Total esophagogastrectomy in the neoplasms of the esophagus and esofagogastric junction: when must be indicated?

Objective: to analyse the indications and results of the total esophagogastrectomy in cancers of the distal esophagus and esophagogastric junction. Methods: twenty patients with adenocarcinomas were operated with a mean age of 55 ± 9.9 years (31-70 years), and 14 cases were male (60%). Indications were 18 tumors of the distal esophagus and esophagogastric junction (90%) and two with invasion of gastric fundus (10%) in patients with previous gastrectomy. Preoperative colonoscopy to exclude colonic diseases was performed in ten cases. Results: the surgical technique consisted of median laparotomy and left cervicotomy, followed by transhiatal esophagectomy associated with D2 lymphadenectomy. The reconstructions were performed with eight esophagocoloduodenoplasty and the others were Roux-en-Y esophagocolojejunoplasty to prevent the alkaline reflux. Three cases were stage I / II, while 15 cases (85%) were stages III / IV, reflecting late diagnosis of these tumors. The operative mortality was 5 patients (25%): a mediastinitis secondary to necrosis of the transposed colon, abdominal cellulitis secondary to wound infection, severe pneumonia, an irreversible shock and sepsis associated with colojejunal fistula. Four patients died in the first year after surgery: 3 (15%) were due to tumor recurrence and 1 (5%) secondary to bronchopneumonia. The 5-year survival was 15%. Conclusion: the total esophagogastrectomy associated with esophagocoloplasty has high morbidity and mortality, requiring precise indication, and properly selected patients benefit from the surgery, with the risk-benefit acceptable, contributing to increased survival and improved quality of life

The role of advance payments in working capital management and profitability

The objective of this thesis is to study the role of received advance payments in working capital management by creating a new measurement and to study the relationship between advance payments and profitability. The study has been conducted using narrative literature review and quantitative research methods. The research was made analyzing 108 companies listed in Helsinki Stock Exchange. The results indicate that 68 % of the studied companies are receiving advance payments and the average cycle time for received advance payments is 13 days. A new key figure is created to include received advance payments into the calculation of working capital. Received advance payments shorten the working capital cycle, by 13 days, when they are used in the calculation. The role of advance payments is not as significant as the role of receivables and inventories but advance payments may have a larger role than payables if the company is receiving noticeable amounts of advance payments. There are three branches where companies are receiving more advance payments than average companies. The branches are project business and ICT and publishing sectors. There is a negative correlation between profitability and advance payments based on the results of this study.

Design of salient pole PM synchronous machines for a vehicle traction application – Analysis and

This doctoral thesis presents a study on the development of a liquid-cooled frame salient pole permanent-magnet-exited traction machine for a four-wheel-driven electric car. The emphasis of the thesis is put on a radial flux machine design in order to achieve a light-weight machine structure for traction applications. The design features combine electromagnetic and thermal design methods, because traction machine operation does not have a strict operating point. Arbitrary load cycles and the flexible supply require special attention in the design process. It is shown that accurate modelling of the machine magnetic state is essential for high-performance operation. The saturation effect related to the cross-saturation has to be taken carefully into account in order to achieve the desired operation. Two prototype machines have been designed and built for testing: one totally enclosed machine with a special magnet module pole arrangement and another through-ventilated machine with a more traditional embedded magnet structure. Both structures are built with magnetically salient structures in order to increase the torque production capability with the reluctance torque component. Both machine structures show potential for traction usage. However, the traditional embedded magnet design turns out to be mechanically the more secure one of these two machine options.

Modeling and Control of the Power Conversion Unit in a Solid Oxide Fuel Cell Environment

In this doctoral thesis, a power conversion unit for a 10 kWsolid oxide fuel cell is modeled, and a suitable control system is designed. The need for research was identified based on an observation that there was no information available about the characteristics of the solid oxide fuel cell from the perspective of power electronics and the control system, and suitable control methods had not previously been studied in the literature. In addition, because of the digital implementation of the control system, the inherent characteristics of the digital system had to be taken into account in the characteristics of the solid oxide fuel cell (SOFC). The characteristics of the solid oxide fuel cell as well the methods for the modeling and control of the DC/DC converter and the grid converter are studied by a literature survey. Based on the survey, the characteristics of the SOFC as an electrical power source are identified, and a solution to the interfacing of the SOFC in distributed generation is proposed. A mathematical model of the power conversion unit is provided, and the control design for the DC/DC converter and the grid converter is made based on the proposed interfacing solution. The limit cycling phenomenon is identified as a source of low-frequency current ripple, which is found to be insignificant when connected to a grid-tied converter. A method to mitigate a second harmonic originating from the grid interface is proposed, and practical considerations of the operation with the solid oxide fuel cell plant are presented. At the theoretical level, the thesis discusses and summarizes the methods to successfully derive a model for a DC/DC converter, a grid converter, and a power conversion unit. The results of this doctoral thesis can also be used in other applications, and the models and methods can be adopted to similar applications such as photovoltaic systems. When comparing the results with the objectives of the doctoral thesis, we may conclude that the objectives set for the work are met. In this doctoral thesis, theoretical and practical guidelines are presented for the successful control design to connect a SOFC-based distributed generation plant to the utility grid.

Cardiorespiratory responses during and after water exercise in pregnant and non-pregnant women

PURPOSE: to compare the blood pressure and oxygen consumption (VO2) responses between pregnant and non-pregnant women, during cycle ergometer exercise on land and in water. METHODS: ten pregnant (27 to 29 weeks of gestation) and ten non-pregnant women were enrolled. Two cardiopulmonary tests were performed on a cycle ergometer (water and land) at the heart rate corresponding to VO2, over a period of 30 minutes each. Exercise measurements consisted of recording blood pressure every five minutes, and heart rate and VO2 every 20 seconds. Two-way ANOVA was used and α=0.05 (SPSS 17.0). RESULTS: there was no difference in cardiovascular responses between pregnant and non-pregnant women during the exercise. The Pregnant Group demonstrated significant differences in systolic (131.6±8.2; 142.6±11.3 mmHg), diastolic (64.8±5.9; 74.5±5.3 mmHg), and mean blood pressure (87.0±4.1; 97.2±5.7 mmHg), during water and land exercise, respectively. The Non-pregnant women Group also had a significantly lower systolic (130.5±8.4; 135.9±8.7 mmHg), diastolic (67.4±5.7; 69.0±10.1 mmHg), and mean blood pressure (88.4±4.8; 91.3±7.8 mmHg) during water exercise compared to the land one. There were no significant differences in VO2 values between water and land exercises or between pregnant and non-pregnant women. After the first five-minute recovery period, both blood pressure and VO2 were similar to pre-exercise values. CONCLUSIONS: for pregnant women with 27 to 29 weeks of gestation, water exercise at the heart rate corresponding to VO2 is physiologically appropriate. These women also present a lower blood pressure response to exercise in water than on land.

Correlation between placental thickness in the second and third trimester and fetal weight

PURPOSE: To investigate relationship between placental thickness during the second and third trimesters and placental and birth weights. METHODS: From January 2011 to June 2012, a total of 250 singleton pregnant women presented at our antenatal clinic were enrolled in this prospective study. All recruited women were assessed at the 1st trimester screening for baseline demographic and obstetric data. The placental thickness was measured trans-abdominally by placing the ultrasound transducer perpendicularly to the plane of the placenta, in the area of the cord insertion at second and third trimester. Pearson's correlation analysis was used to establish the degree of relationship between placental thickness and birth and placental weights. RESULTS: Of 250 recruited participants, 205 women were able to complete the study. The mean age of cases was 26.4±5.1. Values of mean birth and placental weights were 305.56±657.0 and 551.7±104.8 grams respectively. Ultrasonographic measures of placental thickness in second and third trimester and changes between them were 21.68±4.52, 36.26±6.46 and 14.67±5.67 mm respectively. There was a significant positive correlation between placental thickness and birth weight in the second and third trimesters (r=0.15, p=0.03; r=0.14, p=0.04 correspondingly). CONCLUSION: According to our study, birth weight has a positive relation with both second and third trimester placental thickness; however, placental thickness change could not predict low birth weight.

Hofbauer cells morphology and density in placentas from normal and pathological gestations

PURPOSE: In placentas from uncomplicated pregnancies, Hofbauer cells either disappear or become scanty after the fourth to fifth month of gestation. Immunohistochemistry though, reveals that a high percentage of stromal cells belong to Hofbauer cells. The aim of this study was to investigate the changes in morphology and density of Hofbauer cells in placentas from normal and pathological pregnancies. METHODS: Seventy placentas were examined: 16 specimens from normal term pregnancies, 10 from first trimester's miscarriages, 26 from cases diagnosed with chromosomal abnormality of the fetus, and placental tissue specimens complicated with intrauterine growth restriction (eight) or gestational diabetes mellitus (10). A histological study of hematoxylin-eosin (HE) sections was performed and immunohistochemical study was performed using the markers: CD 68, Lysozyme, A1 Antichymotrypsine, CK-7, vimentin, and Ki-67. RESULTS: In normal term pregnancies, HE study revealed Hofbauer cells in 37.5% of cases while immunohistochemistry revealed in 87.5% of cases. In first trimester's miscarriages and in cases with prenatal diagnosis of fetal chromosomal abnormalities, both basic and immunohistochemical study were positive for Hofbauer cells. In pregnancies complicated with intrauterine growth restriction or gestational diabetes mellitus, a positive immunoreaction was observed in 100 and 70% of cases, respectively. CONCLUSIONS: Hofbauer cells are present in placental villi during pregnancy, but with progressively reducing density. The most specific marker for their detection seems to be A1 Antichymotrypsine. It is remarkable that no mitotic activity of Hofbauer cells was noticed in our study, as the marker of cellular multiplication Ki-67 was negative in all examined specimens.

Immediate Decision-Making and Information Needs in Intensive Care Coordination

The aim of this study was to develop a theoretical model for information integration to support the deci¬sion making of intensive care charge nurses, and physicians in charge – that is, ICU shift leaders. The study focused on the ad hoc decision-making and immediate information needs of shift leaders during the management of an intensive care unit’s (ICU) daily activities. The term ‘ad hoc decision-making’ was defined as critical judgements that are needed for a specific purpose at a precise moment with the goal of ensuring instant and adequate patient care and a fluent flow of ICU activities. Data collection and research analysis methods were tested in the identification of ICU shift leaders’ ad hoc decision-making. Decision-making of ICU charge nurses (n = 12) and physicians in charge (n = 8) was observed using a think-aloud technique in two university-affiliated Finnish ICUs for adults. The ad hoc decisions of ICU shift leaders were identified using an application of protocol analysis. In the next phase, a structured online question¬naire was developed to evaluate the immediate information needs of ICU shift leaders. A national survey was conducted in all Finnish, university-affiliated hospital ICUs for adults (n = 17). The questionnaire was sent to all charge nurses (n = 515) and physicians in charge (n = 223). Altogether, 257 charge nurses (50%) and 96 physicians in charge (43%) responded to the survey. The survey was also tested internationally in 16 Greek ICUs. From Greece, 50 charge nurses out of 240 (21%) responded to the survey. A think-aloud technique and protocol analysis were found to be applicable for the identification of the ad hoc decision-making of ICU shift leaders. During one day shift leaders made over 200 ad hoc decisions. Ad hoc decisions were made horizontally, related to the whole intensive care process, and vertically, concerning single intensive care incidents. Most of the ICU shift leaders’ ad hoc decisions were related to human resources and know-how, patient information and vital signs, and special treatments. Commonly, this ad hoc decision-making involved several multiprofessional decisions that constituted a bundle of immediate decisions and various information needs. Some of these immediate information needs were shared between the charge nurses and the physicians in charge. The majority of which concerned patient admission, the organisation and management of work, and staff allocation. In general, the information needs of charge nurses were more varied than those of physicians. It was found that many ad hoc deci-sions made by the physicians in charge produced several information needs for ICU charge nurses. This meant that before the task at hand was completed, various kinds of information was sought by the charge nurses to support the decision-making process. Most of the immediate information needs of charge nurses were related to the organisation and management of work and human resources, whereas the information needs of the physicians in charge mainly concerned direct patient care. Thus, information needs differ between professionals even if the goal of decision-making is the same. The results of the international survey confirmed these study results for charge nurses. Both in Finland and in Greece the information needs of charge nurses focused on the organisation and management of work and human resources. Many of the most crucial information needs of Finnish and Greek ICU charge nurses were common. In conclusion, it was found that ICU shift leaders make hundreds of ad hoc decisions during the course of a day related to the allocation of resources and organisation of patient care. The ad hoc decision-making of ICU shift leaders is a complex multi-professional process, which requires a lot of immediate information. Real-time support for information related to patient admission, the organisation and man¬agement of work, and allocation of staff resources is especially needed. The preliminary information integration model can be applied when real-time enterprise resource planning systems are developed for intensive care daily management

Comparison of two methods for glucocorticoid evaluation in maned wolves

Analysis of faecal glucocorticoid metabolites provides a powerful noninvasive tool for monitoring adrenocortical activity in wild animals. However, differences regarding the metabolism and excretion of these substances make a validation for each species and sex investigated obligatory. Although maned wolves (Chrysocyon brachyurus) are the biggest canids in South America, their behaviour and physiology are poorly known and they are at risk in the wild. Two methods for measuring glucocorticoid metabolites in maned wolves were validated: a radio- and an enzyme immunoassay. An ACTH challenge was used to demonstrate that changes in adrenal function are reflected in faecal glucocorticoid metabolites. Our results suggest that both methods enable a reliable assessment of stress hormones in maned wolves avoiding short-term rises in glucocorticoid concentrations due to handling and restraint. These methods can be used as a valuable tool in studies of stress and conservation in this wild species.

Real-time Image-based RGB-D Camera Motion Tracking and Environment Mapping

In this work, image based estimation methods, also known as direct methods, are studied which avoid feature extraction and matching completely. Cost functions use raw pixels as measurements and the goal is to produce precise 3D pose and structure estimates. The cost functions presented minimize the sensor error, because measurements are not transformed or modified. In photometric camera pose estimation, 3D rotation and translation parameters are estimated by minimizing a sequence of image based cost functions, which are non-linear due to perspective projection and lens distortion. In image based structure refinement, on the other hand, 3D structure is refined using a number of additional views and an image based cost metric. Image based estimation methods are particularly useful in conditions where the Lambertian assumption holds, and the 3D points have constant color despite viewing angle. The goal is to improve image based estimation methods, and to produce computationally efficient methods which can be accomodated into real-time applications. The developed image-based 3D pose and structure estimation methods are finally demonstrated in practise in indoor 3D reconstruction use, and in a live augmented reality application.

Blade and rod coating of low solid dispersions

Työn aiheena oli tehdä ohut barrierkalvo terä- tai sauvapäällystys menetelmällä. Erilaisissa elintarvikepakkauksissa käytetään hyviä barrier-ominaisuuksia omaavia ohuita päällysteitä. Elintarvikepakkauksen tehtävä on suojata pakattua tuotetta ympäristöltä, mahdollistaa helppo kuljetus ja säilytys sekä antaa tarvittavat tiedot tuotteesta tuotteen käsittelijöille ja loppukäyttäjille. Diplomityön teoriaosuudessa keskityttiin barrierpäällystykseen, eri päällystysmenetelmiin, niiden erityisvaatimuksiin ja ominaisuuksiin. Teoriaosuudessa käsiteltiin myös vaadittavia barrier-ominaisuuksia ja haasteita niiden saavuttamisessa. Kirjallisuuden perusteella haasteiksi nousivat helposti muodostuvat mikroreiät. Kokeellinen osa jakautui kahteen osakokonaisuuteen: laboratoriokokeisiin ja pilot-koeajoon. Laboratoriokokeita tehtiin ennen pilot-ajoa, jotta pilot-koeajoon voitiin valita parhaat päällystereseptit. Pilot-koeajonäytteiden päällystemäärät osoittautuivat liian pieniksi ja siksi laboratoriossa tehtiin jatkotutkimuksia riittävän päällystemäärän saavuttamiseksi. Tämän työnperusteella pohjakartongin ominaisuuksilla, erityisesti karheudella, on merkittävä vaikutus päällystyksen onnistumisessa ja yksinkertaisilla resepteillä ja päällystysmenetelmillä ei saada tarpeeksi laadukasta kalvoa.

Modelling of hydrogen stratification and gas mixing in containment using the APROS code

Hydrogen stratification and atmosphere mixing is a very important phenomenon in nuclear reactor containments when severe accidents are studied and simulated. Hydrogen generation, distribution and accumulation in certain parts of containment may pose a great risk to pressure increase induced by hydrogen combustion, and thus, challenge the integrity of NPP containment. The accurate prediction of hydrogen distribution is important with respect to the safety design of a NPP. Modelling methods typically used for containment analyses include both lumped parameter and field codes. The lumped parameter method is universally used in the containment codes, because its versatility, flexibility and simplicity. The lumped parameter method allows fast, full-scale simulations, where different containment geometries with relevant engineering safety features can be modelled. Lumped parameter gas stratification and mixing modelling methods are presented and discussed in this master’s thesis. Experimental research is widely used in containment analyses. The HM-2 experiment related to hydrogen stratification and mixing conducted at the THAI facility in Germany is calculated with the APROS lump parameter containment package and the APROS 6-equation thermal hydraulic model. The main purpose was to study, whether the convection term included in the momentum conservation equation of the 6-equation modelling gives some remarkable advantages compared to the simplified lumped parameter approach. Finally, a simple containment test case (high steam release to a narrow steam generator room inside a large dry containment) was calculated with both APROS models. In this case, the aim was to determine the extreme containment conditions, where the effect of convection term was supposed to be possibly high. Calculation results showed that both the APROS containment and the 6-equation model could model the hydrogen stratification in the THAI test well, if the vertical nodalisation was dense enough. However, in more complicated cases, the numerical diffusion may distort the results. Calculation of light gas stratification could be probably improved by applying the second order discretisation scheme for the modelling of gas flows. If the gas flows are relatively high, the convection term of the momentum equation is necessary to model the pressure differences between the adjacent nodes reasonably.

Cyanobacterial occurrence and detection of microcystin by planar chromatography in surface water of Billings and Guarapiranga Reservoirs, SP, Brazil

Billings and Guarapiranga Reservoirs were deeply affected by environmental disturbances, which more evident consequence are the cyanobacterial blooms. Microcystins are the most common cyanotoxin in freshwaters and more than 70 types are known. Different methods for microcystins analysis in water can be used, among which ELISA and HPLC are the most frequently employed. However, less sophisticated and more economic methods can also be used. This is the case of planar chromatography (thin-layer chromatography) method previously used in cyanotoxins purification but gradually replaced by others. Posterior optimization of the microcystin chromatography conditions and because of its simplicity, rapidity, efficiency and low cost, this method is again considered an option for the analysis of microcystins and nodularins. Considering the importance of Billings and Guarapiranga Reservoirs for drinking water supplies and the few scientific data about cyanobacteria and cyanotoxins in these water bodies, the aims of this work are to analyze the biodiversity of cyanobacteria in the Billings and Guarapiranga Reservoirs and the detection of dissolved microcystins in the water. It was possible to identify 17 species of cyanobacteria, 9 of them being potentially toxic. In Billings Reservoir Microcystis aeruginosa (Kützing) Kützing and Cylindrospermopsis raciborskii (Woloszynska) Seenayya & Subba Raju are the most common species, while in Guarapiranga Reservoir only M. aeruginosa was considered as a common species. Microcystins were detected in all Billings Reservoir samples and in only one sample from Guarapiranga Reservoir.

Automatic traffic sign inventory- and condition analysis

This thesis researches automatic traffic sign inventory and condition analysis using machine vision and pattern recognition methods. Automatic traffic sign inventory and condition analysis can be used to more efficient road maintenance, improving the maintenance processes, and to enable intelligent driving systems. Automatic traffic sign detection and classification has been researched before from the viewpoint of self-driving vehicles, driver assistance systems, and the use of signs in mapping services. Machine vision based inventory of traffic signs consists of detection, classification, localization, and condition analysis of traffic signs. The produced machine vision system performance is estimated with three datasets, from which two of have been been collected for this thesis. Based on the experiments almost all traffic signs can be detected, classified, and located and their condition analysed. In future, the inventory system performance has to be verified in challenging conditions and the system has to be pilot tested.

Mechanical design and analysis of modular active magnetic bearing test rig

Tässä työssä on tutkittu modulaarisen aktiivimagneettilaakeroidun koelaitteen mekaanista suunnittelua ja analysointia. Suurnopeusroottorin suunnittelun teoria on esitelty. Lisäksi monia analyyttisiä mallinnusmenetelmiä mekaanisten kuormitusten mallintamiseksi on esitelty. Koska kyseessä on suurnopeussähkökone, roottoridynamiikka ja sen soveltuvuus suunnittelussa on esitelty. Magneettilaakerien rakenteeseen ja toimintaan on tutustuttu osana tätä työtä. Kirjallisuuskatsaus nykyisistä koelaitteista esimerkiksi komponenttien ominaisuuksien tunnistamiseen ja roottoridynamiikan tutkimuksiin on esitelty. Työn rajauksena on konseptisuunnittelu muunneltavalle magneettilaakeroidulle (AMB) koelaitteelle ja suunnitteluprosessin dokumentointi. Muunneltavuuteen päädyttiin, koska se mahdollistaa erilaisten komponenttiasetteluiden testaamisen erilaisille magneettilaakerikokoonpanoille ja roottoreille. Pääpaino tässä työssä on suurnopeus induktiokoneen roottorin suunnittelussa ja mallintamisessa. Modulaaristen toimilaitteiden kuten magneettilaakerien ja induktiosähkömoottorin rakenne on esitelty ja modulaarisen rakenteen käytettävyyden hyödyistä koelaitekäytössä on dokumentoitu. Analyyttisiä ja elementtimenetelmään perustuvia tutkimusmenetelmiä on käytetty tutkittaessa suunniteltua suurnopeusroottoria. Suunnittelun ja analysoinnin tulokset on esitelty ja verrattu keskenään eri mallinnusmenetelmien välillä. Lisäksi johtopäätökset sähkömagneettisten osien liittämisen monimutkaisuudesta ja vaatimuksista roottoriin ja toimilaitteisiin sekä mekaanisten että sähkömagneettisten ominaisuuksien optimoimiseksi on dokumentoitu.