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Pressure Gradient (pressure + gradient)
Kinds of Pressure Gradient Terms modified by Pressure Gradient Selected AbstractsEchocardiographic Estimation of Systemic Systolic Blood Pressure in Dogs with Mild Mitral RegurgitationJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2006DACVIM, Sandra P. Tou DVM Background:Systemic hypertension is likely underdiagnosed in veterinary medicine because systemic blood pressure is rarely measured. Systemic blood pressure can theoretically be estimated by echocardiography. According to the modified Bernoulli equation (PG = 4v2), mitral regurgitation (MR) velocity should approximate systolic left ventricular pressure (sLVP), and therefore systolic systemic blood pressure (sSBP) in the presence of a normal left atrial pressure (LAP) and the absence of aortic stenosis. The aim of this study was to evaluate the use of echocardiography to estimate sSBP by means of the Bernoulli equation. Hypothesis:Systemic blood pressure can be estimated by echocardiography. Animal: Seventeen dogs with mild MR. No dogs had aortic or subaortic stenosis, and all had MR with a clear continuous-wave Doppler signal and a left atrial to aorta ratio of , 1.6. Methods:Five simultaneous, blinded continuous-wave measurements of maximum MR velocity (Vmax) and indirect sSBP measurements (by Park's Doppler) were obtained for each dog. Pressure gradient was calculated from Vmax by means of the Bernoulli equation, averaged, and added to an assumed LAP of 8 mm Hg to calculate sLVP. Results:Calculated sLVP was significantly correlated with indirectly measured sSBP within a range of 121 to 218 mm Hg (P= .0002, r= .78). Mean ± SD bias was 0.1 ± 15.3 mm Hg with limits of agreement of-29.9 to 30.1 mm Hg. Conclusion: Despite the significant correlation, the wide limits of agreement between the methods hinder the clinical utility of echocardiographic estimation of blood pressure. [source] Modeling and analysis of thickness gradient and variations in vacuum-assisted resin transfer molding processPOLYMER COMPOSITES, Issue 5 2008Jing Li As vacuum-assisted resin transfer molding (VARTM) is being increasingly used in aerospace applications, the thickness gradient and variation issues are gaining more attention. Typically, thickness gradient and variations result from the infusion pressure gradient during the process and material variations. Pressure gradient is the driving force for resin flow and the main source of thickness variation. After infusion, an amount of pressure gradient is frozen into the preform, which primarily contributes to the thickness variation. This study investigates the mechanism of the thickness variation dynamic change during the infusion and relaxing/curing processes. A numerical model was developed to track the thickness change of the bagging film free surface. A time-dependent permeability model as a function of compaction pressure was incorporated into an existing resin transfer molding (RTM) code for obtaining the initial conditions for relaxing/curing process. Control volume (CV) and volume of fluid (VOF) methods were combined to solve the free surface problem. Experiments were conducted to verify the simulation results. The proposed model was illustrated with a relatively complex part. POLYM. COMPOS., 2008. © 2008 Society of Plastics Engineers [source] Overpressure and petroleum generation and accumulation in the Dongying Depression of the Bohaiwan Basin, ChinaGEOFLUIDS (ELECTRONIC), Issue 4 2001X. Xie Abstract The occurrence of abnormally high formation pressures in the Dongying Depression of the Bohaiwan Basin, a prolific oil-producing province in China, is controlled by rapid sedimentation and the distribution of centres of active petroleum generation. Abnormally high pressures, demonstrated by drill stem test (DST) and well log data, occur in the third and fourth members (Es3 and Es4) of the Eocene Shahejie Formation. Pressure gradients in these members commonly fall in the range 0.012,0.016 MPa m,1, although gradients as high as 0.018 MPa m,1 have been encountered. The zone of strongest overpressuring coincides with the areas in the central basin where the principal lacustrine source rocks, which comprise types I and II kerogen and have a high organic carbon content (>2%, ranging to 7.3%), are actively generating petroleum at the present day. The magnitude of overpressuring is related not only to the burial depth of the source rocks, but to the types of kerogen they contain. In the central basin, the pressure gradient within submember Es32, which contains predominantly type II kerogen, falls in the range 0.013,0.014 MPa m,1. Larger gradients of 0.014,0.016 MPa m,1 occur in submember Es33 and member Es4, which contain mixed type I and II kerogen. Numerical modelling indicates that, although overpressures are influenced by hydrocarbon generation, the primary control on overpressure in the basin comes from the effects of sediment compaction disequilibrium. A large number of oil pools have been discovered in the domes and faulted anticlines of the normally pressured strata overlying the overpressured sediments; the results of this study suggest that isolated sandstone reservoirs within the overpressured zone itself offer significant hydrocarbon potential. [source] Tubular reabsorption and diabetes-induced glomerular hyperfiltrationACTA PHYSIOLOGICA, Issue 1 2010P. Persson Abstract Elevated glomerular filtration rate (GFR) is a common observation in early diabetes mellitus and closely correlates with the progression of diabetic nephropathy. Hyperfiltration has been explained to be the result of a reduced load of sodium and chloride passing macula densa, secondarily to an increased proximal reabsorption of glucose and sodium by the sodium-glucose co-transporters. This results in an inactivation of the tubuloglomerular feedback (TGF), leading to a reduced afferent arteriolar vasoconstriction and subsequently an increase in GFR. This hypothesis has recently been questioned due to the observation that adenosine A1 -receptor knockout mice, previously shown to lack a functional TGF mechanism, still display a pronounced hyperfiltration when diabetes is induced. Leyssac demonstrated in the 1960s (Acta Physiol Scand58, 1963:236) that GFR and proximal reabsorption can work independently of each other. Furthermore, by the use of micropuncture technique a reduced hydrostatic pressure in Bowman's space or in the proximal tubule of diabetic rats has been observed. A reduced pressure in Bowman's space will increase the pressure gradient over the filtration barrier and can contribute to the development of diabetic hyperfiltration. When inhibiting proximal reabsorption with a carbonic anhydrase inhibitor, GFR decreases and proximal tubular pressure increases. Measuring intratubular pressure allows a sufficient time resolution to reveal that net filtration pressure decreases before TGF is activated which highlights the importance of intratubular pressure as a regulator of GFR. Taken together, these results imply that the reduced intratubular pressure observed in diabetes might be crucial for the development of glomerular hyperfiltration. [source] Simulation Study of the MHD Stability Beta Limit in LHD by TASK3DCONTRIBUTIONS TO PLASMA PHYSICS, Issue 6-7 2010M. Sato Abstract The numerical method for analysis of the "MHD stability beta limit" based on a hierarchy integrated simulation code TASK3D has been developed. The numerical model for the effect of the MHD instabilities is introduced such that the pressure profile is flattened around the rational surface due to the MHD instabilities. The width of the flattening of the pressure gradient is determined from the width of the eigenmode structure of the MHD instabilities (© 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Comparison of Coronary Flow Velocities Between Patients with Obstructive and Nonobstructive Type Hypertrophic Cardiomyopathy: Noninvasive Assessment by Transthoracic Doppler EchocardiographyECHOCARDIOGRAPHY, Issue 1 2005Seden Celik M.D. Background: We aimed to compare coronary flow velocity (CFV) measurements of patients with nonobstructive (NHCM) and obstructive hypertrophic cardiomyopathy (HOCM) by using transthoracic Doppler echocardiography (TTDE). Methods and Results: In 11 patients with NHCM and 26 with HOCM, CFV in the distal left anterior descending (LAD) coronary was measured by TTDE (3.5 MHz) under the guidance of color Doppler flow mapping in addition to standard 2D and Doppler echocardiography. The results were compared with 24 normal participants who had no evidence of cardiac disease. Peak diastolic velocity of LAD was also higher in NHCM and HOCM than controls (52 ± 14 cm/sec and 54 ± 20 cm/sec vs 41 ± 11 cm/sec, respectively, P < 0.01). The analysis of systolic velocities revealed abnormal flow patterns in 16 (61%) patients with HOCM (12 systolic-reversal flow and 4 no systolic flow) and 6 (54%) (5 reversal flow and 1 zero flow) patients with NHCM (,11 ± 30 cm/sec and ,13 ± 38 cm/sec, vs 24 ± 9 cm/sec, respectively, P < 0.001). Linear regression analysis demonstrated no correlation between intraventricular pressure gradient and coronary flow velocities in HOCM patients. However, there were significant positive and negative correlations between septal thickness and diastolic and systolic velocities, respectively (r = 0.50, P < 0.002, and r =,0.43, P < 0.005). Conclusion: We conclude that the coronary flow velocity abnormalities are independent from the type of hypertrophic cardiomyopathy. [source] 5 DIAGNOSTIC PITFALLS IN THE ECHOCARDIOGRAPHIC EVALUATION OF HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM) REFERRED FOR CATHETER INTERVENTIONAL THERAPYECHOCARDIOGRAPHY, Issue 1 2004G. Beer Introduction: Generally, the diagnosis of typical HOCM with subaortic obstruction and a dynamic pressure gradient across the left ventricular outflow tract is made by noninvasive diagnostic procedures with great certainty by employing transthoracic (TTE) and/or transoesophageal (TEE) echocardiography. However, in patients with asymmetric septal hypertrophy pitfalls in echocardiographic examination may arise from several additional diseases as described in casuistic reports. To date systematic investigations in patients referred for catheter interventional therapy of HOCM are lacking. Patients and Methods: Therefore we investigated for the first time in a systematic study 200 symptomatic patients. (180 consecutive and 20 nonconsecutive patients; functional class 3 or 4 according to NYHA) with HOCM who were referred for this new catheter interventional therapy. In all patients TTE, bicycle exercise Doppler echocardiography and multiplane TEE were performed. Results: In 4 of 180 consecutive patients. (2.2%) discrete subvalvular membranous aortic stenosis (DSAS) (3 female patients and 1 male patient; age 20 to 58 years; mean septal diameter 19 mm; Sam-like motion in all 4 patients) was made. In all cases the diagnosis could be confirmed by surgical treatment. TEE evaluation was of crucial importance with demonstration of a typical subvalvular membrane that was situated a few millimeters below the aortic valve. In all cases a typical asymmetric septal hypertrophy mimicking HOCM was seen. Additionally, in 2 patients there was a conincidence of severe symptomatic valvular aortic stenosis and HOCM and in 1 patient a tunnel type of subvalvular aortic stenosis was present. Conclusion: These results show the potential pitfalls in echocardiographic diagnosis of HOCM. Especially, the frequency of DSAS in symptomatic patients referred for HOCM is unexpectedly high (2.2%). Especially in patients in whom TTE is of insufficient quality, investigation employing multiplane TEE with careful evaluation of the small poststenotic subvalvular area in HOCM is of crucial importance. This is of special significance prior to catheter interventional therapy, because in these patients surgical treatment is mandatory. [source] Cavitation versus Degassing: In Vitro Study of the Microbubble Phenomenon Observed During Echocardiography in Patients with Mechanical Prosthetic Cardiac ValvesECHOCARDIOGRAPHY, Issue 7 2002Grégoire Girod M.D. Background: With the advent of second harmonic imaging in echocardiography, microbubbles have been observed during opening and closure of mechanical prosthetic valves. The single phenomenon of cavitation, an extremely short event described in the literature, cannot explain the persistence of microbubbles during several hundred milliseconds. Therefore, in vitro we reproduced two distinct phenomena created by a local depression occurring during the closure and/or opening of prosthetic valves: Cavitation and degassing. Methods: We used a water circuit system enriched with CO2 that passes through a Venturi tube in order to create variable pressure gradients. Three types of observations were performed: (1) the dimensions of the bubbles as a function of pressure, (2) calibration of the echocardiograph, and (3) comparison and illustrations of the difference between bubble formation by cavitation (vaporization) and degassing (liberation of CO2). Results: According to the different pressures exerted, the dimensions of the bubbles only vary by several microns, not measurable in practice. Second, the calibration of the echocardiograph reveals that the dimensions of the bubbles measured by ultrasound are greater by a factor of 1.75. Finally, the observed cavitation is a short phenomenon (several milliseconds) and happens under a great local pressure gradient. The degassing produces microbubbles lasting up to as long as > 1 second under much lower pressure. Conclusion: This in vitro study suggests that microbubbles observed during several hundred milliseconds after the opening of prosthetic cardiac valves are the result of degassing of CO2 in blood rather than a cavitation phenomenon as suggested in the literature. [source] A spring-driven press device for hot embossing and thermal bonding of PMMA microfluidic chipsELECTROPHORESIS, Issue 15 2010Zhi Chen Abstract A novel spring-driven press device was designed and manufactured for hot embossing and thermal bonding of PMMA microfluidic chips in this work. This simple device consisted of two semi-cylinder silicone rubber press heads, three steel clamping plates, and three compression springs that were assembled together using two screw bolts and two butterfly nuts. The three springs were clamped between the upper and the middle clamping plates, whereas the two press heads were assembled between the middle and the lower clamping plates. After an epoxy template covered by a PMMA plate or a PMMA channel plate together with a cover were sandwiched between two microscopic glass slides for embossing or bonding, respectively, they were clamped between the two elastic press heads of the press device by fastening the screw nuts on the upper clamping plate. Because the convex press heads applied pressure along the middle line of the glass slides, they would deform resulting in a negative pressure gradient from the middle to the sides so that air bubbles between the sandwiched parts could be squeezed out during embossing and bonding processes. High-quality PMMA microfluidic chips were prepared by using this unique device and were successfully applied in the electrophoretic separation of several cations. [source] Numerical studies of electrokinetic control of DNA concentration in a closed-end microchannelELECTROPHORESIS, Issue 5 2010Yasaman Daghighi Abstract A major challenge in lab-on-a-chip devices is how to concentrate sample molecules from a dilute solution, which is critical to the effectiveness and the detection limit of on-chip bio-chemical reactions. A numerical study of sample concentration control by electrokinetic microfluidic means in a closed-end microchannel is presented in this paper. The present method provides a simple and efficient way of concentration control by using electrokinetic trapping of a charged species of interest, controlling liquid flow and separating different sample molecules in the microchannel. The electrokinetic-concentration process and the controlled transport of the sample molecules are numerically studied. In this system, in addition to the electroosmotic flow and the electrophoresis, the closed-end of the chamber causes velocity variation at both ends of the channel and induces a pressure gradient and the associated fluid movement in the channel. The combined effects determine the final concentration field of the sample molecules. The influences of a number of parameters such as the channel dimensions, electrode size and the applied electric field are investigated. [source] Estimation of Joule heating effect on temperature and pressure distribution in electrokinetic-driven microchannel flowsELECTROPHORESIS, Issue 3 2006Reiyu Chein Professor Abstract In this study we present simple analytical models that predict the temperature and pressure variations in electrokinetic-driven microchannel flow under the Joule heating effect. For temperature prediction, a simple model shows that the temperature is related to the Joule heating parameter, autothermal Joule heating parameter, external cooling parameter, Peclet number, and the channel length to channel hydraulic diameter ratio. The simple model overpredicted the thermally developed temperature compared with the full numerical simulation, but in good agreement with the experimental measurements. The factors that affect the external cooling parameters, such as the heat transfer coefficient, channel configuration, and channel material are also examined based on this simple model. Based on the mass conservation, a simple model is developed that predicts the pressure variations, including the temperature effect. An adverse pressure gradient is required to satisfy the mass conservation requirement. The temperature effect on the pressure gradient is via the temperature-dependent fluid viscosity and electroosmotic velocity. [source] Algorithm for determining optimum sequestration depth of CO2 trapped by residual gas and solubility trapping mechanisms in a deep saline formationGEOFLUIDS (ELECTRONIC), Issue 4 2008C. K. LIN Abstract An algorithm is proposed here for determining the optimum sequestration depth (in terms of depth corresponding to maximum net income per unit rock volume) in a saline formation for CO2 trapped by residual gas and solubility trapping mechanisms. The Peng,Robinson equation of state was used to determine the density and fugacity of sequestered CO2 and the compression energy required for CO2 injection. Geochemist's Workbench®, a commercial geochemical software package, was used to estimate CO2 solubility in groundwater. Operational costs and CO2 emissions due to compression energy consumption were estimated. A hypothetical reference case was constructed to illustrate the proposed algorithm, assuming constant values of geothermal gradient, hydrostatic pressure gradient, sweep efficiency and initial groundwater chemistry, with a depth-dependent porosity and porosity-dependent saturation of residual gas. In general, the algorithm was illustrated successfully for the hypothetical reference case and produced the following results. The depth corresponding to maximum trapping capacity was approximately 3000 m, but the depth representing maximum net income was approximately 1300 m. CO2 emissions due to compression energy consumption per unit mass of CO2 sequestration cannot be ignored, but may be <0.15, even down to a depth of 7000 m. Both the trapping capacity and net income of CO2 sequestration decreased with geothermal gradient, but the corresponding optimum depths increased with geothermal gradient. [source] Mineral precipitation associated with vertical fault zones: the interaction of solute advection, diffusion and chemical kineticsGEOFLUIDS (ELECTRONIC), Issue 1 2007CHONGBIN ZHAO Abstract This article is concerned with chemical reactions that occur between two interacting parallel fluid flows using mixing in vertical faults as an example. Mineral precipitation associated with fluid flow in permeable fault zones results in mineralization and chemical reaction (alteration) patterns, which in turn are strongly dependent on interactions between solute advection (controlled by fluid flow rates), solute diffusion/dispersion and chemical kinetics. These interactions can be understood by simultaneously considering two dimensionless numbers, the Damköhler number and the Z -number. The Damköhler number expresses the interaction between solute advection (flow rate) and chemical kinetics, while the Z -number expresses the interaction between solute diffusion/dispersion and chemical kinetics. Based on the Damköhler and Z -numbers, two chemical equilibrium length-scales are defined, dominated by either solute advection or by solute diffusion/dispersion. For a permeable vertical fault zone and for a given solute diffusion/dispersion coefficient, there exist three possible types of chemical reaction patterns, depending on both the flow rate and the chemical reaction rate. These three types are: (i) those dominated by solute diffusion and dispersion resulting in precipitation at the lower tip of a vertical fault and as a thin sliver within the fault, (ii) those dominated by solute advection resulting in precipitation at or above the upper tip of the fault, and (iii) those in which advection and diffusion/dispersion play similar roles resulting in wide mineralization within the fault. Theoretical analysis indicates that there exists both an optimal flow rate and an optimal chemical reaction rate, such that chemical equilibrium following focusing and mixing of two fluids may be attained within the fault zone (i.e. type 3). However, for rapid and parallel flows, such as those resulting from a lithostatic pressure gradient, it is difficult for a chemical reaction to reach equilibrium within the fault zone, if the two fluids are not well mixed before entering the fault zone. Numerical examples are given to illustrate the three possible types of chemical reaction patterns. [source] Overpressure and petroleum generation and accumulation in the Dongying Depression of the Bohaiwan Basin, ChinaGEOFLUIDS (ELECTRONIC), Issue 4 2001X. Xie Abstract The occurrence of abnormally high formation pressures in the Dongying Depression of the Bohaiwan Basin, a prolific oil-producing province in China, is controlled by rapid sedimentation and the distribution of centres of active petroleum generation. Abnormally high pressures, demonstrated by drill stem test (DST) and well log data, occur in the third and fourth members (Es3 and Es4) of the Eocene Shahejie Formation. Pressure gradients in these members commonly fall in the range 0.012,0.016 MPa m,1, although gradients as high as 0.018 MPa m,1 have been encountered. The zone of strongest overpressuring coincides with the areas in the central basin where the principal lacustrine source rocks, which comprise types I and II kerogen and have a high organic carbon content (>2%, ranging to 7.3%), are actively generating petroleum at the present day. The magnitude of overpressuring is related not only to the burial depth of the source rocks, but to the types of kerogen they contain. In the central basin, the pressure gradient within submember Es32, which contains predominantly type II kerogen, falls in the range 0.013,0.014 MPa m,1. Larger gradients of 0.014,0.016 MPa m,1 occur in submember Es33 and member Es4, which contain mixed type I and II kerogen. Numerical modelling indicates that, although overpressures are influenced by hydrocarbon generation, the primary control on overpressure in the basin comes from the effects of sediment compaction disequilibrium. A large number of oil pools have been discovered in the domes and faulted anticlines of the normally pressured strata overlying the overpressured sediments; the results of this study suggest that isolated sandstone reservoirs within the overpressured zone itself offer significant hydrocarbon potential. [source] Simulation of coherent structures in turbulent boundary layer using Gao,Yong equations of turbulenceHEAT TRANSFER - ASIAN RESEARCH (FORMERLY HEAT TRANSFER-JAPANESE RESEARCH), Issue 5 2004Bo Liu Abstract The equations of incompressible turbulent flow developed by the Gao,Yong turbulence model have two important features. First, they do not contain any empirical coefficients or wall functions. Second, the series representation of turbulence energy equation reflects multi-scale structures of the nonlinearity of turbulence, and, therefore, is capable of describing both statistical mean flows and the coherent structures. This paper presents some simulation results of a two-dimensional turbulent boundary layer with zero pressure gradient based on Gao,Yong equations of turbulence. With a staggered grid arrangement, an incompressible SIMPLE code was used in the simulations. The simulated coherent structures have verified the adaptability of the newly derived equations to real intermittent turbulent flows. The effect of the orders of the energy equation and computational grid scales on the detection of coherent structures is also investigated. © 2004 Wiley Periodicals, Inc. Heat Trans Asian Res, 33(5): 287,298, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/htj.20019 [source] Liver stiffness identifies two different patterns of fibrosis progression in patients with hepatitis C virus recurrence after liver transplantation,HEPATOLOGY, Issue 1 2010José A. Carrión Significant liver fibrosis (F , 2) and portal hypertension (hepatic venous pressure gradient [HVPG] , 6 mmHg) at 1 year after liver transplantation (LT) identify patients with severe hepatitis C recurrence. We evaluated whether repeated liver stiffness measurements (LSM) following LT can discriminate between slow and rapid "fibrosers" (fibrosis stage F2-F4 at 1 year after LT). Eighty-four patients who had undergone LT and who were infected with hepatitis C virus (HCV) and 19 LT controls who were not infected with HCV underwent LSM at 3, 6, 9, and 12 months after LT. All HCV-infected patients underwent liver biopsy 12 months after LT (paired HVPG measurements in 74); 31 (37%) were rapid fibrosers. Median LSM (in kilopascal) at months 6, 9, and 12 were significantly higher in rapid fibrosers (9.9, 9.5, 12.1) than in slow fibrosers (6.9, 7.5, 6.6) (P < 0.01 all time points). The slope of liver stiffness progression (kPa × month) in rapid fibrosers (0.42) was significantly greater than in slow fibrosers (0.05) (P < 0.001), suggesting two different speeds of liver fibrosis progression. Figures were almost identical for patients with HVPG , 6 mmHg or HVPG < 6 mmHg at 1 year after LT. Multivariate analysis identified donor age, bilirubin level, and LSM as independent predictors of fibrosis progression and portal hypertension in the estimation group (n = 50) and were validated in a second group of 34 patients. The areas under the receiver operating characteristic curve that could identify rapid fibrosers and patients with portal hypertension as early as 6 months after LT were 0.83 and 0.87, respectively, in the estimation group and 0.75 and 0.80, respectively, in the validation group. Conclusion: Early and repeated LSM following hepatitis C recurrence in combination with clinical variables discriminates between rapid and slow fibrosers after LT. (HEPATOLOGY 2009.) [source] Platelet count is not a predictor of the presence or development of gastroesophageal varices in cirrhosis,HEPATOLOGY, Issue 1 2008Amir A. Qamar Current guidelines recommend esophagogastroduodenoscopy (EGD) in patients with cirrhosis to screen for gastroesophageal varices (GEV). Thrombocytopenia has been proposed as a noninvasive test to predict the presence of GEV. There is no agreement regarding a specific platelet count (PLT) that can reliably predict GEV. The present longitudinal study aims to (1) further investigate the relationship between varices and PLT at the time of endoscopy, (2) investigate whether changes in PLT from the baseline over time can predict the development of GEV, and (3) investigate whether changes in PLT correlate with the hepatic venous pressure gradient (HVPG). A secondary analysis was conducted for 213 subjects with compensated cirrhosis with portal hypertension but without GEV enrolled in a randomized, placebo-controlled, double-blind trial of a nonselective beta-blocker used to prevent GEV. PLTs were obtained every 3 months, and HVPG measurements and EGD were done annually. The PLTs were compared between subjects who did and did not develop GEV. In a median follow-up of 54.9 months, 84 patients developed GEV. PLT was greater than 150,000 in 15% of patients at the development of GEV. A receiver operating curve did not show any PLT with high sensitivity or specificity for the presence of GEV. Subjects with clinically insignificant portal hypertension (HVPG < 10 mm Hg) whose PLT remained greater than 100,000 had a 2-fold reduction in the occurrence of GEV (P = 0.0374). A significant correlation was found between HVPG and PLT at the baseline, year 1, and year 5 (P < 0.0001). Conclusion: Cross-sectional or longitudinal evaluations of PLTs are inadequate noninvasive markers for GEV. Patients with mild portal hypertension whose PLT remains greater than 100,000 have significantly less risk of GEV. Although HVPG correlates somewhat with PLT, changes in PLT cannot be used as a surrogate for HVPG changes. (HEPATOLOGY 2008;47:153,159.) [source] Increasing dimethylarginine levels are associated with adverse clinical outcome in severe alcoholic hepatitis,HEPATOLOGY, Issue 1 2007Rajeshwar P. Mookerjee Previous studies suggest reduced hepatic endothelial nitric oxide synthase activity contributes to increased intrahepatic resistance. Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, undergoes hepatic metabolism via dimethylarginine-dimethylamino-hydrolase, and is derived by the action of protein-arginine-methyltransferases. Our study assessed whether ADMA, and its stereo-isomer symmetric dimethylarginine (SDMA), are increased in alcoholic hepatitis patients, and determined any relationship with severity of portal hypertension (hepatic venous pressure gradient measurement) and outcome. Fifty-two patients with decompensated alcoholic cirrhosis were studied, 27 with acute alcoholic hepatitis and cirrhosis, in whom hepatic venous pressure gradient was higher (P = 0.001) than cirrhosis alone, and correlated with ADMA measurement. Plasma ADMA and SDMA were significantly higher in alcoholic hepatitis patients and in nonsurvivors. Dimethylarginine-dimethylamino-hydrolase protein expression was reduced and protein-arginine-methyltransferase-1 increased in alcoholic hepatitis livers. ADMA, SDMA and their combined sum, which we termed a dimethylarginine score, were better predictors of outcome compared with Pugh score, MELD and Maddrey's discriminant-function. Conclusion: Alcoholic hepatitis patients have higher portal pressures associated with increased ADMA, which may result from both decreased breakdown (decreased hepatic dimethylarginine-dimethylamino-hydrolase) and/or increased production. Elevated dimethylarginines may serve as important biological markers of deleterious outcome in alcoholic hepatitis. (HEPATOLOGY 2007;45:62,71.) [source] Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitisHEPATOLOGY, Issue 5 2003Luis Ruiz-del-Arbol M.D. Spontaneous bacterial peritonitis (SBP) is frequently associated with renal failure. This study assessed if systemic and hepatic hemodynamics are also affected by this condition. Standard laboratory tests, tumor necrosis factor , (TNF-,) in plasma and ascitic fluid, plasma renin activity (PRA) and norepinephrine (NE), and systemic and hepatic hemodynamics were determined in 23 patients with SBP at diagnosis and after resolution of infection. Eight patients developed renal failure during treatment. At diagnosis of infection, patients developing renal failure showed significantly higher values of TNF-,, blood urea nitrogen (BUN), PRA and NE, peripheral vascular resistance, and hepatic venous pressure gradient (HVPG) and lower cardiac output than patients not developing renal failure. During treatment, a significant reduction in cardiac output and arterial pressure and increase in PRA and NE, HVPG, and Child-Pugh score were observed in the first group but not in the second. Peripheral vascular resistance remained unmodified in both groups. Changes in PRA and NE correlated inversely with changes in arterial pressure and directly with changes in BUN, Child-Pugh score, and HVPG. Five patients in the renal failure group developed encephalopathy, and 6 died. In the group without renal failure, none of the patients developed encephalopathy or expired. In conclusion, patients with SBP frequently develop a rapidly progressive impairment in systemic hemodynamics, leading to severe renal and hepatic failure, aggravation of portal hypertension, encephalopathy, and death. This occurs despite rapid resolution of infection and is associated with an extremely poor prognosis. [source] Low doses of isosorbide mononitrate attenuate the postprandial increase in portal pressure in patients with cirrhosisHEPATOLOGY, Issue 2 2003Lia Bellis Postprandial hyperemia is associated with a significant increase in portal pressure in cirrhosis, which may contribute to progressive dilation and rupture of gastroesophageal varices. In cirrhosis, an insufficient hepatic production of nitric oxide (NO) may impair the expected hepatic vasodilatory response to increased blood flow, further exaggerating the postprandial increase in portal pressure. This study was aimed at investigating whether low doses of an oral NO donor might counteract the postprandial peak in portal pressure. Twenty-three portal hypertensive cirrhotics, 8 of them under propranolol therapy, were randomized to receive orally 5-isosorbide mononitrate (ISMN; 10 mg; n = 11) or placebo (n = 12) and a standard liquid meal 15 minutes later. Hepatic venous pressure gradient (HVPG), mean arterial pressure (MAP), and hepatic blood flow (HBF) were measured at baseline and 15, 30, and 45 minutes after a meal. ISMN significantly attenuated the postprandial increase in portal pressure as compared with placebo (peak HVPG increase: 2.4 ± 1.4 mm Hg vs. 5.2 ± 2.1 mm Hg, P = .002). Percentual increases in HBF were similar in both groups. MAP decreased slightly in ISMN group (,7.5% ± .5%; P < .01 vs. baseline). These effects were also observed in patients on chronic propranolol therapy. In conclusion, hepatic NO supplementation by low doses of ISMN effectively reduces the postprandial increase of portal pressure in cirrhosis, with only a mild effect on arterial pressure. The same was observed in patients receiving propranolol. Our results suggest that therapeutic strategies based on selective hepatic NO delivery may improve the treatment of portal hypertension. [source] Hepatic arterial buffer response in patients with advanced cirrhosisHEPATOLOGY, Issue 3 2002Veit Gülberg Hepatic arterial buffer response (HABR) is considered an important compensatory mechanism to maintain perfusion of the liver by hepatic arterial vasodilation on reduction of portal venous perfusion. HABR has been suggested to be impaired in patients with advanced cirrhosis. In patients with hepatopetal portal flow, placement of a transjugular intrahepatic portosystemic shunt (TIPS) reduces portal venous liver perfusion. Accordingly, patients with severe cirrhosis should have impaired HABR after TIPS implantation. Therefore, the aim of this study was to investigate the effect of TIPS on HABR as reflected by changes in resistance index (RI) of the hepatic artery. A total of 366 patients with cirrhosis (Child-Pugh class A, 106; class B, 168; class C, 92) underwent duplex Doppler ultrasonographic examination with determination of RI and maximal flow velocity in the portal vein before and 1 month after TIPS placement. Portosystemic pressure gradient was determined before and after TIPS placement. In 29 patients with hepatofugal portal blood flow, RI was significantly lower than in 337 patients with hepatopetal flow (0.63 ± 0.02 vs. 0.69 ± 0.01; P < .001). TIPS induced a significant decrease of the RI in patients with hepatopetal flow (RI, 0.69 ± 0.01 before vs. 0.64 ± 0.01 after TIPS; P = .001) but not in patients with hepatofugal flow (RI, 0.63 ± 0.02 before vs. 0.63 ± 0.02 after TIPS; NS). This response was not dependent on the Child-Pugh class. In conclusion, our results suggest that some degree of HABR is preserved even in patients with advanced cirrhosis with significant portal hypertension. [source] The hemodynamic response to medical treatment of portal hypertension as a predictor of clinical effectiveness in the primary prophylaxis of variceal bleeding in cirrhosisHEPATOLOGY, Issue 5 2000Carlo Merkel In the prevention of variceal rebleeding, it is already established that hemodynamic response to drug treatment (decrease in hepatic venous pressure gradient [HVPG] to 12 mm Hg or by >20%) is predictive of clinical effectiveness. In primary prophylaxis very few clinical data are available. We assessed the role of the hemodynamic response to beta-blockers or beta-blockers plus nitrates in predicting clinical efficacy of prophylaxis. A total of 49 cirrhotic patients with varices at risk of bleeding, without prior variceal bleeding, were investigated by hepatic vein catheterization before and after 1 to 3 months of chronic treatment with nadolol or nadolol plus isosorbide mononitrate, and were followed during treatment for up to 5 years. A total of 30 patients (61%) were good hemodynamic responders, and among them in 12 (24%) HVPG was ,12 mm Hg during treatment. During treatment 9 patients had variceal bleeding: 7 were poor responders and 2 were good responders. The probability of bleeding at 3 years of follow-up was significantly higher in poor responders (41%) than in good responders (7%; P = .0008). No patient reaching an HVPG of 12 mm Hg or less during treatment had variceal bleeding during follow-up. Cox's regression analysis showed that poor hemodynamic response was the main factor predicting bleeding (, = 1.91; SE(,) = 0.80; P = .01). During follow-up 11 patients died of hepatic causes. Survival was related to Child-Pugh class and to initial value of HVPG, according to Cox's analysis. In conclusion, the assessment of hemodynamic response to drugs in terms of HVPG is the best predictor of efficacy of prophylaxis of variceal bleeding in patients treated with beta-blockers or beta-blockers plus nitrates. [source] Hepatic venous pressure gradient: To measure or not to measure, that is the questionHEPATOLOGY, Issue 5 2000Arun J. Sanyal M.B.B.S. No abstract is available for this article. [source] Finite element analysis of land subsidence above depleted reservoirs with pore pressure gradient and total stress formulationsINTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 4 2001Giuseppe Gambolati Abstract The solution of the poroelastic equations for predicting land subsidence above productive gas/oil fields may be addressed by the principle of virtual works using either the effective intergranular stress, with the pore pressure gradient regarded as a distributed body force, or the total stress incorporating the pore pressure. In the finite element (FE) method both approaches prove equivalent at the global assembled level. However, at the element level apparently the equivalence does not hold, and the strength source related to the pore pressure seems to generate different local forces on the element nodes. The two formulations are briefly reviewed and discussed for triangular and tetrahedral finite elements. They are shown to yield different results at the global level as well in a three-dimensional axisymmetric porous medium if the FE integration is performed using the average element-wise radius. A modification to both formulations is suggested which allows to correctly solve the problem of a finite reservoir with an infinite pressure gradient, i.e. with a pore pressure discontinuity on its boundary. Copyright © 2001 John Wiley & Sons, Ltd. [source] Hydromagnetic flow and heat transfer of a conducting Casson fluid in a rectangular channelINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING, Issue 4 2006Hazem Ali Attia Abstract The transient hydromagnetic flow of an electrically conducting viscous incompressible non-Newtonian Casson fluid bounded by two parallel non-conducting plates is studied with heat transfer considering the Hall effect. An external uniform magnetic field is applied perpendicular to the plates and the fluid motion is subjected to a pressure gradient in the axial direction. The lower plate is stationary and the upper plate is suddenly set into motion and simultaneously suddenly isothermally heated to a temperature other than the lower plate temperature. Numerical solutions are obtained for the governing momentum and energy equations taking the Joule and viscous dissipations into consideration. The effect of the Hall term and the parameter describing the non-Newtonian behaviour on both the velocity and temperature distributions are studied. Copyright © 2005 John Wiley & Sons, Ltd. [source] Numerical simulation of two-dimensional transient water driven non-Newtonian fluid flow in porous mediaINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING, Issue 4 2002Zuojin Zhu Abstract Numerical simulation of two-dimensional transient water driven non-Newtonian fluid flow in porous media has been performed. The hyperbolic non-Newtonian fluid model was used to describe the characteristics of non-Newtonian fluid flow. Governing equations were first approximated by implicit finite difference, and then solved by a stabilized bi-conjugate gradient (Bi-CGSTAB) approach. A comparison of the numerical results for the case of water driven Newtonian fluid was made to validate the numerical method. For water driven Newtonian fluid flow, it was found that the numerical results are satisfactorily consistent with those obtained by commercial software VIP which is the abbreviation of vector implicit procedure for numerical simulation of Newtonian fluid flow in porous media. The maximum deviation for average pressure is less than 1.5 per cent; the distribution of water saturation is almost the same as that obtained by VIP. For water driven non-Newtonian fluid flow in porous media, it was found that the factor of pressure gradient of the non-Newtonian fluid has significant effects on the process of oil recovery. The correction of numerical simulation based on the global mass balance plays an important role in oil reservoir simulation. Copyright © 2002 John Wiley & Sons, Ltd. [source] Stabilized finite element methods with reduced integration techniques for miscible displacements in porous mediaINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 4 2004C. M. Dias Abstract The objective of this work is to study some techniques to increase computational performance of stabilized finite element simulations of miscible displacements. We propose the use of a reduced integration technique for bilinear quadrilateral elements in the determination of the pressure and concentration fields. We also study the evaluation of pressure gradient (Darcy's velocity) by differentiation at super-convergent points. Numerical examples are shown to validate our approach, accessing its efficiency and accuracy. Copyright © 2003 John Wiley & Sons, Ltd. [source] Peristaltic transport and heat transfer of a MHD Newtonian fluid with variable viscosityINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 12 2010S. Nadeem Abstract The influence of temperature-dependent viscosity and magnetic field on the peristaltic flow of an incompressible, viscous Newtonian fluid is investigated. The governing equations are derived under the assumptions of long wavelength approximation. A regular perturbation expansion method is used to obtain the analytical solutions for the velocity and temperature fields. The expressions for the pressure rise, friction force and the relation between the flow rate and pressure gradient are obtain. In addition to analytical solutions, numerical results are also computed and compared with the analytical results with good agreement. The results are plotted for different values of variable viscosity parameter ,, Hartmann number M, and amplitude ratio ,. It is found that the pressure rise decreases as the viscosity parameter , increases and it increases as the Hartmann number M increases. Finally, the maximum pressure rise (,=0) increases as M increases and , decreases. Copyright © 2009 John Wiley & Sons, Ltd. [source] Turbulence in a three-dimensional wall-bounded shear flowINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 8 2010A. Holstad Abstract A new turbulent flow with distinct three-dimensional characteristics has been designed in order to study the impact of mean-flow skewing on the turbulent coherent vortices and Reynolds-averaged statistics. The skewing of a unidirectional plane Couette flow was achieved by means of a spanwise pressure gradient. Direct numerical simulations of the statistically steady Couette,Poiseuille flow enabled in-depth explorations of the turbulence field in the skewed flow. The imposition of a modest spanwise gradient turned the mean flow about 8° away from the original Couette flow direction and this turning angle remained nearly the same over the entire cross section. Nevertheless, a substantial non-alignment between the turbulent shear stress angle and the mean velocity gradient angle was observed. The structure parameter turned out to slightly exceed that in the pure Couette flow, contrary to the observations made in some other three-dimensional shear flows. Coherent flow structures, which are known to be associated with the Reynolds shear stress in near-wall regions, were identified by the ,2 -criterion. Instantaneous and ensemble-averaged vortices resembled those found in the unidirectional Couette flow. In the skewed flow, however, the vortex structures were turned to align with the local mean-flow direction. The conventional symmetry between Case 1 and Case 2 vortices was broken due to the mean-flow three-dimensionality. The turning of the coherent vortices and the accompanying symmetry-breaking gave rise to secondary and tertiary turbulent shear stress components. By averaging the already ensemble-averaged shear stresses associated with Case 1 and Case 2 vortices in the homogeneous directions, a direct link between the educed near-wall structures and the Reynolds-averaged turbulent stresses was established. These observations provide evidence in support of the hypothesis that the structural model proposed for two-dimensional turbulent boundary layers remains valid also in flows with moderate mean three-dimensionality. Copyright © 2009 John Wiley & Sons, Ltd. [source] Bounds on outputs of the exact weak solution of the three-dimensional Stokes problemINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN FLUIDS, Issue 10 2009Zhong Cheng Abstract A method for obtaining rigorous upper and lower bounds on an output of the exact weak solution of the three-dimensional Stokes problem is described. Recently bounds for the exact outputs of interest have been obtained for both the Poisson equation and the advection-diffusion-reaction equation. In this work, we extend this approach to the Stokes problem where a novel formulation of the method also leads to a simpler flux calculation based on the directly equilibrated flux method. To illustrate this technique, bounds on the flowrate are calculated for an incompressible creeping flow driven by a pressure gradient in an endless square channel with an array of rectangular obstacles in the center. Copyright © 2009 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||