Percutaneous radiologic drainage of pancreatic abscesses

OBJECTIVE: The purpose of our study was to review and report the patient selection, techniques, and results of percutaneous drainage of pancreatic abscesses by retrospective review. MATERIALS AND METHODS: Fifty-nine patients (46 men and 13 women) with a mean age of 44 years old had 80 pancreatic abscesses that were drained percutaneously under radiologic guidance (CT, n = 77; sonography, n = 2; and fluoroscopy, n = 1). Abscesses had a wide spectrum of causes, with alcoholic pancreatitis being most common, trauma second most common, and gallstones third. Ten patients had undergone surgery for pancreatic necrosis or abscess. Patients with pancreatic pseudocysts, necrosis, or acute fluid collections were excluded from this study. RESULTS: Of the 59 patients, 51 (86%) were cured with percutaneous drainage and antibiotic therapy. Of the patients who were not cured with percutaneous drainage, seven required surgery and one underwent repeat percutaneous drainage. In the 59 patients, complications included non-life-threatening bleeding in three patients. Ten of 59 patients (17%) had fistulas that spontaneously formed into the gastrointestinal tract. The duration of catheterization ranged from 4 to 119 days, with a mean duration of 33 days. The rate of mortality at 30 days after completion of percutaneous drainage was 8% (5 of 59). CONCLUSION: Percutaneous drainage was an effective therapy for this defined group of patients with pancreatic abscesses. Factors leading to the relatively high success rate described in this study likely included selection of patients; catheters of adequate size, number, and location; careful follow-up with appropriate catheter manipulations; and an integrated, cooperative approach whereby surgeons were willing to permit drainage to effect its benefits, rather than operating prematurely.     

The effects of non-insulin-dependent diabetes mellitus on the kinetics of onset of insulin action in hepatic and extrahepatic tissues

The mechanism(s) of insulin resistance in non-insulin-dependent diabetes mellitus remains ill defined. The current studies sought to determine whether non-insulin-dependent diabetes mellitus is associated with (a) a delay in the rate of onset of insulin action, (b) impaired hepatic and extrahepatic kinetic responses to insulin, and (c) an alteration in the contribution of gluconeogenesis to hepatic glucose release. To answer these questions, glucose disappearance, glucose release, and the rate of incorporation of 14CO2 into glucose were measured during 0.5 and 1.0 mU/kg-1 per min-1 insulin infusions while glucose was clamped at approximately 95 mg/dl in diabetic and nondiabetic subjects. The absolute rate of disappearance was lower (P < 0.05) and the rate of increase slower (P < 0.05) in diabetic than nondiabetic subjects during both insulin infusions. In contrast, the rate of suppression of glucose release in response to a change in insulin did not differ in the diabetic and nondiabetic subjects during either the low (slope 30-240 min:0.02 +/- 0.01 vs 0.02 +/- 0.01) or high (0.02 +/- 0.00 vs 0.02 +/- 0.00) insulin infusions. However, the hepatic response to insulin was not entirely normal in the diabetic subjects. Both glucose release and the proportion of systemic glucose being derived from 14CO2 (an index of gluconeogenesis) was inappropriately high for the prevailing insulin concentration in the diabetic subjects. Thus non-insulin-dependent diabetes mellitus slows the rate-limiting step in insulin action in muscle but not liver and alters the relative contribution of gluconeogenesis and glycogenolysis to hepatic glucose release.     

Wind turbine response to parameter variation of analytic inflow vortices

As larger wind turbines are placed on taller towers, rotors frequently operate in atmospheric conditions that support organized, coherent turbulent structures. It is hypothesized that these structures have a detrimental impact on the blade fatigue life experienced by the wind turbine. These structures are extremely difficult to identify with sophisticated anemometry such as ultrasonic anemometers. This study was performed to identify the vortex characteristics that contribute to high‐amplitude cyclic blade loads, assuming that these vortices exist under certain atmospheric conditions. This study does not attempt to demonstrate the existence of these coherent turbulent structures. In order to ascertain the idealized worst‐case scenario for vortical inflow structures impinging on a wind turbine rotor, we created a simple, analytic vortex model. The Rankine vortex model assumes that the vortex core undergoes solid body rotation to avoid a singularity at the vortex centre and is surrounded by a two‐dimensional potential flow field. Using the wind turbine as a sensor and the FAST wind turbine dynamics code with limited degrees of freedom, we determined the aerodynamic loads imparted to the wind turbine by the vortex structure. We varied the size, strength, rotational direction, plane of rotation, and location of the vortex over a wide range of operating parameters. We identified the vortex conformation with the most significant effect on the blade root bending moment cyclic amplitude. Vortices with radii on the scale of the rotor diameter or smaller caused blade root bending moment cyclic amplitudes that contribute to high damage density. The rotational orientation, clockwise or counter‐clockwise, produces little difference in the bending moment response. Vortices in the XZ plane produce bending moment amplitudes significantly greater than vortices in the YZ plane. Published in 2005 by John Wiley & Sons, Ltd.     

Application of an isothermal,three-phase catalytic reactor model to predict unsteady-state fixed-bed performance

CatReac, a three-phase catalytic mathematical model, was developed for analysis and optimization of the volatile reactor assembly used in International Space Station water processor. This wet oxidation process is used to remove low molecular weight contaminants such as acetic acid, acetone, ethanol, 1-propanol, 2-propanol, and propionic acid, which are not removed by the other treatment processes. The Langmuir-Hinshelwood (Hinshelwood, C. N. The Kinetics of Chemical Change in Gaseous Systems, 3rd ed.; Oxford: London, 1933; pp 301-347) isothermal adsorption expression was successfully used to describe the reaction kinetics of compounds on the catalyst surface for the compounds mentioned above. Small-column experiments combined with the use of the Arrhenius equation were successfully used to predict the Langmuir-Hinshelwood parameters under different temperatures for a temperature range from 93 to 149 degrees C. Full-scale and small-column experiments were successfully used to validate the model predictions for unsteady-state fixed-bed operations.     

Telomerase activity and telomere lengths in various cell lines: changes of telomerase activity can be another method for chemosensitivity evaluation

For the cancer cells which have overcome the second mitotic clock (M2), activated telomerase is essential and used as another marker of immortality. Many trials had been initiated to target telomerase, which is known to be specific to tumors. To determine the best in vitro cell system for testing the efficacy of telomerase inhibitors, we evaluated the telomerase activity of various cancer cell lines and measured their telomere lengths. We also treated some cancer cell lines with adriamycin and measured the changes of telomerase activity. Telomerase activity was evaluated in various cell lines with the TRAP (telomeric repeat amplification protocol) assay. Telomerase activity was calculated and translated into arbitrary units by computer-assisted densitometry with the control of telomerase activity in the 293 control cell line. Also, terminal restriction fragment lengths were measured using Southern blotting. We also measured telomerase activity and telomere lengths in 11 benign breast tumor tissues and 19 paired stomach cancer and normal tissues. Cancer cell lines treated with adriamycin we evaluated for changes of telomerase activity and the cell proliferation by MTT assay and dye exclusion test. Telomerase activity of cell lines was 95.3 24.1 unit with a range of 27.6-129.6 unit, while the telomere lengths of those cell lines were variable from 5.0 to 10.4 kbp with a median of 6 kbp. In 11 cancer cell lines which were not yet firmly established, we could not detect any telomerase activity. Low telomerase activity was detected in only 2 benign tumor tissues of breast with a median telomere length of 8.8 (7-10.5) kbp. Among paired 19 gastric cancer and normal tissues, only 7 cancer tissues showed weak telomerase activity. After adriamycin treatment, telomerase activity in YCC-S-1, YCC-S-3, MCF-7 and MCF-7/ADR was decreased in accordance with the changes of the cell numbers. Telomerase is specific to cancer tissues and is expressed differently from organ to organ. Telomerase activity by TRAP assay could be used as a chemosensitivity assay.