Concurrent primary carcinoma of the gallbladder and acute cholecystitis

BACKGROUND/AIMS: Primary carcinoma of the gallbladder is rare and associated with a late diagnosis and poor prognosis. Concurrent acute cholecystitis frequently obscures the presence of carcinoma. The information regarding gallbladder carcinoma with acute cholecystitis is limited. In order to better understand the presentation of gallbladder carcinoma with acute cholecystitis, we retrospectively reviewed the data of patients with primary carcinoma of the gallbladder. METHODOLOGY: The data of 86 patients with primary carcinoma of the gallbladder treated between 1979 and 1994 were compiled and reviewed. The patients were divided into 2 groups: Group 1 (with acute cholecystitis, 21 patients) and Group 2 (without cholecystitis, 65 patients). Clinicopathological comparisons were made and evaluated between these two groups RESULTS: The average age of Group 1 patients was older than that of Group 2 patients (75+/-2 years vs. 63+/-2 years; p<0.05). Three Group 1 patients presented with sepsis. The interval between the onset of symptoms and hospital admission in Group 2 patients was significantly (p<0.05) longer than that in Group 1 patients (243+/-95 days vs. 20+/-11 days). Leukocytosis (>11,000/mm3) was more common in Group 1 patients than in Group 2 patients (47.6% vs. 15.4%). Jaundice was more common in Group 2, and fever was common in Group 1. The majority of Group 2 gallbladder cancers were stage V (75.4%). In contrast, 52.4% of Group 1 gallbladder cancers were stage III and 38.1% were stage V. The 30-day postoperative mortality rate in Group 1 and Group 2 patients was 9.5% and 7.7%, respectively. The cumulative survival of Group 1 patients was not different from that of Group 2 patients (log-rank test, p>0.05). CONCLUSIONS: Age, the interval of symptoms prior to admission, the location of abdominal pain, fever, leukocytosis, and the absence of jaundice suggested the presence of acute cholecystitis in gallbladder carcinoma. A high index of suspicion of the disease, intraoperative examination of gallbladder specimens, and more aggressive surgical treatment may improve patient survival.     

边缘接入智能化

MMAP(多功能、多业务接入平台)集成了光纤传输和接入技术,使接入网和城域网(MAN)融合在一起。     

Development of a new ceramic inclusion separator for steel melts

The majority of steels produced by continuous casting is fully Al-killed. Ceramic foam and multi hole filters have been tested so far in laboratory and small scale production experiments to lower the total oxygen content of steel melts. The use of such filters in tundishes has hitherto been limited by their insuffiicient mechanical and thermal durability over extended periods. Owing to their small pore sizes, these filters allow a high inclusion separation efficiency, but a limited mass throughput. Therefore a technique is looked for to extract non-metallic inclusions efficiently from the melt at higher mass throughputs. Further ideas led to a new ceramic inclusion separator which has been tested in small scale experimental runs. To verify the flow and separation process, a water model has been built and numerical modelling was applied. The results of the molten steel experiments, the water model and the mathematical modelling are described and compared to each other. For the small scale it is confirmed that the new experimental device may yield high filtration efficiencies.     

A new underground air traffic control centre for Oslo

The Civil Aviation Administration of Norway (NCAA) is currently undertaking a comprehensive programme for the modernization and enhancement of air traffic control services in southeast Norway. The most important element within this programme is the establishment of a new Air Traffic Control Centre (ATCC) for Oslo that will provide both area and approach control services within the area. A national air traffic control school (the ATS Academy), which will provide both basic and advanced training for air traffic controllers, will be established in conjunction with the ATCC. The facility will also provide for maintenance, development and testing of application software and system enhancements. The ATCC is sited underground, and administration and training facilities are in buildings outside, connected to the air traffic control centre by a tunnel. The paper describes the major operation systems and sub-systems that will support the ATCC activities.     

Outcome of neonatal stroke in full-term infants without significant birth asphyxia

Ehlers-Danlos syndrome (EDS) is a heterogeneous group of connective tissue disorders. Recently mutations have been found in the genes for type V collagen in a small number of people with the most common forms of EDS, types I and II. Here we characterise a COL5A2 mutation in an EDS II family. Cultured dermal fibroblasts obtained from an affected subject synthesised abnormal type V collagen. Haplotype analysis excluded COL5A1 but was concordant with COL5A2 as the disease locus. The entire open reading frame of the COL5A2 cDNA was directly sequenced and a single base mutation detected. It substituted a glycine residue within the triple helical domain (G934R) of alpha2(V) collagen, typical of the dominant negative changes in other collagens, which cause various other inherited connective tissue disorders. All three affected family members possessed the single base change, which was absent in 50 normal chromosomes.     

Crosslinking of PVC and NBR blends

The purpose of our work is to control the interfacial bonds between PVC and NBR using the ammonium salts of triazine thiols and dithiodimorpholine (DTDM) and thereby reveal the relation between the interfacial bonds and the final mechanical properties of products. In the experimental work a two-stage process was used. At first, an NBR/PVC blend was mixed with a mono-tetra-n-butylammonium salt of triazine trithiol at a temperature of 100°C on a two-roll mill to give the branching structure of triazine thiols into PVC. In the second stage branched NBR/PVC reacted with DTDM to afford the branched PVC containing trithiomorphonyl groups. In the presence of ZnO at 160°C trithiomorphonyl groups react with NBR to form a crosslinking structure between NBR and PVC. The mechanical properties of cured NBR/PVC blends were markedly improved by the treatment process and after addition of tetramethylthiuram monosulphide also. The mechanical properties were not improved by increasing the concentration of TT-TBA (tetrabutylammonium salt of 1,3,5-triazine-2,4,6-trithiol) over 4.2 phr.     

Analysis of edge slots in rectangular waveguide with finitewaveguide wall thickness

A novel analysis for computing the admittance characteristics of edge slots with a salient feature in successfully considering the finite waveguide wall thickness is presented. The variational equation for the electric field in the slot region between the inner and outer waveguide walls is derived by applying the variational reaction theory and solved by the finite-element method. The division of the slot region into small elements of triangular cylinders and the basis function for each element are described in detail. In the limiting case of zero wall thickness, this finite-element analysis is reduced to a moment-method analysis using Galerkin's approach with triangular basis functions. The effects of waveguide wall thickness on the characteristics of the slot are investigated by comparing the numerical results with and without considering the wall thickness. Negligence of the wall thickness may result in a severe underestimation of the resonant length by as large as 14% for edge slots cut in typical X-band waveguides. The computed results with the finite wall thickness taken into account have been checked with the measured data published in previous literature and those obtained by a carefully devised experimental setup. Good agreement between theoretical and experimental results is obtained to demonstrate the validity of the analysis     

Melting of secondary-phase particles in Al-Mg-Si alloys

The melting of secondary-phase particles—or, more precisely, the melting of such particles together with the surrounding matrix—in two ternary Al-Mg-Si alloys has been studied. In the quasi-binary Al-Mg₂Si alloy, one melting reaction is found. In the alloy with an Si content in excess of that necessary to form Mg₂Si, three different melting reactions are observed. At upquenching temperatures above the eutectic temperature, the reaction rates are very high, and it is assumed that they are controlled by diffusion of the alloying elements in the liquid. Melting is also observed after prolonged annealing at temperatures below the eutectic temperature in these alloys, which is explained by the different diffusion rates of Mg and Si. The rate of the melting reaction is in this case assumed to be controlled by diffusion of the alloying elements in the solid α-Al phase. It is shown that calculation of the particle/matrix interface composition, which determines when melting is possible, cannot be made solely on the basis of the phase diagram, but must also include the rate of diffusion of Mg and Si. The melting temperatures observed differ somewhat from the accepted eutectic temperatures for these alloys. On prolonged annealing, the liquid droplets formed dissolve into the surrounding matrix and their chemical composition is found to change during dissolution. The resulting eutectic structure after quenching of a droplet is explained by the phase diagram and the different diffusion rates of Mg and Si as well as by the nucleation conditions of the constituents involved.