Acute hepatitis A (AHA) is one of the most common infectious diseases; it is usually a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, some cases have been reported associated with acute renal failure. We reviewed the clinical features of patients with AHA complicated by acute renal failure (ARF group) and compared them with patients with noncomplicated AHA (non-ARF group). The medical records of 208 consecutive patients with AHA who were diagnosed between January 2003 and October 2008 were reviewed. We identified 15 patients (7.2%) with ARF associated with AHA. There were no differences between the ARF and non-ARF group with regard to gender and age. The peak value of alanine aminotransferase (ALT) (median: 6060 IU/L vs 1792 IU/L, P < 0.001), prothrombin time (PT) (International normalized ratio, median 1.72 vs 1.10, P < 0.001), and total bilirubin level (median: 9.6 mg/dL vs 6.3 mg/dL, P = 0.04) were significantly higher in the ARF than in the non-ARF group. Twelve patients (80%) recovered completely with haemodialysis (seven patients, 46.7%) or only conservative management (five patients, 33.3%), while one patient underwent liver transplantation because of fulminant hepatic failure, and two patients died because of fulminant hepatic failure. There were no deaths among patients with noncomplicated AHA in the non-ARF group. Five patients underwent kidney biopsy; two patients were diagnosed with acute tubular necrosis, two patients with acute interstitial nephritis with IgA nephropathy and one patient with acute tubulointerstitial nephritis. All patients in the ARF group had microscopic haematuria and proteinuria (100%vs 31.1%, P < 0.001). Urine sodium levels were more than 10 mEq/L in 10 patients. The findings of high urinary sodium concentrations, microscopic haematuria and proteinuria did not support the diagnosis of hepatorenal syndrome (HRS). Patients with AHA with ARF had higher ALT levels, more prolonged PTs, and higher total bilirubin levels. The prognosis for these patients was poorer than for those without ARF. However, the patients with ARF and nonfulminant AHA had recovered with proper treatment and should not be confused with patients that have HRS.
One primary issue in pulse electrochemical micromachining is using pulses of electrical current to control precise machining resolution as well as the uniform electrolyte flow inside inter electrode gap between two electrodes. Periodical replacement of electrolyte flush away generated heat and gas bubbles which interrupt stable electrochemical reaction with uniform ionic charging in electrolyte. Though PECM require precise control of electrical parameters, such as pulse time, duty factor, applied current/voltage and total machining time, quantitative analysis of these parameter, especially pulse time, has not been introduced. This paper demonstrates rough prediction process of pulse time and machining resolution by analyzing high resolution pulse signals acquired from PECM operation. Additionally this research suggests vibration electrochemical polishing (VECP) assisted by ultrasonic vibration for enhancing electrochemical reaction and surface quality compared to the conventional ECP. The localized roughness of work material is measured by atomic force microscopy (AFM) for detailed information on surface. Besides roughness, overall surface quality and productivity etc. are compared with conventional EC
In recent years, interest is growing about stereoscopic to the dissemination and development of 3D-TV. However, according to the development of image is also very important to the development of real sound. So recently interest is growing about the stereo sound. It is limited to typical speakers for implementing to stereo speakers. So, recently, has improved sound using flat panel sound. In this study, analyzed apparatus and selected optimum points through the design and CAE (Computer aided engineering) for production of selective tension apparatus of vibration membrane for the flat panel type speaker production. Many tension points offer variety sound environments but it action adverse element in mass production. In this study analyzed through the CAE by designing in tension point location and tension frame for stereo speaker production. CAE was analyzed the optimized conditions using ansys program. The results variously changed parts of affected tension by tension point location or according to the quantity clamped. We selected to optimized tension point and tension frame based on the simulation results. This study is intended to suitable for mass production in the stereo speaker production.
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