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| 33. |
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| 34. |
- Faia, Pedro M., et al.
(författare)
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A comparative study of magnetic resonance imaging, electrical impedance tomography and ultrasonic doppler velocimetry for semi-dilute fibre flow suspension characterisation
- 2016
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Ingår i: International Journal of Computational Methods & Experimental Measurements. - : WIT Press Ltd.. - 2046-0546 .- 2046-0554. ; 4:2, s. 165-175
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Tidskriftsartikel (refereegranskat)abstract
- Experimental comparisons between imaging techniques serve to provide confidence in the validity of each technique for the study of multiphase flow systems. Such cross-validation can establish the limitations of each technique quantitatively. In the present paper, the authors report efforts made on the characterization of semi-dilute, mono-dispersed suspensions of rayon fibres in turbulent water flow using Magnetic Resonance Imaging (MRI), Ultrasound Velocity Profiling (UVP) and Electrical Impedance Tomography (EIT). Increasing flow velocities and fibre concentration were studied using these three experimental techniques. For lower fibre concentrations more uniform distributions were observed and as flow velocity increased fibre agglomerations were found in the centre region of the pipe.
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| 35. |
- Graversen, M, et al.
(författare)
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Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) as an outpatient procedure
- 2018
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Ingår i: Pleura and peritoneum. - : Walter de Gruyter GmbH. - 2364-768X .- 2364-7671. ; 3:4, s. 20180128-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is a drug-delivery method for patients with peritoneal metastasis (PM). The study objective was to investigate whether PIPAC is possible in an outpatient setting.MethodsData was extracted from the prospective PIPAC-OPC2 study (ClinicalTrials.gov NCT03287375). Patients with PM were treated by cisplatin and doxorubicin (PIPAC C/D), except patients with colorectal PM, who were treated by oxaliplatin (PIPAC OX). Patients were evaluated concerning the suitability for carrying out the PIPAC procedure in an out- patient setting. The preconditions for outpatient surgery were that the patient should be (1) freely mobilized, (2) adequately pain-relieved, (3) have untroubled urination and (4) without anxiety or discomfort caused by leaving the hospital.ResultsDuring the study period, 106 PIPAC procedures (79 PIPAC C/D, 27 PIPAC OX) were performed in 41 patients with gastrointestinal or ovarian PM. Ninety percent (37/41) of the patients were pretreated with systemic chemotherapy. Eight patients (20%) received bidirectional chemotherapy. Twenty-four percent (10/41) of the first PIPAC procedures were completed in an outpatient setting, which increased to 65% (13/20) in PIPAC no 3 (p=0.008). In the PIPAC C/D cohort, 28% and 80% of the PIPACs were performed in the outpatient setting at PIPAC 1 and 3 respectively, contrasting to only 11% and 20% in the PIPAC OX group. No readmissions after outpatient care. Postoperative morphine administration was more frequent in the PIPAC OX group.ConclusionsThe PIPAC procedure can be performed in an outpatient setting. The critical component for success is pain control.
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| 36. |
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| 37. |
- Haraldsson, E, et al.
(författare)
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Endoscopic classification of the papilla of Vater. Results of an inter- and intraobserver agreement study
- 2017
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Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 5:4, s. 504-510
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many endoscopists acknowledge that the appearance of the papilla of Vater seems to affect biliary cannulation. To assess the association between the macroscopic appearance of the papilla and biliary cannulation and other related clinical issues, a system is needed to define the appearance of the papilla. Objective: The purpose of this study was to validate an endoscopic classification of the papilla of Vater by assessing the interobserver and intraobserver agreements among endoscopist with varying experience. Methods: An endoscopic classification, based on pictures captured from 140 different papillae, containing four types of papillae was proposed. The four types are (a) Type 1: regular papilla, no distinctive features, ‘classic appearance’; (b) Type 2: small papilla, often flat, with a diameter ≤ 3 mm (approximately 9 Fr); (c) Type 3: protruding or pendulous papilla, a papilla that is standing out, protruding or bulging into the duodenal lumen or sometimes hanging down, pendulous with the orifice oriented caudally; and (d) Type 4: creased or ridged papilla, where the ductal mucosa seems to extend distally, rather out of the papillary orifice, either on a ridge or in a crease. To assess the level of interobserver agreement, a web-based survey was sent out to 18 endoscopists, containing 50 sets of still images of the papilla, distributed between the four different types. Three months later a follow-up survey, with images from the first survey was sent to the same endoscopists. Results: Interobserver agreement was substantial (κ = 0.62, 95% confidence interval (CI) 0.58–0.65) and were similar for both experts and non-experts. The intraobserver agreement assessed with the second survey was also substantial (κ = 0.66, 95% CI 0.59–0.72). Conclusion: The proposed endoscopic classification of the papilla of Vater seems to be easy to use, irrespective of the level of experience of the endoscopist. It carries a substantial inter- and intraobserver agreement and now the clinical relevance of the four different papilla types awaits to be determined.
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| 38. |
- Haraldsson, Erik, et al.
(författare)
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Endoscopic papillectomy and KRAS expression in the treatment of adenoma in the major duodenal papilla
- 2015
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 50:11, s. 1419-1427
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The use of endoscopic papillectomy for resecting adenomas in the major duodenal papilla is increasing. This study focuses on the following three issues: Can endoscopic papillectomy be performed as a safe diagnostic and/or therapeutic procedure in biopsy-verified or suspected ampullary adenoma? Does expression of mutated KRAS in resected adenomatous tissue predict long-term outcome? What other factors may affect long-term outcome and should, therefore, be considered in decision making prior to endoscopic papillectomy? Material and methods. Thirty-six prospectively collected patients who underwent endoscopic papillectomy at Karolinska University Hospital between 2005 and 2014 were analyzed. Results. The rate of exact agreement between the histomorphological grading of the endoscopic biopsies and the papillectomy specimens was low (48%). Obstructive jaundice at presentation increased the risk of undetected adenocarcinoma (RR = 3.98; 95% CI = 1.46-10.85, p = 0.007). Lesions with malignancies were significantly larger (mean 30.6 mm) than those where only adenomas were found (mean 14.4 mm, p = 0.001). Mutated KRAS was detected in 9 of the 36 post-papillectomy specimens, including 4 of the 5 cases of ampullary adenocarcinoma. Eighteen cases were endoscopically cured after a mean follow-up period of 47 months (range 16-92 months). Conclusions. Endoscopic papillectomy is a valuable staging tool because of the limitations of endoscopic biopsy. Endoscopic papillectomy concomitantly offers a curative treatment for most patients with adenoma in the major duodenal papilla. Jaundice at presentation and large adenomas may indicate the presence of more advanced disease. Determination of mutated KRAS seems to be of limited value in predicting long-term outcome.
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| 39. |
- Håkansson, Karl M. O., et al.
(författare)
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Nanofibril Alignment in Flow Focusing : Measurements and Calculations
- 2016
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1520-6106 .- 1520-5207. ; 120:27, s. 6674-6686
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Tidskriftsartikel (refereegranskat)abstract
- Alignment of anisotropic supermolecular building blocks is crucial to control the properties of many novel materials. In this study, the alignment process of cellulose nanofibrils (CNFs) in a flow-focusing channel has been investigated using small-angle X-ray scattering (SAXS) and modeled using the Smoluchowski equation, which requires a known flow field as input. This flow field was investigated experimentally using microparticle-tracking velocimetry and by numerically applying the two-fluid level set method. A semidilute dispersion of CNFs was modeled as a continuous phase, with a higher viscosity as compared to that of water. Furthermore, implementation of the Smoluchowski equation also needed the rotational Brownian diffusion coefficient, which was experimentally determined in a shear viscosity measurement. The order of the nanofibrils was found to increase during extension in the flow-focusing channel, after which rotational diffusion acted on the orientation distribution, driving the orientation of the fibrils toward isotropy. The main features of the alignment and dealignment processes were well predicted by the numerical model, but the model overpredicted the alignment at higher rates of extension. The apparent rotational diffusion coefficient was seen to increase steeply as the degree of alignment increased. Thus, the combination of SAXS measurements and modeling provides the necessary framework for quantified studies of hydrodynamic alignment, followed by relaxation toward isotropy.
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| 40. |
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