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.     

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.     

Connexin 43 and Connexin 26 Involvement in the Ponatinib-Induced Cardiomyopathy: Sex-Related Differences in a Murine Model

Cardiac connexins (Cxs) are proteins responsible for proper heart function. They form gap junctions that mediate electrical and chemical signalling throughout the cardiac system, and thus enable a synchronized contraction. Connexins can also individually participate in many signal transduction pathways, interacting with intracellular proteins at various cellular compartments. Altered connexin expression and localization have been described in diseased myocardium and the aim of this study is to assess the involvement of Cx43, Cx26, and some related molecules in ponatinib-induced cardiac toxicity. Ponatinib is a new multi-tyrosine kinase inhibitor that has been successfully used against human malignancies, but its cardiotoxicity remains worrisome. Therefore, understanding its signaling mechanism is important to adopt potential anti cardiac damage strategies. Our experiments were performed on hearts from male and female mice treated with ponatinib and with ponatinib plus siRNA-Notch1 by using immunofluorescence, Western blotting, and proteomic analyses. The altered cardiac function and the change in Cxs expression observed in mice after ponatinib treatment, were results dependent on the Notch1 pathway and sex. Females showed a lower susceptibility to ponatinib than males. The downmodulation of cardiac Cx43, Cx26 and miR-122, high pS368-Cx43 phosphorylation, cell viability and survival activation could represent some of the female adaptative/compensatory reactions to ponatinib cardiotoxicity.     

A METHOD FOR GENERATING INDEPENDENT REALIZATIONS OF A MULTIVARIATE NORMAL STATIONARY AND INVERTIBLE ARMA(p, q) PROCESS

Abstract. A method for generating finite independent realizations of a normal multivariate stationary ARMA( p, q ) process is proposed. It is based on an AR (1) representation of an ARMA( p, q ) process allowing for an exact generation of the initial values of the simulation algorithm. Input facilities are supplied in order to assure stationarity and invertibility of the considered process.     

Support environment for active rule design

The lack of tools for rule generation, analysis, and run-time monitoring appears one of the main obstacles to the widespreading of active database applications. This paper describes a complete tool environment for assisting the design of active rules applications; the tools were developed at Politecnico di Milano in the context of the IDEA Project, a 4-years Esprit project sponsored by the European Commission which was launched in June 1992. We describe tools for active rule generation, analysis, debugging, and browsing; rules are defined in Chimera, a conceptual design model and language for the specification of active rules applications. We also introduce a tool for mapping from Chimera into Oracle, a relational product supporting triggers.Most of the tools described in this paper are fully implemented and currently in operation (beta-testing) within the companies participating to the IDEA Project, with the exception of two of them (called Argonaut-V and Pandora), which will be completed by the end of 1996.Research presented in this paper is supported by Esprit project P6333 IDEA, and by ENEL contract VDS 1/94: Integrity Constraint Management     

Knowledge representation and inference techniques to improve the management of gas and oil facilities

This paper describes an experimental work carried out in the framework of an important European project to create and make use of a wide-ranging knowledge base in the gas/oil domain. In the context of this work, “knowledge base” means a collection of formal statement relating, with a negligible loss of information, the inner content (the ‘meaning’) of “complex events” included in two different “storyboards”. These events – originally presented under the form of unstructured natural language information – concern some general activities proper to the management of gas/oil facilities, like recognizing and monitoring gas leakage alarms in a gas processing plant or triggering the different steps needed to activate a gas turbine. To express this sort of information and to set up the knowledge base, the NKRL (Narrative Knowledge Representation Language) formalism has been used. NKRL is a conceptual meta-model and Computer Science environment expressly created to deal, in an ‘intelligent’ and complete way, with complex and content-rich ‘narrative’ data sources. The final knowledge base has been firstly tested in depth using the standard NKRL querying and information retrieval tools. High-level inference procedures have then been used, both “transformation rules” – unsuccessful queries are ‘transformed’ to produce results that are ‘semantically similar’ to those searched for initially – and “hypothesis rules” – information in the knowledge base is automatically aggregated to supply a sort of ‘causal’ explanation of some retrieved events.     

Construct validation of the Rorschach Reality-Fantasy Scale in alexithymia.

The study applies Winnicott's conceptualization of potential space to the alexithymia construct by using a new Rorschach index, the Reality-Fantasy Scale (RFS). The scale uses variables derived from the Rorschach Comprehensive System (Exner, 2000, 2001) to detect different types of psychopathological manifestations conceptualized as forms of collapse of potential space. Following previous research, the present study further evaluates the construct validity of the RFS in a sample of 92 patients with inflammatory bowel disease, categorized on the basis of the Toronto Alexithymia Scale (TAS-20) as alexithymic, indeterminate alexithymia, and nonalexithymic groups. As hypothesized, the RFS significantly correlated with the TAS-20, discriminated among the 3 groups, and showed incremental validity in detecting alexithymia over isolated Rorschach markers. The study supports the exploration of psychoanalytic ideas by empirical, statistically based methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rheological studies with spherically shaped thin liquid films

The present work shows the first experimental and theoretical results for investigations on the rheology of liquid films. The experiments are planned to be performed under microgravity conditions. This environment will allow forming films of different thickness, which is impossible under ground conditions due to drainage. Then the films are forced to harmonic oscillations of the film area so that the film elasticity can be measured as a function of frequency. The presented theoretical model demonstrates the main relationships to be solved under corresponding boundary conditions     

Reasoning with infinite stable models

This paper illustrates extensively the theoretical properties, the implementation issues, and the programming style underlying finitary programs. They are a class of normal logic programs whose consequences under the stable model semantics can be effectively computed, despite the fact that finitary programs admit function symbols (hence infinite domains) and recursion. From a theoretical point of view, finitary programs are interesting because they enjoy properties that are extremely unusual for a nonmonotonic formalism, such as compactness. From the application point of view, the theory of finitary programs shows how the existing technology for answer set programming can be extended from problem solving below the second level of the polynomial hierarchy to all semidecidable problems. Moreover, finitary programs allow a more natural encoding of recursive data structures and may increase the performance of credulous reasoners.