ABSTRACT
In this study, the grinding kinetics and the flowability of balloon flowers (BFs) with various moisture contents (8, 12, and 20%) were determined. Three semi-empirical grinding models (Bond, Kick, and Rittinger) were applied to describe the BFs' grinding process. A lower moisture content resulted in a decreased grinding constant value (Bond's index). Based on the kinetics of particles during grinding, a sigmoid model was developed which successfully described changes in the particle sizes of BFs with various moisture contents during the grinding process except for smaller ones (< 0.60 mm) with a high moisture content (20%). The flow function at different particle sizes was not consistently correlated with results regarding the internal friction angle. This might be due to different particle shapes and sizes of BFs. The poorest flowability was observed for BF powder with the smallest particle size.
ABSTRACT
Warfarin skin necrosis (WSN) is an infrequent complication of warfarin treatment and is characterized by painful ulcerative skin lesions that appear a few days after the start of warfarin treatment. Calciphylaxis also appears as painful skin lesions caused by tissue injury resulting from localized ischemia caused by calcification of small- to medium-sized vessels in patients with end-stage renal disease. We report on a patient who presented with painful skin ulcers on the lower extremities after the administration of warfarin after a valve operation. Calciphylaxis was considered first because of the host factors; eventually, the skin lesions were diagnosed as WSN by biopsy. The skin lesions improved after warfarin discontinuation and short-term steroid therapy. Most patients with end-stage renal disease have some form of cardiovascular disease and some require temporary or continual warfarin treatment. It is important to differentiate between WSN and calciphylaxis in patients with painful skin lesions.
ABSTRACT
Recently, extracorporeal membrane oxygenation (ECMO) support has been increasingly applied in acute respiratory failure. The ECMO brings some advantages for enhancing the capacity of lung regeneration. Thus, the timing of determining irreversibility of the injured lung could be delayed. In this study, we experienced a case of prolonged maintenance of veno-venous ECMO for 104 days that resulted in native lung recovery. In this case, the initial empirical treatment showed no response within 4 weeks with ECMO support but the patient did not want a lung transplantation. With prolonged maintenance of the ECMO, related ethical issues arose, such as how long should the applied ECMO be maintained. Hence, there was a discussion that was centered on the timing of determining futility and ethical issues, while applying the ECMO in acute respiratory failure.
