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.     

Study of a BGO calorimeter using electron and hadron beams from 1 to 50 GeV

A calorimeter of 25 bismuth germanate (BGO) crystals equipped with silicon photodiode readout has been tested at the CERN SPS in the energy range 1–50 GeV. The response for electrons has been shown to be linear in this energy range and the rms resolution obtained ( ) is approximately 1%, for E > 4 GeV. The electron/pion separation was found to be better than 1:500 in the energy range 1–20 GeV. Data on lateral and longitudinal shower development were compared with the results of a Monte Carlo simulation using the SLAC-EGS program and found to be in good agreement.     

Optimal thermal design of injection molds for filled thermosets

Since the cure rate of injection molded thermosets is usually very sensitive to cavity surface temperature, spatial variations in these temperatures can lengthen the necessary cure time for the entire part and cause distortion and residual stress in the molded article. This problem is addressed in the present paper by combining an optimization algorithm with a quasi-steady heat conduction analysis in the mold to determine the heating line positions and operating temperatures that minimize the spatial variation in cavity surface temperature. The method is applied to an example mold for a flat panel of uniform thickness, using two different gate locations. At a one-minute cycle, the optimal designs for each gate location dramatically reduce the variation in cavity surface temperature compared with corresponding results using a conventional heating system. These results are made more significant by the fact that the optimal designs use considerably fewer heating lines. In spite of their simplicity, the optimal designs still have enough flexibility to adjust to a changing cycle without sacrificing uniformity in cavity surface temperature.     

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.     

The beneficial effects of storage on the quality of wastewater for irrigation: a case study in Sicily.

Although the main function of reservoirs in agriculture is to allow the storage and temporal shifting of large volumes of waters, further benefits emerge from their application in wastewater reuse systems. In fact, as observed in several other studies carried out on such complex natural systems, the storage period, under proper conditions, can lead to a significant improvement of the water quality for irrigation thanks to concurrent physical, chemical and biological processes. In order to investigate the reservoir dynamics, an experimental research was carried out in a farm reservoir (volume of 11,000 m3, maximum depth of 6.3 m and mean depth of about 5 m), receiving treated wastewater and subject to scheduled highly variable input to volume ratios, in order to observe the broadest range of behaviour responses. Specifically, over a monitoring period lasted 4 months, the reservoir was operated as a standard batch reactor in the first and third phases and as a continuous flow reactor in the second one. Based on correlation analysis between the chemical, physical and biological water parameters and operational ones, a new operative index is proposed which integrates the morphological characteristics of the tank and the management ones, and shows a significant correlation with the qualitative characteristics of the stored water.     

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.