Free Flap Monitoring. Using Tissue Oxygen Measurement and Positron Emission Tomography

Aims:This study was carried out to evaluate the feasibility of two different methods to determine free flap perfusion in cancer patients undergoing major reconstructive surgery. The hypotheses was that low perfusion in the flap is associated with flap complications. Patients and methods: Between August 2002 and June 2008 at the Department of Otorhinolaryngology – Head and Neck Surgery, Department of Surgery, and at the PET Centre, Turku, 30 consecutive patients with 32 free flaps were included in this study. The perfusion of the free microvascular flaps was assessed with positron emission tomography (PET) and radioactive water ([¹⁵O] H₂O) in 40 radiowater injections in 33 PET studies. Furthermore, 24 free flaps were monitored with a continuous tissue oxygen measurement using flexible polarographic catheters for an average of three postoperative days. Results: Of the 17 patients operated on for head and neck (HN) cancer and reconstructed with 18 free flaps, three re-operations were carried out due to poor tissue oxygenation as indicated by p_tiO₂ monitoring results and three other patients were reoperated on for postoperative hematomas in the operated area. Blood perfusion assessed with PET (BF_PET) was above 2.0 mL / min / 100 g in all flaps and a low flap-to-muscle BFPET ratio appeared to correlate with poor survival of the flap. Survival in this group of HN cancer patients was 9.0 months (median, range 2.4-34.2) after a median follow-up of 11.9 months (range 1.0-61.0 months). Seven HN patients of this group are alive without any sign of recurrence and one patient has died of other causes. All of the 13 breast reconstruction patients included in the study are alive and free of disease at a median follow-up time of 27.4 months (range 13.9-35.7 months). Re-explorations were carried out in three patients due data provided by p_tiO₂ monitoring and one re-exploration was avoided on the basis of adequate blood perfusion assessed with PET. Two patients had donorsite morbidity and 3 patients had partial flap necrosis or fat necrosis. There were no total flap losses. Conclusions: P_tiO₂ monitoring is a feasible method of free flap monitoring when flap temperature is monitored and maintained close to the core temperature. When other monitoring methods give controversial results or are unavailable, [₁₅O] H₂O PET technique is feasible in the evaluation of the perfusion of the newly reconstructed free flaps.

Measurement and Improvement of Wet Paper Web Strength

Various strength properties of paper are measured to tell how well it resists breaks in a paper machine or in printing presses. The most often measured properties are dry tensile strength and dry tear strength. However, in many situations where paper breaks, it is not dry. For example, in web breaks after the wet pressing the dry matter content can be around 45%. Thus, wet-web strength is often a more critical paper property than dry strength. Both wet and dry strength properties of the samples were measured with a L&W tensile tester. Originally this device was not designed for the measurement of the wet web tensile strength, thus a new procedure to handle the wet samples was developed. The method was tested with Pine Kraft (never dried). The effect of different strength additives on the wet-web and dry paper tensile strength was studied. The polymers used in this experiment were aqueous solution of a cationic polyamidoamine-epichlorohydrin resin (PAE), cationic hydrophilised polyisocyanate and cationic polyvinylamine (PVAm). From all three used chemicals only Cationic PAE considerably increased the wet web strength. However it was noticed that at constant solids content all chemicals decreased the wet web tensile strength. So, since all chemicals enhanced solid content it can be concluded that they work as drainage aids, not as wet web strength additives. From all chemicals only PVAm increased the dry strength and two other chemicals even decreased the strength. As chemicals were used in strong diluted forms and were injected into the pulp slurry, not on the surface of the papersheets, changes in samples densities did not happen. Also it has to be noted that all these chemicals are mainly used to improve the wet strength after the drying of the web.

Performance Measurement of the Logistics Process

The objective of the thesis was to create a performance measurement system for the logistics process of a company. In addition, one goal was to make suggestions for improvements based on description and analysis of the process and current measures. The logistics process was described in detail, and the objectives for it were derived from the company strategy and goals. Suggestions for performance measurement system and process improvement were made based on current state analysis. As a result of the thesis, three new performance measures were decided to take into use. In addition, several improvements were suggested to the ERP system to make process smoother. Some of the improvements have already been added to the system and the rest will be added in the near future.

Teknisen auringonsuojauksen tukikonseptin liiketoimintalähtöinen arviointi

Työssä tutkitaan erään tekniseen auringonsuojaukseen keskittyneen yrityksen päätöstä tuottaa aloittelevia yrityksiä palveleva tukikonsepti. Konsepti sisältää mitoitusohjelmia, kokoonpano-ohjeita sekä markkinointimateriaalia. Oleellista on selvittää kannattaako yrityksen keskittyä kyseisiin asiakkaisiin, sekä onko konsepti oikea ratkaisu tälle segmentille. Tätä varten työssä tutustuttiin toimiala-analyysiin, strategiaan, segmentointiin sekä differointiin. Työssä selvitettiin, että Porterin viiden voiman malli on yhä toimiva aloitus toimiala-analyysin laatimiseen. Strategiaan liittyviä koulukuntia löytyy kirjallisuudesta useita erilaisia, oleellista on löytää oikea lähestymistapa kuhunkin tilanteeseen. Segmentointi on tärkeä vaihe, koska sen avulla selvitetään yrityksen eri asiakasryhmiä. Differointi on usein suositeltu keino kilpailuedun tavoittelemiseen. Työtä varten laadittiin yritykselle toimiala-analyysi. Lisäksi yritykselle etsittiin segmenttejä sekä pohdittiin sen mahdollisuuksia differointiin. Segmenttejä löydettiin kolme erilaista. Samalla todettiin, että paras tapa differoida yrityksen tuotteita on keskittyä tuotteiden aineettomiin ominaisuuksiin. Toimiala-analyysin, segmenttien sekä differointimahdollisuuksien perusteella päädyttiin siihen, että yrityksen päätös keskittyä enemmän uusiin ja aloitteleviin asiakkaisiin vaikuttaa järkevältä. Konseptin ominaisuuksien perusteella myös konsepti vaikuttaa hyvältä tavalta palvella kyseistä asiakassegmenttiä.

Harmonized performance measurement system for basic industry's service centers

The objective of this study is to create measurement system that is capable to measure performance in basic industry’s service centers. First it is examined what is performance and how it can be measured. The study also introduces commonly known measurement frameworks. After theory the study investigates how companies in the field of basic industry measure their operations in practise. The investigation is done examining three case examples and by analyzing survey results from basic industry companies. On the survey results focus is on what meters and measurement systems companies use. It is also viewed what measurement problems companies have faced. In the applied part of the study harmonized performance measurement system is created. The framework of the measurement system is introduced and measurement system for the target company is created. The target company felt that the harmonized performance measurement system has good potential and continues to develop it further.

Phase voltage control and filtering in a converter-fed single-phase customer-end system of the LVDC distribution network

In recent years, the network vulnerability to natural hazards has been noticed. Moreover, operating on the limits of the network transmission capabilities have resulted in major outages during the past decade. One of the reasons for operating on these limits is that the network has become outdated. Therefore, new technical solutions are studied that could provide more reliable and more energy efficient power distributionand also a better profitability for the network owner. It is the development and price of power electronics that have made the DC distribution an attractive alternative again. In this doctoral thesis, one type of a low-voltage DC distribution system is investigated. Morespecifically, it is studied which current technological solutions, used at the customer-end, could provide better power quality for the customer when compared with the current system. To study the effect of a DC network on the customer-end power quality, a bipolar DC network model is derived. The model can also be used to identify the supply parameters when the V/kW ratio is approximately known. Although the model provides knowledge of the average behavior, it is shown that the instantaneous DC voltage ripple should be limited. The guidelines to choose an appropriate capacitance value for the capacitor located at the input DC terminals of the customer-end are given. Also the structure of the customer-end is considered. A comparison between the most common solutions is made based on their cost, energy efficiency, and reliability. In the comparison, special attention is paid to the passive filtering solutions since the filter is considered a crucial element when the lifetime expenses are determined. It is found out that the filter topology most commonly used today, namely the LC filter, does not provide economical advantage over the hybrid filter structure. Finally, some of the typical control system solutions are introduced and their shortcomings are presented. As a solution to the customer-end voltage regulation problem, an observer-based control scheme is proposed. It is shown how different control system structures affect the performance. The performance meeting the requirements is achieved by using only one output measurement, when operating in a rigid network. Similar performance can be achieved in a weak grid by DC voltage measurement. An additional improvement can be achieved when an adaptive gain scheduling-based control is introduced. As a conclusion, the final power quality is determined by a sum of various factors, and the thesis provides the guidelines for designing the system that improves the power quality experienced by the customer.

Creating a Performance Measurement System for Accounting Services of Large Paper Company

The main objective of this research is creating a performance measurement system for accounting services of a large paper industry company. In this thesis there are compared different performance measurement system and then selected two systems, which are presented and compared more detailed. Performance Prism system is the used framework in this research. Performance Prism using success maps to determining objectives. Model‟s target areas are divided into five groups: stakeholder satisfaction, stakeholder contribution, strategy, processes and capabilities. The measurement system creation began by identifying stakeholders and defining their objectives. Based on the objectives are created success map. Measures are created based on the objectives and success map. Then is defined needed data for measures. In the final measurement system, there are total just over 40 measures. Each measure is defined specific target level and ownership. Number of measures is fairly large, but this is the first version of the measurement system, so the amount is acceptable.

Sales performance measurement and steering in a multinational company

The objective of the study is to find out how sales performance should be measured and how should sales be steered in a multinational company. The beginning of the study concentrates on the literature regarding sales, performance measurement, sales performance measurement, and sales steering. The empirical part of the study is a case study, in which the information was acquired from interviews with the key personnel of the company. The results of the interviews and the revealed problems were analyzed, and comparison for possible solutions was performed. When measuring sales performance, it is important to discover the specific needs and objectives for such a system. Specific needs should be highlighted in the design of the system. The system should be versatile and the structure of the system should be in line with the organizational structure. The role of the sales performance measurement system was seen to be important in helping sales steering. However, the importance of personal management and especially conversations were seen as really critical issue in the steering. Sales performance measurement could be based on the following perspectives: financial, market, customer, people, and future. That way the sales department could react to the environmental changes more rapidly.

Soodakattilan lentotuhkan uudentyyppisen analysaattorin arviointi

RBDA (Recovery Boiler Dust Analyzer) on soodakattilan savukaasujen hiukkasten määrää mittaava laite. Yksi laitteen mahdollisista sovelluskohteista on soodakattilan nuohouksen optimointi. Tämän työn tarkoituksena oli parantaa RBD-analysaattorin toimintaa ja erityisesti tutkia laitteen toimivuutta soodakattilan nuohouksen optimoinnis-sa. Soodakattilan nuohouksen optimoinnilla voidaan vähentää nuohoukseen kuluneen höyryn määrää ja näin saavuttaa taloudellisia säästöjä. RBD-analysaattorin toimivuutta testattiin toimivan soodakattilan avulla. Tutkimuksen tueksi testeissä käytetyn soodakattilan savukaasujen lämpötilat ja tuhkan tarttumisomi-naisuudet selvitettiin. Laitteen toimivuutta testattiin vertaamalla RBDA:n mittaustulosta standardin mukaiseen savukaasujen hiukkasmittausmenetelmään. Mittajärjestelmän soveltuvuutta soodakattilan nuohouksen optimointiin tutkittiin ajamalla nuohoimia käsin eri seisonta-aikojen jälkeen sekä mittaamalla soodakattilan normaalia nuohousjärjes-tystä. Mittausten perusteella todettiin, että RBDA havaitsee savukaasujen pölypitoisuuden ja sen muutokset luotettavasti. Nuohouksen optimointiin RBDA:n todettiin soveltuvan ny-kyisessä mallissaan vain vedenesilämmittimien osalta. Keittopinnan ja tulistimien nuo-hointen optimointiin ei saatu riittävän luotettavia mittaustuloksia. RBDA:n kehittäminen jatkotutkimuksilla todettiin mahdolliseksi.

Design of Pulsed Electroacoustic Measurement System for Space Charge Characterisation

Pulsed electroacoustic (PEA) method is a commonly used non-destructive technique for investigating space charges. It has been developed since early 1980s. These days there is continuing interest for better understanding of the influence of space charge on the reliability of solid electrical insulation under high electric field. The PEA method is widely used for space charge profiling for its robust and relatively inexpensive features. The PEA technique relies on a voltage impulse used to temporarily disturb the space charge equilibrium in a dielectric. The acoustic wave is generated by charge movement in the sample and detected by means of a piezoelectric film. The spatial distribution of the space charge is contained within the detected signal. The principle of such a system is already well established, and several kinds of setups have been constructed for different measurement needs. This thesis presents the design of a PEA measurement system as a systems engineering project. The operating principle and some recent developments are summarised. The steps of electrical and mechanical design of the instrument are discussed. A common procedure for measuring space charges is explained and applied to verify the functionality of the system. The measurement system is provided as an additional basic research tool for the Corporate Research Centre of ABB (China) Ltd. It can be used to characterise flat samples with thickness of 0.2–0.5 mm under DC stress. The spatial resolution of the measurement is 20 μm.

Automatisointiin ja monistettavuuteen perustuvan palvelumallin soveltaminen tietojärjestelmätoimituksissa

Ohjelmistotuotannon yleinen ongelma on se, että toimitusprojektien läpivientiajat pitkittyvät. Kilpailun kiristyessä ohjelmistoalalla on alettu kiinnittää erityistä huomiota projektien eri vaiheiden tehostamiseen. Process Vision Oy kehittää energiatietojärjestelmiä Suomen energia-alan yrityksille. Yrityksessä on kehitetty vuonna 2010 palvelumalli, jonka avulla pyritään nopeuttamaan toimitusprojektien eri vaiheita. Valtioneuvosto valmisteli vuonna 2009 tuntimittausasetuksen, joka määritti sääntöjä mittaustiedon hallintaan energia-alalla. Kyseisen asetuksen pohjalta Energiateollisuus julkaisi vuonna 2010 ohjeistuksen, joka selkeyttää asetuksen sisällön vaatimuksia jakeluverkonhaltijoille ja sähkön myyjille. Process Vision Oy on valmistellut ohjeistuksen pohjalta tuntimittauspaketin, joka sisältää ohjeistuksen mukaiset toiminnot GENERIS-järjestelmässä. Tässä diplomityössä määritellään Process Vision Oy:n palvelumallin mukaiset standardikomponentit tuntimittauspaketin toimitusprojekteja varten. Työn tavoitteena on kehittää mahdollisimman pitkälle tuotteistettu tuntimittauspaketin toimitus uusille ja vanhoille asiakkaille. Työn lopussa pohditaan miten hyvin palvelumalli soveltuu tuntimittauspaketin toimitusprojekteihin. Lisäksi työssä kartoitetaan yrityksessä käytössä olevien automatisointityökalujen kehitystarpeita. Työn tuloksena saatiin määriteltyä GENERIS-objektit ja konfiguraatiot, jotka toimitetaan tuntimittauspaketin mukana. Työn ohessa sisällytettiin yrityksen Suomen taseselvitysjärjestelmien asennusohjeeseen tuntimittauspaketin toiminnallisuuksien konfigurointi. Uusien vientimäärittelyjen avulla voidaan tuntimittauspaketin toiminnallisuudet toimittaa jatkossa tehokkaammin kuin aiemmin.

Developing the measurement and management of knowledge: applying the constructive research approach in a knowledge intensive service environment

Intellectual assets have attained continuous attention in the academic field, as they are vital sources of competitive advantage and organizational performance in the contemporary knowledge intensive business environment. Intellectual capital measurement is quite thoroughly addressed in the accounting literature. However, the purpose of the measurement is to support the management of intellectual assets, but the reciprocal relationship between measurement and management has not been comprehensively considered in the literature. The theoretical motivation for this study rose from this paradox, as in order to maximise the effectiveness of knowledge management the two initiatives need to be closely integrated. The research approach of this interventionist case study is constructive. The objective is to develop the case organization’s knowledge management and intellectual capital measurement in a way that they would be closely integrated and the measurement would support the management of intellectual assets. The case analysis provides valuable practical considerations about the integration and related issues as the case company is a knowledge intensive organization in which the know-how of the employees is the central competitive asset and therefore, the management and measurement of knowledge are essential for its future success. The results suggest that the case organization is confronting challenges in managing knowledge. In order to appropriately manage knowledge processes and control the related risks, support from intellectual capital measurement is required. However, challenges in measuring intellectual capital, especially knowledge, could be recognized in the organization. By reflecting the knowledge management situation and the constructed strategy map, a new intellectual measurement system was developed for the case organization. The construction of the system as well as its indicators can be perceived to contribute to the literature, emphasizing of the importance of properly considering the organization’s knowledge situation in developing an intellectual capital measurement system.