinear finite element (FE) analysis, behaviour and design of rectangular outer lean duplex stainless steel (EN 1.4162) CFDST short columns under compression. All classes of the outer rectangular hollow section according to the depth-to-thickness (D/t) ratios were considered. The results showed that the axial ultimate strength of rectangular CFDST short columns increased linearly by increasing the concrete compressive strength, while it does not influence when changing the hollow ratios. Finally, the axial capacities were compared with the available design methods, and recommendations were conducted for the design strength of this type of column.

Keywords: concrete-filled double skin columns, compressive strength, finite element analysis, lean duplex stainless steel, ultimate axial strength, short columns

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69 Process Optimization for 2205 Duplex Stainless Steel by Laser Metal Deposition

Authors: Siri Marthe Arbo, Afaf Saai, Sture Sørli, Mette Nedreberg

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This work aims to establish a reliable approach for optimizing a Laser Metal Deposition (LMD) process for a critical maritime component, based on the material properties and structural performance required by the maritime industry. The component of interest is a water jet impeller, for which specific requirements for material properties are defined. The developed approach is based on the assessment of the effects of LMD process parameters on microstructure and material performance of standard AM 2205 duplex stainless steel powder. Duplex stainless steel offers attractive properties for maritime applications, combining high strength, enhanced ductility and excellent corrosion resistance due to the specific amounts of ferrite and austenite. These properties are strongly affected by the microstructural characteristics in addition to microstructural defects such as porosity and welding defects, all strongly influenced by the chosen LMD process parameters. In this study, the influence of deposition speed and heat input was evaluated. First, the influences of deposition speed and heat input on the microstructure characteristics, including ferrite/austenite fraction, amount of porosity and welding defects, were evaluated. Then, the achieved mechanical properties were evaluated by standard testing methods, measuring the hardness, tensile strength and elongation, bending force and impact energy. The measured properties were compared to the requirements of the water jet impeller. The results show that the required amounts of ferrite and austenite can be achieved directly by the LMD process without post-weld heat treatments. No intermetallic phases were observed in the material produced by the investigated process parameters. A high deposition speed was found to reduce the ductility due to the formation of welding defects. An increased heat input was associated with reduced strength due to the coarsening of the ferrite/austenite microstructure. The microstructure characterizations and measured mechanical performance demonstrate the great potential of the LMD process and generate a valuable database for the optimization of the LMD process for duplex stainless steels.

Keywords: duplex stainless steel, laser metal deposition, process optimization, microstructure, mechanical properties

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68 Finite Element Modeling of Two-Phase Microstructure during Metal Cutting

Authors: Junior Nomani

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This paper presents a novel approach to modelling the metal cutting of duplex stainless steels, a two-phase alloy regarded as a difficult-to-machine material. Calculation and control of shear strain and stresses during cutting are essential to achievement of ideal cutting conditions. Too low or too high leads to higher required cutting force or excessive heat generation causing premature tool wear failure. A 2D finite element cutting model was created based on electron backscatter diffraction (EBSD) data imagery of duplex microstructure. A mesh was generated using ‘object-oriented’ software OOF2 version V2.1.11, converting microstructural images to quadrilateral elements. A virtual workpiece was created on ABAQUS modelling software where a rigid body toolpiece advanced towards workpiece simulating chip formation, generating serrated edge chip formation cutting. Model results found calculated stress strain contour plots correlated well with similar finite element models tied with austenite stainless steel alloys. Virtual chip form profile is also similar compared experimental frozen machining chip samples. The output model data provides new insight description of strain behavior of two phase material on how it transitions from workpiece into the chip.

Keywords: Duplex stainless steel, ABAQUS, OOF2, Chip formation

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67 Sexual Health Experiences of Older Men: Health Care Professionals' Perspectives

Authors: Andriana E. Tran, Anna Chur-Hansen

Abstract:

Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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66 Ultrasound Markers in Evaluation of Hernias

Authors: Aniruddha Kulkarni

Abstract:

In very few cases of external hernias we require imaging modalities as on most occasions clinical examination tests are good enough. Ultrasound will help in chronic abdominal or groin pain, equivocal clinical results & complicated hernias. Ultrasound is useful in assessment of cause of raised intrabdominal pressure. In certain cases will comment about etiology, complications and chronicicty of lesion. Screening of rest of abdominal organs too is important advantage being real time modality. Cost effectiveness, no radiation allows modality be used repeatedly in indicated cases. Sonography is better accepted by patients too as it is cost effective. Best advanced tissue harmonic equipment and increasing expertise making it popular. Ultrasound can define surgical anatomy, rent size, contents, etiological /recurrence factors in great detail and with authority hence accidental findings in a planned surgical procedure can be easily avoided. Clinical dynamic valselva and reducibility test can better documented by real time ultrasound study. In case of recurrence, Sonography will help in assessing the hernia details better as being dynamic real time investigation. Ultrasound signs in case of internal hernias are well comparable with CT findings.

Keywords: laparoscopic repair, Hernia, CT findings, chronic pain

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65 Effect of Variation of Temperature Distribution on Mechanical Properties of Shield Metal Arc Welded Duplex Stainless Steel

Authors: Arvind Mittal, Rajesh Gupta

Abstract:

Influence of heat input on the micro structure and mechanical properties of shield metal arc welded of duplex stainless steel UNSNO.S-31803 has been investigated. Three heat input combinations designated as low heat (0.675 KJ/mm), medium heat (0.860 KJ/mm) and high heat (1.094 KJ/mm) and weld joints made using these combinations were subjected to micro structural evaluations and tensile and impact testing so as to analyze the effect of thermal arc energy on the micro structure and mechanical properties of these joints. The result of this investigation shows that the joints made using low heat input exhibited higher tensile strength than those welded with medium and high heat input. Heat affected zone of welded joint made with medium heat input has austenitic ferritic grain structure with some patchy austenite provide high toughness. Significant grain coarsening was observed in the heat affected zone (HAZ) of medium and high heat input welded joints, whereas low heat input welded joint shows the fine grain structure in the heat affected zone with small amount of dendritic formation and equiaxed grain structure where inner zone indicates slowly cooled grains in the direction of heat dissipation. This is the main reason for the observable changes of tensile properties of weld joints welded with different arc energy inputs.

Keywords: microstructure, mechanical properties, shield metal arc welded, duplex stainless steel

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64 An Extremely Rare Anatomical Vascular Variant of Lower Limb Arterial System - Duplication of Superficial Femoral Artery

Authors: Manik Sharma

Abstract:

Understanding the anatomy and normal anatomical variations of the lower limb arterial system is undeniably important not only to understand the pathology involving the vessels of the lower limb but also as a part of endovascular intervention and surgical planning in cases that demand them as a part of treatment. There have been very few cases of duplication of SFA cited in the literature, close to six worldwide and this being the seventh case in the world and first to be reported in the Indian population. We incidentally came across this normal variant during US lower limb (US-LL) duplex scan in a patient with claudicating pain in bilateral lower limbs hence suspected of having peripheral vascular disease. It was confirmed on CT-Peripheral Angiography (CT-PA), which was done successively.

Keywords: peripheral vascular disease, claudicating pain, normal anatomical variants, endovascular intervention, duplication, CT-peripheral angiography, duplex scan, Iohexol

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63 Cracking Mode and Path in Duplex Stainless Steels Failure

Authors: Faraj A. E. Alhegagi, Bassam F. A. Alhajaji

Abstract:

Ductile and brittle fractures are the two main modes for the failure of engineering components. Fractures are classified with respect to several characteristics, such as strain to fracture, ductile or brittle crystallographic mode, shear or cleavage, and the appearance of fracture, granular or transgranular. Cleavage is a brittle fracture involves transcrystalline fracture along specific crystallographic planes and in certain directions. Fracture of duplex stainless steels takes place transgranularly by cleavage of the ferrite phase. On the other hand, ductile fracture occurs after considerable plastic deformation prior to failure and takes place by void nucleation, growth, and coalescence to provide an easy fracture path. Twinning causes depassivation more readily than slip and appears at stress lower than the theoretical yield stress. Consequently, damage due to twinning can occur well before that due to slip. Stainless steels are clean materials with the low efficiency of second particles phases on the fracture mechanism. The ferrite cleavage and austenite tear off are the main mode by which duplex stainless steels fails. In this study, the cracking mode and path of specimens of duplex stainless steels were investigated. Zeron 100 specimens were heat treated to different times cooled down and pulled to failure. The fracture surface was investigated by scanning electron microscopy (SEM) concentrating on the cracking mechanism, path, and origin. Cracking mechanisms were studied for those grains either as ferrite or austenite grains identified according to fracture surface features. Cracks propagated through the ferrite and the austenite two phases were investigated. Cracks arrested at the grain boundary were studied as well. For specimens aged for 100h, the ferrite phase was noted to crack by cleavage along well-defined planes while austenite ridges were clearly observed within the ferrite grains. Some grains were observed to fail with topographic features that were not clearly identifiable as ferrite cleavage or austenite tearing. Transgranular cracking was observed taking place in the ferrite phase on well-defined planes. No intergranular cracks were observed for the tested material. The austenite phase was observed to serve as a crack bridge and crack arrester.

Keywords: austenite ductile tear off, cracking mode, ferrite cleavage, stainless steels failure

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62 Investigation of Specific Wear Rate of Austenitic and Duplex Stainless Steel Alloys in High Temperatures

Authors: Dler Abdullah Ahmed, Zozan Ahmed Mohammed

Abstract:

Wear as an unavoidable phenomenon in stainless steel contact sliding parts is investigated In this work. Two grades of austenitic AISI 304, and S31254, as well as duplexes of S32205, and AISI 2507, were chosen to compare their wear behavior in temperatures ranging from room temperature to 550°C. The experimental results show that AISI 304 austenitic and AISI 2205 duplex stainless steel had lower wear resistance compared with S31254 and AISI 2507 in various temperatures. When the temperature rose to 140°C, and the wear rate of all grades increased, AISI 304 had the highest at 7.028x10-4 mm3/Nm, and AISI 2507 had the lowest at 4.9033 x 10-4 mm3/Nm. At 300°C, the oxides began to form on the worn surfaces, causing the wear rate to slow. As a result, when temperatures exceeded 300°C, the specific wear rate decreased significantly in all specimens. According to the XRD patterns, the main types of oxides formed on worn surfaces were magnetite, hematite, and chromite.

Keywords: wear, stainless steel, temperature, groove, oxide

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61 Investigation of Specific Wear Rate of Austenitic and Duplex Stainless Steel Alloys in High Temperatures

Authors: Dler Abdullah Ahmed, Zozan Ahmed Mohammed

Abstract:

Wear as an unavoidable phenomenon in stainless steel contact sliding parts is investigated In this work. Two grades of austenitic AISI 304, and S31254, as well as duplexes of S32205, and AISI 2507, were chosen to compare their wear behavior in temperatures ranging from room temperature to 550°C. The experimental results show that AISI 304 austenitic and AISI 2205 duplex stainless steel had lower wear resistance compared with S31254 and AISI 2507 in various temperatures. When the temperature rose to 140°C, and the wear rate of all grades increased, AISI 304 had the highest at 7.028x10-4 mm3/Nm, and AISI 2507 had the lowest at 4.9033 x 10-4 mm3/Nm. At 300°C, the oxides began to form on the worn surfaces, causing the wear rate to slow. As a result, when temperatures exceeded 300°C, the specific wear rate decreased significantly in all specimens. According to the XRD patterns, the main types of oxides formed on worn surfaces were magnetite, hematite, and chromite.

Keywords: wear, stainless steel, temperature, groove, oxide

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60 Hydration of Protein-RNA Recognition Sites

Authors: Amita Barik, Ranjit Prasad Bahadur

Abstract:

We investigate the role of water molecules in 89 protein-RNA complexes taken from the Protein Data Bank. Those with tRNA and single-stranded RNA are less hydrated than with duplex or ribosomal proteins. Protein-RNA interfaces are hydrated less than protein-DNA interfaces, but more than protein-protein interfaces. Majority of the waters at protein-RNA interfaces makes multiple H-bonds; however, a fraction does not make any. Those making Hbonds have preferences for the polar groups of RNA than its partner protein. The spatial distribution of waters makes interfaces with ribosomal proteins and single-stranded RNA relatively ‘dry’ than interfaces with tRNA and duplex RNA. In contrast to protein-DNA interfaces, mainly due to the presence of the 2’OH, the ribose in protein-RNA interfaces is hydrated more than the phosphate or the bases. The minor groove in protein-RNA interfaces is hydrated more than the major groove, while in protein-DNA interfaces it is reverse. The strands make the highest number of water-mediated H-bonds per unit interface area followed by the helices and the non-regular structures. The preserved waters at protein-RNA interfaces make higher number of H-bonds than the other waters. Preserved waters contribute toward the affinity in protein-RNA recognition and should be carefully treated while engineering protein-RNA interfaces.

Keywords: h-bonds, minor-major grooves, preserved water, protein-RNA interfaces

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59 Crack Initiation Assessment during Fracture of Heat Treated Duplex Stainless Steels

Authors: Faraj Ahmed E. Alhegagi, Anagia M. Khamkam Mohamed, Bassam F. Alhajaji

Abstract:

Duplex stainless steels (DSS) are widely employed in industry for apparatus working with sea water in petroleum, refineries and in chemical plants. Fracture of DSS takes place by cleavage of the ferrite phase and the austenite phase ductile tear off. Pop-in is an important feature takes place during fracture of DSS. The procedure of Pop-ins assessment plays an important role in fracture toughness studies. In present work, Zeron100 DSS specimens were heat treated at different temperatures, cooled and pulled to failure to assess the pop-ins criterion in crack initiation prediction. The outcome results were compared to the British Standard (BS 7448) and the ASTEM standard (E1290) for Crack-Tip Opening Displacement (CTOD) fracture toughness measurement. Pop-in took place during specimens loading specially for those specimens heat treated at higher temperatures. The standard BS7448 was followed to check specimen validity for fractured toughness assessment by direct determination of KIC. In most cases, specimens were invalid for KIC measurement. The two procedures were equivalent only when single pop-ins were assessed. A considerable contrast in fracture toughness value between was observed where multiple pop-ins were assessed.

Keywords: fracture toughness, stainless steels, pop ins, crack assessment

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58 Non-Invasive Assessment of Peripheral Arterial Disease: Automated Ankle Brachial Index Measurement and Pulse Volume Analysis Compared to Ultrasound Duplex Scan

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

Abstract:

Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

Procedia PDF Downloads 127