Critical leg ischaemia with tissue loss : a challenge for the vascular surgeon

There is a widespread reporting habit of combining the outcomes for patients with rest pain (Fontaine III) and tissue loss (Fontaine IV) under the single category of critical leg ischaemia (CLI). This study focused on patients with ischaemic tissue loss treated with infrainguinal bypass surgery (IBS). All patients included in the study were treated at Helsinki University Central Hospital in 2000-2007. First, ulcer healing time after IBS and factors influencing healing time were prospectively assessed in 2 studies including 148 and 110 patients, respectively. Second,the results of redo IBS were retrospectively evaluated in 593 patients undergoing primary IBS for CLI with tissue loss . Third,long-term outcome were retrospectively analysed in 636 patients who underwent IBS for CLI with tissue loss . Fourth, the outcome of IBS was retrospectively compared with endovascular treatment (PTA) of the infrapopliteal arteries in 1023 CLI patients. Fifth, the influence multidrug resistant Pseudomans aeruginosa (MDR Pa) bacteria contamination in CLI patients treated with IBS was retropectively assessed. Sixty-four patients with positive MDR Pa -culture were matched with 64 MDR Pa - negative controls. Complete ulcer healing rate, including the ischemic ulcers and incisional wounds, was 40% at 6 months after IBS and 75% at one year. Diabetes was a risk factor for prolonged complete ulcer healing time. Ischaemic tissue lesions located in mid-and hindfoot healed poorly. At one year after IBS 50% of the patients were alive with salvaged leg and completely healed ulcers. The absence of gap between tertiary graft patency and leg salvage rates indicates the importance of a patent infrainguinal graft to save a leg with ischaemic tissue loss. Long-term survival for patients with ischaemic tissue loss was poor, 38% at 5 years. Only 30% of the patients were alive without amputation at 5 years. Several of the patient comorbidities increased independently the mortality risk; coronary artery disease, renal insufficiency, chronic obstructive lung disease and high age. When both PTA and bypass is feasible, infrapopliteal PTA as a first-line strategy is expected to achieve similar long-term results to bypass surgery in CLI when redo surgery is actively utilized. MDR Pa in a patient with CLI should be considered as a serious event with increased risk of early major amputation or death. Conclusion: Despite a successful infrainguinal bypass healing of the ischaemic ulcers and incisional wounds ulcer healing is a slow process especially in diabetics. Bypass surgery and PTA improve the outcome of the ischaemic leg but the mortality rate of the patients is high due to their severe comorbidities.

Unsteady mixed convection flow in stagnation region adjacent to a vertical surface

The unsteady two-dimensional laminar mixed convection flow in the stagnation region of a vertical surface has been studied where the buoyancy forces are due to both the temperature and concentration gradients. The unsteadiness in the flow and temperature fields is caused by the time-dependent free stream velocity. Both arbitrary wall temperature and concentration, and arbitrary surface heat and mass flux variations have been considered. The Navier-Stokes equations, the energy equation and the concentration equation, which are coupled nonlinear partial differential equations with three independent variables, have been reduced to a set of nonlinear ordinary differential equations. The analysis has also been done using boundary layer approximations and the difference between the solutions has been discussed. The governing ordinary differential equations for buoyancy assisting and buoyancy opposing regions have been solved numerically using a shooting method. The skin friction, heat transfer and mass transfer coefficients increase with the buoyancy parameter. However, the skin friction coefficient increases with the parameter lambda, which represents the unsteadiness in the free stream velocity, but the heat and mass transfer coefficients decrease. In the case of buoyancy opposed flow, the solution does not exist beyond a certain critical value of the buoyancy parameter. Also, for a certain range of the buoyancy parameter dual solutions exist.

Varistors based on mixed‐phase ceramics containing ZnO and negative temperature coefficient spinels

High nonlinearity coefficients of 60–150 are observed in the current‐voltage (I‐V) curves of the mixed phase ceramics formed by cosintering ZnO with spinel phases having large negative temperature coefficients (NTCs) in resistivity. The region of negative slope in the I‐V curves of the NTC ceramics is progressively made positive with ZnO phase content, wherein ZnO grains function as a built‐in resistor in series to the resistance of the NTC phase. High α depends on the optimum phase content of ZnO as much as its intrinsic conductivity. The studies indicate that the predominent contribution to power dissipation is by way of joule heating from the resistive component of the current.

Heat conduction with a phase change in a cylindrical mould

Analytical short time solution of moving boundary in heat conduction in a cylindrical mould under prescribed flux boundary condition has been studied in this paper. Partial differential equations are converted to integro-differential equations. These integro-differential equations which are coupled have been solved analytically for short time by choosing suitable series expansions for the unknown quantitities.

Heat Shock Protein 90 as a Drug Target against Protozoan Infections Biochemical characterization of HSP90 From plasmodium falciparum and trypanosoma evansi and evaluation of its inhibitor as a candidate drug

Using a pharmacological inhibitor of Hsp90 in cultured malarial parasite, we have previously implicated Plasmodium falciparum Hsp90 (PfHsp90) as a drug target against malaria. In this study, we have biochemically characterized PfHsp90 in terms of its ATPase activity and interaction with its inhibitor geldanamycin (GA) and evaluated its potential as a drug target in a preclinical mouse model of malaria. In addition, we have explored the potential of Hsp90 inhibitors as drugs for the treatment of Trypanosoma infection in animals. Our studies with full-length PfHsp90 showed it to have the highest ATPase activity of all known Hsp90s; its ATPase activity was 6 times higher than that of human Hsp90. Also, GA brought about more robust inhibition of PfHsp90 ATPase activity as compared with human Hsp90. Mass spectrometric analysis of PfHsp90 expressed in P. falciparum identified a site of acetylation that overlapped with Aha1 and p23 binding domain, suggesting its role in modulating Hsp90 multichaperone complex assembly. Indeed, treatment of P. falciparum cultures with a histone deacetylase inhibitor resulted in a partial dissociation of PfHsp90 complex. Furthermore, we found a well known, semisynthetic Hsp90 inhibitor, namely 17-(allylamino)-17-demethoxygeldanamycin, to be effective in attenuating parasite growth and prolonging survival in a mouse model of malaria. We also characterized GA binding to Hsp90 from another protozoan parasite, namely Trypanosoma evansi. We found 17-(allylamino)-17-demethoxygeldanamycin to potently inhibit T. evansi growth in a mouse model of trypanosomiasis. In all, our biochemical characterization, drug interaction, and animal studies supported Hsp90 as a drug target and its inhibitor as a potential drug against protozoan diseases.

A Heat and Light Mediated Synthetic Sequence Serendipitous Synthesis of Methyl Ester of Tris-Norpterosin-E

Synthesis of methyl ester of 3-oxo-indan-5-acetic acid (3), an analogue of the natura1 product pterosin-E (4), starting from cyclopentadiene (1) and p-benzoquinone (2) using a sequence of six ground and excited state reactions, is described.

Compensator for constant relative stability in process control systems

Process control systems are designed for a closed-loop peak magnitude of 2dB, which corresponds to a damping coefficient () of 0.5 approximately. With this specified constraint, the designer should choose and/or design the loop components to maintain a constant relative stability. However, the manipulative variable in almost all chemical processes will be the flow rate of a process stream. Since the gains and the time constants of the process will be functions of the manipulative variable, a constant relative stability cannot be maintained. Up to now, this problem has been overcome either by selecting proper control valve flow characteristics or by gain scheduling of controller parameters. Nevertheless, if a wrong control valve selection is made then one has to account for huge loss in controllability or eventually it may lead to an unstable control system. To overcome these problems, a compensator device that can bring back the relative stability of the control system was proposed. This compensator is similar to a dynamic nonlinear controller that has both online and offline information on several factors related to the control system. The design and analysis of the proposed compensator is discussed in this article. Finally, the performance of the compensator is validated by applying it to a two-tank blending process. It has been observed that by using a compensator in the process control system, the relative stability could be brought back to a great extent despite the effects of changes in manipulative flow rate.

Performance prediction and loss analysis of low specific speed submersible pumps

A performance prediction procedure is presented for low specific speed submersible pumps with a review of loss models given in the literature. Most of the loss theories discussed in this paper are one dimensional and improvements are made with good empiricism for the prediction to cover the entire range of operation of the low specific speed pumps. Loss correlations, particularly in the low flow range, are discussed. Prediction of the shape of efficiency-capacity and total head-capacity curves agrees well with the experimental results in almost the full range of operating conditions. The approach adopted in the present analysis, of estimating the losses in the individual components of a pump, provides means for improving the performance and identifying the problem areas in existing designs of the pumps. The investigation also provides a basis for selection of parameters for the optimal design of the pumps in which the maximum efficiency is an important design parameter. The scope for improvement in the prediction procedure with the nature of flow phenomena in the low flow region has been discussed in detail.

On some results of A. E. Livingston and coefficient problems for concave univalent functions

We consider functions that map the open unit disc conformally onto the complement of a bounded convex set. We call these functions concave univalent functions. In 1994, Livingston presented a characterization for these functions. In this paper, we observe that there is a minor flaw with this characterization. We obtain certain sharp estimates and the exact set of variability involving Laurent and Taylor coefficients for concave functions. We also present the exact set of variability of the linear combination of certain successive Taylor coefficients of concave functions.

A Novel Method for the Uniform Incorporation of Grain-Boundary Layer Modifiers in Positive Temperature Coefficient of Resistivity Barium Titanate

The presently developed two-stage process involves diping the prefired porous disks of n-BaTiO3 in nonaqueous solutions containing Al-buty rate, Ti-isopropoxide, and tetraethyl silicate and subsequent sintering. This leads to uniform distribution of the grain-boundary layer (GBL) modifiers (Al2O3+ TiO2+ SiO2) and better control of the grain size as well as the positive temperature coefficient of resistivity characteristics. The technique is particularly suited for GBL modifiers in low concentrations (< 1%).