An extension of Wagner's analysis of competing scale formation

Wagner's criterion to predict the minimum concentration of solute (N _B(min) ⁰ )necessary for the exclusive formation of its scale has been modified to incorporate both thermodynamic and kinetics requirements. The analysis presented here involves a receding alloy/scale interface for which the composition of the alloy at this interface is governed by thermodynamic equilibrium between the two competing scale phases and the base alloy. This is a more rigorous analysis than that of Wagner's, who assumed the alloy/scale interface to be immobile and the solute composition at the interface to be zero. A comparison is made between values of N _B(min) ⁰ found experimentally and those predicted by Wagner's and the present criterion for a number of alloy-gas systems. It is shown that the criterion developed in the present analysis can often provide a better approximation of the actual N _B(min) ⁰ .The expressions derived from the present analysis have been extended also in a semiquantitative manner to provide a criterion for the minimum amount of solute in the alloy required for the transition from internal to external scale formation.     

Effects of Minor Elements on the Cyclic-Oxidation Behavior of Commercial Fe-Base 800-Series Alloys

The cyclic-oxidation behavior of commercial iron-base 800-series chromia-scale-forming alloys was studied at 1000°C in still air. Each thermal cycle consisted of one day at temperature followed by air cooling to room temperature. Two different types of 800-series alloys were studied (800 and 800HT), with each type being supplied by two different producers. Although the alloys were of similar chemical composition, their variations in minor-constituent contents were apparently sufficiently different to cause marked differences in oxidation behavior. Compared to the 800 alloys, the higher-strength 800HT alloys generally performed the worst, undergoing rapid weight-loss kinetics after an initial period of relatively protective oxidation. The time required for the commencement of rapid weight-loss kinetics depended significantly on the producer of the 800HT alloy. In general, however, the 800HT alloys developed protrusion of Ti- and Cr-rich oxides into the alloy along the alloy/scale interface, which promoted spallation and poorer cyclic-oxidation resistance. The formation of Si-rich oxide particles in the vicinity of the alloy/scale interface could improve cyclic-oxidation resistance; however, higher Si contents would cause internal Si-rich oxide formation and promote the formation of Ti- and Cr-rich oxide protrusions at the alloy/scale interface. Good cyclic-oxidation resistance requires optimization of the minor-element constituents, Si, Ti, and Al in particular.     

Beneficial Effects of Rhenium Additions on the Cyclic-Oxidation Resistance of β-NiAl + α-Cr Alloys

This study reports the effects of up to 4 at.%rhenium addition on the cyclicoxidation behavior of-NiAl + -Cr alloys having a basecomposition (in at.%) Ni-40Al-17Cr. Tests were conductedin still air at 1100°C for up to 250 1-hr cycles.The ternary alloy (without rhenium addition) exhibitedpoor cyclic-oxidation resistance, undergoing extensivescale spallation and internal oxidation. Additions of rhenium considerably improved the oxidationbehavior, reducing the extent of both scale spallationand internal oxidation. These beneficial effectsincreased with increasing rhenium content. Rhenium additions improved cyclic-oxidation resistanceby both decreasing the solubility of chromium in the phase and causing the interdendritic -Crprecipitates in the alloy microstructure to become more spheroidized and disconnected. Theseeffects aided in preventing both interdendritic attackand the dissolution of the -Cr precipitates fromthe subsurface region of the alloy. The maintenance of -Cr precipitates at the alloy-scaleinterface decreased the extent of scale spallation byproviding a lower coefficient of thermal-expansion (CTE)mismatch between the alloy and theAl₂O₃-rich scale.     

The unanticipated difficult airway with recommendations for management

PURPOSE: To review the current literature and generate recommendations on the role of newer technology in the management of the unanticipated difficult airway. METHODS: A literature search using key words and filters of English language and English abstracted publications from 1990-96 contained in the Medline, Current Contents and Biological Abstracts databases was carried out. The literature was reviewed and condensed and a series of evidence-based recommendations were evolved. CONCLUSIONS: The unanticipated difficult airway occurs with a low but consistent incidence in anaesthesia practice. Difficult direct laryngoscopy occurs in 1.5-8.5% of general anaesthetics and difficult intubation occurs with a similar incidence. Failed intubation occurs in 0.13-0.3% general anaesthetics. Current techniques for predicting difficulty with laryngoscopy and intubation are sensitive, non-specific and have a low positive predictive value. Assessment techniques which utilize multiple characteristics to derive a risk factor tend to be more accurate predictors. Devices such as the laryngeal mask, lighted stylet and rigid fibreoptic laryngoscopes, in the setting of unanticipated difficult airway, are effective in establishing a patient airway, may reduce morbidity and are occasionally lifesaving. Evidence supports their use in this setting as either alternatives to facemask and bag ventilation, when it is inadequate to support oxygenation, or to the direct laryngoscope, when tracheal intubation has failed. Specifically, the laryngeal mask and Combitube have proved to be effective in establishing and maintaining a patent airway in "cannot ventilate" situations. The lighted stylet and Bullard (rigid) fibreoptic scope are effective in many instances where the direct laryngoscope has failed to facilitate tracheal intubation. The data also support integration of these devices into strategies to manage difficult airway as the new standard of care. Training programmes should ensure graduate physicians are trained in the use of these alternatives. Continuing medical education courses should allow physicians in practice the opportunity to train with these alternative devices.     

Multidimensionality of oral health in dentate adults

OBJECTIVES: An understanding of the validity and usefulness of self-reported measures (as distinct from clinically determined measures) of oral health is emerging. These self-reported measures include self-rated oral health (SROH). Three objectives were to: (1) describe self-rated oral health in dentate adults, (2) quantify associations between self-rated oral health and other measures of oral health (oral disease and tissue damage, pain and discomfort, functional limitation, and disadvantage), and (3) assess the construct validity of a model of oral health proposed herein. METHODS: The Florida Dental Care Study is a longitudinal study of oral health, which included at baseline 873 subjects who had at least one tooth, were 45 years or older, and who participated for an interview and clinical examination. RESULTS: The prevalence of self-rated oral health decrements was substantial; approximately one fourth of subjects reported their oral health as only fair or poor. Bivariate and multivariate results provided consistent evidence of the construct validity of the proposed model of oral health. Additionally, the salience of one measure of dental appearance suggests that persons may use esthetic cues when rating their oral health. CONCLUSIONS: The proposed multidimensional model of oral health has construct validity. Self-rated oral health is affected by oral disease and tissue damage, oral pain and discomfort, oral functional limitation, and oral disadvantage. These self-reported measures and the proposed model should provide useful information for dental care effectiveness research. General health status has been disaggregated into the "physical" and the "mental;" an additional separation into the "oral" aspects of health seems warranted.     

A clinical evaluation in children of the Pharmacia ImmunoCAP system for inhalant allergens

BACKGROUND: The Pharmacia ImmunoCAP system (CAP) for assaying serum IgE specific antibodies was evaluated in a clinical setting against skin-prick test (SPT) performed using Dome/Hollister-Steir allergen extracts. The five common inhalant allergens D. pteronyssinus, D. farinae, mould mix, grass mix and cat epithelium were tested concurrently by both methods in 167 children aged 7.5-12 years. The specific SPT for D. pteronyssinus and D. farinae were also tested against the CAP house dust mite (HDM) mix. OBJECTIVE: The purpose of the study was to determine the sensitivity and specificity of the Pharmacia ImmunoCAP system for detecting serum IgE specific antibodies to inhalant allergens in a clinical setting, using SPT result as the "gold standard'. METHODS: The SPTs were performed using Dome/Hollister-Steir allergen extracts. The serum IgE specific antibodies were quantitated using the radioimmunoassay version of the Pharmacia ImmunoCAP system. A history of allergic disease was assessed using a validated questionnaire. RESULTS: SPT gave more positive reactions than CAP with the exception of cat epithelium. The concordance between SPT and CAP results was 91% over all the tests. The concordance with SPT was slightly higher for the specific CAP for D. pteronyssinus and D. farinae (93% and 95% respectively) than for the CAP HDM mix (86% and 90% respectively). There was a higher proportion of positive results for both SPT and CAP in the 115 children defined as having a history of allergic disease. Using SPT defined allergy as the gold standard, the sensitivity of the CAP system was 87% for the two specific house dust mites but was lower for cat epithelium (67%), mould mix (59%) and grass mix (46%). The sensitivity of the CAP system improved for D. pteronyssinus (96%) and the HDM mix (91%) when tested in subjects defined as having a history of allergy associated disease. The specificity of the CAP system showed less variation between allergens and ranged from 90-99%. CONCLUSION: The results of this study of children aged 7.5-12 years demonstrate that, for the inhalant allergens tested, the Pharmacia ImmunoCAP system performs well in the setting of known allergic disease.     

A clinical retrospective evaluation of FA/HA coated (Biocomp) dental implants. Results after 1 year

The development of ovulation-inducing drugs has enabled clinicians to more effectively treat the hypothalamic, pituitary, and ovarian abnormalities resulting in infertility. Pregnancy rates have been improved with the use of agents such as clomiphene citrate (CC), human menopausal gonadotropin [hMG or follicle-stimulating hormone (FSH) preparations], with gonadotropin-releasing hormone (GnRH) and its analogs, stimulating the development of multiple ovarian follicles and increasing the number of fertilizable oocytes. The use of these drugs is not without certain detrimental or "toxic" consequences. The negative effects from superovulation can occur during follicle development, decreasing the number of healthy oocytes and embryos capable of leading to viable pregnancy. Ovulation induction can lead not only to higher incidences of spontaneous abortions, and multiple and ectopic pregnancies, but also to poor pregnancy rates, due, in part, to asynchrony between embryonic development and the uterine environment. Diseases such as ovarian hyperstimulation syndrome (OHSS), resulting in the secretion of supraphysiologic levels of estradiol, can lend to severe health complications, possibly requiring hospitalization. Most drugs used for ovulation induction can lead to OHSS. Although incidences of OHSS following CC use are less frequent, CC has been associated with hot flushes, multiple gestations, visual disturbances, cervical mucus abnormalities, and luteal phase deficiency. Finally, there are reports that link any or all of the ovulation-inducing drugs with a higher incidence of ovarian and breast cancer, however, a cause-effect relationship has yet to be proven.     

Functional correction of renal defects in a mouse model for ARPKD through expression of the cloned wild-type Tg737 cDNA

Autosomal recessive polycystic kidney disease (ARPKD) is characterized by the formation of large collecting tubule and ductular cysts that often result in renal insufficiency within the first decade of life. Understanding the process leading to cyst formation will require the identification and characterization of genes involved in the etiology of this disease. In this regard, we previously described the generation of a mouse model (TgN737Rpw) for ARPKD and the cloning of a candidate gene. Here we show direct involvement of the Tg737 gene in collecting duct cyst formation by expressing the wild-type Tg737 cDNA as a transgene in TgN737Rpw mutants. In contrast to TgN737Rpw mutants, the "rescued" animals survive longer, have normal renal function and normal localization of the EGFr to the basolateral surfaces of collecting duct epithelium.