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.     

Vibrational analysis of functionalized polyolefins/poly(vinylchloride) blends

Polyolefins functionalized with diethylmaleate were mixed with poly(vinylchloride) (PVC) in different compositions. Intermolecular interactions involving the carbonyl groups of the side chains of the functionalized polyolefins and methine hydrogens of PVC were investigated by means of infrared spectroscopy. The major flexibility of the ester groups attached to the backbone chains, with respect to polyesters, seems to increase the capability of such groups to interact with groups of more polar polymers, thus allowing prediction of easier miscibility, which however also depends on the starting polyolefin structure and function-alization degree.     

Silver dissolution on copper-based alloys

Electrical resistivity measurements and scanning electron microscopy was used to study the dissolution of silver on Cu-Ag and Cu-Al-Ag alloys. The results seem to indicate that the dissolution temperature is affected by the addition of aluminium.     

Vacuum-u.v. circular dichroism of optically active isotactic poly-α-olefins

Summary Circular dichroism of isotactic samples of poly-(S)-4-methyl-1-hexene and poly-(R)-3,7-dimethyl-1-octene, have been measured in the vacuum ultraviolet spectral region (200-140 nm). The c.d. band at about 160. nm accounts for the optical activity in the visible region and reflects the presence of one screw sense helical conformation of the sample examined.The authors thank Prof. W.C. Johnson, Jr., Department of Biochemistry and Biophysics, Oregon State University, for allowing them to use the vacuum u.v. spectrometer. This work has been partially supported by a N.A.T.O. grant, and by Ministero Pubblica Istruzione (MPI), Roma — Italy.     

Microstructure study of Sm,Mn-modified PbTiO3 piezoelectric ceramics by XRD profile-fitting technique

By using the X-ray diffraction profile-fitting technique, the microstructures of Sm, Mn-modified PbTiO₃ piezoelectric ceramic discs, including ferroelectric domain sizes, microstrains, and their variations with the poling strength have been quantitatively investigated. The results manifest that the modified PbTiO₃ ceramics contain a high density of domain walls due to the presence of finely-divided coherent domain structures (tens of nanometres in dimension). The poling treament can evidently influence the domain-size distribution, with a more homogeneous microstructure being developed; however, it simultaneously causes high anisotropic microstrains within the structure which, together with the high density of domain walls, is expected to be responsible for the unusual high electromechanical coupling properties possessed by this material.     

Brittle detachment of a stiffener bonded to an elastic plate

The diffusion of contact stresses between an elastic bar, bonded to an elastic half-plane and loaded longitudinally, requires the integration of a singular integral equation. The solution of this equation is not available in closed form, but only by a series expansion of the contact tangential force mutually transmitted between the stiffener and the plate. Since forty years it has been realized that the expansion of the solution in terms of Chebyshev polynomials is its most convenient method of representation. The procedure can also be extended to treat the brittle detachments of the tips of the stiffener when, according to Griffith's criterion of fracture, a balance can be virtually established between the increase of strain energy due to a propagation of cracks and the surface energy created.     

Ontologies and reasoning techniques for (legal) intelligent information retrieval systems

An application of Narrative Knowledge Representation Language (NKRL) techniques on (declassified) ‘terrorism in Southern Philippines’ documents has been carried out in the context of the IST Parmenides project. This paper describes some aspects of this work: it is our belief, in fact, that the Knowledge Representation techniques and the Intelligent Information Retrieval tools used in this experiment can be of some interest also in an ‘Ontological Modelling of Legal Events and Legal Reasoning’ context.     

Analytical prediction of composite beams response in fire situations

In this paper an extension of the method of the Fourier series expansion to the fire analysis of composite beams is presented. In particular the extension concerns the introduction of the temperature dependent interaction of all the components: steel beams, concrete slab and steel connectors. These last are considered of finite stiffness, and a proper account is given to the combined effect of thermal degradation of the properties, and stress amplification caused by the differential thermal expansion across the interface.The proposed method compares very well with some experimental fire tests of simply supported and framed composite beams. Due to its relative simplicity and speed, it can be used for design purposes in evaluating the critical temperature in terms of critical deflection. Finally we recall that the method is capable of dealing with every type of fastening distribution, such as discontinuous or variable length.     

Mesomorphic behavior of polydiethylphosphazenes as described by13C,14N,and2H NMR

The existence of mesomorphism in polydiethylphosphazene was recently established by MAS NMR and X-ray diffraction characterization. In the present work the mechanism of motion of the ethyl side groups in the high-temperature polymorph tabove 45 C) is identified and compared to the arrangement of side groups in the low-temperature polymorph. For this purpose a few NMR active nuclei (¹³C,¹⁴N, and²H) were exploited to define the side-chain motions occurring at transition. Experiments performed at varying temperatures close to the onset of solid transition suggest the presence of jumps between two conformations in the pretransition state. Rotor-synchronized triple-resonance NMR of the high-temperature phase determined the average distances between the carbons and the nitrogens in the polymorphs. The theoretical prediction of the dipolar interaction between the nuclei supports the hypothesis that ethyl groups can undergo a complete rotation about the P CH₂ bond by jumping across a conformational barrier. The mechanism of motion of the ethyl groups must be cooperative and the collapse of the rigid shell around the main chain is described at the transition.