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Journal of Geriatric Cardiology 2016年第2期13卷 115-117页

作者： pablo diez-villanueva Femando Alfonso Department of Cardiology Hospital Universitario de la Princesa Madrid Spain

Heart failure （HF） is a major public health problem worldwide entailing high morbidity and mortality as well as high costs. This chronic syndrome associates with a low functional status and quality of life. Most patients with HF are elderly, constituting up to 80% of patients suffering from this disease with both incidence and prevalence of the condition increasing with age. This is due to the progressive aging of the population as well as improved and better survival after cardiac insults, such as myocardial infarction,

关键词： Elderly Heart failure Prognosis

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Cardiac tamponade as a rare complication after giant coronary fistula percutaneous closure

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World Journal of Cardiovascular Diseases 2013年第2期3卷 215-217页

作者： pablo diez villanueva Fernando Sarnago Cebada Enrique Gutierrez Ibanes Ricardo Sanz-Ruiz Jaime Elizaga-Corrales Francisco Fernandez-Aviles Cardiology Department Hospital General Universitario Gregorio MaranonMadridSpain

We present the case of an unusual complication after percutaneous closure of a giant coronary artery fis-tula. A 76-year-old man with previous admissions due to right heart failure and previous history of atrial fibrillation under acenocumarol, was admitted to our hospital for new onset of symptoms, characterized by progressive dyspnoea and peripheral edema. Physical examination revealed signs of congestive heart failure and a continuous murmur loudest along the lower sternal border. X-Ray showed cardiomegaly due to right chambers dilatation. Transthoracic echocardiography showed right chambers pressure and volume overload, with right ventricular enlargement and dysfunction, tricuspid annulus dilatation and severe tricuspid regurgitation. Cardiac catheterization showed significant elevation of right atrial pressure, as well as significant step-up of oxygen saturation in this chamber. Coronary angiography revealed the presence of a large fistula between the circumflex coronary artery (CCA) and coronary sinus (CS), with severe dilation of the CCA (maximum diameter20 mm). An Amplatzer? PDA was implanted in a distal elbow of the fistula with initailly good results. Anticoagulant therapy was then reinitiated, and a few days later, the patient developed clinical worsening of heart failure and dyspnoea. Echocardiogram showed significant pericardial effusion. Pleuropericardial window was then made draining a500 cm3 of bloody pericardial effusion. The postoperative outcome was excellent, with symptomatic relief and no signs of heart failure.

关键词： Giant Coronary Fistula Circumflex Coronary Artery Coronary Sinus Percutaneous Transcatheter Closure Pericardial Effusion Cardiac Tamponade

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Planetary Gear Profile Modification Design Based on Load Sharing Modelling

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Chinese Journal of Mechanical Engineering 2015年第4期28卷 810-820页

作者： IGLESIAS Miguel FERNáNDEZ DEL RINCóN Alfonso DE-JUAN Ana Magdalena GARCIA pablo diez Alberto VIADERO Fernando Mechanical Engineering Research Group University of Cantabria

In order to satisfy the increasing demand on high performance planetary transmissions, an important line of research is focused on the understanding of some of the underlying phenomena involved in this mechanical system. Through the development of models capable of reproduce the system behavior, research in this area contributes to improve gear transmission insight, helping developing better maintenance practices and more efficient design processes. A planetary gear model used for the design of profile modifications ratio based on the levelling of the load sharing ratio is presented. The gear profile geometry definition, following a vectorial approach that mimics the real cutting process of gears, is thoroughly described. Teeth undercutting and hypotrochoid definition are implicitly considered, and a procedure for the incorporation of a rounding arc at the tooth tip in order to deal with corner contacts is described. A procedure for the modeling of profile deviations is presented, which can be used for the introduction of both manufacturing errors and designed profile modifications. An easy and flexible implementation of the profile deviation within the planetary model is accomplished based on the geometric overlapping. The contact force calculation and dynamic implementation used in the model are also introduced, and parameters from a real transmission for agricultural applications are presented for the application example. A set of reliefs is designed based on the levelling of the load sharing ratio for the example transmission, and finally some other important dynamic factors of the transmission are analyzed to assess the changes in the dynamic behavior with respect to the non-modified case. Thus, the main innovative aspect of the proposed planetary transmission model is the capacity of providing a simulated load sharing ratio which serves as design variable for the calculation of the tooth profile modifications.

关键词： transmission planetary gear load sharing relief profile modification

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Pneumo-CT assessing response to neoadjuvant therapy in esophageal cancer: Imaging-pathological correlation

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World Journal of Gastrointestinal Oncology 2013年第12期5卷 222-229页

作者： Marina Ulla Ernestina Gentile Ezequiel Levy Yeyati Maria L diez Demetrio Cavadas Ricardo D Garcia-Monaco pablo R Ros Department of Radiology Hospital Italiano de Buenos Aires

Pneumo-computed tomography (PnCT) is a technique primarily developed and used to study stenotic lesions of the esophagus, gastroesophageal junction and stom-ach for pre-surgical planning. It helps to define both upper and lower borders of neoplasms located in the aforementioned areas. It achieves maximum lumen distension with CO2 highlighting thickened areas of the esophageal wall, thus allowing an accurate quantifica-tion of their extents. Although there are other alterna-tives for distension (oral contrast agents, water and ef-fervescent granules), they may be suboptimal. Patients with locally advanced esophageal cancer have a dismal prognosis despite surgical resection. Therefore, neo-adjuvant treatment strategies using radiation therapy and chemotherapy were developed to improve sur-vival. Neoadjuvant therapy improves esophageal tumor prognosis in a substantial proportion of patients, and the use of imaging techniques is mandatory to detect their response. PnCT combined with virtual endoscopy and multiplanar reconstruction enhances morphologic details in esophageal cancer, and thus would allow animproved assessment of response to neoadjuvant treat-ment. Therefore, more information could be provided to assess the efficacy of pre-surgical treatment. We de-scribe the potential use of PnCT to assess the response to neoadjuvant therapy in esophageal cancer with an imaging pathologic correlation.

关键词： Esophagus Cancer 64-multidetector com-puted tomography Neoadjuvant treatment Assess-ment response

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