The Things They Piled

No. 40 Embolization of the Superior and Middle Rectal Arteries for the Treatment of Symptomatic Hemorrhoidal Disease using the Combination of Metallic Coils and Microspheres

Formation of a soil plug in an open-ended pile is a very important factor in determining the pile behavior both during driving and during static loading. The degree of soil plugging can be represented by the incremental filling ratio (IFR) which is defined as the change in the plug length to the change of the pile embedment length. The experimental tests carried out in this research contain 138 tests that are divided as follows: 36 tests for single pile, 36 tests for pile group (2x1), 36 tests for pile group (2x2) and 30 pile group (2x3). All tubular piles were tested using the poorly graded sand from the city of Karbala in Iraq. The sand was prepared at three different densities using a raining technique. Different parameters are considered such as method of installation, relative density, removal of soil plug with respect to length of plug and pile length to diameter ratio. The soil plug is removed using a new device which is manufactured to remove the soil column inside open pipe piles group installed using driving and pressing device. The principle of soil plug removal depends on suction of sand inside the pile. It was concluded that the incremental filling ratio (IFR) is changed with the changing of soil state and method of installation. For driven pipe pile group, the average IFR for piles in loose is 18% and 19.5% for L/D=12 and 15, respectively, while the average of IFR for driven piles in dense sand is 30% and 20% for L/D=12 and L/D=15 respectively. For pressed method of pile installation, the average IFR for group is zero for loose and medium sand and about 5% for dense sand. The group capacity increases with the increase of IFR. For driven pile with length of 450 mm, the average IFR % is about 30.3% in dense sand, 14% in medium and 18.3% for loose sand while when the length of pile is 300 mm, the percentage equals to 20%, 17% and 19.5%, respectively.

For the current methods can not consider the stress dispersion of pile end soil,a calculation method was presented for the settlement calculation of single pile embedded in layered soils by assuming pile end soil to be virtual soil pile which took into account the stress dispersion of pile end soil.In the elastic state,by using bilinear load transfer model to simulate the surrounding soil and using the virtual soil pile model which took into account the stress dispersion to simulate the pile end soil,a set of analytical equations for the settlement of single pile embedded in layered soils considering stress dispersion of pile end soil were obtained by virtue of the load transfer method.The effects of elastic limit displacement,elastic shear stiffness coefficient,length of virtual soil pile and cone angle on the settlement of single pile were analyzed.Comparisons of the calculation results of this method with those of the normative method and the measured data showed that the pile top settlement calculated by this presented method was approximate to the measured value,and also superior to the normative method.

This article presents the methods developed to test piles located in buildings under operation. The first testing method allows preserving the stress-strain state of the soil containing a pile, which has been formed during the operation of a building, thus increasing the reliability of the pile load testing. It is achieved by making two notches at opposite corners of the pile shaft, a hydraulic jack is installed in each notch, the reinforcement in two other corners of the pile shaft is cut, and the pile is separated from the pile cap by the tension of the remaining part of the pile shaft at the start of static loading. During the test, the bearing capacity of the pile, which was tested using the proposed method, was from 5 % to 7,1 % greater than the one of the piles tested according to GOST 5686-2012. The second testing method takes into account the influence of the adjacent piles on the tested one. It is achieved by installing deformation measuring devices (extensometers) on the tested and adjacent piles before separating the pile from the cap, which makes it possible to measure the changes of the strain state of the pile shaft during the test, as well as to determine the influence of the adjacent piles on the tested one. Also, the tests determine the actual load influencing the tested foundation pile, which is obligatory, when it comes to developing an engineering design of a reconstruction project. The proposed methods of the static load testing in operated buildings can be used for investigations prior to reconstruction and technical upgrades of operated buildings.

In offshore engineering, lateral cyclic loading may induce excessive lateral movement and bending strain in pile foundations. Previous studies mainly focused on deformation mechanisms of single piles due to lateral cyclic loading. In this paper, centrifuge model tests were conducted to investigate the response of a 2x2 pile group due to lateral cyclic loading in clay. After applying each loading-unloading cycle, the pile group cannot move back to its original location. It implies that residual movement and bending strain are induced in the pile group. This is because cyclic loading induces plastic deformation in the soil surrounding the piles. As the cyclic load increases from 62.5 to 375 kN, the ratio of the residual to the maximum pile head movements varies from 0.30 to 0.84. Moreover, the ratio of the residual to the maximum bending strains induced in the piles is in a range of 0.23 to 0.82. The bending strain induced in the front pile is up to 3.2 times as large as that in the rear pile. Thus, much more protection measures should be applied to the front piles to ensure the serviceability and safety of pile foundations.

Pile group are vastly used in marine structures for several applications. Loadings exerted to these structures are divided into two main categories: lateral loading and vertical loading. All researchers agree to use vertical piles in the case of pure vertical loading where as the use of batter piles in the case of lateral loading is still in doubt. The behavior of batter piles in a pile group is somehow two-faced. Although batter piles reduce the lateral displacement of the pile group under lateral loading but they also cause stress concentration in batter pile and pile head. Thereby complete understanding of batter and vertical piles is of great importance. In our research, different pile group configurations are analyzed numerically that based on the finite difference method. Soil is modeled as a mohr-coulomb continuous medium obeying model and piles and pile head are assumed to be elastic concrete. To validate the simulation, results from numerical modeling are compared to those from available experimental data and analytical solution.

Experiences of patients with haemorrhoidal disease – a qualitative study

In this paper, Pile-Soil interaction is modeled in SAP2000, a finite element based program. The modeling technique developed for pile-soil interaction gives spring load-deformation curve for soil surrounding the pile and hence captures the response of the soil to movement of pile relative to surrounding soil (t-z curve), as experimental technique of instrumenting the pile along the length of pile for the same purpose would have been very costly. The pile-soil system modeled in SAP2000 requires the available load settlement data from pile load test not instrumented along pile length during load testing and establishes an average bi-linear spring load deformation curve. Once the spring load deformation curve is established, the site-specific t-z curve can be obtained, the curve can then be used for the same site to carry out the parametric study i.e. to predict the effect of different length and/or diameter of the pile on the load settlement curve of pile. in addition, the load settlement curve for other sites can be generated if the soil profile does not vary remarkably from that soil profile from which the spring load deformation curve is developed. This technique is applied to load settlement data of three pile load tests conducted in various localities of NWFP. The site-specific spring load-deformation curves are generated and transformed into t-z curves.

Objective To analyze the complications after procedure for prolapse and hemorrhoids (PPH) in treating severe mucocutaneous hemorrhoids.Methods The clinical data of 550 patients with severe mucocutaneous hemorrhoids who were admitted to the Hangzhou Hospital of Nanjing Medical University from January 2005 to December 2013 were retrospectively analyzed.All the patients were treated by PPH or PPH + external hemorrhoids resection.The postoperative complications were recorded and assessed.Patients were followed up via outpatient examination and telephone interview till June 2014.Results Operation was successfully carried out on all the 550 patients.The operation time and duration of hospital stay were (15 ± 10)minutes and (4.2 ± 1.8)days,respectively.A total of 445 patients were followed up for 6-60 months,with the median time of 28 months.The overall incidence of complications was 14.61％ (65/445).Forty-five patients were complicated with anal pain,12 with hemorrhoid recurrence,7 with bleeding,5 with dysporia,4 with anastomotic stenosis and 2 with rectal and perianal infection.Of the 12 patients with hemorrhoids recurrence,5 was alleviated by medication and 7 received PPH for the second time.Of the 4 patients with anastomotic stricture,the condition of 2 patients were alleviated by anus dilatation,and the condition of 1 patient was alleviated by balloon dilatation under enteroscope,1 patient received circular incision of the stricture because of severe stricture and failed of conservative treatment.Of the 2 patients with rectal and perianal infection,1 was alleviated by intravenous and local medication,and the other patient who was complicated with anal fistula was alleviated by surgery.The condition of other patients was improved after symptomatic treatment.Conclusions PPH is effective and safe for the treatment of severe mucocutaneous hemorrhoids.The main complication is anal pain,and it could be cured or alleviated by symptomatic treatment. Key words: Severe mucocutaneous hemorrhoids; Procedure for Prolapsed Hemorrhoids; Complications

Objective To analyze the application effect of glass fiber pile and cast metal pile in tooth defect repair and its influence on periodontal tissue. Methods From February 2014 to February 2015, 112 patients with dental defect in the Central Hospital of Yiwu were randomly divided into the control group and the research group according to the digital table, with 56 cases in each group.The control group received the casting metal pile repair, the research group was repaired with glass fiber piles.The remediation effect, periodontal tissue status, inflammatory response and adverse reaction were compared between the two groups. Results The success rate of the research group was significantly higher than that of the control group(89.29% vs.66.07%), and there was statistically significant difference(χ2=8.70, P 0.05). Conclusion The effect of glass fiber pile in tooth defect repair is better than cast metal pile, and its stability and biocompatibility are better, and it is a simple operation, which is worthy of clinical promotion. Key words: Dental prosthesis repair; Glass fiber pile; Cast metal pile; Application effect; Periodontal tissue

Objective To compare the clinical outcome of procedure for prolapse and hemorrhoids (PPH) and PPH + selective Milligan-Morgan hemorrhoidectomy(MMH) in surgical treatment of Ⅲ ～ Ⅳ stage hemorrhoids and research the best surgical procedures.Methods Retrospective analysis was made on the clinical data of 125 cases with Ⅲ ～ Ⅳ stage mixed hemorrhoids,they were non-randomized-controlled divided into PPH group (group 1) and PPH + selective MMH group(group 2),comparing the data of recurrence,complication and symptoms relief including anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.Results While observing 3 years after operation,group 1 and group 2 both relieved symptoms of anal prolapse,bleeding,anus fall feeling,wet anus and pruritus ani.The relief rate of these symptoms in the two group were all high than 92%.There was one cases relapsed in the group 2 (the recurrence rate of 2%) was better than the group 1 (the recurrence rate of 13%) which were 8 case,there was a significant statistical significance (x2 =4.629,P ＜ 0.05) in the recurrence and clinical outcome.Conclusion Radical choose of PPH and selective MMH to treat Ⅲ ～ Ⅳ stage mixed hemorrhoids patients,which could relieve postoperative symptoms and acquire better long-term clinic outcomes. Key words: Hemorrhoids; Circumferential mixed hemorrhoids; Procedure for Prolapse and hemorrhoids; Milligan-Morgan hemorrhoidectomy

Objective To demonstrate the feasibility, effectiveness and reliability of combination of procedure for prolapse and hemorrhoids (PPH) and excision-closed hemorrhoidectomy (ECH) for severe hemorrhoids. Methods Sixty patients with Ⅲ- Ⅳ degree hemorrhoids which left remnant prolapsed hemorrhoids after stapled hemorrhoidopexy, were randomly divided into group A (PPH with additional ECH group,30 cases.) and group B [PPH with additional Milligan-Morgan hemorrhoidectomy (MMH) group, 30 cases]. Ten indexes of the results in two groups were compared. Results The hemorrhoidectomy lasted (35.6 ± 5.3) min in group A and (47.3 ± 10.2) min in group B. The indexes related to 24 h visual analogue scale (VAS) after operation were (2.9 ± 1.2) scores in group A and (5.7 ± 1.9) scores in group B. Wound healing time were (6.3 ± 1.4) d in group A and (28.5 ± 4.8) d in group B. Many indexes showed the results in group A was better than those in group B ( P ＜ 0.05 ). The six-month follow-up visits after operation showed no complications, such as recurrence in either group. Conclusions Combination treatment for Ⅲ -Ⅳ degree hemorrhoids with PPH with additional ECH is a easy,safe,reliable,minimal-aching and quick-recovering method of hemorrhoidectomy with favorable results than PPH with additional MMH. Key words: Hemorrhoids; Procedure for prolapse and hemorrhoids; Excision-closed hemorrhoidectomy; Milligan-Morgan hemorrhoidectomy

In-place analysis for offshore platforms is essentially required to make proper design for new structures and true assessment for existing structures, in addition to the structural integrity of platforms components under the maximum and minimum operating loads when subjected to the environmental conditions. In-place analysis have been executed to check that the structural member with all appurtenance&#180s robustness have the capability to support the applied loads in either storm or operating conditions. A nonlinear finite element analysis is adopted for the platform structure above the seabed and pile-soil interaction to estimate the in-place behavior of a typical fixed offshore platform. The SACS software is utilized to calculate the dynamic characteristics of the platform model and the response of platform joints then the stresses at selected members, as well as their nodal displacements. The directions of environmental loads and water depth variations have significant effects in the results of the in-place analysis behavior. The most of bending moment responses of the piles are in the first fourth of pile penetration depth from pile head level. The axial deformations of piles in all load combinations cases of all piles are inversely proportional with penetration depth. The largest values of axial soil reaction are shown at the pile tips levels (the maximum penetration level). The most of lateral soil reactions resultant are in the first third of pile penetration depth from pile head level and approximately vanished after that penetration. The influence of the soil-structure interaction on the response of the jacket foundation predicts that the flexible foundation model is necessary to estimate the force responses demands of the offshore platform with a piled jacket-support structure well.

Brillouin Optical Frequency Domain Analysis (BOFDA) is a distributed fiber optic sensing (DFOS) technique that has unique advantages for performance monitoring of piles. However, the complicated production process and harsh operating environment of offshore PHC pipe piles make it difficult to apply this method to pile load testing. In this study, sensing cables were successfully pre-installed into an offshore PHC pipe pile directly for the first time and the BOFDA technique was used for in-situ monitoring of the pile under axial load. High-resolution strain and internal force distributions along the pile were obtained by the BOFDA sensing system. A finite element analysis incorporating the Degradation and Hardening Hyperbolic Model (DHHM) was carried out to evaluate and predict the performance of the pile, which provides an improved insight into the offshore pile-soil interaction mechanism.

PurposeIn this study, we describe current practices in the management of hemorrhoidal disease in the Netherlands.MethodsA validated online survey was performed among Dutch surgeons and residents treating hemorrhoidal disease. Contact details were retrieved from the Dutch Association for Surgery resulting in 619 contacts. Only doctors who were treating hemorrhoidal disease regularly were asked to complete the questionnaire. The following items were assessed: initial treatment, recurrence, complications, and follow-up.ResultsIn total, 133 respondents completed the survey. Ninety percent of the respondents started with rubber band ligation (RBL) as the first treatment in low-grade hemorrhoidal disease. In case of recurrence, 64% of the respondents repeated RBL three times before switching to a more invasive treatment modality. In grade III hemorrhoidal disease, the respondents preferred more invasive techniques: a sutured hemorrhoidopexy was performed in 24%, Doppler-guided hemorrhoidal artery ligation (DG-HAL) in 9%, stapled hemorrhoidopexy in 19%, and the traditional hemorrhoidectomy in 31% of the patients, respectively. The majority of the respondents (39%) reported a mild complication in 5–10% of the patients. The most reported complication was pain. Nearly all the respondents (98%) reported a major complication in less than 5% of the patients. The majority of the patients (57%) were seen in outpatient clinics 6 weeks post-treatment.ConclusionThis Dutch survey showed areas of common practice for primary treatment of hemorrhoidal disease. However, it also demonstrated varying practices regarding recurrent hemorrhoidal disease. Practical guidelines are required to support colorectal surgeons in the Netherlands.