Percutaneous endoscopic gastrostomy (PEG) in upper gastrointestinal tract occlusion in gynecologic oncology

BACKGROUND AND AIMS: Intestinal obstruction is a frequent cause of death in patients suffering from gynecological cancer, who have undergone multiple treatment in the form of surgery and/or chemotherapy and/or radiotherapy. The usual form of rescue treatment consists in the use of a nasogastric tube to administer support and analgesic treatment. Surgical gastrostomy is not a viable proposition in these extremely weak patients with large masses compressing and displacing the stomach. Percutaneous endoscopic gastrostomy (PEG), a technique first introduced for nutritional purposes, can be beneficially used to achieve decompression in these patients. METHODS: PEG was performed in a total of 67 patients who had already undergone multiple treatment for abdominal-pelvic neoplasia with upper gastrointestinal obstruction, who could no longer be operated and who had a life expectancy of less than sixty days. In three cases positioning was not possible owing to the lack of transillumination of the gastric and abdominal wall. 54/64 patients had previously undergone at least two operations. RESULTS: Esophagogastric lesions were found in 29% of patients, some of which were attributed to the nasogastric tube. Symptomatic wellbeing was obtained in 76.5% a few days after PEG. PEG remained in situ from 4 to 472 days. Slight peristomal infection was observed in 9% of cases. In seven cases it was necessary to add octreotide owing to the reappearance of symptoms. CONCLUSIONS: PEG is relatively easy to use and allows obstructive symptoms to be resolved in the majority of patients. Special medical skills are not required and the patient may be easily managed at home together with support therapy and pain management. Once PEG has been performed, it is possible to take fluids and semi-liquid foods, offering the patient a chance to taste flavours which have often been forgotten. PEG enables neoadjuvant chemotherapy to be performed in patients with previously untreated intestinal obstruction.     

Modeling of Diffusion in Capillary Porous Materials During the Drying Process

This paper presents a model of heterogenous diffusion in capillary porous materials during the process of drying. The governing heat and mass transfer equations have been established using the liquid as well as vapor flow. Two models have been presented. Model 1 does not consider the heat conduction while the model 2 has been established by considering the conduction. The developed models and the numerical solutions of the resulting differential equations can take into account the moisture and temperature dependent thermophysical properties of the product. All equations have been established in spherical coordinates but the programme written for the purpose of calculations can be used for other geometries also. Numerical calculations have been performed for gas concrete and tiles using model 1, while model 2 has been used for gas concrete only because of the lack of data for thermophysical properties of the tile. For gas concrete it was seen that conduction has only marginal effect on the drying process and the numerical predictions of the drying process were reasonably accurate.     

Low-temperature phase transformation in Li-10 at. % Mg

It is not known whether impaired hematopoiesis noted during human immunodeficiency virus (HIV) infection results from infection of stem/progenitor cells or of cells of the bone marrow microenvironment. Normal adherent primary stromal layers were exposed to HIV to determine which of this mixture of endothelial cells, fibroblasts, and macrophages are susceptible to the virus. Viral p24 in supernatants was noted with monocytotropic HIV-1Ada, HIV-1Ba-L, and HIV-1JR-FL but not with lymphotropic HIV-1LAI nor HIV-1MN strain, and only stromal macrophages expressed the viral antigens. Coculture of the layers with PHA-activated normal lymphocytes failed to rescue lymphotropic virus. No p24 was produced when macrophage-depleted stromal cells were exposed to either HIV-1Ba-L or HIV-1LAI; proviral DNA was then amplified by PCR in cells exposed to either virus, though coculture with lymphocytes rescued only HIV-1Ba-L. Altogether, these data indicate that macrophages are the major targets of HIV in cultured stromal layers. As virus replication in macrophages did not affect the profile of major cytokines involved in regulating hematopoiesis, HIV infection could alter hematopoiesis by other as yet unspecified mechanisms.     

Diffusion bonding of ferritic oxide dispersion strengthened alloys to austenitic superalloys

The superior high temperature mechanical strength and oxidation resistance of ferritic oxide dispersion strengthened (ODS) tubular alloys are compromised by the difficulties encountered in joining. Conventional fusion welding techniques generate a weld fusion zone which is devoid of the mechanical strength exhibited by the base material. Therefore, more sophisticated solid state joining techniques, such as diffusion bonding, must be employed when joining ODS materials. This paper describes a series of solid state diffusion bonding experiments carried out between two tubular ferritic ODS alloys and two high temperature austenitic alloys. Careful control of bonding conditions produced pressure retaining joints between one of the tubular ODS alloys and both austenitic alloys. The successful joint design was incorporated into the manufacture of a tubular creep component, which enabled a series of internally pressurized creep tests to be carried out. The microstructure developed at the bond interface of each of the four separate material couples is described and the high temperature performance of the pressure retaining joints is discussed.     

Magnetization and rotation of MTG HTSC ring in magnetic field

The magnetization of a melt-texture growth (MTG) HTSC ring has been studied. It is shown that the magnetic field inside the ring is larger than the external field under a certain range of external magnetic fields. We have also investigated the magnetic field dependence of the response of a detective coil near a rotating superconducting ring. The responses of the MTG sample are different for different cooling methods.     

Investigations of delamination criticality and the transferability of growth criteria

This article describes a study of delamination growth along 0 °/0 °, 0 °/ 5 °, ± 5 °, and 0 °/90 ° interfaces sandwiched between unidirectional carbon fibre/epoxy composite material. Relationships between damage criticality, growth rate and acoustic emission activity for delamination growth have been studied and the transferability of results from laboratory coupons to composite structural elements has been examined. Two types of coupon tests, conventional delamination beams and rigidly loaded single edge notched strips, have been compared for different mode ratios. Comparative tests have been made on buckling-induced delamination in plates. A graphite crack gauge has been used to measure delamination length and growth rate, ranging from 0.05–2000 m/s. Damage growth was also followed using visual, ultrasonic C-scan, X-ray radiography, macro-video and acoustic emission measurements. Empirical evaluations of interlaminar toughness for delamination beams are made using the Irwin-Kies relation. Unstable growth is analysed using elasto-dynamic moving finite elements. Bucklinginduced delamination is analysed using plate/shell FE methods with growth/remeshing algorithms.