Mechanical Expansion of Steel Tubing as a Solution to Leaky Wellbores

Wellbore cement, a procedural component of wellbore completion operations, primarily provides zonal isolation and mechanical support of the metal pipe (casing), and protects metal components from corrosive fluids. These are essential for uncompromised wellbore integrity. Cements can undergo multiple forms of failure, such as debonding at the cement/rock and cement/metal interfaces, fracturing, and defects within the cement matrix. Failures and defects within the cement will ultimately lead to fluid migration, resulting in inter-zonal fluid migration and premature well abandonment. Currently, there are over 1.8 million operating wells worldwide and over one third of these wells have leak related problems defined as Sustained Casing Pressure (SCP)¹. The focus of this research was to develop an experimental setup at bench-scale to explore the effect of mechanical manipulation of wellbore casing-cement composite samples as a potential technology for the remediation of gas leaks. The experimental methodology utilized in this study enabled formation of an impermeable seal at the pipe/cement interface in a simulated wellbore system. Successful nitrogen gas flow-through measurements demonstrated that an existing microannulus was sealed at laboratory experimental conditions and fluid flow prevented by mechanical manipulation of the metal/cement composite sample. Furthermore, this methodology can be applied not only for the remediation of leaky wellbores, but also in plugging and abandonment procedures as well as wellbore completions technology, and potentially preventing negative impacts of wellbores on subsurface and surface environments.     

Pelvis of Gargoyleosaurus (Dinosauria: Ankylosauria) and the Origin and Evolution of the Ankylosaur Pelvis

Discovery of a pelvis attributed to the Late Jurassic armor-plated dinosaur Gargoyleosaurus sheds new light on the origin of the peculiar non-vertical, broad, flaring pelvis of ankylosaurs. It further substantiates separation of the two ankylosaurs from the Morrison Formation of the western United States, Gargoyleosaurus and Mymoorapelta. Although horizontally oriented and lacking the medial curve of the preacetabular process seen in Mymoorapelta, the new ilium shows little of the lateral flaring seen in the pelvis of Cretaceous ankylosaurs. Comparison with the basal thyreophoran Scelidosaurus demonstrates that the ilium in ankylosaurs did not develop entirely by lateral rotation as is commonly believed. Rather, the preacetabular process rotated medially and ventrally and the postacetabular process rotated in opposition, i.e., lateral and ventrally. Thus, the dorsal surfaces of the preacetabular and postacetabular processes are not homologous. In contrast, a series of juvenile Stegosaurus ilia show that the postacetabular process rotated dorsally ontogenetically. Thus, the pelvis of the two major types of Thyreophora most likely developed independently. Examination of other ornithischians show that a non-vertical ilium had developed independently in several different lineages, including ceratopsids, pachycephalosaurs, and iguanodonts. Therefore, a separate origin for the non-vertical ilium in stegosaurs and ankylosaurs does have precedent.     

Roentgen Examination of Soft Tissues of the Pelvis

With meticulous preparation of the patient and with careful technique, the soft tissues of the pelvis are identifiable in most cases. Search should be made for the traces of abnormal pelvic structures on plain-film studies. Once the normal is recognized, any variations are easily identified. The fundamental differences between various radiologic densities—air, fat, fluid, muscle, calcium, bone and metal—should be observed. Special procedures can be used to enhance the contrasts after adequate evaluation of the simplest and, on many occasions, the invaluable, plain-film study of the soft tissues of the pelvis.     

Immunoglobulin G4-related Retroperitoneal Fibrosis of the Pelvis

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the replacement of normal tissue with fibrosis and/or inflammation. In this case, a 68-year-old man presented with RPF in the pelvis, a rare location for this disease. Biopsies were performed, which showed elevated levels of C-reactive protein, erythrocyte sedimentation rate, and, most importantly, immunoglobulin G4 (IgG4). It has been postulated that IgG4-related sclerosing disease is a systemic disease. Treatment has been successful with systemic corticosteroids.Key words: Retroperitoneal fibrosis, Serum immunoglobulin G4Retroperitoneal fibrosis (RPF) is characterized by the replacement of the normal retroperitoneal tissue with fibrosis and/or chronic nonspecific inflammation.¹ Pelvic retroperitoneal fibrosis is a rare location for the primary presentation of this disease, with only a few documented cases in the literature.² Identification of immunoglobulin G4 (IgG4) autoimmune activity among these cases has begun to improve our understanding of the inflammatory nature of this rare disease process.³ This case demonstrates the involvement of immune-mediated IgG4 within a case of pelvic retroperitoneal fibrosis.     

Soluble Isoform of the Receptor for Advanced Glycation End Products as a Biomarker for Postoperative Respiratory Failure after Cardiac Surgery

Purpose

Postoperative respiratory failure is a major problem which can prolong the stay in the intensive care unit in patients undergoing cardiac surgery. We measured the serum levels of the soluble isoform of the receptor for advanced glycation end products (sRAGE), and we studied its association with postoperative respiratory failure.

Methods

Eighty-seven patients undergoing elective cardiac surgery were enrolled in this multicenter observational study in three university hospitals. Serum biomarker levels were measured perioperatively, and clinical data were collected for 7 days postoperatively. The duration of mechanical ventilation was studied for 28 days.

Results

Serum levels of sRAGE elevated immediately after surgery (median, 1751 pg/mL; interquartile range (IQR) 1080–3034 pg/mL) compared with the level after anesthetic induction (median, 884 pg/mL; IQR, 568–1462 pg/mL). Postoperative sRAGE levels in patients undergoing off-pump coronary artery bypass grafting (median, 1193 pg/mL; IQR 737–1869 pg/mL) were significantly lower than in patients undergoing aortic surgery (median, 1883 pg/mL; IQR, 1406–4456 pg/mL; p = 0.0024) and valve surgery (median, 2302 pg/mL; IQR, 1447–3585 pg/mL; p = 0.0005), and postoperative sRAGE correlated moderately with duration of cardiopulmonary bypass (r_s = 0.44, p<0.0001). Receiver operating characteristic curve analysis demonstrated that postoperative sRAGE had a predictive performance with area under the curve of 0.81 (95% confidence interval 0.71–0.88) for postoperative respiratory failure, defined as prolonged mechanical ventilation >3 days. The optimum cutoff value for prediction of respiratory failure was 3656 pg/mL, with sensitivity and specificity of 62% and 91%, respectively.

Conclusions

Serum sRAGE levels elevated immediately after cardiac surgery, and the range of elevation was associated with the morbidity of postoperative respiratory failure. Early postoperative sRAGE levels appear to be linked to cardiopulmonary bypass, and may have predictive performance for postoperative respiratory failure; however, large-scale validation studies are needed.