Lymph node transfer in the treatment of postmastectomy lymphedema

Background: Lymphedema is a debilitating disorder with few treatment options. Clinical studies have shown that microvascular lymph node transfer may improve the lymphatic function of the affected limb. This study provides information about the clinical efficacy and safety of this procedure. Further, the biological background of this technique is clarified with an analysis of postoperative production of lymphatic growth factors and cytokines related to lymphangiogenesis. Patients and Methods: The effect of lymph node transfer to recipient and donor sites was analyzed with lymphoscintigraphy, limb circumference measurements, and appearance of clinical symptoms. Axillary seroma samples were analyzed from four patient groups: Axillary lymph node removal (ALND), Microvascular breast reconstruction (BR), lymph node transfer (LN) and combined lymph node transfer and breast reconstruction (LN-BR). Results: The postoperative lymphatic transport index was improved in 7/19 patients. Ten patients were able to reduce or discontinue compression therapy 6 - 24 months postoperatively. The donor lower limb lymphatic flow was slightly impaired (Ti >10) in 2 patients. No donor site lymphedema symptoms appeared during the 8 – 56-month follow-up. A high concentration of the VEGF-C protein was detected in the seroma fluid of all flap transfer groups. The concentration of the anti-inflammatory and anti-fibrotic cytokine IL-10 was increased in the LN-BR group samples when compared to the ALND or BR group. Conclusions: According to this preliminary study, the lymph node transfer seems to be beneficial for the lymphedema patients. However, a randomized study comparing the effect of BR and LN-BR is needed to evaluate the clinical efficacy of lymph node transfer. In addition, the effect of this surgery on the donor site needs to be studied further. The clinical effects of the lymph node transfer might be partly mediated by increased production of the lymphangiogenic growth factor (VEGF-C) as well as the anti-fibrotic cytokine (IL-10).

Use of fiber-reinforced composite framework and thermochromic pigment in maxillofacial prostheses

The purpose of this investigation was to evaluate the possibility to enhance certain qualities of facial prostheses. Polymethyl methacrylate is still being used as base mate¬rial or clip carrier material, but it is hard and heavy, and debonding of the silicone from the acrylic base material is a frequent problem. This thesis aims to evaluate the use of fiber-reinforced composite (FRC) as framework material for maxillofacial silicone prostheses. FRC has been used as reinforcement in removable and fixed partial dentures since the 1990s. This material is lightweight and can be fabricated to compress the margins of the prosthesis slightly, to keep it tightly against the skin during jaw movements and facial expressions. Additionally, the use of a thermochromic pigment, colorless in room temperature and red in a cold environment, was studied in order to evaluate the possibility of using this color changing pigment in facial prostheses to mimic the color change of facial skin in cold weather. The tensile bond strength between pre-impregnated, unidirectional FRC and maxillofacial silicone elastomer was studied. Three different bonding agents or primers were compared. Bond strength was improved by one of the primers and by roughening the surface. The effect of a skin compressing glass fiber-reinforced composite framework on facial skin blood flow was studied by using a face mask, constructed with a compression pad corresponding to the outer margin of a glass fiber-reinforced framework beam of a facial prosthesis. The skin blood flow of ten healthy volunteers, aged 23-25 years, was measured during touch, light, and moderate compression of the skin, by using laser Doppler imaging technique. None of the compressions showed any marked effects on local skin blood flow. There were no significant differences between blood flow during compression and at baseline. Maxillofacial silicone elastomer was colored intrinsically with conventional color pigments: a control group containing only conventional pigments was compared to two test groups with 0.2 wt% and 0.6 wt% thermochromic pigment added. The color of the material was measured with a spectrophotometer in room temperature and after storage in a freezer. The color stability of the maxillofacial silicone elastomer colored with thermo¬chromic pigment was evaluated by artificial aging. The color dif¬ference of the L* (lightness) and a* values (redness), comparing color after the samples were stored at room temperature and in a freezer (-19°C), was statistically significant for both 0.2 wt% and 0.6 wt% thermo¬chromic pigment groups. The differences in the b* values (yellowness) were statistically significant for the 0.6 wt% group. Exposure to ultraviolet (UV) radiation led to visually noticeable and statistically signifi¬cant color changes (ΔE) in all color values in both test groups. The specimens containing thermochromic pigment were very sensitive to UV radiation. In conclusion, a framework of fiber-reinforced composite can successfully be bonded to maxillofacial silicone elastomer, and a framework beam, compressing the facial skin, did not remarkably alter the skin blood flow on healthy, young adults. The thermochromic pigment showed color change in maxillofacial silicone elastomer. However, artificial aging showed that it was too sensitive to UV radiation to be used, as such, in maxillofacial prostheses.

Towards sustainable Iron- and steelmaking with economic optimization

The iron and steelmaking industry is among the major contributors to the anthropogenic emissions of carbon dioxide in the world. The rising levels of CO2 in the atmosphere and the global concern about the greenhouse effect and climate change have brought about considerable investigations on how to reduce the energy intensity and CO2 emissions of this industrial sector. In this thesis the problem is tackled by mathematical modeling and optimization using three different approaches. The possibility to use biomass in the integrated steel plant, particularly as an auxiliary reductant in the blast furnace, is investigated. By pre-processing the biomass its heating value and carbon content can be increased at the same time as the oxygen content is decreased. As the compression strength of the preprocessed biomass is lower than that of coke, it is not suitable for replacing a major part of the coke in the blast furnace burden. Therefore the biomass is assumed to be injected at the tuyere level of the blast furnace. Carbon capture and storage is, nowadays, mostly associated with power plants but it can also be used to reduce the CO2 emissions of an integrated steel plant. In the case of a blast furnace, the effect of CCS can be further increased by recycling the carbon dioxide stripped top gas back into the process. However, this affects the economy of the integrated steel plant, as the amount of top gases available, e.g., for power and heat production is decreased. High quality raw materials are a prerequisite for smooth blast furnace operation. High quality coal is especially needed to produce coke with sufficient properties to ensure proper gas permeability and smooth burden descent. Lower quality coals as well as natural gas, which some countries have in great volumes, can be utilized with various direct and smelting reduction processes. The DRI produced with a direct reduction process can be utilized as a feed material for blast furnace, basic oxygen furnace or electric arc furnace. The liquid hot metal from a smelting reduction process can in turn be used in basic oxygen furnace or electric arc furnace. The unit sizes and investment costs of an alternative ironmaking process are also lower than those of a blast furnace. In this study, the economy of an integrated steel plant is investigated by simulation and optimization. The studied system consists of linearly described unit processes from coke plant to steel making units, with a more detailed thermodynamical model of the blast furnace. The results from the blast furnace operation with biomass injection revealed the importance of proper pre-processing of the raw biomass as the composition of the biomass as well as the heating value and the yield are all affected by the pyrolysis temperature. As for recycling of CO2 stripped blast furnace top gas, substantial reductions in the emission rates are achieved if the stripped CO2 can be stored. However, the optimal recycling degree together with other operation conditions is heavily dependent on the cost structure of CO2 emissions and stripping/storage. The economical feasibility related to the use of DRI in the blast furnace depends on the price ratio between the DRI pellets and the BF pellets. The high amount of energy needed in the rotary hearth furnace to reduce the iron ore leads to increased CO2 emissions.

Double grade – rakenneputkien puristuskestävyys

Double grade S420MH/S355J2H – rakenneputki on Ruukin kylmämuovattujen rakenneputkien vakioteräslaji. Se voidaan mitoittaa joko lujuusluokan S355 tai S420 mukaisesti. Teräslajin S355 mukaisesti mitoitettaessa on suunnittelu yksinkertaista. Painonsäästöä ja pidennettyjä jännevälejä haluttaessa käytetään lujuusluokan S420 mukaista mitoitusta. Työn tavoitteena oli selvittää kylmämuovattujen teräsrakenneputkien todellinen puristuskestävyys. Eurocode 3:n mukaan kylmämuovatut teräsrakenneputket kuuluvat nurjahduskäyrälle c. Tutkimukseen valittiin viisi eri profiilia olevaa rakenneputkea, joiden poikkileikkausluokat olivat 1, 2, 3 ja 4. Käytettäessä rakenneputkia puristussauvoina, on teräksen käyttö tehokkainta poikkileikkausluokassa 3, lähellä poikkileikkausluokkaa 4. Rakenneputkista laskettiin muunnetun hoikkuuden arvoilla 0.1, 0.5, 1.0 ja 1.5 koesauvojen pituudet kaikille profiileille. Valmistettiin kolme samanlaista koesauvaa jokaisesta koosta ja puristuskokeita suoritettiin yhteensä 57 kappaletta. Koesauvojen todelliset pituudet, alkukäyryydet ja poikkileikkaukset mitattiin. Ainestodistuksista saatiin materiaalin todelliset lujuudet. Laskettiin Eurocode 3:n mukaisesti kestävyydet nurjahduskäyrille a, b ja c. Laskennallisia kestävyyksiä verrattiin puristuskokeiden tuloksiin. Puristuskokeiden tulosten perusteella voidaan b-käyrää pitää oikeana profiileille 100x100x3, 150,150x5 ja 200x200x6. Profiili 150x150x5 kuuluu poikkileikkausluokkaan 2. Profiilit 100x100x3 ja 200x200x6 kuuluvat poikkileikkausluokkaan 4. Profiili 50x50x2 kuuluu nurjahduskäyrälle c. Profiilin poikkileikkausluokka on 1 ja aiemmat tutkimukset tukevat nurjahduskäyrän c käyttöä. Profiilista 300x300x8.8 ei saatu testattua täyttä sarjaa sen suuren kapasiteetin rikottua testilaitteiston, mutta puristuskokeiden perusteella se kuuluu nurjahduskäyrälle b. Profiili kuuluu poikkileikkausluokkaan 4.

Vedyn käytön tarkastelu Kemira Chemicals Oy:n Joutsenon tehtailla

Kemira Chemicals Oy:n Joutsenon tehtailla valmistetaan lipeää, suolahappoa, natriumhypokloriittia sekä natriumkloraattia. Lipeää, suolahappoa ja natriumhypokloriittia valmistetaan lipeätehtaassa. Natriumkloraattia valmistetaan kloraattitehtaassa. Kloraatti- ja lipeätehtaan tuotteet valmistetaan elektrolyysimenetelmällä. Elektrolyysien sivutuotteena syntyy vetykaasua, joka voidaan käyttää suolahapon valmistukseen, vetyvoimalaitoksen polttoaineena tai myydä asiakkaalle. Työn tavoitteena oli tarkastella vedyn käyttöä Joutsenon tehtailla. Tarkastelun tavoitteena oli löytää mahdollisia kehitys- tai jatkotutkimuskohteita vety- ja höyryjärjestelmästä. Koska vetyä käytetään myös vetyvoimalaitoksen polttoaineena, joka tuottaa tehtailla tarvittavan prosessihöyryn, tarkasteltiin työssä myös höyryn käyttöä tehtailla. Tarkastelua varten tehtiin Microsoft Excel-pohjainen taselaskentamalli, jolla simuloitiin vedyn ja höyryn käyttöä tehtailla. Työn tuloksena saatiin Excel-pohjainen simulointimalli, jolla pystyttiin tutkimaan vedyn ja höyryn käyttöä. Vedyn ja höyryn käyttöä tutkittiin viidessä eri skenaariossa. Skenaariossa yksi määritettiin pienimmät mahdolliset elektrolyysiin syötettävät sähkövirran arvot, joilla tehtaita on turvallista käyttää. Skenaariossa kaksi määritettiin pienimmät mahdolliset elektrolyysiin syötettävät sähkövirran arvot, joilla voimalaitoksen turbiini pysyisi ajossa. Skenaariossa kolme määritettiin tehtaiden tämän hetkinen maksimi kapasiteetti. Skenaarioissa neljä ja viisi tutkittiin, miten mahdollinen tehtaiden tuotantojen kasvattaminen vaikuttaisi vety- ja höyryjärjestelmään. Työn tuloksien perusteella kehitys- ja jatkotutkimuskohteita olisivat lipeän haihdutuksen höyryn kulutuksen pienentäminen, turbiinin käyttöajan kasvattaminen sekä eri lähteistä saatavan hukkalämmön parempi hyödyntäminen kaukolämmön tuotannossa. Tehtaiden tuotantoja kasvatettaessa on syytä kiinnittää huomioita myös voimalaitoksen pääkattilan ja turbiinin kapasiteettiin.

Genesis and Evolution of Brittle Structures In Southwestern Finland and Western South Africa. Insights into Fault Reactivation, Fluid Flow and Structural Maturity in Precambrian Cratons

The bedrock of old crystalline cratons is characteristically saturated with brittle structures formed during successive superimposed episodes of deformation and under varying stress regimes. As a result, the crust effectively deforms through the reactivation of pre-existing structures rather than by through the activation, or generation, of new ones, and is said to be in a state of 'structural maturity'. By combining data from Olkiluoto Island, southwestern Finland, which has been investigated as the potential site of a deep geological repository for high-level nuclear waste, with observations from southern Sweden, it can be concluded that the southern part of the Svecofennian shield had already attained structural maturity during the Mesoproterozoic era. This indicates that the phase of activation of the crust, i.e. the time interval during which new fractures were generated, was brief in comparison to the subsequent reactivation phase. Structural maturity of the bedrock was also attained relatively rapidly in Namaqualand, western South Africa, after the formation of first brittle structures during Neoproterozoic time. Subsequent brittle deformation in Namaqualand was controlled by the reactivation of pre-existing strike-slip faults.In such settings, seismic events are likely to occur through reactivation of pre-existing zones that are favourably oriented with respect to prevailing stresses. In Namaqualand, this is shown for present day seismicity by slip tendency analysis, and at Olkiluoto, for a Neoproterozoic earthquake reactivating a Mesoproterozoic fault. By combining detailed field observations with the results of paleostress inversions and relative and absolute time constraints, seven distinctm superimposed paleostress regimes have been recognized in the Olkiluoto region. From oldest to youngest these are: (1) NW-SE to NNW-SSE transpression, which prevailed soon after 1.75 Ga, when the crust had sufficiently cooled down to allow brittle deformation to occur. During this phase conjugate NNW-SSE and NE-SW striking strike-slip faults were active simultaneous with reactivation of SE-dipping low-angle shear zones and foliation planes. This was followed by (2) N-S to NE-SW transpression, which caused partial reactivation of structures formed in the first event; (3) NW-SE extension during the Gothian orogeny and at the time of rapakivi magmatism and intrusion of diabase dikes; (4) NE-SW transtension that occurred between 1.60 and 1.30 Ga and which also formed the NW-SE-trending Satakunta graben located some 20 km north of Olkiluoto. Greisen-type veins also formed during this phase. (5) NE-SW compression that postdates both the formation of the 1.56 Ga rapakivi granites and 1.27 Ga olivine diabases of the region; (6) E-W transpression during the early stages of the Mesoproterozoic Sveconorwegian orogeny and which also predated (7) almost coaxial E-W extension attributed to the collapse of the Sveconorwegian orogeny. The kinematic analysis of fracture systems in crystalline bedrock also provides a robust framework for evaluating fluid-rock interaction in the brittle regime; this is essential in assessment of bedrock integrity for numerous geo-engineering applications, including groundwater management, transient or permanent CO2 storage and site investigations for permanent waste disposal. Investigations at Olkiluoto revealed that fluid flow along fractures is coupled with low normal tractions due to in-situ stresses and thus deviates from the generally accepted critically stressed fracture concept, where fluid flow is concentrated on fractures on the verge of failure. The difference is linked to the shallow conditions of Olkiluoto - due to the low differential stresses inherent at shallow depths, fracture activation and fluid flow is controlled by dilation due to low normal tractions. At deeper settings, however, fluid flow is controlled by fracture criticality caused by large differential stress, which drives shear deformation instead of dilation.

Dynamic carbon dioxide liquidization model

In literature CO 2 liquidization is well studied with steady state modeling. Steady state modeling gives an overview of the process but it doesn’t give information about process behavior during transients. In this master’s thesis three dynamic models of CO2 liquidization were made and tested. Models were straight multi-stage compression model and two compression liquid pumping models, one with and one without cold energy recovery. Models were made with Apros software, models were also used to verify that Apros is capable to model phase changes and over critical state of CO 2. Models were verified against compressor manufacturer’s data and simulation results presented in literature. From the models made in this thesis, straight compression model was found to be the most energy efficient and fastest to react to transients. Also Apros was found to be capable tool for dynamic liquidization modeling.

Cardiac Imaging in the Diagnosis of Coronary Artery Disease: The Value of Quantitative Imaging of Myocardial Perfusion and Deformation

Atherosclerosis is a chronic and progressive disease of the vasculature. Increasing coronary atherosclerosis can lead to obstructive coronary artery disease (CAD) or myocardial infarction. Computed tomography angiography (CTA) allows noninvasive assessment of coronary anatomy and quantitation of atherosclerotic burden. Myocardial blood flow (MBF) can be accurately measured in absolute terms (mL/g/min) by positron emission tomography (PET) with [15O] H O as a radiotracer. We studied the coronary microvascular dysfunction as a risk factor for future coronary calcification in healthy young men by measuring the coronary flow reserve (CFR) which is the ratio between resting and hyperemic MBF. Impaired vasodilator function was not linked with accelerated atherosclerosis 11 years later. Currently, there is a global interest in quantitative PET perfusion imaging. We established optimal thresholds of [15O] H O PET perfusion for diagnosis of CAD (hyperemic MBF of 2.3 mL/g/min and CFR of 2.5) in the first multicenter study of this type (Turku, Amsterdam and Uppsala). In myocardial bridging a segment of the coronary artery travels inside the myocardium and can be seen as intramural course (CTA) or systolic compression (invasive coronary angiography). Myocardial bridging is frequently linked with proximal atherosclerotic plaques. We used quantitative [15O] H O PET perfusion to evaluate the hemodynamic effects of myocardial bridging. Myocardial bridging was not associated with decreased absolute MBF or increased atherosclerotic burden. Speckle tracking allows quantitative echocardiographic imaging of myocardial deformation. Speckle tracking during dobutamine stress echocardiography was feasible and comparable to subjective wall motion analysis in the diagnosis of CAD. In addition, it correctly risk stratified patients with multivessel disease and extensive ischemia.

Design and Material Selection of High-Speed Rotating Electrical Machines

The increasing emphasis on energy efficiency is starting to yield results in the reduction in greenhouse gas emissions; however, the effort is still far from sufficient. Therefore, new technical solutions that will enhance the efficiency of power generation systems are required to maintain the sustainable growth rate, without spoiling the environment. A reduction in greenhouse gas emissions is only possible with new low-carbon technologies, which enable high efficiencies. The role of the rotating electrical machine development is significant in the reduction of global emissions. A high proportion of the produced and consumed electrical energy is related to electrical machines. One of the technical solutions that enables high system efficiency on both the energy production and consumption sides is high-speed electrical machines. This type of electrical machines has a high system overall efficiency, a small footprint, and a high power density compared with conventional machines. Therefore, high-speed electrical machines are favoured by the manufacturers producing, for example, microturbines, compressors, gas compression applications, and air blowers. High-speed machine technology is challenging from the design point of view, and a lot of research is in progress both in academia and industry regarding the solution development. The solid technical basis is of importance in order to make an impact in the industry considering the climate change. This work describes the multidisciplinary design principles and material development in high-speed electrical machines. First, high-speed permanent magnet synchronous machines with six slots, two poles, and tooth-coil windings are discussed in this doctoral dissertation. These machines have unique features, which help in solving rotordynamic problems and reducing the manufacturing costs. Second, the materials for the high-speed machines are discussed in this work. The materials are among the key limiting factors in electrical machines, and to overcome this limit, an in-depth analysis of the material properties and behavior is required. Moreover, high-speed machines are sometimes operating in a harsh environment because they need to be as close as possible to the rotating tool and fully exploit their advantages. This sets extra requirements for the materials applied.