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"Questo volume di ecocardiografia si propone di trattare il tema della valvola mitrale nei suoi aspetti normali e patologici, aggiornandone la trattazione in base ai più recenti sviluppi della tecnologia. L’approccio interdisciplinare nella diagnosi e nella scelta dei trattamenti ha caratterizzato il taglio medico-divulgativo dell’opera e il linguaggio chiaro e conciso del testo, rivolto anche ai cardiologi clinici e non ai soli ecocardiografisti. Ampio spazio è dedicato quindi all’eziologia e alla fisiopatologia della valvulopatia mitralica."

"PURPOSE: To evaluate and compare the clinical outcomes and hospital costs of using sutureless aortic valves vs conventional stented aortic valves.METHODS: Between 2007 and 2011, 52 elderly patients undergoing aortic valve replacement for aortic stenosis in our center had a sutureless valve inserted. From among 180 patients who had a stented valve inserted during the same period, 52 patients were matched to the sutureless group, based on age, gender, and operation type. We compared clinical outcomes and hospital costs between the two groups.RESULTS: The sutureless group had a higher Euroscore (logistic Euroscore I) risk (12,8 vs 9,7; p = 0,02), with significantly shorter aortic cross-clamp (ACC) time (p<0,01), cardiopulmonary bypass (CPB) time (p<0,01), intensive care unit stay (p<0,01), intubation time (p<0,01), and overall hospital stay (p=0.05). The sutureless group also revealed a significant hospital cost saving of approximately 8200 (p=0,01).CONCLUSIONS: The clinical and hemodynamic outcomes of using the sutureless bioprosthesis were excellent. The reduced ACC and CPB times had a favorable effect on the duration of intubation and intensive care stay, resulting not only in faster recovery and discharge home, but also in a significant hospital cost reduction."

"Background. Spontaneous Echo Contrast (SEC) appears as a curling motion of echo in real lime and this indicates Wood stasis, ft is therefore predictive for thrombus formation and higher risk for thrombocmbolic phenomenon. Accumulating evidence showed higher incidence of (hrombus formation in mitral stenosis (MS) patients if they presented with positive SEC. Detection of left atrial thrombus is even more important before mitral valvuloplasty procedure to prevent .systemic and especially cerebral embolism. The aim of this study was to compare the utility of transthoracal eehocardiography (TIE) to transesophageal cchocardiography (TEE) in detecting SEC and thrombus in patients with MS.Method. Forty-eight patients with MS were studied with TEE and TTE. The diagnosis of MS was established by TTE.Result. With TTE, 15 patients (31,3%) had positive SEC, 33 patients (68, 7%) had negative SEC and 6 patients (12,5%) of the SEC positive patienls had thrombus in LA. On the other hand with TEE, SEC were positive in 36 (75%) patients, negative in 12 (25%) patients and 17 (35,4%) of the SEC positive patients showed LA thrombus. This study confirmed the strong association between SEC and thrombus formation, as thrombus was only observed in SEC positive patients.Conclusion. TEE is superior to TTB in detecting SEC and LA thrombus in patients with MS, because of the belter acoustic window of TEE. TEE should be considered in every patients with MS where thrombus formation has to be ruled out, particularly before baloon mitral valvuloplasly procedure."

"Dalam industri pengolahan minyak dan gas bumi, istilah relief valve berkaitan erat dengan istilah pressure relief valve (PRV), pressure safety valve (PSV) dan safety valve. Relief valve merupakan jenis valve yang digunakan untuk mengontrol atau membatasi tekanan dalam suatu sistem. Tujuan utama dari relief valve adalah untuk menjamin personal dan peralatan operasi terlindungi dari kondisi tekanan berlebih (overpressure). Relief valve didesain untuk mencegah terjadinya kecelakaan dengan cara melepas tekanan berlebih yang terjadi selama gangguan proses, kegagalan sistem, dan kebakaran. Perhitungan yang akurat terhadap kapasitas relief valve merupakan salah satu faktor kunci dalam keselamatan kilang. Penentuan kapasitas dan jenis relief valve membutuhkan analisis proses yang mendalam dari sistem yang akan diproteksi. Tujuan dari studi ini adalah menentukan kapasitas dan jenis relief valve berdasarkan analisis proses dengan menggunakan alat bantu simulasi proses dan pemrograman visual basic. Komposisi dan kondisi operasi gas dari salah satu lapangan gas Pertamina Jambi digunakan sebagai studi kasus. Selanjutnya dilakukan analisis proses untuk mengetahui penyebab terjadinya overpressure. Simulasi proses digunakan untuk membuat Process Flow Diagram (PFD) dan menghasilkan neraca massa dan panas sedangkan pemrograman visual basic digunakan untuk menghitung kapasitas relief valve.

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In the oil and natural gas processing, the term relief valve is associated with the terms pressure relief valve (PRV), pressure safety valve (PSV) and safety valve. A relief valve is a type of valve used to control or limit the pressure in a system. The primary purpose of the pressure relief system is to ensure that the operation?s personnel and equipment are protected from overpressure conditions. It is designed to avoid accidents by relieving overpressure that happen during process upsets, power failures, and external fires. Accurately calculation for the relief valve capacity is key factor of plant safety. It requires deeply process analysis of system will be protected. The purpose of this study is to determine the relief valve capacity and type base on process analysis using process simulation dan visual basic programming. The gas composition and operating condition from Pertamina Jambi gas field is used as a case study. Then, process analysis is performed to know cause of overpressure. Process simulation is used to create Process Flow Diagram (PFD) and generate heat and material balance while visual basic programming is used to calculate the relief valve capacity."

"ABSTRAK Latar Belakang. Penyakit jantung katup masih banyak ditemui di Indonesia, akan tetapi karena keterbatasan fasilitas kesehatan, banyak pasien yang terlambat mendapatkan intervensi. Keterlambatan intervensi akan mengakibatkan peningkatan morbiditas dan mortalitas. Beberapa studi besar seperti EuroSCORE dan STS telah mengembangkan model prediksi mortalitas pasca pembedahan katup jantung, akan tetapi sedikit sekali studi terkait yang dilakukan di Indonesia, padahal terdapat perbedaan karakteristik pasien. Studi ini bertujuan mengidentifikasi faktor-faktor yang dapat menjadi prediktor kejadian mortalitas di rumah sakit pada pasien yang menjalani pembedahan katup jantung.Metode. Studi kohort retrospektif dilakukan di Pusat Jantung Nasional Harapan Kita, Jakarta pada pasien yang menjalani pembedahan katup jantung.Karakteristik demografi, parameter klinis, data laboratorium, ekokardiografi dan teknis operasi merupakan kategori dari variabel yang dikumpulkan melalui rekam medis dan sistem informasi rumah sakit. Data kemudian diolah dengan analisis multivariat menggunakan metode regresi logistik.Hasil. Sebanyak 305 sampel berhasil dikumpulkan, dengan 24 diantaranya mengalami kematian (7.9%). Variabel yang berkaitan dengan mortalitas adalah kelas fungsional, riwayat diabetes, endokarditis aktif, riwayat operasi jantung sebelumnya, kadar hemoglobin, TAPSE dan durasi CPB dan jenis operasi. Uji diskriminasi dan kalibrasi dari model menunjukkan hasil yang baik.Kesimpulan. Beberapa variabel telah diidentifikasi merupakan prediktor mortalitas pasca operasi katup jantung. Informasi ini diharapkan dapat membantu menentukan strategi tatalaksana selama intervensi dan perawatan

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ABSTRAK Background. Valvular heart disease still become one of the leading heart disease in Indonesia. Unfortunately, because of very limited cardiac centres, many patients diagnosed late. Delay in intervention would increase the morbidity andmortality rate if intervention ultimately performed. Several surgical mortality prediction models such as EuroSCORE and STS had been developed. However, until now, there is no specific mortality risk assessment in our population, despite very different in patients characteristics. Aim of this study is to identify risk factors to predict in-hospital mortality in patient underwent heart valve surgery Methods. A retrospective cohort study, done in National Cardiovascular Center Harapan Kita, Jakarta in patients underwent heart valve surgery. Categories for data obtained was basic characteristics, clinical examinations, echocardiography and operation procedure. Statistical analysis was done using multivariat analysis using logistic regression method.Result. 305 subjects fit the inclusion and exclusion criteria. Mortality event occured in 24 patients (7.9%). The variables are functional class III or IV, diabetes, active endocarditis, previous open heart surgery, hemoglobin level, TAPSE, CPB time and type of operation. Calibration and discrimination test of prediction model shows good result.Conclusion. Several variables has been identified as predictor of in-hospital mortality after heart valve surgery. These information are expected to be helpful in deciding intervention and treatment strategies."

"Sistem keran biasanya digerakkan secara manual oleh manusia dengan cara memutar atau menggerakkan keran ke atas atau ke bawah. Namun sistem keran secara manual ini memiliki kelemahannya yaitu keran yang mudah rusak dan pemborosan air dikarenakan kelalaian menutup keran. Dengan memanfaatkan sensor Passive Infrared (PIR) dan Ultrasonik sebagai pendeteksi objek berupa anggota tubuh manusia dan mengirimkan sinyal tersebut ke Mikrokontroler ATMEGA8535 sebagai pusat pengendalinya. Mikrokontroler ini akan mengirimkan instruksi untuk menggerakkan solenoid valve yang berfungsi sebagai katup aliran air. Hasil penelitian menunjukkan bahwa sensor PIR ini dapat mendeteksi objek dalam jarak maksimum 3 meter dan sensor Ultrasonik mendeteksi jarak sampai 4 meter. Ketika sensor PIR menerima radiasi panas dari objek, maka solenoide valve membuka katu untuk mengalirkan air. Begitu juga dengan Ultrasonik Ketika sensor Ultrasonik menerima pantulan bunyi dari objek didepannya dalam jarak tertentu maka solenoide valve membuka katup untuk mengalirkan air. Di samping itu dibutuhkan debit air tertentu untuk dapat mengaktifkan solenoide valve

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Water valve usually manual controlled by human with spin up or spin down but water valve manual system have negative side which this water valve easily destroyed and close the water valve. From that use passive infrared sensor ( PIR ) and Ultrasonic sensor as object detector in human organ and transimite that signal to microcontroller ATMEGA35 as central controller. This Microcontroller will transmit some instruction to spin the solenoid valve which used to water controler. Based on observasion this Passive Infrared sensor can detection motion with the maximum distance 3 meter and ultrasonic sensor detection until 4 meter. When PIR sensor receive calor radiation from object that solenoid valve will be open. Same with solenoid valve the ultrasonic sensor receive signal from in front the sensor. Beside that needed water debit to can make solenoid valve active condition"

"Telah dibuat alat yang dapat mengisi dan mengepres gelas plastik secara otomatis berbasis mikrokontroller. Menggunakan ATmega 16 yang mana programnya dapat diubah sesuai dengan keinginan. Disini proses pengisian air, pengemasan dan pengambilan hasil produksi dengan adanya pendorong keatasmengunakan motor semuanya dikontrol oleh mikrokontroller

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Has created a tool that can fill a plastic cup and pressing automatically based microcontroller. Using the program ATmega 16 which can be modified in

accordance with the desire. Here the process of water filling, packaging and making products with the driver of the motor uses up all controlled by the microcontroller"

"ABSTRAKPada penelitian ini dilakukan analisa terhadap tiga alternatif Unit Proses untuk Menurunkan Titik Embun Gas yaitu JT Valve, refrigerasi dan Turbo Ekspander agar didapatkan unit proses yang paling laik untuk diaplikasikan pada Lapangan XYZ di PT. X.Analisa yang pertama adalah analisa secara teknis menggunakan perangkat lunak Unisim R390.1 dengan parameter teknis adalah suhu gas keluaran Unit Proses untuk Menurunkan Titik Embun Gas sama dengan 60 oF. Hasil dari analisa teknis ini adalah ketiga alternatif proses tersebut laik secara teknis.Analisa selanjutnya adalah analisa keekonomian menggunakan metode levelized cost dengan parameter keekonomian adalah NPV > 0 dan IRR > 10 . Dari ketiga alternatif proses, hanya alternatif proses 2 sistem refrigerasi yang laik secara ekonomi. Alternatif proses 2 memiliki nilai NPV = 2,9 juta US dan IRR = 52 . Kata kunci: JT Valve; Sistem Refrigerasi; Turbo Ekspander; Unit Proses Untuk Menurunkan Titik Embun Gas

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ABSTRACTthis study, there is an analysis of three DPCU process alternatives i.e. JT Valve, refrigeration and Turbo Expander to obtain the most feasible process unit to be applied in XYZ Field at PT. X.The first analysis is technical analysis using Unisim R390.1 software with technical parameter is the output gas temperature of the DPCU equal to 60 0F. The result of this technical analysis is that the three process alternatives are technically feasible.The next analysis is economic analysis using the levelized cost method with economic parameters are NPV 0 and IRR 10 . From the three process alternatives, only process alternative 2 is economically feasible. Process alternative 2 has a value of NPV 2.9 million US and IRR 52 . Keywords DPCU JT Valve Refigeration System Turbo Expander"

"ABSTRACTInfective endocarditis (IE) is associated with high mortality and morbidity and requires surgical intervention in about half of all patients. Mitral valve repair (MVrep) is reported to achieve better results than mitral valve replacement because the insertion of a prosthesis during active infection is avoided. However, MVrep in active IE is complicated and no definitive guidelines have been compiled. The current study reviews the literature from 2000 to 2016 and summarizes the surgical details of MVrep for IE."

"Regulator yang kita gunakan untuk tabung gas LPG adalah regulator tekanan rendah yang beroperasi pada tekanan masuk 7 bar dan tekanan keluar maksimal 41 mbar. Diluar tekanan tersebut akan terjadi lock up atau menutupnya katup secara otomatis apabila tekanan sudah melebihi tekanan desain. Regulator tabung LPG merupakan sebuah katup kontrol (safety valve) dengan tipe diafragma. Regulator akan mengatur tekanan yang keluar dari regulator hingga mencapai tekanan atmosfir. aliran LPG yang mengalir dari tabung adalah aliran dua fase yaitu cair dan gas. LPG merupakan campuran dari berbagai unsur Hidrokarbon yang berasal dari penyulingan Minyak Mentah dan masih berbentuk Gas. Dengan menambah tekanan dan menurunkan suhunya, gas berubah menjadi cair, sehingga dapat disebut sebagai Bahan Bakar Gas Cair. Dalam penelitian ini akan dilihat bagaimana kestabilan regulator terhadap perubahan kecepatan aliran LPG. Perubahan kecepatan aliran gas sangat mempengaruhi besarnya tekanan yang keluar dan masuk regulator. hal ini diakibatkan adanya hukum kesetimbangan energi.. Tekanan dari energi statik dirubah menjadi energi kinetik berupa kecepatan. Perubahan kecepatan aliran gas ini dalam kehidupan sehari-hari terjadi saat kita memutar knop pada kompor gas untuk memperbesar atau mengecilkan api. Hasil dari penelitian ini akan dibandingkan dengan data dari Standar nasional Indonesia (SNI) sehingga dapat dilihat bagaimana kinerja dari regulator yang kita gunakan.

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Regulators that we use for LPG gas cylinders are low pressure regulator that operates at inlet pressure for 7 bar and outlet maximum pressure of 41 mbar. When the pressure reach outside that range, lock up will occur. Lock up is the condition when the valve shut automatically if the pressure exceeds the design pressure. Regulator of LPG cylinders is a safety valve with a diaphragm type. Regulator will regulate the pressure that comes out of the regulator until it reaches atmospheric pressure. LPG stream that flows from the cylinders is a two-phase flow of liquid and gas. LPG gas is a mixture of various elements Hydrocarbon derived from refining crude oil and still shaped oil. By increasing pressure and decreasing temperature, the gas turns into liquid, so it can be referred to as Liquid Fuel Gas.. Two-phase flow has a more complex aspects as compared with singlephase flow. There are two types of fluid moving at different speeds in a single stream.

In this study will be seen how the stability of the regulator to the LPG flow rate changes. Changes in gas flow rate greatly affects the magnitude of the outgoing and incoming pressure of regulator. This caused by the equilibrium law of energy, where energy cannot be created or destroyed and only be converted into other forms. The pressure of the static energy is converted into kinetic energy in the form of speed. The results of this study will be compared with data from the National Standards of Indonesia (SNI) to be seen how the performance of the regulator that we use every day."