A 49‐year‐old man, who had not been vaccinated against COVID‐19 visited the hospital for fever and cough, and a PCR test for COVID‐19 was positive on the Day X. Initially, there was no decrease in oxygen saturation and the patient was under observation as a mild case without medication. Five days after the onset (Day X + 5), chest pain appeared. Electrocardiogram showed widespread ST‐segment elevation, and blood tests showed high levels of troponin I. However, given that there was no stenotic lesion on coronary computed tomography, myocarditis was suspected, and he was transferred to our hospital on the Day X + 6. We started treatment with lemdesivir and dexamethasone. On the Day X + 7, the patient developed decreased left ventricular ejection fraction, hypotension, and hyperlactatemia. We decided that mechanical circulatory support was necessary and an Impella 5.0 was inserted under ventilator management. The patient was successfully weaned from the Impella 5.0 on the Day X + 17, was transferred to the general ward on the Day X + 24, continued rehabilitation, and was discharged home on the Day X + 39 with no heart failure symptoms. In this case, we performed daily bedside echocardiography and chose the Impella 5.0 instead of extra corporeal membrane oxygenation (ECMO) because there were no findings of severe pneumonia or right heart failure. The Impella 5.0 device was inserted via an axillary artery approach, given that it provides more assisted flow than the Impella CP inserted through the inguinal route. Furthermore, early rehabilitation was possible due to the lack of restriction of the lower body.
The damage of the structures is classified into two types. The one is caused by the direct action of tsunami, and floating bodies such as destroyed facilities and drifting ships and cars cause the other one. The purpose of the present study is to investigate the damage on structures due to the drifting bodies with tsunami. In order to perform the investigation focused on a drifting body, experimental tests are carried out, and a combination method of non-linear long wave theory and DEM is suggested for drifting numerical models. The models are applied to reproduce the experimental tests. As a result, it is confirmed that suggesting method can predict the behavior of drifting bodies due to tsunami.
To reduce the damage of structures caused by tsunamis, it is essential to know the characteristics of tsunami load. In the present study, a three dimensional hydraulic experiment was performed to investigate the spatio-temporal variation of the tsunami wave pressure acting on a land structure. The followings were found out.(1) Wave pressure can be regarded as the sum of the average component and the random component of pressure.(2) The spatial distribution of wave pressure for 3-D experiment case is similar to that of 2D case.(3)Wave pressure distribution depends on not only run-up depth but also water surface steepness. (4)Random component of tsunami wave pressure is impulsive.
Through the rapid progress of computer technology, direct wave simulation techniques using CFD (Computational Fluid Dynamics) have been applied to practical problems in coastal, port and harbor engineering. A numerical wave flume, which is one of the representative direct simulation techniques, has been expected to substitute for hydraulic model tests.In this paper, wave transformation of bore on a reef, sand spit and lagoon is computed by the numerical wave flume. The applicability of numerical wave flume is examined through comparisons of numerical results with experimental ones.
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