Fluorimetric determination of uranium in certain refractory minerals, environmental samples and industrial waste materials

International Nuclear Information System (INIS)

Premadas, A.; Saravanakumar, G.

2005-01-01

A simple sample decomposition and laser fluorimetric determination of uranium at trace level is reported in certain refractory minerals, like ilmenite, rutile, zircon and monazite; environmental samples viz. soil and sediments; industrial waste materials, such as, coal fly ash and red mud. Ilmenite sample is decomposed by heating with ammonium fluoride. Rutile, zircon and monazite minerals are decomposed by fusion using a mixture of potassium bifluoride and sodium fluoride. Environmental and industrial waste materials are brought into solution by treating with a mixture of hydrofluoric and nitric acids. The laser induced fluorimetric determination of uranium is carried out directly in rutile, zircon and in monazite minerals and after separation in other samples. The determination limit was 1 μg x g -1 for ilmenite, soil, sediment, coal fly ash and red mud samples, and it is 5 μg x g -1 for rutile, zircon and monazite. The method is also developed for the optical fluorimetric determination of uranium (determination limit 10 μg x g -1 ) in ilmenite, rutile, zircon and monazite minerals. The methods are simple, accurate, and precise and they require small quantity of sample and can be applied for the routine analysis. (author)

Slagging gasifier refractories. A new pathway to longer refractory life

Energy Technology Data Exchange (ETDEWEB)

Schnake, Mark [Harbinson-Walker Refractories Company, Mexico, MO (United States)

2013-07-01

Solid fuel slagging gasification to convert coal or petroleum coke feedstocks into syngas has rapidly evolved over the last 25 years. The gasifier is a high temperature, high pressure reaction chamber. Operating temperatures are between 1250 and 1575 C. Pressures will be between 20.4 and 68 atm. Syngas has been typically used for chemical feedstocks, fuel for power plants, or for steam and hydrogen generation in other industrial applications. Ash which comes from the solid fuel during gasification has many impurities. It melts during the gasifier reactor operation forming a liquid that penetrates the refractory lining. Given time, the refractory will wear away from thermal spalling, structural spalling, or overheating of the refractory. In some cases, all three wear mechanisms are seen in the same gasifier lining. Industry users have identified refractory life as one major limiting factor in worldwide use of this technology. Users have stated if the refractory liner can increase on-line availability of the gasifier operation, more industry acceptance of this technology is possible. Harbison-Walker Refractories Company will review destructive factors affecting lining life and discuss new refractory materials that have dramatically increased gasifier lining life and reliability. New refractory materials will be presented and supported by field trial results and post mortem analysis.

High alumina refractories

International Nuclear Information System (INIS)

Simao, L.C.; Lopes, A.B.; Galvao Filho, N.B.; Souza, R.B. de

1989-01-01

High alumina refractories with 92 to 96.5% Al 2 O 3 were produced using brown and white fused as aggregate. Those refractories present only alumina-α and mullite as crystalline mineralogical phase. Other physical and chemical characteristics are similar to the ones found in refractories produced in Brazil, Japan and U.S.A. The most important physical and chemical tests used for the characterization of the raw materials and refractories, complemented by those realized at high temperatures, plus X-ray Difractometry and optical microscopy are presented, besides the refractory formulation and main parameters of production [pt

Refractory migraine in a headache clinic population

Directory of Open Access Journals (Sweden)

Fernandez-Torron Roberto

2011-08-01

Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

Merits of using andalusite-based refractories compared to bauxite-based refractories

OpenAIRE

Nyoka, M.; Brazier, D.; Courtney, T.; Parry, R.A.

2013-01-01

Historically bauxite-based refractories have been used in applications where andalusite-based refractories could work. Bauxite-based refractories were chosen over andalusite-based refractories mainly because of the availability of low-cost Chinese bauxite and also because many furnaces were designed by international companies that cannot easily access high-quality products. Currently, the availability of low-cost bauxite is under threat as a result of high export duties and tariffs as well as...

Refractory Materials for Flame Deflector Protection System Corrosion Control: Refractory Ceramics Literature Survey

Science.gov (United States)

Calle, Luz Marina; Hintze, Paul E.; Parlier, Christopher R.; Curran, Jerome P.; Kolody, Mark; Perusich, Stephen; Whitten, Mary C.; Trejo, David; Zidek, Jason; Sampson, Jeffrey W.;

Refractory vasculitis

NARCIS (Netherlands)

Rutgers, Bram; Kallenberg, Cees G. M.

Refractory vasculitis occurs in 4-5% of patients with anti-neutrophil cytoplasmic antibody associated vasculitis (AAV). Differences between therapies used for refractory disease are mostly reflected in the percentages of complete and partial remissions, but also in the number of serious side

Preparation and characterization of clay bonded high strength silica refractory by utilizing agriculture waste

International Nuclear Information System (INIS)

Bhardwaj, A.; Hossain, S.K.S.; Majh, M.R.

2017-01-01

Clay bonded silica refractory was prepared by utilizing agriculture waste called rice husk ash (RHA) and refractory grog. Various samples were prepared with different compositions based upon partial replacement of quartz by RHA. Rectangular samples were prepared by following semi dry process prior to pressing in a uniaxial hydraulic press and sintering at a temperature of 1200°C in air atmosphere. Various physical, mechanical and thermal characterizations were done like X-ray diffraction (XRD), scanning electron microscope (SEM), apparent porosity (AP), bulk density (BD), cold crushing strength (CCS), refractoriness and thermal conductivity measurement. The sample utilizing 30% of RHA was considered most optimum composition which produced cold crushing strength of 38MPa and thermal conductivity of 2.08W/mK at 800°C with a considerable good refractoriness. Enhancement in the mechanical as well as thermal properties may be considered as attributed to the amorphous silica which has reacted more easily and efficiently with other material surrounding giving rise to the densification and produced stable crystalline phase to the refractory material. These promising characteristics suggests that the RHA may lead to be used as a potential material for the preparation of clay bonded high strength silica refractories. [es

Pharmacotherapy for Refractory and Super-Refractory Status Epilepticus in Adults.

Science.gov (United States)

Holtkamp, Martin

2018-03-01

Patients with prolonged seizures that do not respond to intravenous benzodiazepines and a second-line anticonvulsant suffer from refractory status epilepticus and those with seizures that do not respond to continuous intravenous anesthetic anticonvulsants suffer from super-refractory status epilepticus. Both conditions are associated with significant morbidity and mortality. A strict pharmacological treatment regimen is urgently required, but the level of evidence for the available drugs is very low. Refractory complex focal status epilepticus generally does not require anesthetics, but all intravenous non-anesthetizing anticonvulsants may be used. Most descriptive data are available for levetiracetam, phenytoin and valproate. Refractory generalized convulsive status epilepticus is a life-threatening emergency, and long-term clinical consequences are eminent. Administration of intravenous anesthetics is mandatory, and drugs acting at the inhibitory gamma-aminobutyric acid (GABA) A receptor such as midazolam, propofol and thiopental/pentobarbital are recommended without preference for one of those. One in five patients with anesthetic treatment does not respond and has super-refractory status epilepticus. With sustained seizure activity, excitatory N-methyl-d-aspartate (NMDA) receptors are increasingly expressed post-synaptically. Ketamine is an antagonist at this receptor and may prove efficient in some patients at later stages. Neurosteroids such as allopregnanolone increase sensitivity at GABA A receptors; a Phase 1/2 trial demonstrated safety and tolerability, but randomized controlled data failed to demonstrate efficacy. Adjunct ketogenic diet may contribute to termination of difficult-to-treat status epilepticus. Randomized controlled trials are needed to increase evidence for treatment of refractory and super-refractory status epilepticus, but there are multiple obstacles for realization. Hitherto, prospective multicenter registries for pharmacological

Clinical and microbiological features of refractory periodontitis subjects.

Science.gov (United States)

Colombo, A P; Haffajee, A D; Dewhirst, F E; Paster, B J; Smith, C M; Cugini, M A; Socransky, S S

1998-02-01

The purpose of this investigation was to compare the clinical parameters and the site prevalence and levels of 40 subgingival species in successfully treated and refractory periodontitis subjects. 94 subjects received scaling and root planing and if needed, periodontal surgery and systemically administered tetracycline. 28 refractory subjects showed mean full mouth attachment loss and/or > 3 sites showing attachment loss > 2.5 mm within 1 year post-therapy. 66 successfully treated subjects showed mean attachment level gain and no sites with attachment loss > 2.5 mm. Baseline subgingival plaque samples were taken from the mesial aspect of each tooth and the presence and levels of 40 subgingival taxa were determined using whole genomic DNA probes and checkerboard DNA-DNA hybridization. The mean levels and % of sites colonized by each species (prevalence) was computed for each subject and differences between groups sought using the Mann-Whitney test. Most of the 40 species tested, including Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Bacteroides forsythus, were equally or less prevalent in the refractory group. Prevotella nigrescens was significantly more prevalent in successfully treated subjects, while refractory subjects harbored a larger proportion of Streptococcus species, particularly Streptococcus constellatus. The odds of a subject being refractory was 8.6 (p or = 3.5% of the total DNA probe count. Since few microbiological differences existed between treatment outcome groups using DNA probes to known species, the predominant cultivable microbiota of 33 subgingival samples from 14 refractory subjects was examined. 85% of the 1649 isolates were identified using probes to 69 recognized subgingival species. The remaining unidentified strains were classified by analyzing 16S rRNA gene sequences. Many sequenced isolates were of taxa not considered a common part of the oral microbiota such as Acinetobacter baumanni

Autoradiographic study of corrosion of refractories

International Nuclear Information System (INIS)

Lisenenkova, S.B.; Kucheryavyi, M.N.; Bursteva, T.A.

1988-01-01

A comparative study was made of the character of the interaction between a container-glass melt consisting of sodium calcium silicate and refractories in various furnace sections using an autoradiographic method. Static tests were conducted on specimens of the following refractories: chrome-aluminum-zircon, Bakor 41, corundum, a high alumina refractory, and a refractory based on tin dioxide. The specimens were activated by calcium 45. Autoradiography and photomicrography indicated that an intrinsic feature of all refractories was that calcium from the melt penetrated the refractories along the weak link; for fused-cast refractories, the glass phase; and for sintered refractories, through the binder and cracks

IMPROVED CORROSION RESISTANCE OF ALUMINA REFRACTORIES

Energy Technology Data Exchange (ETDEWEB)

John P. Hurley; Patty L. Kleven

2001-09-30

The initial objective of this project was to do a literature search to define the problems of refractory selection in the metals and glass industries. The problems fall into three categories: Economic--What do the major problems cost the industries financially? Operational--How do the major problems affect production efficiency and impact the environment? and Scientific--What are the chemical and physical mechanisms that cause the problems to occur? This report presents a summary of these problems. It was used to determine the areas in which the EERC can provide the most assistance through bench-scale and laboratory testing. The final objective of this project was to design and build a bench-scale high-temperature controlled atmosphere dynamic corrosion application furnace (CADCAF). The furnace will be used to evaluate refractory test samples in the presence of flowing corrodents for extended periods, to temperatures of 1600 C under controlled atmospheres. Corrodents will include molten slag, steel, and glass. This test should prove useful for the glass and steel industries when faced with the decision of choosing the best refractory for flowing corrodent conditions.

Refractoriness in human atria

DEFF Research Database (Denmark)

Skibsbye, Lasse; Jespersen, Thomas; Christ, Torsten

2016-01-01

BACKGROUND: Refractoriness of cardiac cells limits maximum frequency of electrical activity and protects the heart from tonic contractions. Short refractory periods support major arrhythmogenic substrates and augmentation of refractoriness is therefore seen as a main mechanism of antiarrhythmic...... drugs. Cardiomyocyte excitability depends on availability of sodium channels, which involves both time- and voltage-dependent recovery from inactivation. This study therefore aims to characterise how sodium channel inactivation affects refractoriness in human atria. METHODS AND RESULTS: Steady......-state activation and inactivation parameters of sodium channels measured in vitro in isolated human atrial cardiomyocytes were used to parameterise a mathematical human atrial cell model. Action potential data were acquired from human atrial trabeculae of patients in either sinus rhythm or chronic atrial...

Mixed Uranium/Refractory Metal Carbide Fuels for High Performance Nuclear Reactors

International Nuclear Information System (INIS)

Knight, Travis; Anghaie, Samim

2002-01-01

Single phase, solid-solution mixed uranium/refractory metal carbides have been proposed as an advanced nuclear fuel for advanced, high-performance reactors. Earlier studies of mixed carbides focused on uranium and either thorium or plutonium as a fuel for fast breeder reactors enabling shorter doubling owing to the greater fissile atom density. However, the mixed uranium/refractory carbides such as (U, Zr, Nb)C have a lower uranium densities but hold significant promise because of their ultra-high melting points (typically greater than 3700 K), improved material compatibility, and high thermal conductivity approaching that of the metal. Various compositions of (U, Zr, Nb)C were processed with 5% and 10% metal mole fraction of uranium. Stoichiometric samples were processed from the constituent carbide powders, while hypo-stoichiometric samples with carbon-to-metal (C/M) ratios of 0.92 were processed from uranium hydride, graphite, and constituent refractory carbide powders. Processing techniques of cold uniaxial pressing, dynamic magnetic compaction, sintering, and hot pressing were investigated to optimize the processing parameters necessary to produce high density (low porosity), single phase, solid-solution mixed carbide nuclear fuels for testing. This investigation was undertaken to evaluate and characterize the performance of these mixed uranium/refractory metal carbides for high performance, ultra-safe nuclear reactor applications. (authors)

Plasma spraying of refractory metals and refractory hard materials. State of the art

International Nuclear Information System (INIS)

Eschnauer, H.; Lugscheider, E.; Jaeger, D.

1989-01-01

Suitable spraying processes for manufacturing refractory metals, refractory hard materials as well as spray materials with refractory components are the VPS- and IPS-spraying techniques. The advantages of these special spraying process variations are described. The reactive spraying materials are systematically organized. The characteristical properties used in purpose of improving the substrate surfaces are explained. Finally some examples of the latest results of research concerning plasma spraying of reactive materials are shown. 16 refs., 10 figs. (Author)

Illness identity in young adults with refractory epilepsy.

Science.gov (United States)

Luyckx, Koen; Oris, Leen; Raymaekers, Koen; Rassart, Jessica; Moons, Philip; Verdyck, Ludo; Mijnster, Teus; Mark, Ruth E

2018-03-01

Refractory epilepsy is an intrusive condition with important implications for daily functioning in emerging and young adulthood. The present study examined the degree to which refractory epilepsy is integrated in one's identity, and examined how such a sense of illness identity was related to health-related quality of life (HRQOL). A total of 121 18- to 40-year-old patients with refractory epilepsy (56.2% women) completed self-report questionnaires assessing the four illness identity states of acceptance, enrichment, engulfment, and rejection (Illness Identity Questionnaire (IIQ)); HRQOL (Quality of Life in Epilepsy Inventory - 31); and seizure frequency and severity (Liverpool Seizure Severity Scale (LSSS)). Illness identity scores were compared with a sample of 191 patients with a nonneurological chronic disease (congenital heart disease). Hierarchical regression analyses were conducted to assess the predictive value of illness identity for HRQOL when simultaneously controlling for demographic and clinical features. Patients with refractory epilepsy scored higher on rejection and engulfment and lower on acceptance when compared with patients with congenital heart disease. Further, seizure severity and number of medication side-effects were positively related to engulfment and negatively to acceptance. Finally, when simultaneously controlling for various demographic and clinical variables, illness identity significantly predicted HRQOL (with engulfment being the strongest and most consistent predictor). The extent to which patients with refractory epilepsy succeed in integrating their illness into their identity may have important implications for HRQOL. Clinicians should be especially attentive for signs that patients feel engulfed by their epilepsy. Copyright © 2018 Elsevier Inc. All rights reserved.

Theoretical and practical aspects about corrosion of refractories used in steel metallurgy: part 3: characterization of commercial refractories

International Nuclear Information System (INIS)

Braganca, S.R.

2012-01-01

In this study, it was reviewed the main aspects found in the literature about refractories corrosion, evaluating the feasibility of certain tests and relating them with experimental results. The physical properties and microstructure of commercial refractories were analyzed, considering the differences between them and the quality implications and probable life of the refractory. Thus, it was studied the various types of refractories used as lining on steel ladle. Magnesia-carbon and doloma-carbon refractories were analyzed, highlighting the differences between them. The examined refractory showed characteristics favoring high resistance to corrosion process, presenting a series of properties to be selected in accordance with industry practice. (author)

Determination of 210Pb and 210Po in soil or rock samples containing refractory matrices

International Nuclear Information System (INIS)

Jia Guogang; Torri, Giancarlo

2007-01-01

A new method has been developed for determination of 21 Pb and 21 Po in soil or rock samples containing refractory matrices. The samples were first fused with Na 2 CO 3 and Na 2 O 2 at 600 o C for pre-treatment and then 210 Pb and 210 Po were sequentially leached out at 200-250 o C with HNO 3 +HF, HClO 4 and HCl. About 10% of the leaching solution was used for 21 Po determination, carried out by spontaneous deposition of polonium on a silver disc from a weakly acidic solution that contained hydroxylamine hydrochloride, sodium citrate and 209 Po tracer, measurement being made by α-spectrometry. The remains of the leaching solution were used for determination of 21 Pb, conducted by precipitation as sulphate, purification with Na 2 S as PbS in 6 M ammonium acetate, separation from α-emitters by an anion-exchange resin column, source preparation as PbSO 4 , and measurement with a β-counter. The procedure has been checked with two certified IAEA reference materials, showing good agreement with the recommended values. The lower limits of detection for 1 g of analysed soil or rock samples were found to be 0.75 Bq kg -1 for 210 Po and 2.2 Bq kg -1 for 210 Pb. A variety of solid sample species analysed through use of the procedure gave average yields of 90.0±9.8% for 210 Po and 88.4±7.1% for 210 Pb

Refractory metal based superalloys

International Nuclear Information System (INIS)

Alonso, Paula R.; Vicente, Eduardo E.; Rubiolo, Gerardo H.

1999-01-01

Refractory metals are looked as promising materials for primary circuits in fission reactors and even as fusion reactor components. Indeed, superalloys could be developed which take advantage of their high temperature properties together with the benefits of a two- phase (intermetallic compound-refractory metal matrix) coherent structure. In 1993, researchers of the Office National d'Etudes et de Recherches Aerospatiales of France reported the observation of such a coherent structure in the Ta-Ti-Zr-Al-Nb-Mo system although the exact composition is not reported. The intermetallic compound would be Ti 2 AlMo based. However, the formation of this compound and its possible coexistence with a disordered bcc phase in the ternary system Ti-Al-Mo is a controversial subject in the related literature. In this work we develop a technique to obtain homogeneous alloys samples with 50 Ti-25 Al-25 Mo composition. The resulting specimens were characterized by optical and electronic metallography (SEM), microprobe composition measurements (EPMA) and X-ray diffraction (XRD) analyses. The results show the evidence for a bcc (A2→B2) ordering reaction in the Ti-Al-Mo system in the 50 Ti-25 Al-25 Mo composition. (author)

Evaluation of the reusing of MGO-C refractory brick in refractory mixes

International Nuclear Information System (INIS)

Silva, R.D.S. da; Braganca, S.R.

2012-01-01

The residue from the use of MgO-C refractories in electric arc furnace presents, mostly, magnesium oxide in its composition and some slag contamination and impurities from the process of electrofusion scrap iron/steel. In this study, it was studied the characteristics of this residue and reused through its introduction into a commercial refractory mix, employed as material of coating and repair. This refractory mix was tested by thermogravimetric analysis, compressive strength, evaluation of plasticity and porosity as well as aspects of its installation, such as adhesion in situ. Results showed that there potential for reuse with the introduction of the waste in commercial mix was 30%, with little loss of compressive strength and plasticity. (author)

Sub-micrometer refractory carbonaceous particles in the polar stratosphere

Science.gov (United States)

Schütze, Katharina; Wilson, James Charles; Weinbruch, Stephan; Benker, Nathalie; Ebert, Martin; Günther, Gebhard; Weigel, Ralf; Borrmann, Stephan

2017-10-01

Eleven particle samples collected in the polar stratosphere during SOLVE (SAGE III Ozone loss and validation experiment) from January until March 2000 were characterized in detail by high-resolution transmission and scanning electron microscopy (TEM/SEM) combined with energy-dispersive X-ray microanalysis. A total of 4202 particles (TEM = 3872; SEM = 330) were analyzed from these samples, which were collected mostly inside the polar vortex in the altitude range between 17.3 and 19.9 km. Particles that were volatile in the microscope beams contained ammonium sulfates and hydrogen sulfates and dominated the samples. Some particles with diameters ranging from 20 to 830 nm were refractory in the electron beams. Carbonaceous particles containing additional elements to C and O comprised from 72 to 100 % of the refractory particles. The rest were internal mixtures of these materials with sulfates. The median number mixing ratio of the refractory particles, expressed in units of particles per milligram of air, was 1.1 (mg air)-1 and varied between 0.65 and 2.3 (mg air)-1. Most of the refractory carbonaceous particles are completely amorphous, a few of the particles are partly ordered with a graphene sheet separation distance of 0.37 ± 0.06 nm (mean value ± standard deviation). Carbon and oxygen are the only detected major elements with an atomic O/C ratio of 0.11 ± 0.07. Minor elements observed include Si, S, Fe, Cr and Ni with the following atomic ratios relative to C: Si/C: 0.010 ± 0.011; S/C: 0.0007 ± 0.0015; Fe/C: 0.0052 ± 0.0074; Cr/C: 0.0012 ± 0.0017; Ni/C: 0.0006 ± 0.0011 (all mean values ± standard deviation).High-resolution element distribution images reveal that the minor elements are distributed within the carbonaceous matrix; i.e., heterogeneous inclusions are not observed. No difference in size, nanostructure and elemental composition was found between particles collected inside and outside the polar vortex. Based on chemistry and nanostructure

Compatibility of refractory materials with boiling sodium

International Nuclear Information System (INIS)

Meacham, S.A.

1976-01-01

The program employed to determine the compatibility of commercially available refractories with boiling sodium is described. The effects of impurities contained within the refractory material, and their relations with the refractory's physical stability are discussed. Also, since consideration of refractories for use as an insulating material within Liquid Metal Fast Breeder Reactor Plants (LMFBR's) is currently under investigation; recommendations, based upon this program, are presented

REFRACTORY THROMBOCYTOPENIA AND NEUTROPENIA: A DIAGNOSTIC CHALLENGE

OpenAIRE

Emmanuel Gyan; François Dreyfus; Pierre Fenaux

2015-01-01

Background. The 2008 WHO classification identified refractory cytopenia with unilineage dysplasia (RCUD) as a composite entity encompassing refractory anemia, refractory thrombocytopenia (RT), and refractory neutropenia (RN), characterized by 10% or more dysplastic cells in the bone marrow respective lineage. The diagnosis of RT and RN is complicated by several factors.  Diagnosing RT first requires exclusion of familial thrombocytopenia, chronic auto-immune thrombocytopenia, concomitant medi...

Refractory bin for burning

Energy Technology Data Exchange (ETDEWEB)

McPherson, D.L.; McPherson, T.L.

1989-12-26

This patent describes a refractory bin. It has a generally rectangular horizontal cross sectional configuration. It has wall structures each comprising an upper and a lower pair of elongated horizontal vertically spaced generally parallel support beams each having a vertical flange defining a support edge along its upper surface, a first generally rectangular refractory panel arranged with its lower edge at the bottom of the bin and with its outer surface in flat face contacting relation with the vertical flanges of the lower pair of support beams, a plurality of brackets each having a horizontal part and a vertical part and being secured to the outer surface of the first refractory panel.

Talimogene Laherparepvec and Nivolumab in Treating Patients With Refractory Lymphomas or Advanced or Refractory Non-melanoma Skin Cancers

Science.gov (United States)

2018-05-21

Adenoid Cystic Carcinoma; Adnexal Carcinoma; Apocrine Carcinoma; Eccrine Porocarcinoma; Extraocular Cutaneous Sebaceous Carcinoma; Hidradenocarcinoma; Keratoacanthoma; Malignant Sweat Gland Neoplasm; Merkel Cell Carcinoma; Microcystic Adnexal Carcinoma; NK-Cell Lymphoma, Unclassifiable; Non-Melanomatous Lesion; Paget Disease; Papillary Adenocarcinoma; Primary Cutaneous Mucinous Carcinoma; Refractory Anaplastic Large Cell Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Refractory Mycosis Fungoides; Refractory Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory T-Cell Non-Hodgkin Lymphoma; Sezary Syndrome; Signet Ring Cell Carcinoma; Skin Basal Cell Carcinoma; Skin Basosquamous Cell Carcinoma; Skin Squamous Cell Carcinoma; Spiradenocarcinoma; Squamous Cell Carcinoma of Unknown Primary Origin; Stage III Skin Cancer; Stage IV Skin Cancer; Sweat Gland Carcinoma; Trichilemmocarcinoma; Vulvar Squamous Cell Carcinoma

Emergency Surgery for Refractory Status Epilepticus.

Science.gov (United States)

Botre, Abhijeet; Udani, Vrajesh; Desai, Neelu; Jagadish, Spoorthy; Sankhe, Milind

2017-08-15

Management of refractory status epilepticus in children is extremely challenging. Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data.

Updates in Refractory Status Epilepticus

Science.gov (United States)

Mahulikar, Advait; Suchdev, Kushak; Shah, Aashit

2018-01-01

Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodulatory treatment. Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered. Short-term and long-term outcomes tend to be poor with significant morbidity and mortality with only one-third of patients reaching baseline neurological status. PMID:29854452

Sub-micrometer refractory carbonaceous particles in the polar stratosphere

Directory of Open Access Journals (Sweden)

K. Schütze

2017-10-01

Full Text Available Eleven particle samples collected in the polar stratosphere during SOLVE (SAGE III Ozone loss and validation experiment from January until March 2000 were characterized in detail by high-resolution transmission and scanning electron microscopy (TEM/SEM combined with energy-dispersive X-ray microanalysis. A total of 4202 particles (TEM  =  3872; SEM  =  330 were analyzed from these samples, which were collected mostly inside the polar vortex in the altitude range between 17.3 and 19.9 km. Particles that were volatile in the microscope beams contained ammonium sulfates and hydrogen sulfates and dominated the samples. Some particles with diameters ranging from 20 to 830 nm were refractory in the electron beams. Carbonaceous particles containing additional elements to C and O comprised from 72 to 100 % of the refractory particles. The rest were internal mixtures of these materials with sulfates. The median number mixing ratio of the refractory particles, expressed in units of particles per milligram of air, was 1.1 (mg air−1 and varied between 0.65 and 2.3 (mg air−1. Most of the refractory carbonaceous particles are completely amorphous, a few of the particles are partly ordered with a graphene sheet separation distance of 0.37 ± 0.06 nm (mean value ± standard deviation. Carbon and oxygen are the only detected major elements with an atomic O∕C ratio of 0.11 ± 0.07. Minor elements observed include Si, S, Fe, Cr and Ni with the following atomic ratios relative to C: Si∕C: 0.010 ± 0.011; S∕C: 0.0007 ± 0.0015; Fe∕C: 0.0052 ± 0.0074; Cr∕C: 0.0012 ± 0.0017; Ni∕C: 0.0006 ± 0.0011 (all mean values ± standard deviation.High-resolution element distribution images reveal that the minor elements are distributed within the carbonaceous matrix; i.e., heterogeneous inclusions are not observed. No difference in size, nanostructure and elemental composition was found between

Low-Chrome/Chrome Free Refractories for Slagging Gasifiers

International Nuclear Information System (INIS)

Bennett, J.P.; Kwong, K.-S.; Powell, C.P.; Thomas, H.; Petty, A.V. Jr.

2007-01-01

Gasifiers are containment vessels used to react carbon-containing materials with oxygen and water, producing syngas (CO and H2) that is used in chemical and power production. It is also a potential source of H2 in a future hydrogen economy. Air cooled slagging gasifiers are one type of gasifier, operating at temperatures from 1275-1575 C and at pressures of 400 psi or higher. They typically use coal or petroleum coke as the carbon source, materials which contain ash impurities that liquefy at the gasification temperatures, producing liquid slag in quantities of 100 or more tons/day, depending on the carbon fed rate and the percent ash present in the feedstock. The molten slag is corrosive to refractory linings, causing chemical dissolution and spalling. The refractory lining is composed of chrome oxide, alumina, and zirconia; and is replaced every 3-24 months. Gasifier users would like greater on-line availability and reliability of gasifier liners, something that has impacted gasifier acceptance by industry. Research is underway at NETL to improve refractory service life and to develop a no-chrome or low-chrome oxide alternative refractory liner. Over 250 samples of no- or low-chrome oxide compositions have been evaluated for slag interactions by cup testing; with potential candidates for further studies including those with ZrO2, Al2O3, and MgO materials. The development of improved liner materials is necessary if technologies such as IGCC and DOE's Near Zero Emissions Advanced Fossil Fuel Power Plant are to be successful and move forward in the marketplace

Refractory status epilepticus

Directory of Open Access Journals (Sweden)

Sanjay P Singh

2014-01-01

Full Text Available Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED, i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits.

Refractory status epilepticus

Science.gov (United States)

Singh, Sanjay P; Agarwal, Shubhi; Faulkner, M

2014-01-01

Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED), i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs) and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits. PMID:24791086

High-Density Infrared Surface Treatments of Refractories

Energy Technology Data Exchange (ETDEWEB)

Tiegs, T.N.

2005-03-31

Refractory materials play a crucial role in all energy-intensive industries and are truly a crosscutting technology for the Industries of the Future (IOF). One of the major mechanisms for the degradation of refractories and a general decrease in their performance has been the penetration and corrosion by molten metals or glass. Methods and materials that would reduce the penetration, wetting, and corrosive chemistry would significantly improve refractory performance and also maintain the quality of the processed liquid, be it metal or glass. This report presents the results of an R&D project aimed at investigating the use of high-density infrared (HDI) heating to surface treat refractories to improve their performance. The project was a joint effort between Oak Ridge National Laboratory (ORNL) and the University of Missouri-Rolla (UMR). HDI is capable of heating the near-surface region of materials to very high temperatures where sintering, diffusion, and melting can occur. The intended benefits of HDI processing of refractories were to (1) reduce surface porosity (by essentially sealing the surface to prevent liquid penetration), (2) allow surface chemistry changes to be performed by bonding an adherent coating onto the underlying refractory (in order to inhibit wetting and/or improve corrosion resistance), and (3) produce noncontact refractories with high-emissivity surface coatings.

Application of x-ray fluorescence (XRF) absolute analysis method for silica refractories

International Nuclear Information System (INIS)

Asakura, Hideo; Yamada, Yasujiro; Kansai, Kouhei; Tomatsu, Ichirou; Murata, Mamoru

2015-01-01

X-ray fluorescence (XRF) analysis is a rapid and precise quantitative analytical method for the determination of major and trace elements in many industries and academics. XRF analytical values are relative due to the use of the calibration curves calculated from measuring the reference standard materials such as Japanese Refractory Reference Materials (JRRM) series with certified values determined by wet chemical analysis. The development of the XRF analytical method from relative to absolute analysis will help much to determine the absolute values of samples from the fields where reference standard samples have not been prepared, and thus can be applied widely in many industries. The implement of the absolute XRF analysis for silica refractories requires high purity reagents and/or reference standard solution for the binary basic calibration curve, and theoretical matrix correction coefficients for the multi-components silica refractories analysis. The reproducibility and repeatability of this method for Al 2 O 3 5 mass% sample were 0.009 and 0.006 mass% in Al 2 O 3 and showed better values that those of ICP-AES recognized as an absolute method in JIS R 2212-2, which yielded 0.028 and 0.031 mass%, respectively. The XRF absolute analysis for JRRM 200 series, 201a and 205a does not show a bias but coincides with their certified values. (author)

Genetics Home Reference: iron-refractory iron deficiency anemia

Science.gov (United States)

... refractory iron deficiency anemia Iron-refractory iron deficiency anemia Printable PDF Open All Close All Enable Javascript ... expand/collapse boxes. Description Iron-refractory iron deficiency anemia is one of many types of anemia , which ...

Refractory hypertension: definition, prevalence, and patient characteristics.

Science.gov (United States)

Acelajado, Maria Czarina; Pisoni, Roberto; Dudenbostel, Tanja; Dell'Italia, Louis J; Cartmill, Falynn; Zhang, Bin; Cofield, Stacey S; Oparil, Suzanne; Calhoun, David A

2012-01-01

Among patients with resistant hypertension (RHTN), there are those whose blood pressure (BP) remains uncontrolled in spite of maximal medical therapy. This retrospective analysis aims to characterize these patients with refractory hypertension. Refractory hypertension was defined as BP that remained uncontrolled after ≥3 visits to a hypertension clinic within a minimum 6-month follow-up period. Of the 304 patients referred for RHTN, 29 (9.5%) remained refractory to treatment. Patients with refractory hypertension and those with controlled RHTN had similar aldosterone levels and plasma renin activity (PRA). Patients with refractory hypertension had higher baseline BP (175±23/97±15 mm Hg vs 158±25/89±15 mm Hg; P=.001/.005) and heart rate, and higher rates of prior stroke and congestive heart failure. During follow-up, the BP of patients with refractory hypertension remained uncontrolled (168.4±14.8/93.8±17.7 mm Hg) in spite of use of an average of 6 antihypertensive medications, while those of patients with controlled RHTN decreased to 129.3±11.2/77.6±10.8 mm Hg. Spironolactone reduced the BP by 12.9±17.8/6.6±13.7 mm Hg in patients with refractory hypertension and by 24.1±16.7/9.2±12.0 mm Hg in patients with controlled RHTN. In patients with RHTN, approximately 10% remain refractory to treatment. Similar aldosterone and PRA levels and a diminished response to spironolactone suggest that aldosterone excess does not explain the treatment failure. © 2011 Wiley Periodicals, Inc.

Refractories for Industrial Processing. Opportunities for Improved Energy Efficiency

Energy Technology Data Exchange (ETDEWEB)

Hemrick, James G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hayden, H. Wayne [Metals Manufacture Process and Controls Technology, Inc., Oak Ridge, TN (United States); Angelini, Peter [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Moore, Robert E. [R.E. Moore Associates, Maricopa, AZ (United States); Headrick, William L. [R.E. Moore Associates, Maricopa, AZ (United States)

2005-01-01

Refractories are a class of materials of critical importance to manufacturing industries with high-temperature unit processes. This study describes industrial refractory applications and identifies refractory performance barriers to energy efficiency for processing. The report provides recommendations for R&D pathways leading to improved refractories for energy-efficient manufacturing and processing.

Fluid Creep Effects on Near-Wall Solute Transport for Non-Isothermal Ampoules

Science.gov (United States)

Papadopoulos, Dimitrios; Rosner, Daniel E.

1996-01-01

There is a growing practical and theoretical interest in developing accurate macroscopic modelling for flows arising in chemical or physical vapor transport (VT) crystal growth experiments, including those conducted in reduced gravity environments. Rosner was the first person to point out that previously neglected rarefield gas dynamics phenomena (Stefan and bouyancy-driven flows) become rather important sources of convection. In particular, the combination of rarefaction and strong gradients of temperature (and/or concentration) tangential to the side-walls of the ampoule induces convective flows known as thermal (and concentration) 'creep' respectively. His order-of-magnitude estimates revealed that thermal creep effects can be non-negligible even at normal gravitational levels. On the macroscopic level, the bulk fluid mechanics can be adequately described by the familiar macroscopic equations as long as the boundary conditions are modified to account for the integrated effect of kinetic boundary layers adjacent to solid boundaries. Motivated by the growing importance of these phenomena, we have embarked on a series of computational studies to elucidate these fundamental creep-induced effects for a rarefied gas in simple, two-dimensional confined geometries. However, unlike previous related studies, we resort to a microscopic description of the gas, mathematically expressed by the Boltzmann integro-differential equation. We employ the direct simulation Monte Carlo (DSMC) method of Bird, the theoretical foundations and several practical applications. In the case of thermally induced flows, the no-time counter method of Bird is used, as implemented for a hard-sphere gas. The scheme has been also extended to account for realistic molecular interaction models, an extension necessary if the diffusion physics underlying concentration creep are to be captured.

Tungsten and refractory metals 3, proceedings

International Nuclear Information System (INIS)

Bose, A.; Dowding, R.J.

1996-01-01

The Third International Conference on Tungsten and Refractory Metals was held in Greater Washington DC at the McLean Hilton, McLean Virginia, on November 15--16, 1995. This meeting was the third in a series of conferences held in the Washington DC area. The first meeting was in 1992 and was entitled ''International Conference on Tungsten and Tungsten Alloys.'' In 1994, the scope of the meeting was expanded to include other refractory metals such as molybdenum, iridium, rhenium, tantalum and niobium. The tremendous success of that meeting was the primary motivation for this Conference. The broader scope (the inclusion of other refractory metals and alloys) of the Conference was kept intact for this meeting. In fact, it was felt that the developments in the technology of these materials required a common forum for the interchange of current research information. The papers presented in this meeting examined the rapid advancements in the technology of refractory metals, with special emphasis on the processing, structure, and properties. Among the properties there was emphasis on both quasi-static and dynamic rates. Another topic that received considerable interest was the area of refractory carbides and tungsten-copper composites. One day of concurrent session was necessary to accommodate all of the presentations

Potential refractory alloy requirements for space nuclear power applications

International Nuclear Information System (INIS)

Cooper, R.H. Jr.

1984-01-01

In reviewing design requirements for refractory alloys for space nuclear applications, several key points are identified. First, the successful utilization of refractory alloys is considered an enabling requirement for the successful deployment of high efficiency, lightweight, and small space nuclear systems. Second, the recapture of refractory alloy nuclear technology developed in the 1960s and early 1970s appears to be a pacing activity in the successful utilization of refractory alloys. Third, the successful application of refractory alloys for space nuclear applications will present a significant challenge to both the materials and the systems design communities

Chemical compositions of refractory inclusions in the Murchison C2 chondrite

International Nuclear Information System (INIS)

Ekambaram, V.; Kawabe, I.; Tanaka, T.; Davis, A.M.; Grossman, L.

1984-01-01

Samples from ten refractory inclusions in Murchison, some of which are splits of inclusions whose mineralogical and petrographic characteristics are known, have been analysed for thirty-six elements by neutron activation. Six inclusions have group II or group III patterns or variants of such patterns. Two inclusions, BB-5 and MUCH-1, have large negative Yb anomalies unaccompanied by correspondingly large negative Eu anomalies. It is possible that the latter condensed originally with group III patterns and preferentially took up Eu in later exchange processes under reducing conditions. One inclusion, SH-2, has heavy REE enrichment factors that increase with the refractoriness of the REE, indicating the presence of an extremely high-temperature, or ultrarefractory, REE condensate, but it also has a heavy REE/light REE ratio that indicates mixing of that component with a lower-temperature REE condensate. The frequency of highly fractionated REE patterns and absence of group I patterns suggest that refractory inclusions in Murchison stopped equilibrating with the nebular gas at higher temperatures than most Allende-coarse-grained inclusions. The results are discussed. (author)

Development of AZS refractories for the glass industry

International Nuclear Information System (INIS)

Guzman, A.M.; Rodriguez, P.

2004-01-01

Refractory materials can support high temperatures, thermal strength and the contact with aggressive environments, for this reason they are widely used in the cement, glass and steel industry. Commercial AZS (alumina-zirconia-silica) refractories are a good alternative in refractory materials for the glass industry' because they can support the aggressive conditions during liquid processing of glass. However, another problem encountered in glass industry is contamination by refractory' material that fall into the molten glass, which can produce a series of defects in the final product. This research was conducted to develop new formulations of AZS refractories with different amounts of ZrO 2 with the purpose of improving the characteristics, properties and the work conditions in the glass melting furnaces and, at the same time, lower the costs this type of refractories. The results obtained indicate that the composition with low content of ZrO 2 can provide better properties than the commercial product, with some modifications in the particle size distribution. Copyright (2004) AD-TECH - International Foundation for the Advancement of Technology Ltd

NOvel Refractory Materials for High Alkali, High Temperature Environments

Energy Technology Data Exchange (ETDEWEB)

Hemrick, J.G.; Griffin, R. (MINTEQ International, Inc.)

2011-08-30

Refractory materials can be limited in their application by many factors including chemical reactions between the service environment and the refractory material, mechanical degradation of the refractory material by the service environment, temperature limitations on the use of a particular refractory material, and the inability to install or repair the refractory material in a cost effective manner or while the vessel was in service. The objective of this project was to address the need for new innovative refractory compositions by developing a family of novel MgO-Al2O3 spinel or other similar magnesia/alumina containing unshaped refractory composition (castables, gunnables, shotcretes, etc) utilizing new aggregate materials, bond systems, protective coatings, and phase formation techniques (in-situ phase formation, altered conversion temperatures, accelerated reactions, etc). This family of refractory compositions would then be tailored for use in high-temperature, highalkaline industrial environments like those found in the aluminum, chemical, forest products, glass, and steel industries. A research team was formed to carry out the proposed work led by Oak Ridge National Laboratory (ORNL) and was comprised of the academic institution Missouri University of Science and Technology (MS&T), and the industrial company MINTEQ International, Inc. (MINTEQ), along with representatives from the aluminum, chemical, glass, and forest products industries. The two goals of this project were to produce novel refractory compositions which will allow for improved energy efficiency and to develop new refractory application techniques which would improve the speed of installation. Also methods of hot installation were sought which would allow for hot repairs and on-line maintenance leading to reduced process downtimes and eliminating the need to cool and reheat process vessels.

SINTERED REFRACTORY TUNGSTEN ALLOYS. Gesinterte hochschmelzende wolframlegierungen

Energy Technology Data Exchange (ETDEWEB)

Kieffer, R.; Sedlatschek, K.; Braun, H.

1971-12-15

Dependence of the melting point of the refractory metals on their positions in the periodic system - alloys of tungsten with other refractory metals - sintering of the alloys - processing of the alloys - technological properties.

Stochastic histories of refractory interstellar dust

International Nuclear Information System (INIS)

Liffman, K.; Chayton, D.D.

1988-01-01

The authors calculate histories for refractory dust particles in the interstellar medium. The double purposes are to learn something of the properties of interstellar dust as a system and to evaluate with specific assumptions the cosmic chemical memory interpretation of a specific class of isotopic anomalies. They assemble the profile of a particle population from a large number of stochastic, or Monte Carlo, histories of single particles, which are necessarily taken to be independent with this approach. They specify probabilities for each of the events that may befall a given particle and unfold its history by a sequence of random numbers. They assume that refractory particles are created only by thermal condensation within stellar material during its ejection from stars, and that these refractory particles can be destroyed only by being sputtered to a size too small for stability or by being incorporated into the formation of new stars. In order to record chemical detail, the authors take each new refractory particle to consist of a superrefractory core plus a more massive refractory mantle. They demonstrate that these superrefractory cores have effective lifetimes much longer than the turnover time of dust mass against sputtering. As examples of cosmic chemical memory they evaluate the 16 O-richness of interstellar aluminum and mechanisms for the 48 Ca/ 50 Ti correlation. Several related consequences of this approach are discussed

First Ti-XANES analyses of refractory inclusions from Murchison

International Nuclear Information System (INIS)

Simon, S.B.; Sutton, S.R.; Grossman, L.

2009-01-01

Ti valence in refractory phases is an important recorder of redox conditions in the early solar nebula. We report the valence of Ti in pyroxene, spinel and hibonite in spinel-hibonite and spinel-pyroxene inclusions and in a coarse hibonite grain. A system of solar composition is so reducing that Ti 3+ and Ti 4+ can coexist, making the valence of Ti a valuable indicator of f O2 conditions during formation of nebular materials. The Ti 3+ /Ti 4+ ratios observed in the Ti-rich phases fassaite and rhoenite in coarse-grained refractory inclusions from CV3 chondrites have been shown to be quantitatively consistent with formation in a gas of solar composition (log f O2 = IW-6.8), but these are the only objects in chondrites for which this is the case. Here, we report the valence of Ti in various phases in refractory inclusions from the Murchison CM2 chondrite. The second-highest temperature, major-element-bearing phase predicted to condense from a gas of solar composition, hibonite (ideally CaAl 12 O 19 ), can contain significant amounts of Ti, but the hibonite structure can have oxygen vacancies, so calculation of Ti valence from stoichiometry of electron probe analyses is not recommended for hibonite. To date, the only reported measurement of Ti valence in meteoritic hibonite was done by electron spin resonance, on coarse crystals from a Murchison hibonite-perovskite-melilite inclusion. Spinel and most of the pyroxene in CM inclusions contain too little Ti for derivation of Ti 3+ /Ti 4+ ratios from electron probe analyses. X-ray absorption near edge spectroscopy (XANES), however, allows determination of Ti valence in relatively Ti-poor phases. In the present work, we apply synchrotron microXANES to a large hibonite grain from Murchison and to spinel-hibonite (sp-hib) and spinel-pyroxene (sp-pyx) inclusions from Murchison, refractory materials whose Ti 3+ /Ti 4+ ratios have not been previously measured. Analysis of these samples allows comparison of Ti valence of (1

Morphology study of refractory carbide powders

International Nuclear Information System (INIS)

Vavrda, J.; Blazhikova, Ya.

1982-01-01

Refractory carbides were investigated using JSM-U3 electron microscope of Joelco company at 27 KV accelerating voltage. Some photographs of each powder were taken with different enlargements to characterise the sample upon the whole. It was shown that morphological and especially topographic study of powders enables to learn their past history (way of fabrication and treatment). The presence of steps of compact particle fractures and cracks is accompanied by occurence of fine dispersion of carbides subjected to machining after facrication. On the contrary, the character of crystallographic surfaces and features of surface growth testify to the way of crystallization

Response properties of the refractory auditory nerve fiber.

Science.gov (United States)

Miller, C A; Abbas, P J; Robinson, B K

2001-09-01

The refractory characteristics of auditory nerve fibers limit their ability to accurately encode temporal information. Therefore, they are relevant to the design of cochlear prostheses. It is also possible that the refractory property could be exploited by prosthetic devices to improve information transfer, as refractoriness may enhance the nerve's stochastic properties. Furthermore, refractory data are needed for the development of accurate computational models of auditory nerve fibers. We applied a two-pulse forward-masking paradigm to a feline model of the human auditory nerve to assess refractory properties of single fibers. Each fiber was driven to refractoriness by a single (masker) current pulse delivered intracochlearly. Properties of firing efficiency, latency, jitter, spike amplitude, and relative spread (a measure of dynamic range and stochasticity) were examined by exciting fibers with a second (probe) pulse and systematically varying the masker-probe interval (MPI). Responses to monophasic cathodic current pulses were analyzed. We estimated the mean absolute refractory period to be about 330 micros and the mean recovery time constant to be about 410 micros. A significant proportion of fibers (13 of 34) responded to the probe pulse with MPIs as short as 500 micros. Spike amplitude decreased with decreasing MPI, a finding relevant to the development of computational nerve-fiber models, interpretation of gross evoked potentials, and models of more central neural processing. A small mean decrement in spike jitter was noted at small MPI values. Some trends (such as spike latency-vs-MPI) varied across fibers, suggesting that sites of excitation varied across fibers. Relative spread was found to increase with decreasing MPI values, providing direct evidence that stochastic properties of fibers are altered under conditions of refractoriness.

Refractory alloy technology for space nuclear power applications

International Nuclear Information System (INIS)

Cooper, R.H. Jr.; Hoffman, E.E.

1984-01-01

Purpose of this symposium is twofold: (1) to review and document the status of refractory alloy technology for structural and fuel-cladding applications in space nuclear power systems, and (2) to identify and document the refractory alloy research and development needs for the SP-100 Program in both the short and the long term. In this symposium, an effort was made to recapture the space reactor refractory alloy technology that was cut off in midstream around 1973 when the national space nuclear reactor program began in the early 1960s, was terminated. The six technical areas covered in the program are compatibility, processing and production, welding and component fabrication, mechanical and physical properties, effects of irradiation, and machinability. The refractory alloys considered are niobium, molybdenum, tantalum, and tungsten. Thirteen of the 14 pages have been abstracted separately. The remaining paper summarizes key needs for further R and D on refractory alloys

An investigation into mineral processing of north Semnan refractory earth

International Nuclear Information System (INIS)

Aslani, S.; Samin-Bani-Hashemi, H.R.; Taghi-Zadeh, O.

2002-01-01

This paper is dealing with refractory earth of North Semnan. Having an area of 2000 square kilometers, Semnan province is mainly formed by sedimentary rocks with a verity of refractory earth, red earth and kaolin containing heavy minerals. The refractory earth of this area contains a considerable rate of aluminum oxide in shape of dia spore minerals, behemoth and gybsite along with heavy minerals of iron and titanium. To improve the quality of refractory earth, in order to be used in related industries, these minerals have to be separated. To assess the quality of refractory earth of North Semnan as the raw materials of refractory industries, their genesis and mineralogy properties have been precisely studied. Based on the rate of aluminium oxide of the refractory earth of North Semnan mines, a suitable mineral deposit has been selected for more investigation. Using XRD and X RF methods along with electronic and photo microscopes, the refractory earth and heavy minerals of them have been assessed. The elementary laboratory experiments of fragmentation and magnetic separation have been performed. It has been proved that the iron minerals can be separated and, therefore, the quality of the refractory earth can be improved. The separation of titanium minerals has to be investigated with other methods

REFRACTORY THROMBOCYTOPENIA AND NEUTROPENIA: A DIAGNOSTIC CHALLENGE

Directory of Open Access Journals (Sweden)

Emmanuel Gyan

2015-02-01

Full Text Available Background. The 2008 WHO classification identified refractory cytopenia with unilineage dysplasia (RCUD as a composite entity encompassing refractory anemia, refractory thrombocytopenia (RT, and refractory neutropenia (RN, characterized by 10% or more dysplastic cells in the bone marrow respective lineage. The diagnosis of RT and RN is complicated by several factors.  Diagnosing RT first requires exclusion of familial thrombocytopenia, chronic auto-immune thrombocytopenia, concomitant medications, viral infections, or hypersplenism. Diagnosis of RN should also be made after ruling out differential diagnoses such as ethnic or familial neutropenia, as well as acquired, drug-induced, infection-related or malignancy-related neutropenia. An accurate quantification of dysplasia should be performed in order to distinguish RT or RN from the provisional entity named idiopathic cytopenia of unknown significance (ICUS. Cytogenetic analysis, and possibly in the future somatic mutation analysis (of genes most frequently mutated in MDS, and flow cytometry analysis aberrant antigen expression on myeloid cells may help in this differential diagnosis. Importantly, we and others found that, while isolated neutropenia and thrombocytopenia are not rare in MDS, those patients can generally be classified (according to WHO 2008 classification as refractory cytopenia with multilineage dysplasia or refractory anemia with excess blasts, while RT and RN (according to WHO 2008 are quite rare.These results suggest in particular that identification of RT and RN as distinct entities could be reconsidered in future WHO classification updates.

Two-Step Oxidation of Refractory Gold Concentrates with Different Microbial Communities.

Science.gov (United States)

Wang, Guo-Hua; Xie, Jian-Ping; Li, Shou-Peng; Guo, Yu-Jie; Pan, Ying; Wu, Haiyan; Liu, Xin-Xing

2016-11-28

Bio-oxidation is an effective technology for treatment of refractory gold concentrates. However, the unsatisfactory oxidation rate and long residence time, which cause a lower cyanide leaching rate and gold recovery, are key factors that restrict the application of traditional bio-oxidation technology. In this study, the oxidation rate of refractory gold concentrates and the adaption of microorganisms were analyzed to evaluate a newly developed two-step pretreatment process, which includes a high temperature chemical oxidation step and a subsequent bio-oxidation step. The oxidation rate and recovery rate of gold were improved significantly after the two-step process. The results showed that the highest oxidation rate of sulfide sulfur could reach to 99.01 % with an extreme thermophile microbial community when the pulp density was 5%. Accordingly, the recovery rate of gold was elevated to 92.51%. Meanwhile, the results revealed that moderate thermophiles performed better than acidophilic mesophiles and extreme thermophiles, whose oxidation rates declined drastically when the pulp density was increased to 10% and 15%. The oxidation rates of sulfide sulfur with moderate thermophiles were 93.94% and 65.73% when the pulp density was increased to 10% and 15%, respectively. All these results indicated that the two-step pretreatment increased the oxidation rate of refractory gold concentrates and is a potential technology to pretreat the refractory sample. Meanwhile, owing to the sensitivity of the microbial community under different pulp density levels, the optimization of microbial community in bio-oxidation is necessary in industry.

Refractory alloy technology for space nuclear power applications

Energy Technology Data Exchange (ETDEWEB)

Cooper, R.H. Jr.; Hoffman, E.E. (eds.)

1984-01-01

Purpose of this symposium is twofold: (1) to review and document the status of refractory alloy technology for structural and fuel-cladding applications in space nuclear power systems, and (2) to identify and document the refractory alloy research and development needs for the SP-100 Program in both the short and the long term. In this symposium, an effort was made to recapture the space reactor refractory alloy technology that was cut off in midstream around 1973 when the national space nuclear reactor program began in the early 1960s, was terminated. The six technical areas covered in the program are compatibility, processing and production, welding and component fabrication, mechanical and physical properties, effects of irradiation, and machinability. The refractory alloys considered are niobium, molybdenum, tantalum, and tungsten. Thirteen of the 14 pages have been abstracted separately. The remaining paper summarizes key needs for further R and D on refractory alloys. (DLC)

Temperature and Thermal Stress Analysis of Refractory Products

Directory of Open Access Journals (Sweden)

Shaoyang Shi

2013-05-01

Full Text Available Firstly current status of temperature and thermal stress research of refractory product at home and aboard are analyzed. Finite element model of two classical refractory products is building by using APDL language. Distribution law of temperature and thermal stress of two typical refractory products-ladles and tundish are analyzed and their structures are optimized. Stress of optimal structure is dropped obviously, and operation life is increased effectively.

Comparative evaluation of the locally manufactured low-alumina fireclay refractories

International Nuclear Information System (INIS)

Mohammad, D.; Ahmed, W.; Khan, M.I.

2007-01-01

Properties of domestically produced low-alumina refractories commonly known as medium duty fireclay refractories were studied and a comparative evaluation was performed. Refractory properties such as density, porosity, cold strength, reheat change and deformation at high-temperature were determined. Significant differences were discovered between these products sold as medium duty fireclay refractories. One brand marketed as medium duty refractory was found to be too inferior to be designated as medium duty firebrick. Absence of any standards and lack of awareness on the part of users of the various test methods appear to be the cause of this situation. (author)

Machining refractory alloys: an overview

International Nuclear Information System (INIS)

Christopher, J.D.

1984-01-01

Nontraditional machining is a generic term for those material removal processes that differ drastically from the historic operations such as turning, milling, drilling, tapping, and grinding. The use of primary energy modes other than mechanical, such as thermal, electrical, and chemical, sets these operations apart and reinforces their nontraditional label. Several of these newer processes have been very successful in machining close tolerance parts from refractory materials. This paper provides a general overview of both traditional and nontraditional aspects of machining refractory materials. 11 figures, 7 tables

Forensic analysis of a smuggled HEU sample interdicted in Bulgaria

International Nuclear Information System (INIS)

Niemeyer, S.; Hutcheon, I.

2002-01-01

Full text: A sample of HEU was seized in Rousse, Bulgaria on May 29, 1999, at a border crossing between Bulgaria and Romania. A search of the suspect's vehicle uncovered a lead canister hidden in the car trunk. The initial examination of the contents by Bulgarian scientists indicated that the sample was indeed HEU, and subsequently arrangements were made for a U.S. team of nuclear forensics scientists from several national laboratories to conduct a thorough examination. This report gives a summary of the results. The HEU sample was contained in a glass ampoule that was embedded in a yellow wax, and in turn the wax filled the inside of the cylindrical lead container. A broad set of techniques was used to examine both nuclear and non-nuclear materials. Our general experimental approach has been previously described at meetings of the Nuclear Smuggling International Technical Working Group (ITWG), but this case represents the application of the most diverse set of nuclear forensic measurements for an actual seized sample. Analysis of the HEU itself included particle characterization, stoichiometry, impurity elements, residual nuclides, age-dating, and U and Pu isotopics. Measurements by XRD, SEM, and TEM show that sample is mostly U3O8, with minor amounts of two other phases. The powder is extremely fine-grained (160 nm mean) and quite uniform in size. Most grains (95%) are equidimensional, with the remainder rod-or plate-shaped. The U is 72.7% U-235 with a high U-236 abundance of 12.1%. The sample is reprocessed, reactor-irradiated material. The original U enrichment was 90% and the irradiation burned up about 50% of the initial U-235. Pu is present at a very low-level (3 ppb); the Pu-239 abundance is 82% with 240/239=0.12. Three fission products were detected at low levels, giving unambiguous evidence of fuel recycling. The total impurity content is about 600 ppmw (mostly S, Cl, Fe, and Br), which we interpret as indicating a batch processing operation because the

Spinning of refractory metals

International Nuclear Information System (INIS)

Chang Wenkua; Zheng Han

1989-01-01

The effects of spinning process parameters including max. pass percentage reduction, spinning temperature, feed rate, lubricant and annealing technology on the quality of shaped components are summarized and discussed in the present paper. The above mentioned parameters are adopted in the process of spinning of barrel-shaped and specially shaped components of refractory metals and their alloys W, Mo, Nb, Zr, TZM molybdenum alloy, C-103, C-752 niobium alloy etc. The cause of leading to usual defects of spun products of refractory metals such as lamellar as 'scaling', crack, swelling, wrinkle, etc. have been analysed and the ways to eliminate the defects have been put forward. 8 figs., 5 tabs. (Author)

Migration of TRU-containing slag into candidate refractories for waste management

International Nuclear Information System (INIS)

Seymour, W.C.

1978-11-01

Results of initial tests on transuranic migration into commercial refractories are reported. Five castable refractories and a plastic-bonded refractory were tested using the cup test method. Initial results indicate that castable materials will not survive conditions expected in the slagging pyrolysis unit; plastic refractories appear to have better performance. The major mechanism of migration into the tested refractories is pore penetration. Al 2 O 3 and Al 2 O 3 -Cr 2 O 3 phases appear resistant to chemical diffusion of transuranics. 2 figures, 16 tables

Refractory of Furnaces to Reduce Environmental Impact

International Nuclear Information System (INIS)

Hanzawa, Shigeru

2011-01-01

The energy load of furnaces used in the manufacturing process of ceramics is quite large. Most of the environmental impact of ceramics manufacturing is due to the CO 2 produced from this high energy load. To improve this situation, R and D has focused on furnace systems and techniques of control in order to reduce energy load. Since furnaces are comprised of refractory, consideration of their mechanical and thermal characteristics is important. Herein are described several refractory types which were chosen through comparison of the characteristics which contribute to heat capacity reduction, heat insulating reinforcement and high emissivity, thereby improving thermal radiation heat transfer efficiency to the ceramic articles. One selected refractory material which will reduce the environmental impact of a furnace, chosen considering low heat capacity and high emissivity characteristics, is SiC. In this study, thermal radiation heat transfer efficiency improvement and its effect on ceramic articles in the furnace and oxidation behaviour were investigated at 1700K. A high density SiC refractory, built into the furnace at construction, has relatively high oxidation durability and has the ability to reduce environmental impact-CO 2 by 10 percent by decreasing the furnace's energy load. However, new oxidation prevention techniques for SiC will be necessary for long-term use in industrial furnaces, because passive to active oxidation transition behaviour of commercial SiC refractory is coming to close ideal.

Refractory of Furnaces to Reduce Environmental Impact

Science.gov (United States)

Hanzawa, Shigeru

2011-10-01

The energy load of furnaces used in the manufacturing process of ceramics is quite large. Most of the environmental impact of ceramics manufacturing is due to the CO2 produced from this high energy load. To improve this situation, R&D has focused on furnace systems and techniques of control in order to reduce energy load. Since furnaces are comprised of refractory, consideration of their mechanical and thermal characteristics is important. Herein are described several refractory types which were chosen through comparison of the characteristics which contribute to heat capacity reduction, heat insulating reinforcement and high emissivity, thereby improving thermal radiation heat transfer efficiency to the ceramic articles. One selected refractory material which will reduce the environmental impact of a furnace, chosen considering low heat capacity and high emissivity characteristics, is SiC. In this study, thermal radiation heat transfer efficiency improvement and its effect on ceramic articles in the furnace and oxidation behaviour were investigated at 1700K. A high density SiC refractory, built into the furnace at construction, has relatively high oxidation durability and has the ability to reduce environmental impact-CO2 by 10 percent by decreasing the furnace's energy load. However, new oxidation prevention techniques for SiC will be necessary for long-term use in industrial furnaces, because passive to active oxidation transition behaviour of commercial SiC refractory is coming to close ideal.

Development of alumino-silicate refractories in Ghana

International Nuclear Information System (INIS)

Kisiedu, A. K.; Tetteh, D.M.B.; Obiri, H. A.; Brenya, E. F.; Ayensu, A.

2008-01-01

Alumino-silicate (bauxite), andalusite, kaolin and clay were investigated for suitability in production of alumina, mullite and fireclay brick refractories. The raw materials were characterized by X-ray diffraction, differential thermal and silicate analyses. The x-ray diffraction analysis of alumina and mullite refractories fired at 1450 0 C, and fireclay bricks fired at 1350 0 C, indicated presence of corundum and alpha-alumina crystals. The values of thermal (fired) shrinkage, crushing, strength, porosity, water absorption and bulk density determined were 31.1%, 2.3 x 10 3 kg/m 3 , 4.86 x 10 6 N/m 2 and 13.2 % for mullite; 30.2%, 2.4 x 10 3 kg/m 3 , 3.20 x 10 6 N/m 2 and W = 12.8 % for alumina; and 25.2 %, 2.1 x 10 3 kg/m 3 , 2.61 x 10 6 N/m 2 and W = 11.8% for fireclay, respectively. Bauxite, andalusite and special kaolin were identified as potential raw materials for developing alumina and mullite refractories for construction of high temperature kilns and furnaces operating at 1350 0 C. The clay and kaolin minerals could be used to produce fireclay refractories for construction of incinerators operating at maximum temperatures of about 1000 0 C. The performance of the refractories was demonstrated by producing bricks to construct kilns and incinerators for the ceramic industry and hospitals. (au)

Possible impact-induced refractory-lithophile fractionations in EL chondrites

Science.gov (United States)

Rubin, Alan E.; Huber, Heinz; Wasson, John T.

2009-03-01

Literature data show that refractory-lithophile elements in most chondrite groups are unfractionated relative to CI chondrites; the principal exception is the EL-chondrite group whose observed falls (all of which are type 6) are depleted in Ca and light REE. In contrast, literature data and our new INAA data on EL3 PCA 91020, EL3 MAC 88136 and EL4 Grein 002 show that some replicates of these samples have nearly flat REE patterns (unlike those of EL6 chondrites); other replicates exhibit fractionated REE patterns similar to those of EL6 chondrites. Petrographic examination shows that many EL6 (and some EL3 and EL4) chondrites are impact-melt breccias or contain impact-melted portions. We suggest that the same impact processes that formed these breccias and produced melt are responsible for the observed bulk compositional fractionations in refractory-lithophile elements, i.e., EL6 chondrites were produced from initially unequilibrated EL3 material. When large amounts of impact heat were deposited, plagioclase and/or oldhamite (CaS) (the major REE carriers in enstatite chondrites) may have been melted and then transported appreciable (>10 cm) distances. EL6 chondrites represent the residuum that is depleted in REE (particularly in LREE) and Ca. Unlike the case for EL chondrites, our new INAA data on ALH 84170, EET 87746 and SAH 97096 (all EH3) show some scatter but are consistent with the EH group having uniform refractory-lithophile abundances.

Refractory disease in antineutrophil cytoplasmic antibodies associated vasculitis

NARCIS (Netherlands)

Rutgers, Abraham; Kallenberg, Cornelis

Purpose of review Induction treatment of antineutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) is not always successful and nonresponding patients are considered refractory. Recent findings Refractory disease should be subdefined to the treatment that was received.

Dielectric relaxation in glassy Se75In25−xPbx alloys

Indian Academy of Sciences (India)

to their atomic percentages and were sealed in quartz ampoules (length ~5 cm and internal dia. ~8 mm) in vacuum ... samples were taken out by breaking the quartz ampoules. The glassy nature of the ... measured with the help of a calibrated copper–constantan thermocouple mounted very near to the sample, which could ...

Diagnosis and management of refractory celiac disease: a systematic review.

Science.gov (United States)

Labidi, Asma; Serghini, Meriem; Karoui, Sami; Boubaker, Jalel; Filali, Azza

2013-01-01

Refractory celiac disease is defined by persisting malabsorptive symptoms in spite of a strict gluten free diet for at least 6 to 12 months. Alternatives to gluten free diet seem to be still controversial. To describe the clinical and epidemiologic aspects of refractory celiac disease, and to identify therapeutic options in this condition. Systematic review and critical analysis of observational studies, clinical trials and case reports that focused on diagnosis and management of refractory celiac disease. Refractory celiac disease can be classified as type 1 or type 2 according to the phenotype of intraepithelial lymphocytes. Great complications such as enteropathy-associated T-cell lymphoma may occur in a subgroup of these patients mainly in refractory celiac disease type 2. Curative therapies are still lacking. Refractory celiac disease remains a diagnosis of exclusion. Its prognosis remains still dismal by the absence yet of curative therapies. However, some new treatments seem to hold promise during few cohort-studies.

Modern materials based on refractory compounds

International Nuclear Information System (INIS)

Kosolapova, T.Ya.

1979-01-01

Discussed are the existing methods for synthesizing powders of binary refractory compounds and high-productivity techniques which hold promise as regards the manufacture of highly disperse and pure powders. Plasmochemical synthesis is shown to be an effective method for obtaining practically all carbides, nitrides and borides. A description is given of three main methods for obtaining single crystals of refractory compounds (TiN, TiC, ZrC, ZrB 2 , NbC) fairly perfect in structure and composition. These processes include deposition from vapour-gas phase, melting in arc plasma and crystallization from solutions in metallic melts. The advantages have been shown of the self-propagating high-temperature synthesis of refractory compounds, ensuring the manufacture of products, close in composition to stoichiometric ones simultaneously with forming of items. Mechanical, thermal, abrasive, and resistive characteristics of the above materials are presented

Analysis of mercury in environmental samples

International Nuclear Information System (INIS)

Schoester, F.S.

1992-01-01

The possibility to determine mercury in sub-ppm levels in biological samples has been studied through neutron activation analysis , using as standards aliquots of mercury nitrate solution, deposited on treated cellulose with thio acetamide and ammonia. Sample and standards were irradiated simultaneously in quartz ampoules during 8 hours at a flux of 5 x 10 13 n/cm 2 s and were counted in a hyper pure germanium detector after 4 weeks of decay. Corrections were made for the interference of 75 Se in the 279 keV photopeak used in the determination. The results obtained for the reference materials IAEA-H-8(horse kidney), IAEA-M A-A2(fish flesh) and IAEA-M A-A-1(cope pod homogenate) were (0.91±0.07), (0.56±0.02) and (0.17±0.02) ppm, versus certified values of (0.91±0.08), (0.47±0.02) and (0.28±0.01) ppm respectively. (EMR). 54 refs., 8 app

Structure, preparation and properties of refractory compounds and systems

International Nuclear Information System (INIS)

Holleck, H.; Thuemmler, F.

1977-01-01

At the beginning of this report the possibilities of hardness optimization of refractory carbides are generally discussed. Three papers deal with TaC-basis refractories and hard metals. In particular, carbides with very low nonmetal/metal ratios and composites with hard phases formed by decomposition of tantalum carbonitrides are discussed. Another contribution reports investigations concerning the influence of the microstructure on the hardness of polycristaline mixed carbides. In a series of four papers, results are presented on the work of optimization conventional WC hard metals by introduction of a Fe,Co,Ni-binder: The influence of composition, carbon content and sintering conditions, as well as the wetting behaviour between carbides and binder metals are discussed. Phase relations in the refractory nitride and refractory nitride-binder metal systems as well as phase stabilities of ordered transition metal phases are reported in three papers, fundamental in character. Finally, the work concerning chemical analysis of refractory systems is described. (orig.) [de

Refractory versus resistant hypertension: Novel distinctive phenotypes

Science.gov (United States)

Dudenbostel, Tanja; Siddiqui, Mohammed; Gharpure, Nitin; Calhoun, David A.

2017-01-01

Resistant hypertension (RHTN) is relatively common with an estimated prevalence of 10-20% of treated hypertensive patients. It is defined as blood pressure (BP) >140/90 mmHg treated with ≥3 antihypertensive medications, including a diuretic, if tolerated. Refractory hypertension is a novel phenotype of severe antihypertensive treatment failure. The proposed definition for refractory hypertension, i.e. BP >140/90 mmHg with use of ≥5 different antihypertensive medications, including a diuretic and a mineralocorticoid receptor antagonist (MRA) has been applied inconsistently. In comparison to RHTN, refractory hypertension seems to be less prevalent than RHTN. This review focuses on current knowledge about this novel phenotype compared with RHTN including definition, prevalence, mechanisms, characteristics and comorbidities, including cardiovascular risk. In patients with RHTN excess fluid retention is thought to be a common mechanism for the development of RHTN. Recently, evidence has emerged suggesting that refractory hypertension may be more of neurogenic etiology due to increased sympathetic activity as opposed to excess fluid retention. Treatment recommendations for RHTN are generally based on use and intensification of diuretic therapy, especially with the combination of a long-acting thiazide-like diuretic and an MRA. Based on findings from available studies, such an approach does not seem to be a successful strategy to control BP in patients with refractory hypertension and effective sympathetic inhibition in such patients, either with medications and/or device based approaches may be needed. PMID:29034321

Forming Refractory Insulation On Copper Wire

Science.gov (United States)

Setlock, J.; Roberts, G.

1995-01-01

Alternative insulating process forms flexible coat of uncured refractory insulating material on copper wire. Coated wire formed into coil or other complex shape. Wire-coating apparatus forms "green" coat on copper wire. After wire coiled, heating converts "green" coat to refractory electrical insulator. When cured to final brittle form, insulating material withstands temperatures above melting temperature of wire. Process used to make coils for motors, solenoids, and other electrical devices to be operated at high temperatures.

High-dose chemotherapy and auto-SCT for relapsed and refractory Hodgkin's lymphoma patients refractory to first-line salvage chemotherapy but responsive to second-line salvage chemotherapy.

Science.gov (United States)

Rauf, Muhammad Shahzad; Maghfoor, Irfan; Elhassan, Tusneem Ahmed M; Akhtar, Saad

2015-01-01

Relapsed or primary refractory Hodgkin's lymphoma (HL) patients refractory to first-line salvage chemotherapy (first salvage) and unable to undergo high-dose chemotherapy (HDC) and autologous stem cell transplant (auto-SCT) have very poor outcome. Some patients are offered second-line salvage chemotherapy (second salvage), if they are responsive and may receive HDC auto-SCT. We identified 31 patients (18 males, 13 females) from 1996-2012 who received second salvage prior to auto-SCT. Median age at auto-SCT is 22 years. Patients were grouped as (1) relapsed-refractory (Rel:Ref): patients with prior complete response (CR) and on relapse found refractory to first salvage and received second salvage and (2) refractory-refractory (Ref:Ref): patients refractory to both primary treatment and first salvage and received second salvage. Median follow-up is 63 months (18-170). Disease status after second salvage prior to HDC was CR 16 %, partial response (PR) 71 % and stable disease 13 %. After HDC auto-SCT, CR:PR: progressive disease was observed in 18 (58 %): four (12 %): nine (29 %) patients, respectively. Five-year overall survival (OS) for whole group is 57 % (Rel:Ref vs. Ref:Ref, 73 % vs. 48 %, p = 0.48). Progression-free survival (PFS) for whole group is 52 % (Rel:Ref vs. Ref:Ref, 73 % vs. 40 % respectively, p = 0.11). Second-line salvage is a valid approach with no long-term side effects for those HL patients who do not respond to first-line salvage chemotherapy and they can be candidate of HDC and stem cell transplant with a high ORR, the PFS and OS in relapse-refractory and refractory-refractory group of patients.

Refractory myasthenia gravis - clinical profile, comorbidities and response to rituximab.

Science.gov (United States)

Sudulagunta, Sreenivasa Rao; Sepehrar, Mona; Sodalagunta, Mahesh Babu; Settikere Nataraju, Aravinda; Bangalore Raja, Shiva Kumar; Sathyanarayana, Deepak; Gummadi, Siddharth; Burra, Hemanth Kumar

2016-01-01

Introduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and features of patients with MG and mode of management using rituximab and complications. Methods: Data of myasthenia gravis patients admitted or presented to outpatient department (previous medical records) with MG between January 2008 and January 2016 were included. A total of 512 patients fulfilled the clinical and diagnostic criteria of myasthenia gravis of which 76 patients met the diagnostic certainty for refractory myasthenia gravis and were evaluated. Results: Out of 76 refractory MG patients, 53 (69.73%) patients fulfilled all the three defined criteria. The median age of onset of the refractory MG group was 36 years with a range of 27-53 years. In our study 25 patients (32.89%) belonged to the age group of 21-30 years. Anti-MuSK antibodies were positive in 8 non-refractory MG patients (2.06%) and 36 refractory MG patients (47.36%). Mean HbA 1C was found to be 8.6±2.33. The dose of administered prednisone decreased by a mean of 59.7% ( p =3.3x10 -8 ) to 94.6% ( p =2.2x10 -14 ) after the third cycle of rituximab treatment. Conclusion: The refractory MG patients are most commonly female with an early age of onset, anti-MuSK antibodies, and thymomas. Refractory MG patients have higher prevalence and poor control (HbA 1C >8%) of diabetes mellitus and dyslipidemia probably due to increased steroid usage. Rituximab is very efficient in treatment of refractory MG with adverse effects being low.

RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

Directory of Open Access Journals (Sweden)

M. M. Batyushin

2015-12-01

Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

Directory of Open Access Journals (Sweden)

M. M. Batyushin

2007-01-01

Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

Preparation and characterization of clay bonded high strength silica refractory by utilizing agriculture waste

Directory of Open Access Journals (Sweden)

Aman Bhardwaj

2017-11-01

Full Text Available Clay bonded silica refractory was prepared by utilizing agriculture waste called rice husk ash (RHA and refractory grog. Various samples were prepared with different compositions based upon partial replacement of quartz by RHA. Rectangular samples were prepared by following semi dry process prior to pressing in a uniaxial hydraulic press and sintering at a temperature of 1200 °C in air atmosphere. Various physical, mechanical and thermal characterizations were done like X-ray diffraction (XRD, scanning electron microscope (SEM, apparent porosity (AP, bulk density (BD, cold crushing strength (CCS, refractoriness and thermal conductivity measurement. The sample utilizing 30% of RHA was considered most optimum composition which produced cold crushing strength of 38 MPa and thermal conductivity of 2.08 W/m K at 800 °C with a considerable good refractoriness. Enhancement in the mechanical as well as thermal properties may be considered as attributed to the amorphous silica which has reacted more easily and efficiently with other material surrounding giving rise to the densification and produced stable crystalline phase to the refractory material. These promising characteristics suggests that the RHA may lead to be used as a potential material for the preparation of clay bonded high strength silica refractories. Resumen: Se preparó sílice refractaria unida a arcilla con residuos agrícolas conocidos como ceniza de cascarilla de arroz (rice husk ash [RHA] y grog refractario. Se prepararon varias muestras con diferentes composiciones basadas en la sustitución parcial de cuarzo por RHA. Las muestras rectangulares se prepararon siguiendo un proceso semiseco antes de prensarlas en una prensa hidráulica uniaxial y sinterizarlas a una temperatura de 1.200 °C en atmósfera de aire. Se realizaron diversas caracterizaciones físicas, mecánicas y térmicas, como la difracción de rayos X, el microscopio electrónico de barrido, la porosidad

Bone marrow immunophenotyping by flow cytometry in refractory cytopenia of childhood

NARCIS (Netherlands)

A.M. Aalbers (Anna Maartje); M.M. van den Heuvel-Eibrink (Marry); I. Baumann (Irith); M.N. Dworzak (Michael); H. Hasle (Henrik); F. Locatelli (Franco); B. de Moerloose (Barbara); M. Schmugge; E. Mejstříková (Ester); M. Nováková (Michaela); M. Zecca (Marco); C.M. Zwaan (Christian Michel); J.G. te Marvelde (Jeroen); A.W. Langerak (Anton); J.J.M. van Dongen (Jacques); R. Pieters (Rob); C.M. Niemeyer (Charlotte); V.H.J. van der Velden (Vincent)

2015-01-01

textabstractRefractory cytopenia of childhood is the most common type of childhood myelodysplastic syndrome. Because the majority of children with refractory cytopenia have a normal karyotype and a hypocellular bone marrow, differentiating refractory cytopenia from the immune-mediated bone marrow

Detection of Active Epstein-Barr Virus Infection in Duodenal Mucosa of Patients With Refractory Celiac Disease.

Science.gov (United States)

Perfetti, Vittorio; Baldanti, Fausto; Lenti, Marco Vincenzo; Vanoli, Alessandro; Biagi, Federico; Gatti, Marta; Riboni, Roberta; Dallera, Elena; Paulli, Marco; Pedrazzoli, Paolo; Corazza, Gino Roberto

2016-08-01

Refractory celiac disease is characterized by mucosal damage in patients with celiac disease despite a gluten-free diet. Little is known about the mechanisms that cause persistent intestinal inflammation in these patients. We performed a case-control study of 17 consecutive patients diagnosed with refractory celiac disease from 2001 through 2014 (median age, 51 y; 10 women) and 24 patients with uncomplicated celiac disease (controls) to determine whether refractory disease is associated with infection by lymphotropic oncogenic viruses. We performed real-time PCR analyses of duodenal biopsy samples from all patients to detect Epstein-Barr virus (EBV), human herpesvirus-8, and human T-cell lymphotropic virus-I, -II, or -III. We used in situ hybridization and immunohistochemical analyses to identify infected cells and viral proteins. We did not detect human herpesvirus-8 or human T-cell lymphotropic viruses in any of the biopsy specimens. However, 12 of 17 (70.5%) biopsy specimens from patients with refractory celiac disease were positive for EBV, compared with 4 of 24 (16.6%) biopsy specimens from controls (P disease and enteropathy-associated T-cell lymphoma. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Colectomy for refractory constipation

DEFF Research Database (Denmark)

Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth

2010-01-01

OBJECTIVE: This study evaluated the type of colectomy, postoperative complications, functional results, and satisfaction in patients with constipation refractory to conservative therapy. Further, colonic transit time (CTT), faecal load (coprostasis), and colon length (redundancies) were compared ...

Statistical experimental design for refractory coatings

International Nuclear Information System (INIS)

McKinnon, J.A.; Standard, O.C.

2000-01-01

The production of refractory coatings on metal casting moulds is critically dependent on the development of suitable rheological characteristics, such as viscosity and thixotropy, in the initial coating slurry. In this paper, the basic concepts of mixture design and analysis are applied to the formulation of a refractory coating, with illustration by a worked example. Experimental data of coating viscosity versus composition are fitted to a statistical model to obtain a reliable method of predicting the optimal formulation of the coating. Copyright (2000) The Australian Ceramic Society

Typical corrosion of alumina refractory in aluminum reflow oven

International Nuclear Information System (INIS)

Baldo, Jaoa B.

2014-01-01

The refractory linings of furnaces for secondary melting of aluminum, are exposed to intense attack by the molten metal. This occurs, because molten aluminum has a strong reducing power over the refractory oxide components, particularly Fe 2 O 3 , SiO 2 and TiO 2 . In this work, based on X-ray diffraction and scanning electron microscopy, it is presented a post mortem study of the mechanisms that lead to a premature wear of a 80% Al2O3 chemically bonded refractory bricks, used in the metal line of an aluminum re-melting furnace. The SEM analysis demonstrated that the oxides SiO 2 and TiO 2 contained in the refractory were reduced and transformed into their metallic elements causing an intense structural spalling. (author)

Beta-blockers in cirrhosis and refractory ascites

DEFF Research Database (Denmark)

Kimer, Nina; Feineis, Martin; Møller, Søren

2015-01-01

OBJECTIVE: It is currently discussed if beta-blockers exert harmful effects and increase mortality in patients with cirrhosis and refractory ascites. In this study, we provide an overview of the available literature in this field in combination with a retrospective analysis of 61 patients...... trials (9 trials on propranolol, 1 case-control study and 4 retrospective analyses) were identified. One trial suggested an increased mortality in patients treated with beta-blockers and refractory ascites. The results of the remaining trials were inconclusive. No increase in mortality among beta-blocker......-treated patients was found in the present retrospective analysis. CONCLUSIONS: Treatment with beta-blockers may increase mortality in patients with cirrhosis and refractory ascites. However, the current evidence is sparse and high-quality studies are warranted to clarify the matter....

Fire and explosion hazards of refractory compound powders

International Nuclear Information System (INIS)

Krivtsov, V.A.; Kostina, E.S.

1978-01-01

Data on fire and explosion hazards of refractory compound powders (HfC, ZrC,LaB 6 , ZrN, etc.) are presented. It is shown that refractory compounds can be fire- and exposion hazardous in various degrees. Qualitative and quantitative estimations of one of fire-hazard characteristics - smoldering temperature - are presented

Immunomodulatory therapy in refractory/recurrent ovarian cancer.

Science.gov (United States)

Chen, Chao-Yu; Lai, Chyong-Huey; Yang, Lan-Yan; Tang, Yun-Hsin; Chou, Hung-Hsueh; Chang, Chee-Jen; Lin, Cheng-Tao

2015-04-01

To investigate the efficacy and toxicity of immunomodulatory therapy (IMT) alone or as an add-on to palliative/salvage chemotherapy in patients with refractory/recurrent epithelial ovarian cancer (EOC). We retrospectively analyzed the efficacy and toxicity of IMT in 15 patients with refractory/recurrent EOC who had previously received multiple chemotherapy regimens. The median age of the patients was 56 years (range, 41-75 years). Three patients were platinum-sensitive, two were platinum-resistant, and the remaining 10 patients were refractory to platinum-based front-line chemotherapy. IMT consisted of picibanil (OK-432) on Day 1, interleukin-2 and/or interferon-α on Day 2 administered by subcutaneous injection (every week or 2-weekly). Five patients never received metronomic oral cyclophosphamide. After IMT, three patients achieved partial remission (PR, lasting for 11 months, ≥ 12 months, and 16 months), and six patients had stable disease (SD). The disease stabilizing rate (PR+SD) was 60% (3/3 in platinum-sensitive and 6/12 in platinum-resistant/refractory patients). The absolute lymphocyte count (ALC) at 1 month after IMT was significantly higher in the PR+SD group (median 1242.0/μL) than in the progression group (median 325.0/μL) (p = 0.012). No ≥ Grade 3 toxicities were observed. The median post-IMT survival time was 12 months (range, 2-39 months). IMT alone or add-on to palliative/salvage chemotherapy for refractory/recurrent EOC achieves a substantial disease stabilizing rate without severe toxicity, which might be a potential option in selected patients. The ALC 1 month after IMT could be an early indicator to disease stabilization. Copyright © 2015. Published by Elsevier B.V.

[Therapy-resistant and therapy-refractory arterial hypertension].

Science.gov (United States)

Wallbach, M; Koziolek, M J

2018-05-02

Therapy-resistant and therapy-refractory arterial hypertension differ in prevalence, pathogenesis, prognosis and therapy. In both cases, a structured approach is required, with the exclusion of pseudoresistance and, subsequently, secondary hypertension. Resistant hypertension has been reported to be more responsive to intensified diuretic therapy, whereas refractory hypertension is presumed to require sympathoinhibitory therapy. Once the general measures and the drug-based step-up therapy have been exhausted, interventional procedures are available.

Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab

Science.gov (United States)

Sudulagunta, Sreenivasa Rao; Sepehrar, Mona; Sodalagunta, Mahesh Babu; Settikere Nataraju, Aravinda; Bangalore Raja, Shiva Kumar; Sathyanarayana, Deepak; Gummadi, Siddharth; Burra, Hemanth Kumar

2016-01-01

Introduction: Myasthenia gravis (MG) is an antibody mediated autoimmune neuromuscular disorder characterized by fatigable muscle weakness. A proportion of myasthenia gravis patients are classified as refractory due to non responsiveness to conventional treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and features of patients with MG and mode of management using rituximab and complications. Methods: Data of myasthenia gravis patients admitted or presented to outpatient department (previous medical records) with MG between January 2008 and January 2016 were included. A total of 512 patients fulfilled the clinical and diagnostic criteria of myasthenia gravis of which 76 patients met the diagnostic certainty for refractory myasthenia gravis and were evaluated. Results: Out of 76 refractory MG patients, 53 (69.73%) patients fulfilled all the three defined criteria. The median age of onset of the refractory MG group was 36 years with a range of 27–53 years. In our study 25 patients (32.89%) belonged to the age group of 21–30 years. Anti-MuSK antibodies were positive in 8 non-refractory MG patients (2.06%) and 36 refractory MG patients (47.36%). Mean HbA1C was found to be 8.6±2.33. The dose of administered prednisone decreased by a mean of 59.7% (p=3.3x10–8) to 94.6% (p=2.2x10–14) after the third cycle of rituximab treatment. Conclusion: The refractory MG patients are most commonly female with an early age of onset, anti-MuSK antibodies, and thymomas. Refractory MG patients have higher prevalence and poor control (HbA1C >8%) of diabetes mellitus and dyslipidemia probably due to increased steroid usage. Rituximab is very efficient in treatment of refractory MG with adverse effects being low. PMID:27790079

Cometary dust: the diversity of primitive refractory grains.

Science.gov (United States)

Wooden, D H; Ishii, H A; Zolensky, M E

2017-07-13

Comet dust is primitive and shows significant diversity. Our knowledge of the properties of primitive cometary particles has expanded significantly through microscale investigations of cosmic dust samples (anhydrous interplanetary dust particles (IDPs), chondritic porous (CP) IDPs and UltraCarbonaceous Antarctic micrometeorites, Stardust and Rosetta ), as well as through remote sensing ( Spitzer IR spectroscopy). Comet dust are aggregate particles of materials unequilibrated at submicrometre scales. We discuss the properties and processes experienced by primitive matter in comets. Primitive particles exhibit a diverse range of: structure and typology; distribution of constituents; concentration and form of carbonaceous and refractory organic matter; Mg- and Fe-contents of the silicate minerals; sulfides; existence/abundance of type II chondrule fragments; high-temperature calcium-aluminium inclusions and ameboid-olivine aggregates; and rarely occurring Mg-carbonates and magnetite, whose explanation requires aqueous alteration on parent bodies. The properties of refractory materials imply there were disc processes that resulted in different comets having particular selections of primitive materials. The diversity of primitive particles has implications for the diversity of materials in the protoplanetary disc present at the time and in the region where the comets formed.This article is part of the themed issue 'Cometary science after Rosetta'. © 2017 The Authors.

Defining refractory migraine: results of the RHSIS Survey of American Headache Society members.

Science.gov (United States)

Schulman, Elliott A; Peterlin, B Lee; Lake, Alvin E; Lipton, Richard B; Hanlon, Alexandra; Siegel, Sherry; Levin, Morris; Goadsby, Peter J; Markley, Herbert G

2009-04-01

To gauge consensus regarding a proposed definition for refractory migraine proposed by Refractory Headache Special Interest Section, and where its use would be most appropriate. Headache experts have long recognized that a subgroup of headache sufferers remains refractory to treatment. Although different groups have proposed criteria to define refractory migraine, the definition remains controversial. The Refractory Headache Special Interest Section of the American Headache Society developed a definition through a consensus process, assisted by a literature review and initial membership survey. A 12-item questionnaire was distributed at the American Headache Society meeting in 2007 during a platform session and at the Refractory Headache Special Interest Section symposium. The same questionnaire was subsequently sent to all American Headache Society members via e-mail. A total of 151 responses from AHS members form the basis of this report. The survey instrument was designed using Survey Monkey. Frequencies and percentages of the survey were used to describe survey responses. American Headache Society members agreed that a definition for refractory migraine is needed (91%) that it should be added to the International Classification of Headache Disorders-2 (86%), and that refractory forms of non-migraine headache disorders should be defined (87%). Responders believed a refractory migraine definition would be of greatest value in selecting patients for clinical drug trials. The current refractory migraine definition requires a diagnosis of migraine, interference with function or quality of life despite modification of lifestyle factors, and adequate trials of acute and preventive medicines with established efficacy. The proposed criteria for the refractory migraine definition require failing 2 preventive medications to meet the threshold for failure. Although 42% of respondents agreed with the working definition of refractory migraine, 43% favored increasing the

The Role of Refractory Dissolved Organic Matter in Ocean Carbon Sequestration

DEFF Research Database (Denmark)

Jørgensen, Linda

The ocean assimilates a large amount of atmospheric CO2 and is potentially a buffer for climate change. A fraction of the assimilated CO2 is incorporated into algal biomass and further converted into refractory dissolved organic matter (DOM). Carbon bound in refractory DOM has the potential...... studies the prokaryotic production and degradation of oceanic refractory DOM and discusses the reasons for the persistent nature of this large DOM fraction. The first two papers investigate the microbial carbon pump, i.e. prokaryotic transfor-mation of organic carbon into refractory DOM. The results show...... DOM compounds in the ocean are rare—possibly too rare to sustain viable uptake and assimilation. Hence, the dilute concentration of individual compounds is a possible explanation for the apparent refractory nature of most DOM in the ocean. Understanding the mechanisms that control the quality...

Biodegradable stents for the treatment of refractory or recurrent benign esophageal stenosis.

Science.gov (United States)

Imaz-Iglesia, Iñaki; García-Pérez, Sonia; Nachtnebel, Anna; Martín-Águeda, Belén; Sánchez-Piedra, Carlos; Karadayi, Bilgehan; Demirbaş, Ali Rıza

2016-06-01

Esophageal stents are used for the treatment of refractory and recurrent dyphagias. In 2007, esophageal biodegradable stents (EBS) were authorised as an alternative to existing metal and plastic stents in Europe. The advantages claimed for EBS are fewer complications concerning tissue ingrowth, stent migration and stent removal. We performed a systematic review to evaluate the efficacy and safety of EBS compared to fully-covered self-expanding metal stents, self-expanding plastic stents, and esophageal dilation for the treatment of refractory or recurrent benign esophageal stenosis. Three comparative studies (one randomized controlled trial and two cohort studies) were assessed. The studies used different inclusion criteria, had a very small (sample) size and the quality of the evidence was very low. Expert commentary: The current evidence is insufficient to determine the relative efficacy or safety of esophageal biodegradable stents. The results of this systematic review should be updated once new evidence is available.

Intraepithelial lymphocytes in refractory celiac disease : lost in transition

NARCIS (Netherlands)

Schmitz, Frederike

2014-01-01

Refractory coeliac disease type II (RCDII) is a severe complication of coeliac disease. Whereas celiac disease can successfully be treated by the strict avoidance of gluten, refractory celiac patients show no remission despite a gluten-free diet. The pathology of RCDII is only partially understood,

Clinical Features of Refractory Ascites in Outpatients

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Wanda Regina Caly

Full Text Available OBJECTIVES: To present the clinical features and outcomes of outpatients who suffer from refractory ascites. METHODS: This prospective observational study consecutively enrolled patients with cirrhotic ascites who submitted to a clinical evaluation, a sodium restriction diet, biochemical blood tests, 24 hour urine tests and an ascitic fluid analysis. All patients received a multidisciplinary evaluation and diuretic treatment. Patients who did not respond to the diuretic treatment were controlled by therapeutic serial paracentesis, and a transjugular intrahepatic portosystemic shunt was indicated for patients who required therapeutic serial paracentesis up to twice a month. RESULTS: The most common etiology of cirrhosis in both groups was alcoholism [49 refractory (R and 11 non-refractory ascites (NR]. The majority of patients in the refractory group had Child-Pugh class B cirrhosis (p=0.034. The nutritional assessment showed protein-energy malnutrition in 81.6% of the patients in the R group and 35.5% of the patients in the NR group, while hepatic encephalopathy, hernia, spontaneous bacterial peritonitis, upper digestive hemorrhage and type 2 hepatorenal syndrome were present in 51%, 44.9%, 38.8%, 38.8% and 26.5% of the patients in the R group and 9.1%, 18.2%, 0%, 0% and 0% of the patients in the NR group, respectively (p=0.016, p=0.173, p=0.012, p=0.012, and p=0.100, respectively. Mortality occurred in 28.6% of the patients in the R group and in 9.1% of the patients in the NR group (p=0.262. CONCLUSION: Patients with refractory ascites were malnourished, suffered from hernias, had a high prevalence of complications and had a high postoperative death frequency, which was mostly due to infectious processes.

Resistant and Refractory Hypertension: Antihypertensive Treatment Resistance vs Treatment Failure

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Siddiqui, Mohammed; Dudenbostel, Tanja; Calhoun, David A.

2017-01-01

Resistant or difficult to treat hypertension is defined as high blood pressure that remains uncontrolled with 3 or more different antihypertensive medications, including a diuretic. Recent definitions also include controlled blood pressure with use of 4 or more medications as also being resistant to treatment. Recently, refractory hypertension, an extreme phenotype of antihypertensive treatment failure has been defined as hypertension uncontrolled with use of 5 or more antihypertensive agents, including a long-acting thiazide diuretic and a mineralocorticoid receptor antagonist. Patients with resistant vs refractory hypertension share similar characteristics and comorbidities, including obesity, African American race, female sex, diabetes, coronary heart disease, chronic kidney disease, and obstructive sleep apnea. Patients with refractory vs resistant hypertension tend to be younger and are more likely to have been diagnosed with congestive heart failure. Refractory hypertension might also differ from resistant hypertension in terms of underlying cause. Preliminary evidence suggests that refractory hypertension is more likely to be neurogenic in etiology (ie, heightened sympathetic tone), vs a volume-dependent hypertension that is more characteristic of resistant hypertension in general. PMID:26514749

The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

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Vali A Mehrzad

2012-01-01

Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

White-Coat Effect Is Uncommon in Patients With Refractory Hypertension.

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Siddiqui, Mohammed; Judd, Eric K; Oparil, Suzanne; Calhoun, David A

2017-09-01

Refractory hypertension is a recently described phenotype of antihypertensive treatment failure defined as uncontrolled blood pressure (BP) despite the use of ≥5 different antihypertensive agents, including chlorthalidone and spironolactone. Recent studies indicate that refractory hypertension is uncommon, with a prevalence of ≈5% to 10% of patients referred to a hypertension specialty clinic for uncontrolled hypertension. The prevalence of white-coat effect, that is, uncontrolled automated office BP ≥135/85 mm Hg and controlled out-of-office BP hypertensive patients overall is ≈30% to 40%. The prevalence of white-coat effect among patients with refractory hypertension has not been previously reported. In this prospective evaluation, consecutive patients referred to the University of Alabama at Birmingham Hypertension Clinic for uncontrolled hypertension were enrolled. Refractory hypertension was defined as uncontrolled automated office BP ≥135/85 mm Hg with the use of ≥5 antihypertensive agents, including chlorthalidone and spironolactone. Automated office BP measurements were based on 6 serial readings, done automatically with the use of a BpTRU device unobserved in the clinic. Out-of-office BP measurements were done by 24-hour ambulatory BP monitor. Thirty-four patients were diagnosed with refractory hypertension, of whom 31 had adequate ambulatory BP monitor readings. White-coat effect was present in only 2 patients, or 6.5% of the 31 patients with refractory hypertension, suggesting that white-coat effect is largely absent in patients with refractory hypertension. These findings suggest that white-coat effect is not a common cause of apparent lack of BP control in patients failing maximal antihypertensive treatment. © 2017 American Heart Association, Inc.

Evaluation of technological properties of alumina refractory systems-zirconia and zirconia-silica-alumina

International Nuclear Information System (INIS)

Marinho, A.R.O.; Carvalho, T.U.S.; Fagury Neto, E.; Rabelo, A.A.

2014-01-01

Alumina-zirconia refractories are noted for being products of excellent cost-effective, however, zirconia may limit its use due to decreasing resistance to thermal shock. This study aims to evaluate these refractories with the addition of microsilica, which can greatly improve their properties. Were used the following starting materials: calcined alumina, zirconia (stabilized and monoclinic) in amounts of 2%, 4% and 6% by weight, plus microsilica (5%w.). The powders were milled together with binder and lubricant for conformation bodies by uniaxial pressing. The samples were dried, calcined and sintered at 1400 °C/2h were characterized using the methods of Archimedes, and scanning electron microscopy (SEM), chemical analysis using energy dispersive X-ray (EDS), and mechanical flexural strength tests at room temperature. Formulations with the presence of microsilica showed satisfactory results and optimized properties. (author)

Friction measurements of steel on refractory bricks

International Nuclear Information System (INIS)

Eiselstein, L.E.

1981-08-01

During startup or shutdown of a pool-type LMFBR, substantial shear stresses may arise between the base of the steel reactor vessel and the refractory brick support base. The magnitude of these stresses, which result from differences in thermal expansion, can be estimated if the friction coefficient is known. This report describes experiments to determine friction coefficients between 2 1/4 Cr-1Mo steel and several refractory materials and to examine effects to contact pressure, temperature, sliding velocity, lubricants, and surface condition

Characterization of refractory brick based on local raw material from Lampung Province - Indonesia

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Amin, Muhammad; Suryana, Yayat I.; Isnugroho, Kusno; Aji, Bramantyo B.; Birawidha, David C.; Hendronursito, Yusup

2018-04-01

Refractories are non-metallic inorganic materials that are difficult to melt at high temperatures and used in high-temperature casting industries. Refractories are classified into their constituent mineral feed stocks, refractories having typical plot properties commonly called fire bricks. In the manufacture of refractory bricks that exist in the market during the use of mangrove materials derived from abroad that is from China. In this research the refractory brick materials used are quartz sand, feldspart, kaolin, bentonite, and ball clay. All materials come from local Lampung Province - Indonesia. The experiment, there are 7 kinds of experimental composition, made of plot shape with size 230 mm, 65 mm in thickness, 114 mm height mould using manual press machine with 10 tons power and burning at 1400°C for 5 hours. Refractory brick product is done by physical test in the form of porosity, specific gravity, compressive strength and XRF and SEM characteristics. The result of XRF characteristic of refractory brick composition of 1 to 5 compared to the refractory brick type SK 34 in the market and the result of composition 1 is a composition close to refractory brick composition type SK 34 namely SiO2 is 54.21 %, Al2O3 is 25.38 % and test Physical of Bulk density is 2.25 g/cm3, porosity is 18.98 % and compressive strength is 325 kg/cm2.

Refractory benign esophageal strictures

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Gopal Goyal

2016-01-01

Full Text Available Refractory benign esophageal stricture (RBES is a frequently encountered problem worldwide. These strictures arise from various causes such as corrosive injury, radiation therapy, peptic origin, ablative therapy, and after surgery. Most strictures can be treated successfully with endoscopic dilatation using bougies or balloons, with only a few complications. Those patients who fail after serial dilatation with bougies or balloons will come to the category of refractory strictures. Dilatation combined with intralesional steroid injections can be considered for peptic strictures, whereas incisional therapy has been demonstrated to be effective for short anastomotic strictures. When these therapeutic options do not resolve the stenosis, stent placement should be considered. Self-bougienage can be proposed to a selected group of patients with a proximal stenosis. Most of the patients of RBES respond to above-mentioned treatment and occasional patient may require surgery as the final treatment option. This review aims to provide a comprehensive approach toward endoscopic management of RBESs based on current literature and personal experience.

Mullite-based coating on silicon carbide refractory obtained from PMSQ [poly(methylsilsesquioxane)

International Nuclear Information System (INIS)

Machado, Glauson Aparecido Ferreira

2017-01-01

Silicon carbide (SiC) presents low thermal expansion, high strength and thermal conductivity. For this reason it is used as kiln furniture for materials sintering. On the other hand, SiC degrades at high temperature under aggressive atmosphere. The use of protective coatings can avoid the right exposition of SiC surface to the furnace atmosphere. Mullite can be a suitable material as protective coating because of its high corrosion resistance and thermal expansion coefficient matching that of SiC (4,7 x 10 -6 /°C e 5,3 x 10 -6 /°C, respectively). In the present work a mullite coating obtained from ceramic precursor polymer and aluminium powder was studied to be applied over SiC refractories. Compositions were prepared with 10, 20, 30 and 50% (vol.) of aluminium powder added to the polymer. They were used aluminium powders with different distributions sizes These compositions were heat treated at different thermal cycles to determine a suitable condition to obtain a high mullite content. The composition with 20% of the smaller particle size Al powder was selected and used to be applied as a suspension over SiC refractory. The applied suspension, after dried, crosslinked and heat treated, formed a mullite coating over SiC refractory. Cycles of thermal shock were performed in coated and uncoated SiC samples to compare each other. They were carried out 26 cycles of thermal shock, in the following conditions: 600°C/30 min. and air cooling to room temperature. After each thermal shock, samples were analysed by mean of optical and electron microscopy, elastic modulus was also determined. After thermal shock cycles the coating presented good adhesion and no significant damage were observed. (author)

Determination of refractory trace elements in Chinese meteorites by RNAA

International Nuclear Information System (INIS)

Kraehenbuehl, U.; Burger, M.

1989-01-01

Some refractory trace elements are important target elements for spallation reactions in meteorites. These elements also serve to characterize the investigated meteorites. The elements Ti, Y, Zr, Hf, W and Ta were measured after radiochemical separation in chondrites from China. After acid digestion of the irradiated samples, the group separations were obtained by precipitation reactions. The necessary radiochemical purification of the pure β emitter Y was realized on a Lewatite OC 1026 column. For all the other elements discrete gamma radiation was measured. (orig.)

Ketogenic diet treatment for pediatric super-refractory status epilepticus.

Science.gov (United States)

Appavu, Brian; Vanatta, Lisa; Condie, John; Kerrigan, John F; Jarrar, Randa

2016-10-01

We aimed to study whether ketogenic diet (KD) therapy leads to resolution of super-refractory status epilepticus in pediatric patients without significant harm. A retrospective review was performed at Phoenix Children's Hospital on patients with super-refractory status epilepticus undergoing ketogenic diet therapy from 2011 to 2015. Ten children with super-refractory status epilepticus, ages 2-16 years, were identified. 4/10 patients had immune mediated encephalitis, including Rasmussen encephalitis, anti-N-methyl-d-aspartate receptor encephalitis, and post-infectious mycoplasma encephalitis. Other etiologies included Lennox Gastaut Syndrome, non-ketotic hyperglycinemia, PCDH19 and GABRG2 genetic epilepsy, New Onset Refractory Status Epilepticus, and Febrile Infection-Related Epilepsy Syndrome. 4/10 patients' EEG features suggested focal with status epilepticus, and 6/10 suggested generalized with status epilepticus. Median hospital length was 61days and median ICU length was 27days. The median number of antiepileptic medications prior to diet initiation was 3.0 drugs, and the median after ketogenic diet treatment was 3.5 drugs. Median duration of status epilepticus prior to KD was 18days. 9/10 patients had resolution of super-refractory status epilepticus in a median of 7days after diet initiation. 8/9 patients were weaned off anesthesia within 15days of diet initiation, and within 1day of achieving ketonuria. 1/10 patients experienced side effects on the diet requiring supplementation. Most patients achieved resolution of status epilepticus on KD therapy, suggesting it could be an effective therapy that can be utilized early in the treatment of children with super refractory status epilepticus. Copyright © 2016. Published by Elsevier Ltd.

Radiation treatment of refractory substances in wastewater for recycling water

International Nuclear Information System (INIS)

Sekiguchi, Masayuki; Tanabe, Hiroko; Sawai, Teruko

1997-01-01

The refractory substances such as molasses pigments and lignin in sewage interfere with recycle system from the secondary effluents from sewage sludge plants, so we investigated the effects of radiation treatment on these substances in sewage. The dialyzed molasses pigments in the wastewater, discharged from baker's yeast factory were easily decomposed and decolorized. When the artificial sewage sample, containing lignin, fumic acid and tannic acid, was irradiated with gamma rays, the TOC was reduced to one-half of its initial value at 10 kGy, and then the pH dropped to near the minimum value. On the other hand, the pH and TOC of sewage influent sample were little affected by gamma ray irradiation. However, the increases of organic acid formation by gamma rays irradiation were observed for both samples: oxalic acid for the artificial sewage sample, and the formic acid and lactic acid for sewage influent sample were produced at lower absorbed doses, respectively. (author)

Bulk Vitrification Castable Refractory Block Protection Study

Energy Technology Data Exchange (ETDEWEB)

Hrma, Pavel R.; Bagaasen, Larry M.; Beck, Andrew E.; Brouns, Thomas M.; Caldwell, Dustin D.; Elliott, Michael L.; Matyas, Josef; Minister, Kevin BC; Schweiger, Michael J.; Strachan, Denis M.; Tinsley, Bronnie P.; Hollenberg, Glenn W.

2005-05-01

Bulk vitrification (BV) was selected for a pilot-scale test and demonstration facility for supplemental treatment to accelerate the cleanup of low-activity waste (LAW) at the Hanford U.S. DOE Site. During engineering-scale (ES) tests, a small fraction of radioactive Tc (and Re, its nonradioactive surrogate) were transferred out of the LAW glass feed and molten LAW glass, and deposited on the surface and within the pores of the castable refractory block (CRB). Laboratory experiments were undertaken to understand the mechanisms of the transport Tc/Re into the CRB during vitrification and to evaluate various means of CRB protection against the deposition of leachable Tc/Re. The tests used Re as a chemical surrogate for Tc. The tests with the baseline CRB showed that the molten LAW penetrates into CRB pores before it converts to glass, leaving deposits of sulfates and chlorides when the nitrate components decompose. Na2O from the LAW reacts with the CRB to create a durable glass phase that may contain Tc/Re. Limited data from a single CRB sample taken from an ES experiment indicate that, while a fraction of Tc/Re is present in the CRB in a readily leachable form, most of the Tc/Re deposited in the refractory is retained in the form of a durable glass phase. In addition, the molten salts from the LAW, mainly sulfates, chlorides, and nitrates, begin to evaporate from BV feeds at temperatures below 800 C and condense on solid surfaces at temperatures below 530 C. Three approaches aimed at reducing or preventing the deposition of soluble Tc/Re within the CRB were proposed: metal lining, sealing the CRB surface with a glaze, and lining the CRB with ceramic tiles. Metal liners were deemed unsuitable because evaluations showed that they can cause unacceptable distortions of the electric field in the BV system. Sodium silicate and a low-alkali borosilicate glaze were selected for testing. The glazes slowed down molten salt condensate penetration, but did little to reduce the

Central Diabetes Insipidus in Refractory Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

Science.gov (United States)

Ohashi, Keiji; Morishita, Michiko; Watanabe, Haruki; Sada, Ken-Ei; Katsuyama, Takayuki; Miyawaki, Yoshia; Katsuyama, Eri; Narazaki, Mariko; Tatebe, Noriko; Watanabe, Katsue; Kawabata, Tomoko; Wada, Jun

2017-11-01

We herein describe two cases of refractory antineutrophil cytoplasmic antibody-associated vasculitis (AAV) complicated with diabetes insipidus (DI) possibly related to hypertrophic pachymeningitis (HP). One patient had microscopic polyangiitis and HP, which were refractory to cyclophosphamide, azathioprine, rituximab, mycophenolate mofetil (MMF), and mizoribine. Remission was finally achieved with the use of etanercept, but DI occurred 5 years later. The other patient had granulomatosis with polyangiitis, which that was refractory to cyclophosphamide, methotrexate, MMF, and rituximab. DI subsequently developed, but was successfully treated with etanercept. Dura mater hypertrophy was macroscopically observed in the latter case.

Comparative analysis of blood and saliva expression profiles in chronic and refractory periodontitis patients.

Science.gov (United States)

Zhang, Bin; Lin, Ting; He, Hong

2015-12-24

This study aimed to identify characteristic representative genes through a comparative analysis of gene expression profiles in the blood and saliva of chronic periodontitis (CP) and refractory periodontitis (RP) patients to provide new treatment strategies that may be helpful in the treatment of different forms of periodontitis. GSE43525 was downloaded from Gene Expression Omnibus. In the dataset, thirteen samples were from blood including 4 controls, 4 CP and 5 RP samples, and ten samples were from saliva including 3 controls, 4 CP and 3 RP samples. After comparing the CP and RP samples, differentially expressed genes (DEGs) between these two types of periodontitis in the blood and saliva samples were identified by an LIMMA package. Then, functional and pathway enrichment analyses were performed by DAVID and KOBAS, respectively. The significantly associated miRNAs in CP and RP were searched by WebGestalt. In total, 213 DEGs in CP and 45 DEGs in RP were identified. Functional enrichment showed that the DEGs of CP were mainly enriched in ribosome and regulation of apoptosis-related pathways in blood as well as saliva, while the DEGs of RP were significantly enriched in immune responses and response to organic substance-related pathways. Several miRNAs, such as miR-381 and miR-494, were identified as being closely associated with CP. In addition, CD24, EST1, MTSS1, ING3, CCND2 and SYNE2 might be potential targets for diagnosis and treatment of CP. The identified DEGs and miRNAs might be potential targets for the treatment of chronic and refractory periodontitis.

Lab Scale Study of the Depletion of Mullite/Corundum-Based Refractories Trough Reaction with Scaffold Materials

International Nuclear Information System (INIS)

Stjernberg, J; Antti, M-L; Ion, J C; Lindblom, B

2011-01-01

To investigate the mechanisms underlying the depletion of mullite/corundum-based refractory bricks used in rotary kilns for iron ore pellet production, the reaction mechanisms between scaffold material and refractory bricks have been studied on the laboratory-scale. Alkali additions were used to enhance the reaction rates between the materials. The morphological changes and active chemical reactions at the refractory/scaffold material interface in the samples were characterized using scanning electron microscopy (SEM), thermal analysis (TA) and X-ray diffraction (XRD). No reaction products of alkali and hematite (Fe 2 O 3 ) were detected; however, alkali dissolves the mullite in the bricks. Phases such as nepheline (Na 2 O·Al 2 O 3 ·2SiO 2 ), kalsilite (K 2 O·Al 2 O 3 ·2SiO 2 ), leucite (K 2 O·Al 2 O 3 ·4SiO 2 ) and potassium β-alumina (K 2 O·11Al 2 O 3 ) were formed as a consequence of reactions between alkali and the bricks.

A Review on Recent Advances on Magnesia-Doloma Refractories by Nano-Technology.

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Salman Ghasemi-Kahrizsangi

2017-07-01

Full Text Available Due to exhibiting an excellent chemical resistance against basic environments at high temperature, good thermal shock resistance, thermodynamic stability in the presence of carbon, and a suitable abrasion resistance, MgO-CaO refractories are widely used in argon-oxygen decarburization furnaces in the metallurgy industry and cement rotary kilns. Furthermore, MgO-CaO refractories are beneficial to removing inclusions from molten steels; thus, they have been considered to be one of the effective refractory types for processing clean steel products. Also, MgO-CaO materials have become one of the attractive steelmaking refractories because of their low cost and high ore reserves.  However, in spite of these primary advantages, the application of MgO-CaO refractories has not been popular due to its tendency to hydration when exposed to the atmosphere.  In world most of MgO-CaO bricks producers used of organic components such as tar, pitch, and peck for produce MgO-CaO refractories. But during the application of these bricks in steel and cement and industrials, they released CO and CO2 gases to air and pollute the atmosphere. For this reason, recently some researcher investigate the effect of additive nanoparticles on MgO-CaO refractories performance. They reported the used of Nano-additive have acceptable results and additive nanoparticles can replace by aforementioned environment contaminating organic compounds. In this study, we reviewed all effort that done for improving the hydration resistance of MgO-CaO refractories by application of Nano-additives with an emphasis on the beneficial the use of additives nanoparticle for reduction of environmental pollution by various industries which used of MgO-CaO refractory bricks.

Refractory Research Group - U.S. DOE, Albany Research Center [Institution Profile

Energy Technology Data Exchange (ETDEWEB)

Bennett, James P.

2004-09-01

The refractory research group at the Albany Research Center (ARC) has a long history of conducting materials research within the U.S. Bureau of Mines, and more recently, within the U.S. Dept. of Energy. When under the U.S. Bureau of Mines, research was driven by national needs to develop substitute materials and to conserve raw materials. This mission was accomplished by improving refractory material properties and/or by recycling refractories using critical and strategic materials. Currently, as a U.S. Dept of Energy Fossil Energy field site, research is driven primarily by the need to assist DOE in meeting its vision to develop economically and environmentally viable technologies for the production of electricity from fossil fuels. Research at ARC impacts this vision by: • Providing information on the performance characteristics of materials being specified for the current generation of power systems; • Developing cost-effective, high performance materials for inclusion in the next generation of fossil power systems; and • Solving environmental emission and waste problems related to fossil energy systems. A brief history of past refractory research within the U.S. Bureau of Mines, the current refractory research at ARC, and the equipment and capabilities used to conduct refractory research at ARC will be discussed.

Brentuximab Vedotin Treatment for Primary Refractory Hodgkin Lymphoma

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Hung-Bo Wu

2013-01-01

Full Text Available Up to 40% of patients with advanced Hodgkin lymphoma (HL become refractory or relapsed after current standard chemotherapy, among which primary refractory HL confers a particularly poor outcome. With intensive salvage chemotherapy and autologous stem cell transplantation, the long-term remission rate for these patients was only 30%, but more selective treatments with higher therapeutic index are needed. We report the experience of using a new anti-CD30 immunotoxin, brentuximab vedotin, in salvage treatment of a 30-year-old woman with primary refractory Hodgkin lymphoma. The patient presented with SVC syndrome due to the bulky mediastinal tumor and was confirmed to have classical Hodgkin lymphoma, nodular sclerosis type, stage IIIA. The tumor responded to induction chemotherapy transiently, but local progression was noted during subsequent cycles of treatment. Salvage radiotherapy to the mediastinal tumor, obtained no remission but was followed by rapid in-field progression and then lung metastasis. She declined stem cell transplantation and received salvage brentuximab vedotin (BV therapy, which induced dramatic shrinkage of tumor without significant side effects. Serial followup of PET/CT imaging confirmed a rapid and continuous complete remission for 12 months. Although durability of the remission needs further observation, this case illustrates the excellent efficacy of brentuximab vedotin in primary refractory Hodgkin lymphoma.

Testing of the melter lid refractory for the West Valley Demonstration Project (WVDP)

International Nuclear Information System (INIS)

Gupta, A.; Jain, V.; Mahoney, J.L.; Holman, T.M.

1991-01-01

Monofrax H and Mulfrax 202 refractory were tested for potential application as the melter lid refractory for the WVDP. Resistance to spalling and corrosion by the slurry and offgas salts were primary criteria for selection. Test specimens were subjected to thermal cycling between 450 and 1,100C for five weeks. Visual examination indicated some corrosion but no spalling. SEM/EDS analysis was performed to determine the glass/refractory interface corrosion mechanism. The refractory selection basis will be discussed

Effectiveness of botulinum toxin A in treatment of refractory erythromelalgia

Directory of Open Access Journals (Sweden)

Kuan-Hsiang Lin

2013-05-01

Full Text Available Erythromelalgia is characterized by intense burning pain, erythema, and heat in affected areas after precipitating factors such as warm temperature or stress. It is refractory to treatment in some situations. We describe a woman with adenosquamous cell carcinoma of the lung and medically refractory erythromelalgia. The symptoms of erythromelalgia presented as refractory to any medical treatment. Due to the unresponsive nature of her condition, botulinum toxin type A (onabotulinumtoxin A was injected over both of her cheeks, periodically for six cycles. Her symptoms responded dramatically to subcutaneous and intradermal injection of botulinum toxin type A. Repetitive injection demonstrated consistent and reproducible responses, and the efficacy was maintained for approximately 1 month. No adverse effects or complications were noted. Botulinum toxin type A might be safe and effective as an alternative treatment for refractory erythromelalgia, but further large-scale studies are required.

Observation of Meyer–Neldel rule in thermally activated Poole ...

Indian Academy of Sciences (India)

to their atomic percentages and were sealed in a quartz ampoule (length ~5 cm and internal dia. ~8 mm) in a ... The quenched sample was taken out by breaking the quartz ampoules. The glassy nature of the ... and the temperature measured by a calibrated copper–constantan thermocouple mounted very near to the films.

Theoretical and practical aspects about corrosion of refractories used in steel metallurgy: part 3: characterization of commercial refractories; Aspectos teoricos e praticos sobre a corrosao de refratarios utilizados na metalurgia: caracterizacao de refratarios comerciais

Energy Technology Data Exchange (ETDEWEB)

Braganca, S.R., E-mail: saulorb@ufrgs.br [Universidade Federal do Rio Grande Sul (DEMAT/UFRGS), RS (Brazil)

2012-07-01

In this study, it was reviewed the main aspects found in the literature about refractories corrosion, evaluating the feasibility of certain tests and relating them with experimental results. The physical properties and microstructure of commercial refractories were analyzed, considering the differences between them and the quality implications and probable life of the refractory. Thus, it was studied the various types of refractories used as lining on steel ladle. Magnesia-carbon and doloma-carbon refractories were analyzed, highlighting the differences between them. The examined refractory showed characteristics favoring high resistance to corrosion process, presenting a series of properties to be selected in accordance with industry practice. (author)

Interventional embolization for refractory hyperthyroidism

International Nuclear Information System (INIS)

Jiang Guomin; Zhang Yunping; Chen Yaxian; Zhao Jinwei; Yang Weihuai; Chen Jinluo

2001-01-01

Objective: To evaluate the clinical effects of the thyroid artery embolization for refractory hyperthyroidism. Methods: Super selective catheterization and interventional embolization of thyroid superior and inferior arteries were performed with PVA microspheres and Gelfoam particles. Changes of function and size of thyroid were investigated after embolization. Results: The procedures were succeeded in all 21 patients. Followed up by 3-12 months, serum level of thyroid hormones dropped significantly (median FT 3 from 17.1 pmol/L to 7.44 pmol/L, median FT 4 from 51.1 pmol/L to 23.3 pmol/L, P< 0.01). The size of thyroid glands decreased remarkably. Symptoms of hyperthyroidism were controlled in 4 patients and were effectively controlled through low dose antithyroid medication in 17 patients. No serious complications occurred. Conclusions: Thyroid artery embolization is a new safe and effective method for refractory hyperthyroidism

Efficacy of infliximab in refractory posterior uveitis in Behcet's disease patients

OpenAIRE

Ayman K. El Garf; Amira A. Shahin; Sherif A. Shawky; Mohammed A. Azim; Dina A. Effat; Sherry K. Abdelrahman

2018-01-01

Aim of the work: Ocular manifestations are the main cause of morbidity in Behcet's disease (BD). Infliximab (IFX), a chimeric monoclonal antibody directed against tumor necrosis factor-alpha, may be efficient in refractory uveitis due to BD. The aim of this study was to assess the efficacy and safety of IFX in the treatment of patients with BD-associated refractory posterior uveitis (PU). Patient and Methods: Twenty patients with refractory Behcet's PU received IFX therapy as intravenous infu...

Ketogenic diet in 3 cases of childhood refractory status epilepticus

DEFF Research Database (Denmark)

Sort, Rune; Born, Alfred P; Pedersen, Karen N.

2013-01-01

Refractory status epilepticus (RSE) in children is associated with a significant risk of death or neurological morbidity. Recently attention has been drawn to the ketogenic diet (KD) as an acute treatment, as it has shown promise in controlling seizures in otherwise refractory status epilepticus...

Perspectives on environmental protection of refractory metals

International Nuclear Information System (INIS)

Perking, R.A.

1992-01-01

Alloys of refractory metals which combine high strength to weight ratios with useful low-temperature toughness and ductility have been designed to meet the requirements for the next generation of high-temperature aerospace structural materials with one exception: long term resistance to oxidation. It is considered unlikely that refractory metal alloys can be modified to possess useful resistance to oxidation as bulk materials or that coating can be designed to provide high reliability fail-safe protection for the structural alloys developed to date. Recent developments indicate that bulk alloys of W and Mo can be designed to possess short term resistance to oxidation, providing a base material which can be coated to extend useful life with fail-safe protection in the event of random coating failures. Current research on silicide coatings indicates that significant improvements in coating reliability and performance also are feasible. The technical basis for these conclusions is presented in this paper and the direction of future work that could lead to environmentally stable refractory metal alloy/coating systems is discussed

Super Refractory Status Epilepticus

African Journals Online (AJOL)

user

et al did retrospective cohort study from 1 January st. 1994 to 31 March 1998 at Presbyterian Medical. Centre in Columbia, to determine the frequency, risk factors and impact on the outcome of RSE. They found out that 69% of seizures recurred after. Key Words: Super refractory status epilepticus, Zambia. Medical Journal of ...

Process technology - rare and refractory metals

International Nuclear Information System (INIS)

Gupta, C.K.; Bose, D.K.

1989-01-01

India has fairly rich resreves of rare and refractory metals. Abundant sources of ilmenite, rutile, zircon and rare earths are found in the placer deposits of the southern and eastern coasts of the country. Columbite-tantalite occur in mica and the mining belts of Bihar and cassiterite deposits are found in Bastar (Madhya Pradesh). Vanadium as a minor associate occurs in bauxites and in the vast deposits of titaniferrous magnetites. Over the years, research and development and pilot plant works in many research organisations in India have built up a sound technological base in the country for process metallurgy of many refractory and rare earth metals starting from their indigenous sources. The present paper provides a comprehensive view of the developments that have taken place till now on the processing of various refractory and rare earth metals with particular reference to the extensive work carried out at the Department of Atomic Energy. The coverage includes mineral benification separation of individual elements, preparation of pure intermediates, techniques of reduction to metal and final purification. The paper also reviews some of the recent developments that have been taken place in these fields and the potential application of these metals in the foreseeable future. (author). 22 refs., 18 fi g., 7 tabs

A preliminary study of oxidation-resistant coatings on refractory-metal thermocouple sheaths

International Nuclear Information System (INIS)

Wilkins, S.C.

1985-01-01

The need to make reliable temperature measurements up to 2200 0 C or higher in steam environments during in-pile nuclear fuel damage tests led to a search for oxidation-resistant coatings for the refractory-metal sheaths used to enclose and protect thermocouples used for such measurements. Iridium, thoria, and thoria-over-iridium coatings were separately sputter-deposited on molybdenum-rhenium alloy protection tubes for evaluation. The coated samples were individually heated in flowing steam in an induction furnace. An extension tube welded to each sample was connected to a vacuum pump and gauge; failure of the sample was detected by noting the degradation of the vacuum maintained in the sample. Relatively heavy coatings of iridium provided a modest degree of oxidation protection at the temperatures of interest. Thoria coatings provided no significant protection at those temperatures, compared to uncoated control samples

Reuse of ultrafine mineral wool production waste in the manufacture of refractory concrete.

Science.gov (United States)

Stonys, R; Kuznetsov, D; Krasnikovs, A; Škamat, J; Baltakys, K; Antonovič, V; Černašėjus, O

2016-07-01

The paper deals with the mineral wool production waste (cupola dust - CD), presents CD characterization and aims to reuse CD in production of refractory concrete with calcium aluminate cement. The study of CD covers its chemical, phase and thermal analyses along with the morphological study and determination of particles size distribution. Zeta-potential, electrical conductivity and pH values of CD suspension are presented in the paper as well. Commercial microsilica additive in refractory concrete has been replaced with cupola dust. Compositions of refractory concrete have been prepared by incorporating 1%, 2% and 3% of CD. The bulk density, ultrasonic wave velocity, cold crushing strength and thermal shock resistance of the created refractory concrete have been determined. Based on experimental results, it has been found that cupola dust may be used for the production of refractory concrete. The environmental impact related to the CD reuse in refractory concrete production has been evaluated as well. Copyright © 2016 Elsevier Ltd. All rights reserved.

When myasthenia gravis is deemed refractory: clinical signposts and treatment strategies

Science.gov (United States)

Mantegazza, Renato; Antozzi, Carlo

2018-01-01

The prognosis for patients with myasthenia gravis (MG) has improved significantly over the past half century, including substantial reductions in mortality and morbidity. However, approximately 10% of patients fails to respond adequately to current therapies and are considered treatment refractory, or treatment intolerant, and up to 80% have disease that fails to achieve complete stable remission. Although patients with autoantibodies to muscle-specific tyrosine kinase (anti-MuSK positive) are more likely to become treatment refractory than those with autoantibodies to the acetylcholine receptor (anti-AChR positive), each of these serotypes is substantially represented in the refractory MG population. Other risk factors for becoming treatment refractory include history of thymoma or thymectomy and female sex. A modified treatment algorithm for MG is proposed: patients who have disease that fails to respond to the stepwise approach to therapy, are treatment intolerant, or who require chronic rescue measures despite ongoing therapy, should be considered treatment refractory and emerging therapies should be considered. Three emerging monoclonal antibody-based therapies are discussed: the anti-B-cell agent rituximab; the terminal complement activation inhibitor eculizumab; and belimumab, which targets B-cell activating factor. Increased understanding of molecular pathophysiology and accurate antibody subtyping in MG should lead to the use of new therapeutic agents and successful management of treatment-refractory patients. PMID:29403543

Evaluation of Alternative Refractory Materials for the Main Flame Deflectors at KSC Launch Complexes

Science.gov (United States)

Calle, Luz Marina; Trejo, David; Rutkowsky, Justin

2006-01-01

The deterioration of the refractory materials used to protect the KSC launch complex steel base structures from the high temperatures during launches results in frequent and costly repairs and safety hazards. KSC-SPEC-P-0012, Specification for Refractory Concrete, is ineffective in qualifying refractory materials. This study of the specification and of alternative refractory materials recommends a complete revision of the specification and further investigation of materials that were found to withstand the environment of the Solid Rocket Booster main flame deflector better than the refractory materials in current use in terms of compressive strength, tensile strength, modulus of rupture, shrinkage, and abrasion.

Therapeutic burst-suppression coma in pediatric febrile refractory status epilepticus.

Science.gov (United States)

Lin, Jainn-Jim; Chou, Cheng-Che; Lan, Shih-Yun; Hsiao, Hsiang-Ju; Wang, Yu; Chan, Oi-Wa; Hsia, Shao-Hsuan; Wang, Huei-Shyong; Lin, Kuang-Lin

2017-09-01

Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013. The clinical characteristics were analyzed. Thirty-five patients (23 boys; age range: 1-18years) were enrolled, of whom 28 (80%) developed super-refractory status epilepticus. All of the patients received the continuous administration of intravenous antiepileptic drugs for febrile refractory status epilepticus, and 26 (74.3%) achieved therapeutic burst-suppression coma. All of the patients received mechanical ventilatory support, and 26 (74.3%) received inotropic agents. Eight (22.9%) patients died within 1month. The neurologically functional outcomes at 6months were good in six (27.3%) of the 22 survivors, of whom two returned to clinical baseline. The patients with therapeutic burst-suppression coma were significantly associated with hemodynamic support than the patients with electrographic seizures control (p=0.03), and had a trend of higher 1-month mortality rate, worse 6months outcomes, and a longer duration of hospitalization. Our results suggest that therapeutic burst-suppression coma to treat febrile refractory status epilepticus may lead to an increased risk of hemodynamic instability and a trend of worse outcomes. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Zirconium determination in refractories (gravimetric method)

International Nuclear Information System (INIS)

Capiotto, N.; Narahashi, Y.; Perish, P.G.; Souza, J.R. de

1991-01-01

A gravimetric method for zirconium determination in refractories is described. X-ray fluorescence analysis is also employed in this experiment and considerations about interfering elements are presented. (M.V.M.)

Development of various welding techniques for refractory and reactive metals and alloys

International Nuclear Information System (INIS)

Tonpe, Sunil; Saibaba, N.

2016-01-01

Nuclear Fuel Complex (NFC), Hyderabad, India with its excellent manufacturing facilities, produces nuclear fuel and structural components for nuclear reactors. NFC has taken up the challenging job of production of various critical components made out of refractory and reactive metals and alloys for nuclear and aerospace applications as an indigenization import substitute program. Refractory metals are prime candidates for many high temperature aerospace components because of refractory metal's high melting points and inherent creep resistance. The use of refractory metals is often limited because of their poor room temperature properties, inadequate oxidation resistance at elevated temperatures, difficulties associated with joining or welding etc. These advanced materials demand stringent requirement with respect to chemistry, dimensional tolerances, mechanical and metallurgical properties. This paper discusses in detail various welding techniques adopted in NFC for refractory and reactive metals and alloys such as Nb, Zr, Ti, Ta, Zircaloy, Titanium-half alloy etc. to manufacture various components and assemblies required for nuclear and aerospace applications

Selection of refractory materials for acid tanks at the CSN continuous pickling line

International Nuclear Information System (INIS)

Silva, Sidiney Nascimento; Marques, Oscar Rosa; Bueno, Mauricio Chaves; Longo, Elson; Silva Pinheiro, Adriano da

1997-01-01

Aiming at the revamping of the CSN continuous pickling line 4 acid tanks, a Post Mortem study of the refractory lining was carried out. The collected samples were characterized through techniques such as chemical analysis, mercury porosimetry, X-ray diffraction and scanning electronic microscopy. Trying to reproduce the operational conditions closely, laboratorial simulations were carried out. Such simulations lead to the addition of some alterations on the test method proposed by ABNT. Primarily, the sulfuric acid was substituted by hydrochloric acid (30%), containing iron in solution (130g/l). As result, it was concluded that acid resistant refractories containing a smaller alumina and /or corundum and mullite concentrations, presenting a smaller open porosity and average pore diameter, have a better performance face to corrosion due to hydrochloric acid solution. In addition, abrasion wear resistance tests, according to the ASTM-G65-85 standard were carried out in order to select different materials to the acid tanks cells. (author)

Applications of radioisotopes for studying refractory wear-out in Bhilai Steel Plant

International Nuclear Information System (INIS)

Dubey, R.S.; Bose, U.P.; Shipstone, A.J.

1979-01-01

In Bhilai Steel Plant, investigations were carried out to study the refractory wear-out of (i) hearth bottom of blast furnaces, (ii) roof of open hearth furnaces, and (iii) hot metal mixer lining, by using radioisotope tracer techniques with a view to evaluate the life of the refractory lining at various locations and to help in planning its timely hot and cold repairs. The life of the refractory lining has the effective bearing on the overall production and hence on the economy of the plant. The two radiometric methods employed for studying the erosion of the refractory lining, by using isotope inserted bricks at various positions without damaging the lining are (i) based on recording the penetration of gamma rays emitting from the radioactive isotopes inserted at definite points of the brick lining and, (ii) by detecting the radioactivity of the pig iron or steel arising due to washing away of the respective radioactive isotopes previously inserted in the lining. In hot mixers also radioisotope sources were placed in the critical location of refractory lining and the washing out of radioisotope due to refractory brick wear out was detected by radiogauging at site. It has been found that radiotracer technique with periodic radiogauging is very useful method for tracing the radioisotope source if more than one refractory brick with isotope is placed, as in the case of open hearth furnaces. The results of radioanalysis revealed that radioactivity coming alongwith hot metal steel has been far below the permissible limit of concentration i.e. 20 micro-curie per ton of metal. Further, during dismantling of the residual refractory lining of open hearth furnaces or hot metal mixers, bricks containing radioisotopes have been successfully retrieved for safe disposal. (auth.)

Fragmentation process of vitrified ceramic waste (VCW) aiming its incorporation in silico-aluminous refractory concrete for production of refractory bricks

International Nuclear Information System (INIS)

Gomes, L.B.; Brandalise, R.N.; Santos, V. dos; Bergmann, C.P.

2012-01-01

Ceramic industry generates large amounts of waste, usually disposed in landfills. Reuse could minimize their generation and provides sustainable solutions. However, the energy cost of grinding these waste becomes a hindrance to their reuse. This work aims to obtain particle sizes of vitrified ceramic waste (VCW) using a fast, efficient and low cost fragmentation process as well as its use in refractory concrete. The results shows a wide range of particle size of VCW, which can be used as a promising source of raw material for production of refractory concrete. (author)

Simultaneous determination of paracetamol, 4-Aminophenol, 4-Chloroacetanilid, Benzyl alcohol,Benzaldehyde and EDTA by HPLC methodin paracetamol injection ampoule

Directory of Open Access Journals (Sweden)

Ali Merrikhi Khosroshahi

2016-06-01

Full Text Available Paracetamol that is known as acetaminophen have the most consume as an analgesic and antipyretic drug in the world. That is formulated in single compound or mixture at many forms such as tablets, syrups, suspensions and drops. The last form is intravenous injections. Paracetamol derived from 4-minophenol which is synthesized by acylated the P-acetaminophenol and acetic anhydride. 4-aminophenol is the main impurity at manufacturing of paracetamol which could produce by hydrolysis during storage or synthesis under normal conditions (temperature, pH, etc.. Also, 4-chloroacetanilid may be observed as an impurity in the raw material of paracetamol synthesis. Benzyl alcohol is a preservative that used in Paracetamol for injection. It will be very important if there are analytical techniques to measuring paracetamol and its degradation products accurately and easily. Undoubtedly the most important and widely used, separation technique is chromatography. There are several reports about separation and quantitative determination of paracetamol lonely or simultaneous determination of paracetamol and 4-aminophenol. In this paper investigated simultaneous determination of paracetamol, 4-aminophenol, 4-chloroacetanilid, benzyl alcohol, benzaldehyde, and EDTA in paracetamol for injection ampoules by high performance liquid chromatography. By changing the ratio of mixing methanol and acetonitrile as mobile phase at the wavelength of 215 nm and pH=3 separation of all compounds were completely done.

Depression in patients with refractory temporal lobe epilepsy

Directory of Open Access Journals (Sweden)

Eleonora Borges Gonçalves

2011-10-01

Full Text Available OBJECTIVE: To evaluate the comorbidity of depressive disorders in patients with refractory temporal lobe epilepsy (TLE. METHOD: We evaluated 25 consecutive patients with refractory TLE (16 women and 9 men, using semi-structured psychiatric interviews, according to the International Classification of Diseases (ICD-10, and the Beck Depression Inventory. RESULTS: Seventeen of 25 patients (68% had depressive disorder: 6 with dysthymia, three with major depressive episodes and 8 with recurrent depressive disorders. Two (8% were diagnosed with mixed anxiety and depression. Only 5 of 17 patients (29.4% were previously diagnosed with depressive disorder and received prior antidepressant treatment. Duration of epilepsy was significantly higher in patients with depressive disorder (p=0.016, but there was no relationship between depression and seizure frequency. CONCLUSION: This study confirmed that depressive disorders are common and underdiagnosed in patients with TLE refractory to AEDs. Patients with longer duration of epilepsy are at higher risk of having depression.

Alkali metal-refractory metal biphase electrode for AMTEC

Science.gov (United States)

Williams, Roger M. (Inventor); Bankston, Clyde P. (Inventor); Cole, Terry (Inventor); Khanna, Satish K. (Inventor); Jeffries-Nakamura, Barbara (Inventor); Wheeler, Bob L. (Inventor)

1989-01-01

An electrode having increased output with slower degradation is formed of a film applied to a beta-alumina solid electrolyte (BASE). The film comprises a refractory first metal M.sup.1 such as a platinum group metal, suitably platinum or rhodium, capable of forming a liquid or a strong surface adsorption phase with sodium at the operating temperature of an alkali metal thermoelectric converter (AMTEC) and a second refractory metal insoluble in sodium or the NaM.sup.1 liquid phase such as a Group IVB, VB or VIB metal, suitably tungsten, molybdenum, tantalum or niobium. The liquid phase or surface film provides fast transport through the electrode while the insoluble refractory metal provides a structural matrix for the electrode during operation. A trilayer structure that is stable and not subject to deadhesion comprises a first, thin layer of tungsten, an intermediate co-deposited layer of tungsten-platinum and a thin surface layer of platinum.

Ir-based refractory superalloys by pulse electric current sintering (PECS) process (II prealloyed powder)

Science.gov (United States)

Huang, C.; Yamabe-Mitarai, Y.; Harada, H.

2002-02-01

Five prealloyed powder samples prepared from binary Ir-based refractory superalloys were sintered at 1800 °C for 4 h by Pulse Electric Current Sintering (PECS). No metal loss was observed during sintering. The relative densities of the sintered specimens all exceeded 90% T.D. The best one was Ir-13% Hf with the density of 97.82% T.D. Phases detected in sintered samples were in accordance with the phase diagram as expected. Fractured surfaces were observed in two samples (Ir-13% Hf and Ir-15% Zr). Some improvements obtained by using prealloyed powders instead of elemental powders, which were investigated in the previous studies, were presented.

Minimization of the blank values in the neutron activation analysis of biological samples considering the whole procedure

International Nuclear Information System (INIS)

Lux, F.; Bereznai, T.; Trebert Haeberlin, S.

1987-01-01

During the determination of trace element contents of animal tissue by neutron activation analysis in the course of structure-activity relationship studies on platinum containing cancer drugs and wound healing the authors tried to minimize the blank values that are caused by different sources of contamination during surgery, sampling and the activation analysis procedure. The following topics were investigated: abrasions from scalpels made of stainless steel, titanium or quartz, the type of surgery, the surface contaminations of the quartz ampoules, etc. The measures to be taken to reduce tha blank values are described. (author) 19 refs.; 4 tables

Temperature measurement of the reactor materials samples irradiated in the fuel channels of the RA reactor - Annex 16

International Nuclear Information System (INIS)

Nikolic, M.; Djalovic, M.

1964-01-01

Reactor materials as graphite, stainless steel, magnox, zirconium alloys, etc. were exposed to fast neutron flux inside the fuel elements specially adapted for this purpose. Samples in the form ampoules were placed in capsules inside the fuel channels and cooled by heavy water which cools the fuel elements. In order to monitor the samples temperature 42 thermocouples were placed in the samples. That was necessary for reactor safety reasons and for further interpretation of measured results. Temperature monitoring was done continuously by multichannel milivoltmeters. This paper describes the technique of introducing the thermocouples, compensation instruments, control of the cold ends and adaptation of the instruments for precision (0.5%) temperature measurement in the range 30 deg - 130 deg C; 30 deg - 280 deg C and 30 deg - 80 deg C [sr

Plasma deposition of refractories

International Nuclear Information System (INIS)

Kudinov, V.V.; Ivanov, V.M.

1981-01-01

The problems of deposition, testing and application of plasma coating of refractory metals and oxides are considered. The process fundamentals, various manufacturing procedures and equipment for their realization are described in detail. Coating materials are given (Al, Mg, Al 2 O 3 , ZrO 2 , MgAlO 4 ) which are used in reactor engineering and their designated purposes are shown [ru

Barrier Coatings for Refractory Metals and Superalloys

Energy Technology Data Exchange (ETDEWEB)

SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

2006-02-23

In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life.

Barrier Coatings for Refractory Metals and Superalloys

International Nuclear Information System (INIS)

SM Sabol; BT Randall; JD Edington; CJ Larkin; BJ Close

2006-01-01

In the closed working fluid loop of the proposed Prometheus space nuclear power plant (SNPP), there is the potential for reaction of core and plant structural materials with gas phase impurities and gas phase transport of interstitial elements between superalloy and refractory metal alloy components during service. Primary concerns are surface oxidation, interstitial embrittlement of refractory metals and decarburization of superalloys. In parallel with kinetic investigations, this letter evaluates the ability of potential coatings to prevent or impede communication between reactor and plant components. Key coating requirements are identified and current technology coating materials are reviewed relative to these requirements. Candidate coatings are identified for future evaluation based on current knowledge of design parameters and anticipated environment. Coatings were identified for superalloys and refractory metals to provide diffusion barriers to interstitial transport and act as reactive barriers to potential oxidation. Due to their high stability at low oxygen potential, alumina formers are most promising for oxidation protection given the anticipated coolant gas chemistry. A sublayer of iridium is recommended to provide inherent diffusion resistance to interstitials. Based on specific base metal selection, a thin film substrate--coating interdiffusion barrier layer may be necessary to meet mission life

Prognostic Factors for Refractory Status Epilepticus

Directory of Open Access Journals (Sweden)

J. Gordon Millichap

2013-03-01

Full Text Available Researchers at the Mayo Clinic, Rochester, MN studied the outcome and identified prognostic factors for refractory status epilepticus (RSE in 54 adult patients, median age 52 years [range 18-93].

Refractory disease in autoimmune diseases

NARCIS (Netherlands)

Vasconcelos, Carlos; Kallenberg, Cees; Shoenfeld, Yehuda

Refractory disease (RD) definition has different meanings but it is dynamic, according to knowledge and the availability of new drugs. It should be differentiated from severe disease and damage definitions and it must take into account duration of adequate therapy and compliance of the patient. It

Chemical analysis of refractories by plasma spectrometry

International Nuclear Information System (INIS)

Coutinho, C.A.

1990-01-01

X-ray spectrometry has been, since the last two or three decades, the traditional procedure for the chemical analysis of refractories, due to its high degree of accuracy and speed to produce analytical results. An interesting alternative to X-ray fluorescence is provided by the Inductively Coupled Plasma Spectrometry technique, for those laboratories where wet chemistry facilities are already available or process control is not required at high speed, or investiment costs have to be low. This paper presents results obtained by plasma spectroscopy for the analysis of silico - aluminous refractories, showing calibration curves, precion and detection limits. Considerations and comparisons with X-ray fluorescence are also made. (author) [pt

Improvements in or relating to refractory materials

International Nuclear Information System (INIS)

Peckett, J.W.A.

1980-01-01

A process is described for the production of a refractory material which includes heating an intermediate material containing carbon to cause a thermally induced reaction involving carbon in the intermediate material, wherein the intermediate material has been produced by heating a shaped gel precipitated gel, and the carbon in the intermediate material for participating in the thermally induced reaction has been produced from a gelling agent, or a derivative thereof, incorporated in the gel during gel precipitation. As examples, the refractory material may comprise uranium/plutonium oxide, or uranium/plutonium carbide, or thorium/uranium carbide, or tungsten carbide, or tungsten carbide/cobalt metal. (author)

Development of electro fused aggregates for use in refractories for the burning zone of cement kilns

International Nuclear Information System (INIS)

Ferreira, Luis Leonardo Horne Curimbaba

2006-01-01

Electro fused aggregates are largely used in refractory production due to the better performance reached when they are employed. In this work electro fused aggregates were designed for application in refractories for the burning zone of cement kilns. Initially reaction evaluation was conducted aiming the identification of the most prone refractory systems when single refractory phases react with Portland cement phases at high temperatures. In the next step, raw materials of the best refractory systems were electro fused to generate different aggregate compositions. The electro fused aggregates properties were evaluated and the classified ones were used to produce refractory bricks for the burning zone of cement kilns. General characteristics of these bricks were measured and compared with a standard magnesia-spinel refractory. Aggregates of the system Mg O - TiO 2 - Ca O, more specifically aggregates belonged to the compatibility triangle Mg O - Mg 2 TiO 4 - CaTiO 3 , showed suitable characteristics for development of refractories for the burning zone cement kilns. (author)

Zirconium determination in refractories (gravimetric method)

International Nuclear Information System (INIS)

Capiotto, N.; Narahashi, Y.; Perish, C.G.; Souza, J.R.

1991-01-01

The zirconium determination in refractories is described, consisting in two separation methods for eliminating the interferences. The formatted product is calcined at 1100 0 C and determined gravimetrically as Zr P z 07. (author)

Genetics of refractoriness to Plasmodium falciparum in the mosquito Anopheles stephensi

NARCIS (Netherlands)

Feldmann, A.M.; Gemert, Geert-Jan van; Vegte-Bolmer, Marga G. van de; Jansen, Ritsert C.

1998-01-01

We previously selected a line of the malaria vector mosquito Anopheles stephensi refractory (resistant) to the human malaria parasite Plasmodium falciparum, using in vitro infections with P. falciparum gametocytes. This report presents data on the genetic background of refractoriness. The results of

Identification of Reactive and Refractory Components of Dissolved Organic Nitrogen by FT-ICR Mass Spectrometry

Science.gov (United States)

Cooper, W. T.; Podgorski, D. C.; Osborne, D. M.; Corbett, J.; Chanton, J.

2010-12-01

Dissolved organic nitrogen is an often overlooked but potentially significant bioavailable component of dissolved organic matter. Studies of bulk DON turnover have been reported, but the compositions of the reactive and refractory components of DON are largely unknown. Here we show the unique ability of atmospheric pressure photoionization (APPI) coupled to ultrahigh resolution mass spectrometry to identify the reactive and refractory components of DON. Figure 1 is an isolated 0.30 m/z window from an ultrahigh resolution APPI FT-ICR mass spectrum of DON in surface waters draining an agricultural area in South Florida. Using this optimized, negative-ion APPI strategy we have been able to identify the reactive and refractory components of DON in these nitrogen-rich waters. Similar results were observed with samples from soil porewaters in sedge-dominated fens and sphagnum-dominated bogs within the Glacial Lake Agassiz Peatlands (GLAP) of northern Minnesota. Surprisingly, microbes appear to initially use similar enzymatic pathways to degrade DON and DOC, often with little release of nitrogen. Figure 1. Isolated 0.30 m/z window at nominal mass 432 from negative-ion APPI FT-ICR mass spectrum of DOM from waters draining an agricultural area in South Florida. Peaks marked contain nitrogen.

Fate and wetting potential of bio-refractory organics in membrane distillation for coke wastewater treatment.

Science.gov (United States)

Ren, Jing; Li, Jianfeng; Chen, Zuliang; Cheng, Fangqin

2018-06-02

Membrane distillation (MD) has been hindered in industrial applications due to the potential wetting or fouling caused by complicated organic compositions. This study investigated the correlations between the fate and wetting potential of bio-refractory organics in the MD process, where three coke wastewater samples pre-treated with bio-degradation and coagulation served as feed solutions. Results showed that although most of the bio-refractory organics in coke wastewater were rejected by the hydrophobic membrane, some volatile aromatic organics including benzenes, phenols, quinolines and naphthalenes passed through the membrane during the MD process. Interestingly, membrane wetting occurred coincidently with the penetration of phenolic and heterocyclic organics. The wetting rate was obviously correlated with the feed composition and membrane surface properties. Ultimately, novel insights into the anti-wetting strategy of MD with bio-refractory organics was proposed, illustrating that the polyaluminum chloride/polyacrylamide coagulation not only removed contaminants which could accelerate membrane wetting, but also retarded membrane wetting by the complexation with organics. The deposition of these complexes on the membrane surface introduced a secondary hydrophilic layer on the hydrophobic substrate, which established a composite membrane structure with superior wetting resistance. These new findings would be beneficial to wetting control in membrane distillation for wastewater treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Symptom changes in five dimensions of the Positive and Negative Syndrome Scale in refractory psychosis.

Science.gov (United States)

Woodward, Todd S; Jung, Kwanghee; Smith, Geoffrey N; Hwang, Heungsun; Barr, Alasdair M; Procyshyn, Ric M; Flynn, Sean W; van der Gaag, Mark; Honer, William G

2014-12-01

Refractory psychosis units currently have little information regarding which symptoms profiles should be expected to respond to treatment. In the current study, we provide this information using structural equation modeling of Positive and Negative Syndrome Scale (PANSS) ratings at admission and discharge on a sample of 610 patients admitted to a treatment refractory psychosis program at a Canadian tertiary care unit between 1990 and 2011. The hypothesized five-dimensional structure of the PANSS fit the data well at both admission and discharge, and the latent variable scores are reported as a function of symptom dimension and diagnostic category. The results suggest that, overall, positive symptoms (POS) responded to treatment better than all other symptoms dimensions, but for the schizoaffective and bipolar groups, greater response on POS was observed relative to the schizophrenia and major depression groups. The major depression group showed the most improvement on negative symptoms and emotional distress, and the bipolar group showed the most improvement on disorganization. Schizophrenia was distinct from schizoaffective disorder in showing reduced treatment response on all symptom dimensions. These results can assist refractory psychosis units by providing information on how PANSS symptom dimensions respond to treatment and how this depends on diagnostic category.

Productivity Costs in Patients with Refractory Chronic Rhinosinusitis

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L.; Schlosser, Rodney J.; Hwang, Peter H.; Mace, Jess C.; Soler, Zachary M.

2014-01-01

Objective Disease-specific reductions in patient productivity can lead to substantial economic losses to society. The purpose of this study was to: 1) define the annual productivity cost for a patient with refractory chronic rhinosinusitis (CRS) and 2) evaluate the relationship between degree of productivity cost and CRS-specific characteristics. Study Design Prospective, multi-institutional, observational cohort study. Methods The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Results A total of 55 patients with refractory CRS were enrolled. The mean work days lost related to absenteeism and presenteeism was 24.6 and 38.8 days per year, respectively. A total of 21.2 household days were lost per year related to daily sinus care requirements. The overall annual productivity cost was $10,077.07 per patient with refractory CRS. Productivity costs increased with worsening disease-specific QoL (r=0.440; p=0.001). Conclusion Results from this study have demonstrated that the annual productivity cost associated with refractory CRS is $10,077.07 per patient. This substantial cost to society provides a strong incentive to optimize current treatment protocols and continue evaluating novel clinical interventions to reduce this cost. PMID:24619604

Productivity costs in patients with refractory chronic rhinosinusitis.

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L; Schlosser, Rodney J; Hwang, Peter H; Mace, Jess C; Soler, Zachary M

2014-09-01

Disease-specific reductions in patient productivity can lead to substantial economic losses to society. The purpose of this study was to: 1) define the annual productivity cost for a patient with refractory chronic rhinosinusitis (CRS) and 2) evaluate the relationship between degree of productivity cost and CRS-specific characteristics. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 U.S. National Census and the 2013 U.S. Department of Labor statistics. A total of 55 patients with refractory CRS were enrolled. The mean work days lost related to absenteeism and presenteeism were 24.6 and 38.8 days per year, respectively. A total of 21.2 household days were lost per year related to daily sinus care requirements. The overall annual productivity cost was $10,077.07 per patient with refractory CRS. Productivity costs increased with worsening disease-specific QoL (r = 0.440; p = 0.001). Results from this study have demonstrated that the annual productivity cost associated with refractory CRS is $10,077.07 per patient. This substantial cost to society provides a strong incentive to optimize current treatment protocols and continue evaluating novel clinical interventions to reduce this cost. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Non-destructive characterization of refractories by mirage effect and photothermal microscopy

International Nuclear Information System (INIS)

Savignat, G.; Boch, P.; Pottier, L.; Vandembroucq, D.; Fournier, D.

1993-01-01

In this paper we will demonstrate how thermal waves have turned out to be a good probe for the thermal parameter determination, at various spatial scales for heterogeneous materials such as ceramics. After the detailed description of the two setups we have used (mirage and photothermal microscope), we will explain how to proceed to achieve theoretical calculations either in a 1D geometry or in a 3D one. Then, we will illustrate our purpose with examples of refractory studies. Because these samples are porous and multiphase materials, they have to be investigated at macroscopic scale as well as at a microscopic scale. Finally, we will show results on the temporal behaviour of heat diffusion which can reveal how heat diffuses inside the sample. (orig.)

Felbamate in an adult population with severe refractory epilepsy.

LENUS (Irish Health Repository)

Kearney, H

2011-04-05

Felbamate (FBM) is efficacious in treating patients with refractory epilepsy but was withdrawn due to cases of aplastic anaemia, hepatic failure and five reported deaths. FBM is currently used in specialist centres and is only being used in one Irish centre to date. This papers aim is to review the efficacy and safety experience of FBM in Irish adult patients with refractory epilepsy. A retrospective chart review was done on patients\\' medical records. Patients were subdivided into responders and non responders based on change in seizure frequency and side effects were recorded for all. Of the 13 patients on FBM nine patients responded to FBM, four patients did not. FBM is a safe and efficacious alternative in an Irish adult population with refractory epilepsy. However close monitoring is still required given the potential fatal side effects that are possible with this anticonvulsant.

MICROWAVE MEASUREMENT OF REFRACTORY MATERIALS AT HIGH-TEMPERATURE

International Nuclear Information System (INIS)

Kharkovsky, S.; Zoughi, R.; Smith, J.; Davis, B.; Limmer, R.

2009-01-01

Knowledge of the electrical behavior of refractory materials may enable the development and optimization of microwave nondestructive techniques to detect and evaluate changes in their physical properties while the materials are in service. This paper presents the results of a limited and preliminary investigation in which two refractory materials (dense chrome and dense zircon) were subjected to increasing temperature in a furnace and in which a frequency-modulated continuous-wave radar operating in the frequency range of 8-18 GHz radar was used to evaluate their attenuation properties.

Microwave Measurement of Refractory Materials at High-Temperature

Science.gov (United States)

Kharkovsky, S.; Zoughi, R.; Smith, J.; Davis, B.; Limmer, R.

2009-03-01

Knowledge of the electrical behavior of refractory materials may enable the development and optimization of microwave nondestructive techniques to detect and evaluate changes in their physical properties while the materials are in service. This paper presents the results of a limited and preliminary investigation in which two refractory materials (dense chrome and dense zircon) were subjected to increasing temperature in a furnace and in which a frequency-modulated continuous-wave radar operating in the frequency range of 8-18 GHz radar was used to evaluate their attenuation properties.

Ten patients with refractory status epilepticus in an intensive care department

NARCIS (Netherlands)

ter Maaten, JC; van Schijndel, RJM; Heimans, JJ; Schreuder, WO

1998-01-01

Status epilepticus (SE) is a serious disease, associated with a high morbidity and mortality, particularly if refractory to initial therapy. We describe the clinical manifestations and outcome in ten cases with refractory SE admitted to our medical intensive care unit. Three of these selected group

Refractory absence epilepsy associated with GLUT-1 deficiency syndrome.

LENUS (Irish Health Repository)

Byrne, Susan

2011-05-01

GLUT-1 deficiency syndrome (GLUT-1 DS) is a disorder of cerebral glucose transport associated with early infantile epilepsy and microcephaly. We report two boys who presented with refractory absence epilepsy associated with hypoglycorrhachia, both of whom have genetically confirmed GLUT-1 DS. We propose that these children serve to expand the phenotype of GLUT-1 DS and suggest that this condition should be considered as a cause of refractory absence seizures in childhood.

Treatment of Refractory Idiopathic Supraorbital Neuralgia Using Percutaneous Pulsed Radiofrequency.

Science.gov (United States)

Luo, Fang; Lu, Jingjing; Ji, Nan

2018-02-26

No ideal therapeutic method currently exists for refractory idiopathic supraorbital neuralgia patients who do not respond to conservative therapy, including medications and nerve blocks. Pulsed radiofrequency is a neuromodulation technique that does not produce sequelae of nerve damage after treatment. However, the efficacy of percutaneous pulsed radiofrequency for the treatment of refractory idiopathic supraorbital neuralgia is still not clear. The purpose of our study was to evaluate the efficacy and safety of pulsed radiofrequency treatment of the supraorbital nerve for refractory supraorbital neuralgia patients. We prospectively investigated the long-term effects of ultrasound-guided percutaneous pulsed radiofrequency in the treatment of 22 refractory idiopathic supraorbital neuralgia patients. A reduction in the verbal pain numeric rating scale score of more than 50% was used as the standard of effectiveness. The effectiveness rates at different time points within 2 years were calculated. After a single pulsed radiofrequency treatment, the effectiveness rate at 1 and 3 months was 77%, and the rates at 6 months, 1 year, and 2 years were 73%, 64%, and 50%, respectively. Except for a small portion of patients (23%) who experienced mild upper eyelid ecchymosis that gradually disappeared after approximately 2 weeks, no obvious complications were observed. In conclusion, the results of our study demonstrate that for patients with refractory idiopathic supraorbital neuralgia, percutaneous pulsed radiofrequency may be an effective and safe treatment choice. © 2018 World Institute of Pain.

Surgical disconnection of patent paraumbilical vein in refractory hepatic encephalopathy.

Science.gov (United States)

Ishikawa, Yoshinori; Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Bando, Koichi; Mizuguchi, Yoshiaki; Kakinuma, Daisuke; Kanda, Tomohiro; Akimaru, Koho; Tajiri, Takashi

2008-06-01

Refractory hepatic encephalopathy (HE) frequently develops in patients with cirrhosis and portal-systemic shunt. Recently, patients with refractory HE associated with portal-systemic shunt have been treated with interventional radiology. We describe a promising new treatment for portal-systemic shunt, ligation of the patent paraumbilical vein (PUV) after partial splenic embolization, in patients with refractory HE. Four patients with cirrhosis (3 women and 1 man; mean age, 56 years) and refractory HE due to a patent PUV were studied. Patency of the PUV had recurred in 1 patient after primary occlusion by interventional radiological procedures. The Child-Pugh class was B in 2 patients and C in 2. Before the present treatment, all patients had been hospitalized at least 3 times because of recurrent HE. Partial splenic embolization was performed in all patients to decrease portal venous pressure before surgery. Surgical ligation of the patent PUV was performed under epidural anesthesia. The patent PUV was carefully skeletonized and doubly ligated. Esophageal varices were evaluated with upper gastrointestinal endoscopy before and after surgery. The mean follow-up duration was 15.8 months. After ligation, there were no clinically significant complications. Esophageal varices were unchanged. The serum ammonia level was higher before surgery (162.3 +/- 56.4 mug/dL, mean +/- SD) than after surgery (41.8 +/- 20.2 mug/dL; p=0.0299). No patient had symptoms of HE. Ligation of the patent PUV is an effective treatment for patients with refractory HE.

Minimization of the blank values in the neutron activation analysis of biological samples considering the whole procedure

International Nuclear Information System (INIS)

Lux, F.; Bereznai, T.; Haeberlin, T.H.

1986-01-01

In our determination of trace element contents of animal tissue by neutron activation analysis in the course of structure-activity relationship studies on platinum containing cancer drugs and wound healing we have tried to minimize the blank values that are caused by different sources of contamination during surgery, sampling and the activation analysis procedure. The following topics have been investigated: the abrasions from scalpels made of stainless steel, titanium or quartz; the type of surgery; the homogenisation of the samples before irradiation by use of a ball milll; the surface contaminations of the quartz ampoules that pass into the digestion solution of the irradiated samples. The appropriate measures taken in order to reduce the blank values are described. The results of analyses performed under these conditions indicate the effectiveness of the given measures, especially shown by the low values obtained for the chromium contents of the analysed muscle samples. (author)

Bulk Vitrification Performance Enhancement: Refractory Lining Protection Against Molten Salt Penetration

Energy Technology Data Exchange (ETDEWEB)

Hrma, Pavel R.; Bagaasen, Larry M.; Schweiger, Michael J.; Evans, Michael B.; Smith, Benjamin T.; Arrigoni, Benjamin M.; Kim, Dong-Sang; Rodriguez, Carmen P.; Yokuda, Satoru T.; Matyas, Josef; Buchmiller, William C.; Gallegos, Autumn B.; Fluegel, Alexander

2007-08-06

Bulk vitrification (BV) is a process that heats a feed material that consists of glass-forming solids and dried low-activity waste (LAW) in a disposable refractory-lined metal box using electrical power supplied through carbon electrodes. The feed is heated to the point that the LAW decomposes and combines with the solids to generate a vitreous waste form. This study supports the BV design and operations by exploring various methods aimed at reducing the quantities of soluble Tc in the castable refractory block portion of the refractory lining, which limits the effectiveness of the final waste form.

Comparison of Refractory Performance in Black Liquor Gasifiers and a Smelt Test System

International Nuclear Information System (INIS)

Peascoe, RA

2001-01-01

Prior laboratory corrosion studies along with experience at the black liquor gasifier in New Bern, North Carolina, clearly demonstrate that serious material problems exist with the gasifier's refractory lining. Mullite-based and alumina-based refractories used at the New Bern facility suffered significant degradation even though they reportedly performed adequately in smaller scale systems. Oak Ridge National Laboratory's involvement in the failure analysis, and the initial exploration of suitable replacement materials, led to the realization that a simple and reliable, complementary method for refractory screening was needed. The development of a laboratory test system and its suitability for simulating the environment of black liquor gasifiers was undertaken. Identification and characterization of corrosion products were used to evaluate the test system as a rapid screening tool for refractory performance and as a predictor of refractory lifetime. Results from the test systems and pl ants were qualitatively similar

Measurement of stable isotope ratio of organic carbon in water samples

International Nuclear Information System (INIS)

Fujii, Toshihiro; Otsuki, Akira

1977-01-01

A new method for the measurement of stable isotope ratios was investigated and applied to organic carbon's isotope ratio measurements in water samples. A few river water samples from Tsuchiura city were tested. After the wet oxidation of organic carbons to carbon dioxide in a sealed ampoule, the isotope ratios were determined with the gas chromatograph-quadrupole mass spectrometer combined with a total organic carbon analyser, under the dynamic conditions. The GC-MS had been equipped with the multiple ion detector-digital integrator system. The ion intensities at m/e 44 and 45 were simultaneously measured at a switching rate of 1 ms. The measurements with carbon dioxide acquired from sodium carbonate (53 μg) gave the isotope ratios with the variation coefficient of 0.62%. However, the variation coefficients obtained from organic carbons in natural water samples were 2 to 3 times as high as that from sodium carbonate. This method is simple and rapid and may be applied to various fields especially in biology and medicine. (auth.)

Oral tranexamic acid lightens refractory melasma.

Science.gov (United States)

Tan, Aaron Wei Min; Sen, Priya; Chua, Sze Hon; Goh, Boon Kee

2017-08-01

Melasma is a common acquired hyperpigmentary disorder, particularly among Asians and Hispanics, but its exact pathomechanism is poorly understood. Tranexamic acid has been found to lighten melasma by interfering with the interaction of melanocytes and keratinocytes by inhibiting the plasminogen/plasmin system. The aim was to evaluate the therapeutic effects of oral tranexamic acid in the treatment of melasma refractory to topical skin-lightening agents. This retrospective study analyses patients with melasma recruited from a tertiary dermatological centre in Singapore between 1 August 2009 and 31 March 2011. The patients chosen had refractory melasma treated with oral tranexamic acid 250 mg twice daily in addition to pre-existing combination topical therapy. Objective assessment using the physician's global assessment and melasma area and severity index (MASI) scores were performed based on a post-hoc analysis of photographic records by three independent physicians. A paired t-test was used to evaluate the changes in the MASI scores pre-therapy and post-treatment. Statistical significance was defined as P tranexamic acid for a mean period of 3.7 ± 0.33 months, in addition to combination topical therapy. Their mean age was 47.2 ± 1.61 years. The mean MASI scores after tranexamic acid treatment (2.7 ± 1.6) were significantly lower (P tranexamic acid can serve as a safe and useful adjunct in the treatment of refractory melasma. © 2016 The Australasian College of Dermatologists.

Analysis and characterization of kaolinitic clay Rio Grande do Norte for use in refractory

International Nuclear Information System (INIS)

Medeiros, A.L.; Souza Junior, C.F.; Silva, C.L. Mendes da

2011-01-01

This work aims to characterize clays from the State of Rio Grande do Norte for use in the manufacture of refractory bricks. Initially, we analyzed the X-ray fluorescence and X-ray diffraction on samples of clay to obtain the components of the starting materials and their microstructures. The test samples were fabricated by uniaxial pressure of 20 MPa, and then were sintered between 1000 ° C and 1200 ° C, with a landing sintering for 1 hour. Tests including thermal shrinkage, water absorption and apparent porosity. Initial results of the analysis indicate the presence of clay minerals kaolinite, montmorillonite and muscovite, as well group minerals of quartz, dolomite, calcite and calcium silicate in the samples tested. (author)

Clinical features and course of refractory anemia with ring sideroblasts associated with marked thrombocytosis

Science.gov (United States)

Broseus, Julien; Florensa, Lourdes; Zipperer, Esther; Schnittger, Susanne; Malcovati, Luca; Richebourg, Steven; Lippert, Eric; Cermak, Jaroslav; Evans, Jyoti; Mounier, Morgane; Raya, José Maria; Bailly, François; Gattermann, Norbert; Haferlach, Torsten; Garand, Richard; Allou, Kaoutar; Besses, Carlos; Germing, Ulrich; Haferlach, Claudia; Travaglino, Erica; Luno, Elisa; Pinan, Maria Angeles; Arenillas, Leonor; Rozman, Maria; Perez Sirvent, Maria Luz; Favre, Bernardine; Guy, Julien; Alonso, Esther; Ahwij, Nuhri; Jerez, Andrés; Hermouet, Sylvie; Maynadié, Marc; Cazzola, Mario; Girodon, François

2012-01-01

Background Refractory anemia with ring sideroblasts associated with marked thrombocytosis was proposed as a provisional entity in the 2001 World Health Organization classification of myeloid neoplasms and also in the 2008 version, but its existence as a single entity is contested. We wish to define the clinical features of this rare myelodysplastic/myeloproliferative neoplasm and to compare its clinical outcome with that of refractory anemia with ring sideroblasts and essential thrombocythemia. Design and Methods We conducted a collaborative retrospective study across Europe. Our database included 200 patients diagnosed with refractory anemia with ring sideroblasts and marked thrombocytosis. For each of these patients, each patient diagnosed with refractory anemia with ring sideroblasts was matched for age and sex. At the same time, a cohort of 454 patients with essential thrombocythemia was used to compare outcomes of the two diseases. Results In patients with refractory anemia with ring sideroblasts and marked thrombocytosis, depending on the Janus Kinase 2 V617F mutational status (positive or negative) or platelet threshold (over or below 600×109/L), no difference in survival was noted. However, these patients had shorter overall survival and leukemia-free survival with a lower risk of thrombotic complications than did patients with essential thrombocythemia (P<0.001) but better survival (P<0.001) and a higher risk of thrombosis (P=0.039) than patients with refractory anemia with ring sideroblasts. Conclusions The clinical course of refractory anemia with ring sideroblasts and marked thrombocytosis is better than that of refractory anemia with ring sideroblasts and worse than that of essential thrombocythemia. The higher risk of thrombotic events in this disorder suggests that anti-platelet therapy might be considered in this subset of patients. From a clinical point of view, it appears to be important to consider refractory anemia with ring sideroblasts and

Nanostructured refractory thin films for solar applications

Science.gov (United States)

Ollier, E.; Dunoyer, N.; Dellea, O.; Szambolics, H.

2014-08-01

Selective solar absorbers are key elements of all solar thermal systems. Solar thermal panels and Concentrated Solar Power (CSP) systems aim respectively at producing heat and electricity. In both cases, a surface receives the solar radiation and is designed to have the highest optical absorption (lowest optical reflectivity) of the solar radiation in the visible wavelength range where the solar intensity is the highest. It also has a low emissivity in the infrared (IR) range in order to avoid radiative thermal losses. Current solutions in the state of the art usually consist in deposited interferential thin films or in cermets [1]. Structured surfaces have been proposed and have been simulated because they are supposed to be more efficient when the solar radiation is not normal to the receiving surface and because they could potentially be fabricated with refractory materials able to sustain high operating temperatures. This work presents a new method to fabricate micro/nanostructured surfaces on molybdenum (refractory metal with a melting temperature of 2623°C). This method now allows obtaining a refractory selective surface with an excellent optical selectivity and a very high absorption in the visible range. This high absorption performance was obtained by achieving a double structuration at micro and nano scales thanks to an innovative process flow.

Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation

NARCIS (Netherlands)

Staal, M. J.; Holm, A. F.; Mooij, J. J. A.; Albers, F. W. J.; Bartels, H.

2007-01-01

Objective: Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by means of chronic electrical stimulation of the vestibulocochlear nerve. Patients: Inclusion criteria were severe, chronic, therapeutically refractory, unilateral tinnitus and severe hearing loss at the

Super-Refractory Status Epilepticus: Report of a Case and Review of the Literature.

Science.gov (United States)

Lapenta, Leonardo; Frisullo, Giovanni; Vollono, Catello; Brunetti, Valerio; Giannantoni, Nadia Mariagrazia; Sandroni, Claudio; Di Lella, Giuseppe; Della Marca, Giacomo

2015-10-01

Super-refractory status epilepticus (SE; ie, SE continuing or recurring despite 24 hours of general anesthesia) is a severe condition with high percentage of mortality and morbidity. Usually, this condition occurs because of serious brain damage; nevertheless, some patients develop super-refractory SE without identifiable etiology. Although not uncommonly encountered in neurointensive care, scientific data on this condition are still lacking in terms of treatment and prognosis. Herein, we report a case of super-refractory SE with recovery after 50 days, despite electroencephalographic (EEG) and magnetic resonance imaging (MRI) signs traditionally related to poor prognosis. A review of the literature on super-refractory SE is also presented. © EEG and Clinical Neuroscience Society (ECNS) 2014.

Tioguanine in the treatment of refractory coeliac disease--a single centre experience.

Science.gov (United States)

Tack, G J; van Asseldonk, D P; van Wanrooij, R L J; van Bodegraven, A A; Mulder, C J

2012-08-01

Refractory coeliac disease type I is a complicated form of coeliac disease characterised by primary or secondary resistance to a gluten-free diet with persisting or reoccurring intestinal villous atrophy and symptoms of malabsorption. Besides corticosteroids, azathioprine has been advocated for the treatment of refractory coeliac disease type I. However, tioguanine (TG) might be better tolerated and more efficacious owing to a simpler metabolism towards bioactivation. To evaluate tolerability and effectiveness of the nonconventional thiopurine derivative TG in refractory coeliac disease type I. Refractory coeliac disease type I patients treated with TG between June 2001 and November 2010 with a follow-up period of at least 1 year were included. Adverse events, laboratory values, 6-thioguanine nucleotide concentrations and rates of both clinical and histological response were evaluated at baseline and during follow-up. Twelve adult refractory coeliac disease type I patients were included. The median TG treatment duration was 14 months. Ten patients tolerated TG treatment on the long term, whereas two patients withdrew treatment due to adverse events. No nodular regenerative hyperplasia of the liver was observed. During follow-up clinical and histological response was observed in 83% and 78%, respectively. Corticosteroid dependency decreased by 50%. Tioguanine appears to be a convenient drug for the treatment of refractory coeliac disease type I based on higher histological and similar clinical response rates as compared with historical conventional therapies. © 2012 Blackwell Publishing Ltd.

Refractory, Abrasive and Other Industrial Mineral Operations

Data.gov (United States)

Department of Homeland Security — This map layer includes refractory, abrasive, and other industrial minerals operations in the United States. The data represent commodities covered by the Minerals...

Evaluation of nutritional status in children with refractory epilepsy

Directory of Open Access Journals (Sweden)

Testolin G

2006-04-01

Full Text Available Abstract Background children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. Methods 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 ± 3,2 years; Body Mass Index 15,7 ± 3,6 underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting and weight-for-height (wasting were estimated compared to those of a reference population of the same age. Results 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate. Adequacy index [nutrient daily intake/recommended allowance (RDA × 100] was Conclusion many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care.

Improvement of castable refractories for RH snorkel; RH shinshitsukanyo futeikeizai no kaizen

Energy Technology Data Exchange (ETDEWEB)

Nishi, K.; Obana, T.; Fijii, T.; Shimizu, I. [Harima Ceramics Corp., Hyogo (Japan)

1999-11-01

Relating to corrosion of RH submerged nozzle, resistance against iron oxide of monolithic refractories was examined. Corrosion and seepage of refractories were measured by rotating corrosion, refractories include alumina-spinel castable, which is applied to RH under tank, and alumina-magnesia castable, which is generally used for RH, submerged nozzle. Alumina-spinel castable is superior in resistance against iron oxide than alumina-magnesia castable, and the resistance decreased with increase of stainless fiber addition to castable. Alumina-spinel castable without stainless fiber was suitable for bottom end of the dipping pipe. (NEDO)

Effectiveness of intravenous levetiracetam as an adjunctive treatment in pediatric refractory status epilepticus.

Science.gov (United States)

Kim, Jon Soo; Lee, Jeong Ho; Ryu, Hye Won; Lim, Byung Chan; Hwang, Hee; Chae, Jong-Hee; Choi, Jieun; Kim, Ki Joong; Hwang, Yong Seung; Kim, Hunmin

2014-08-01

Intravenous levetiracetam (LEV) has been shown to be effective and safe in treating adults with refractory status epilepticus (SE). We sought to investigate the efficacy and safety of intravenous LEV for pediatric patients with refractory SE. We performed a retrospective medical-record review of pediatric patients who were treated with intravenous LEV for refractory SE. Clinical information regarding age, sex, seizure type, and underlying neurological status was collected. We evaluated other anticonvulsants that were used prior to administration of intravenous LEV and assessed loading dose, response to treatment, and any adverse events from intravenous LEV administration. Fourteen patients (8 boys and 6 girls) received intravenous LEV for the treatment of refractory SE. The mean age of the patients was 4.4 ± 5.5 years (range, 4 days to 14.6 years). Ten of the patients were neurologically healthy prior to the refractory SE, and the other 4 had been previously diagnosed with epilepsy. The mean loading dose of intravenous LEV was 26 ± 4.6 mg/kg (range, 20-30 mg/kg). Seizure termination occurred in 6 (43%) of the 14 patients. In particular, 4 (57%) of the 7 patients younger than 2 years showed seizure termination. No immediate adverse events occurred during or after infusions. The current study demonstrated that the adjunctive use of intravenous LEV was effective and well tolerated in pediatric patients with refractory SE, even in patients younger than 2 years. Intravenous LEV should be considered as an effective and safe treatment option for refractory SE in pediatric patients.

Non-Contact Measurements of Creep Properties of Refractory Materials

Science.gov (United States)

Lee, Jonghyun; Bradshaw, Richard C.; Hyers, Robert W.; Rogers, Jan R.; Rathz, Thomas J.; Wall, James J.; Choo, Hahn; Liaw, Peter

2006-01-01

State-of-the-art technologies for hypersonic aircraft, nuclear electric/thermal propulsion for spacecraft, and more efficient jet engines are driving ever more demanding needs for high-temperature (>2000 C) materials. At such high temperatures, creep rises as one of the most important design factors to be considered. Since conventional measurement techniques for creep resistance are limited to about 17OO0C, a new technique is in demand for higher temperatures. This paper presents a non-contact method using electrostatic levitation (ESL) which is applicable to both metallic and non-metallic materials. The samples were rotated quickly enough to cause creep deformation by centrifugal acceleration. The deformation of the samples was captured with a high speed camera and then the images were analyzed to estimate creep resistance. Finite element analyses were performed and compared to the experiments to verify the new method. Results are presented for niobium and tungsten, representative refractory materials at 2300 C and 2700 C respectively.

Neuroimaging in refractory epilepsy. Current practice and evolving trends

Energy Technology Data Exchange (ETDEWEB)

Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

2015-09-15

Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

Neuroimaging in refractory epilepsy. Current practice and evolving trends

International Nuclear Information System (INIS)

Ramli, N.; Rahmat, K.; Lim, K.S.; Tan, C.T.

2015-01-01

Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed

The effect of various sintering temperature on used refractory towards its physical properties

Science.gov (United States)

Sudibyo; Wulandari, Y. R.; Amin, M.; Azhar

2018-01-01

The used magnesia refractory from the kiln of cement industry was successfully recycled to new refractory using Kaolin as an adhesive. In this work, the temperatures of sintering were varied from 1000°C to 1500°C. The result shows that the increment temperature effects in sintering process will enhance refractory physical properties such as bulk density, cold crushing strength or pressure strength and thermal conductivity. Meanwhile, the porosity was decreased as the increase of the sintering temperature.

Rapid pacing results in changes in atrial but not in ventricular refractoriness

NARCIS (Netherlands)

Schoonderwoerd, BA; Van Gelder, IC; Tieleman, RG; Bel, KJ; Crijns, HJGM

It is well known that atrial tachycardia causes atrial electrical remodeling, characterized by shortening of atrial effective refractory periods (AERPs) and loss of physiological adaptation of AERP to rate. However, the nature and time course of changes in ventricular effective refractory periods

Transient refractory material dissolution by a volumetrically-heated melt

Energy Technology Data Exchange (ETDEWEB)

Seiler, Jean Marie, E-mail: jean-marie.seiler@cea.fr [CEA, DEN, DTN, 17 Rue des Martyrs, 38054 Grenoble Cedex 9 (France); Ratel, Gilles [CEA, DEN, DTN, 17 Rue des Martyrs, 38054 Grenoble Cedex 9 (France); Combeau, Hervé [Institut Jean Lamour, UMR 7198, Lorraine University, Ecole des Mines de Nancy, Parc de Saurupt, 54042 Nancy Cedex (France); Gaus-Liu, Xiaoyang; Kretzschmar, Frank; Miassoedov, Alexei [Karlsruhe Institut of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany)

2014-12-15

Highlights: • We describe a test investigating ceramic dissolution by a molten non-eutectic melt. • The evolution of the interface temperature between melt and refractory is measured. • A theoretical model describing dissolution kinetics is proposed. • When dissolution stops, interface temperature is the liquidus temperature of the melt. - Abstract: The present work addresses the question of corium–ceramic interaction in a core catcher during a core-melt accident in a nuclear power plant. It provides an original insight into transient aspects concerning dissolution of refractory material by a volumetrically heated pool. An experiment with simulant material (LIVECERAM) is presented. Test results clearly show that dissolution of solid refractory material can occur in a non-eutectic melt at a temperature which is lower than the melting temperature of the refractory material. During the dissolution transient, the interface temperature rises above the liquidus temperature, corresponding to the instantaneous average composition of the melt pool. With constant power dissipation in the melt and external cooling of the core-catcher, a final steady-state situation is reached. Dissolution stops when the heat flux (delivered by the melt to the refractory) can be removed by conduction through the residual thickness of the ceramic, with T{sub interface} = T{sub liquidus} (calculated for the average composition of the final liquid pool). The final steady state corresponds to a uniform pool composition and uniform interface temperature distribution. Convection in the pool is governed by natural thermal convection and the heat flux distribution is therefore similar to what would be obtained for a single component pool. An interpretation of the experiment with two model-based approaches (0D and 1D) is presented. The mass transfer kinetics between the interface and the bulk is controlled by a diffusion sublayer within the boundary layer. During the dissolution transient

Supporting data for senary refractory high-entropy alloy CrxMoNbTaVW

Directory of Open Access Journals (Sweden)

B. Zhang

2015-12-01

Full Text Available This data article is related to the research paper entitled “senary refractory high-entropy alloy CrxMoNbTaVW [1]”. In this data article, the pseudo-binary Cr-MoNbTaVW phase diagram is presented to show the impact of Cr content to the senary Cr-MoNbTaVW alloy system; the sub-lattice site fractions are presented to show the disordered property of the Cr-MoNbTaVW BCC structures; the equilibrium and Scheil solidification results with the actual sample elemental compositions are presented to show the thermodynamic information of the melted/solidified CrxMoNbTaVW samples; and the raw EDS scan data of the arc-melted CrxMoNbTaVW samples are also provided.

A randomized controlled trial of the ketogenic diet in refractory childhood epilepsy

NARCIS (Netherlands)

Lambrechts, D.A.J.E.; de Kinderen, R.J.A.; Vles, J.S.H.; de Louw, A.J.A.; Aldenkamp, A.P.; Majoie, H.J.M.

2017-01-01

Objective: To evaluate the efficacy and tolerability of the ketogenic diet (KD) during the first 4 months of a randomized controlled trial (RCT) in refractory epilepsy patients aged 1–18 years. Methods: Children and adolescents with refractory epilepsy, not eligible for epilepsy surgery, were

Improved cooler design of electric arc furnace refractory in mining industry using thermal analysis modeling and simulation

International Nuclear Information System (INIS)

Istadi, I.; Bindar, Y.

2014-01-01

Production of steel and nickel using the electric arc furnace should be focused on the intensification of energy. Improvement of energy efficiency of the most consuming facilities was achieved by improving the use of alternative energy minimization such as reducing the heat lost of hot gases, minimizing the heat radiated through refractory linings of metallurgical furnaces, and cooling the highly thermally stressed components. The refractory of electric arc furnace should be modified to achieve the best cooling system of the furnace. In this physical modeling and simulation works, four modification scenarios of wall refractory designs were simulated, i.e. refractory with basic design, refractory with deep plate coolers, refractory with extra plate coolers, and refractory with wall falling film coolers. Finally, the use of deep plate cooler and the existing waffle cooler system was considered to be the best design of efficient electric arc furnace operationally. - Highlights: • Electric arc furnace design should be focused on the intensification of energy. • Refractory of electric arc furnace were modified to achieve the best cooling system. • Four modification scenarios of the wall refractory designs were simulated. • Use of deep plate cooler and existing waffle cooler system is the best cooling

Ixabepilone: a new chemotherapeutic option for refractory metastatic breast cancer

Directory of Open Access Journals (Sweden)

Shannon Puhalla

2008-09-01

Full Text Available Shannon Puhalla, Adam BrufskyUPMC Magee-Womens Cancer Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USAAbstract: Taxane therapy is commonly used in the treatment of metastatic breast cancer. However, most patients will eventually become refractory to these agents. Ixabepilone is a newly approved chemotherapeutic agent for the treatment of metastatic breast cancer. Although it targets microtubules similarly to docetaxel and paclitaxel, ixabepilone has activity in patients that are refractory to taxanes. This review summarizes the pharmacology of ixapebilone and clinical trials with the drug both as a single agent and in combination. Data were obtained using searches of PubMed and abstracts of the annual meetings of the American Society of Clinical Oncology and the San Antonio Breast Cancer Symposium from 1995 to 2008. Ixapebilone is a semi-synthetic analog of epothilone B that acts to induce apoptosis of cancer cells via the stabilization of microtubules. Phase I clinical trials have employed various dosing schedules ranging from daily to weekly to 3-weekly. Dose-limiting toxicites included neuropathy and neutropenia. Responses were seen in a variety of tumor types. Phase II studies verified activity in taxane-refractory metastatic breast cancer. The FDA has approved ixabepilone for use as monotherapy and in combination with capecitabine for the treatment of metastatic breast cancer. Ixabepilone is an efficacious option for patients with refractory metastatic breast cancer. The safety profile is similar to that of taxanes, with neuropathy and neutropenia being dose-limiting. Studies are ongoing with the use of both iv and oral formulations and in combination with other chemotherapeutic and biologic agents.Keywords: ixabepilone, epothilone, metastatic breast cancer, taxane-refractory

Clinical outcomes of intravenous immunoglobulin therapy in refractory uveitis.

Science.gov (United States)

Garcia-Geremias, M; Carreño, E; Epps, S J; Lee, R W J; Dick, A D

2015-04-01

Intravenous immunoglobulin (IVIg) therapy has multiple mechanisms of immunomodulatory action. We wished therefore to assess its efficacy in a spectrum of patients with refractory uveitis. Retrospective review of clinical charts was conducted to document response to IVIg treatment in consecutive patients with treatment-refractory uveitis. Main outcome measures were control of intraocular inflammation, visual acuity, progression of the disease, and complications. Four (two male) patients, with a mean age at the beginning of the treatment of 47 years (range: 39-64), were included in the study. Indication for treatment was patients with active non-infectious uveitis refractory to steroids and immunomodulatory therapy. All patients received a course of 0.5 g/kg per day of IVIg for three consecutive days, repeating this course at a mean of 11 week (range: 2-39 weeks) intervals when indicated clinically. The median duration of the IVIg therapy was 7 months (range: 3-14 months). In three patients treatment resulted in stabilisation and prevention of progression of the disease, and additionally in two patients it facilitated a decrease in prednisolone dose. Treatment failed to induce long-term remission in one patient with recurrence of macular oedema. IVIg was well tolerated with neither immediate nor longer-term adverse events observed. In three out of four cases IVIg was an effective adjunctive therapy and well tolerated for the management of treatment-refractory uveitis.

Advances in refractories for the metallurgical industries III: proceedings of the international symposium

Energy Technology Data Exchange (ETDEWEB)

Allaire, C.; Rigaud, M. [eds.] [Ecole Polytchnique, Montreal, PQ (Canada)

1999-07-01

In the three years since the last symposium key innovations have been made in the penetration of monoliths in all sectors of the metallurgical industries. The symposium was presented within the 38th Annual Conference of Metallurgists of the Canadian Institute of Mining, Metallurgy and Petroleum. Broad international coverage was maintained with papers originating from 12 different countries including: Australia, Canada, China, France, Germany, India, Iran, Japan, Korea, Mexico, New Zealand, Norway, and the United States. The 27 papers presented are divided into seven sessions to reflect the interests of the participants. The sessions included mold fluxes I and II, aluminum refractories, alumina castables, andalusite castables, continuous casting of refractories, aluminum refractories II and copper-nickel refineries. One paper on refractories for exhaust gas scrubbers is abstracted separately.

Determination of ferrous and total iron in refractory spinels

Energy Technology Data Exchange (ETDEWEB)

Amonette, J.E. [Physical Sciences Division, Pacific Northwest National Laboratory, Richland, WA 99352 (United States); Matyáš, J. [Material Science Department, Pacific Northwest National Laboratory, Richland, WA 99352 (United States)

2016-03-03

Accurate and precise determination of the redox state of iron (Fe) in spinels presents a significant challenge due to their refractory nature. The resultant extreme conditions needed to obtain complete dissolution generally oxidize some of the Fe(II) initially present and thus prevent the use of colorimetric methods for Fe(II) measurements. To overcome this challenge we developed a hybrid oxidimetric/colorimetric approach, using Ag(I) as the oxidimetric reagent for determination of Fe(II) and 1,10-phenanthroline as the colorimetric reagent for determination of total Fe. This approach, which allows determination of Fe(II) and total Fe on the same sample, was tested on a series of four geochemical reference materials and then applied to the analysis of Fe(Ni) spinel crystals isolated from simulated high-level-waste (HLW) glass and of several reagent magnetites. Results for the reference materials were in excellent agreement with recommended values, with the exception of USGS BIR-1, for which higher Fe(II) values and lower total Fe values were obtained. The Fe(Ni) spinels showed Fe(II) values at the detection limit (ca. 0.03 wt% Fe) and total Fe values higher than obtained by ICP-AES analysis after decomposition by lithium metaborate/tetraborate fusion. For the magnetite samples, total Fe values were in agreement with reference results, but a wide range in Fe(II) values was obtained indicating various degrees of conversion to maghemite. Formal comparisons of accuracy and precision were made with 13 existing methods. Accuracy for Fe(II) and total Fe was at or near the top of the group. Precision varied with the parameter used to measure it but was generally in the middle to upper part of the group for Fe(II) while that for total Fe ranged from the bottom of the group to near the top. - Highlights: • Refractory samples, such as spinels, are the most difficult for Fe redox analysis. • Oxidimetric(Ag{sup +})/colorimetric (phen) method allows analysis of a single

Evaluation of refractory materials for a nuclear waste incinerator

International Nuclear Information System (INIS)

Grotzky, V.K.; Kneale, P.A.; Teter, A.R.

1980-01-01

An experiment to find a suitable refractory lining for a nuclear waste incinerator has been completed. Eleven brick and six castable products were analyzed by optical and scanning microscopy. All the materials were fashioned into cup shapes and subjected to temperatures ranging from 800 to 1200 0 C for as long as six weeks. Some of the cups were charged weekly with pellets made from ash materials that would contact an incinerator liner. Refractory products containing a high percentage of aluminum oxide had the greatest resistance to cracking and slag buildup. 35 figures

Refractory status epilepticus and glutamic acid decarboxylase antibodies in adults: presentation, treatment and outcomes.

Science.gov (United States)

Khawaja, Ayaz M; Vines, Brannon L; Miller, David W; Szaflarski, Jerzy P; Amara, Amy W

2016-03-01

Glutamic acid decarboxylase antibodies (GAD-Abs) have been implicated in refractory epilepsy. The association with refractory status epilepticus in adults has been rarely described. We discuss our experience in managing three adult patients who presented with refractory status epilepticus associated with GAD-Abs. Case series with retrospective chart and literature review. Three patients without pre-existing epilepsy who presented to our institution with generalized seizures between 2013 and 2014 were identified. Seizures proved refractory to first and second-line therapies and persisted beyond 24 hours. Patient 1 was a 22-year-old female who had elevated serum GAD-Ab titres at 0.49 mmol/l (normal: status epilepticus. Causation cannot be established since GAD-Abs may be elevated secondary to concurrent autoimmune diseases or formed de novo in response to GAD antigen exposure by neuronal injury. Based on this report and available literature, there may be a role for immuno- and chemotherapy in the management of refractory status epilepticus associated with GAD-Abs.

Evaluation of olivine refractories for TES

Science.gov (United States)

Gay, B. M.; Cochrane, R. L.; Palmour, H., III; Paisley, M. J.

1982-02-01

The principal objectives of this program are to (1) experimentally determine the degree of improvement in thermal and mechanical performance that can be obtained with an olivine thermal storage brick made of domestic materials using advanced processing techniques compared with state-of-the-art as represented by commercial European bricks, (2) conduct an assessment of existing German ceramic process technology and determine its adaptability to domestic raw materials and manufacturing practices, and (3) investigate, on a limited basis, method for further improvement of domestic-olivine brick. To date, accomplishments include (1) installation of improved, computer-based instrumentation, (2) the use of this system to determine performance characteristics of a set of heat storage refractories under cyclic use conditions, (3) acquisition of the services of a knowledgeable European consultant, (4) continued lab-scale process/property optimization studies, and (5) comparative testing of olivine-based and magnesite-based heat storage refractories in the calorimetric test facility at Purdue University.

An unusual case of refractory wheeze

Science.gov (United States)

Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

2015-01-01

A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3 years’ duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtained via bronchoscopy) was positive for acid-fast bacilli. The patient presented after completing 6 months of ATT with persistent symptoms, a loud S1 and a mid-diastolic murmur at the apex. High-resolution CT of the chest showed bilateral dependent ground glass opacities. An echocardiogram revealed a left atrial myxoma, and normal RV size and pressures. The patient underwent successful surgical removal of the same, and made a complete recovery. Refractory wheeze is a very unusual presentation of a left atrial myxoma. PMID:25733086

Enhancement of the life of refractories through the operational experience of plasma torch melter

Energy Technology Data Exchange (ETDEWEB)

Moon, Young Pyo [Technology Institute, Korea Radioactive waste Agency (KORAD), Daejeon (Korea, Republic of); Choi, Jaang Young [Chungnam National University, Daejeon (Korea, Republic of)

2016-06-15

The properties of wastes for melting need to be considered to minimize the maintenance of refractory and to discharge the molten slags smoothly from a plasma torch melter. When the nonflammable wastes from nuclear facilities such as concrete debris, glass, sand, etc., are melted, they become acid slags with low basicity since the chemical composition has much more acid oxides than basic oxides. A molten slag does not have good characteristics of discharge and is mainly responsible for the refractory erosion due to its low liquidity. In case of a stationary plasma torch melter with a slant tapping port on the wall, a fixed amount of molten slags remains inside of tapping hole as well as the melter inside after tapping out. Nonmetallic slags keep the temperature higher than melting point of metal because metallic slags located on the bottom of melter by specific gravity difference are simultaneously melted when dual mode plasma torch operates in transferred mode. In order to minimize the refractory erosion, the compatible refractories are selected considering the temperature inside the melter and the melting behavior of slags whether to contact or noncontact with molten slags. An acidic refractory shall not be installed in adjacent to a basic refractory for the resistibility against corrosion.

Refractory heartburn: comparison of intercellular space diameter in documented GERD vs. functional heartburn.

Science.gov (United States)

Vela, Marcelo F; Craft, Brandon M; Sharma, Neeraj; Freeman, Janice; Hazen-Martin, Debra

2011-05-01

Refractory heartburn despite acid suppression may be explained by ongoing gastroesophageal reflux disease (GERD) or functional heartburn (FH), i.e., symptoms without evidence of GERD. Impedance-pH monitoring (impedance-pH) detects acid and nonacid reflux and is useful for evaluating acid-suppressed, refractory patients. Intercellular space diameter (ISD) of esophageal epithelium measured by transmission electron microscopy (TEM) is a marker of epithelial damage present in both erosive and nonerosive reflux disease. ISD has not been used to study refractory heartburn or FH. Our aim was to compare ISD in healthy controls and refractory heartburn patients with GERD and FH. In refractory heartburn patients (heartburn more than twice/week for at least 2 months despite proton pump inhibitor (PPI) b.i.d.), erosive esophagitis and/or abnormal impedance-pH (increased acid exposure or positive symptom index) defined GERD; normal esophagogastroduodenoscopy (EGD)/impedance-pH defined FH. Asymptomatic, healthy controls had normal EGD and pH-metry. Mean ISD in each subject, determined by blinded TEM of esophageal biopsies, was the average of 100 measurements (10 measurements in each of 10 micrographs). In all, 11 healthy controls, 11 FH, and 15 GERD patients were studied. Mean ISD was significantly higher in GERD compared with controls (0.87 vs. 0.32 μm, P=0.003) and FH (0.87 vs. 0.42 μm, P=0.012). Mean ISD was similar in FH and controls (0.42 vs. 0.32 μm, P=0.1). The proportion of patients with abnormal ISD was significantly higher for GERD compared with FH (60 vs. 9%, P=0.014). ISD is increased in refractory heartburn patients with GERD but not those with FH. Our findings suggest that measurement of ISD by TEM might be a useful tool to distinguish GERD from FH in patients with refractory heartburn.

Colectomy for refractory constipation

DEFF Research Database (Denmark)

Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth

2010-01-01

OBJECTIVE: This study evaluated the type of colectomy, postoperative complications, functional results, and satisfaction in patients with constipation refractory to conservative therapy. Further, colonic transit time (CTT), faecal load (coprostasis), and colon length (redundancies) were compared...... had at hemicolectomy, 11 patients a subtotal colectomy and 3 patients an ileostomy. Two patients had an anastomotic leak and one died. In 11 patients, further surgery was necessary, because of recurrent constipation. Abdominal pain disappeared and defecation patterns improved significantly to 1-4 per...

Refractory alloy component fabrication

International Nuclear Information System (INIS)

Young, W.R.

1984-01-01

Purpose of this report is to describe joining procedures, primarily welding techniques, which were developed to construct reliable refractory alloy components and systems for advanced space power systems. Two systems, the Nb-1Zr Brayton Cycle Heat Receiver and the T-111 Alloy Potassium Boiler Development Program, are used to illustrate typical systems and components. Particular emphasis is given to specific problems which were eliminated during the development efforts. Finally, some thoughts on application of more recent joining technology are presented. 78 figures

Method for hot pressing irregularly shaped refractory articles

Science.gov (United States)

Steinkamp, William E.; Ballard, Ambrose H.

1982-01-01

The present invention is directed to a method for hot pressing irregularly haped refractory articles with these articles of varying thickness being provided with high uniform density and dimensional accuracy. Two partially pressed compacts of the refractory material are placed in a die cavity between displaceable die punches having compact-contacting surfaces of the desired article configuration. A floating, rotatable block is disposed between the compacts. The displacement of the die punches towards one another causes the block to rotate about an axis normal to the direction of movement of the die punches to uniformly distribute the pressure loading upon the compacts for maintaining substantially equal volume displacement of the powder material during the hot pressing operation.

Ketogenic Diet in Super-Refractory Status Epilepticus

OpenAIRE

Smith, Garnett; Press, Craig A.

2017-01-01

Researchers from the Children’s National Health System in Washington, D.C. studied the feasibility, rate of complications, and effect on seizures of initiating the Ketogenic Diet (KD) in pediatric patients with Super-Refractory Status Epilepticus (SRSE).

Clinical and etiological profile of refractory rickets from western India.

Science.gov (United States)

Joshi, Rajesh R; Patil, Shailesh; Rao, Sudha

2013-07-01

To present clinical and etiological profile of refractory rickets from Mumbai. Case records of 36 patients presenting over 2½ y with refractory rickets were evaluated with respect to clinical presentation, biochemical, radiological features and where needed, ophthalmological examination, ultrasonography and special tests on blood and urine. Twenty three (63 %) patients had renal tubular acidosis (RTA)-distal RTA in 20 and proximal RTA in 3 patients; 5 (14 %) had vitamin D dependent rickets (VDDR I in 2 and VDDR II in 3 patients), 4 (11 %) had chronic renal failure (CRF) and 2 each (6 %) had hypophosphatemic rickets and chronic liver disease as cause of refractory rickets. A significant proportion of patients with RTA and VDDR showed skeletal changes of rickets in the first 2 y of life, while those with hypophosphatemic rickets presented later. Patients with hypophosphatemic rickets had predominant involvement of lower limbs, normal blood calcium and PTH levels and phosphorus leak in urine. All patients with RTA presented with failure to thrive, polyuria and marked rickets; blood alkaline phosphatase levels being normal in almost 50 % patients. Three (75 %) patients with rickets due to CRF had GFR rickets inspite of taking high dose of vitamin D orally. Refractory rickets is a disorder of multiple etiologies; a good history and clinical examination supplemented with appropriate investigations helps to determine its cause.

USE OF STRUCTURAL MRI IN PATIENTS WITH MEDICALLY REFRACTORY SEIZURES

Directory of Open Access Journals (Sweden)

Ara G. Kaprelyan

2012-12-01

Full Text Available Introduction: Refractory epilepsy is common in patients with structural brain lesions including acquired disorders and genetic abnormalities. Recently, MRI is a precise diagnostic tool for recognition of different structural causes underlying medically intractable seizures.Objective: To evaluate the usefulness of MRI for detection of brain lesions associated with refractory epilepsy.Material and methods: 49 patients (20M and 29F; aged 48.6±24.7 years with refractory epilepsy were included in the study. They presented with partial (46.0%, secondary (31.0% or primary (23.0% generalized tonic-clonic seizures. Clinical diagnosis was based on the revised criteria of ILAE. Structural neuroimaging (MRI, EEG recording, and neurological examination were performed.Results: MRI detected different structural brain abnormalities totally in 36 (73.5% patients, including cerebral tumors (21p, cerebrovascular accidents (5p, hyppocampal sclerosis (3p, developmental malformations (2p, postencephalitic lesions (2p, arachnoid cysts (2p, and tuberous sclerosis (1p. Neuroimaging revealed normal findings in 13 (27.5% cases. EEG recordings showed focal epileptic activity in 38 (77.6% patients, including 33 cases with and 5 without structural brain abnormalities.Conclusion: This study revealed that structural brain lesions are commonly associated with refractory epilepsy. We suggested that MRI is a useful diagnostic method for assessment of patients with uncontrolled seizures or altered epileptic pattern.

Penetration and Effectiveness of Micronized Copper in Refractory Wood Species.

Science.gov (United States)

Civardi, Chiara; Van den Bulcke, Jan; Schubert, Mark; Michel, Elisabeth; Butron, Maria Isabel; Boone, Matthieu N; Dierick, Manuel; Van Acker, Joris; Wick, Peter; Schwarze, Francis W M R

2016-01-01

The North American wood decking market mostly relies on easily treatable Southern yellow pine (SYP), which is being impregnated with micronized copper (MC) wood preservatives since 2006. These formulations are composed of copper (Cu) carbonate particles (CuCO3·Cu(OH)2), with sizes ranging from 1 nm to 250 μm, according to manufacturers. MC-treated SYP wood is protected against decay by solubilized Cu2+ ions and unreacted CuCO3·Cu(OH)2 particles that successively release Cu2+ ions (reservoir effect). The wood species used for the European wood decking market differ from the North American SYP. One of the most common species is Norway spruce wood, which is poorly treatable i.e. refractory due to the anatomical properties, like pore size and structure, and chemical composition, like pit membrane components or presence of wood extractives. Therefore, MC formulations may not suitable for refractory wood species common in the European market, despite their good performance in SYP. We evaluated the penetration effectiveness of MC azole (MCA) in easily treatable Scots pine and in refractory Norway spruce wood. We assessed the effectiveness against the Cu-tolerant wood-destroying fungus Rhodonia placenta. Our findings show that MCA cannot easily penetrate refractory wood species and could not confirm the presence of a reservoir effect.

Wettability between TiN,TiC Containing Carbon Composite Refractory and Molten Slag or Hot Metal

Institute of Scientific and Technical Information of China (English)

SHIYue－xun; LIYingand; 等

1994-01-01

In order to develop a new-type TiC-TiN containing carbon composite refractory so as to improve the service life of blast furnace hearth,the wettability between the carbon refractory and molten slag or metal has been mea-sured.It was indicated that the carbon refractory is wet-ted by slag(θ≤90°） when(TiC+TiN)>33.52%,The effects of TiN or TiC on wetting behavior are basi-cally identical.When the amount of TiC in the carbon com-posite refractory is greater than 60% it will be wetted by hot metal;therefore,the carbon composite refractory will be wetted by slag but not permeated by hot metal when the amount of TiC is restricted.

Refractory Coated/Lined Low Density Structures, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — This project addresses the development of refractory coated or lined low density structures applicable for advanced future propulsion system technologies. The...

Refractory Hypertension: Determination of Prevalence, Risk Factors and Comorbidities in a Large, Population-Based Cohort

Science.gov (United States)

Calhoun, David A.; Booth, John N.; Oparil, Suzanne; Irvin, Marguerite R.; Shimbo, Daichi; Lackland, Daniel T.; Howard, George; Safford, Monika M.; Muntner, Paul

2014-01-01

Refractory hypertension is an extreme phenotype of antihypertensive treatment failure. Participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study, a large (n=30,239), population-based cohort were evaluated to determine the prevalence of refractory hypertension and associated cardiovascular risk factors and comorbidities. Refractory hypertension was defined as uncontrolled blood pressure (systolic/diastolic ≥ 140/90 mm Hg) on ≥ 5 antihypertensive drug classes. Participants with resistant hypertension (systolic/diastolic ≥140/90 mm Hg on ≥ 3 orhypertensive participants served as comparator groups. Of 14,809 REGARDS participants receiving antihypertensive treatment, 78 (0.5%) had refractory hypertension. The prevalence of refractory hypertension was 3.6% among participants with resistant hypertension(n=2,144) and 41.7% among participants on 5 or more antihypertensive drug classes. Among all hypertensive participants, African American race, male gender, living in the stroke belt or buckle, higher body mass index, lower heart rate, reduced estimated glomerular filtration rate, albuminuria, diabetes and history of stroke and coronary heart disease were associated with refractory hypertension. Compared to resistant hypertension, prevalence ratios for refractory hypertension were increased for African Americans (3.00, 95% CI 1.68 – 5.37) and those with albuminuria (2.22, 95% CI 1.40 – 3.52) and diabetes (2.09, 95% CI 1.32 – 3.31). The median 10-year Framingham risk for coronary heart disease and stroke was higher among participants with refractory hypertension compared to either comparator group. These data indicate that while resistant hypertension is relatively common among treated hypertensive patients, true antihypertensive treatment failure is rare. PMID:24324035

Super-refractory status epilepticus in West China.

Science.gov (United States)

Tian, L; Li, Y; Xue, X; Wu, M; Liu, F; Hao, X; Zhou, D

2015-07-01

This study aims to determine the general frequency, mortality, and risk factors of super-refractory status epilepticus (SRSE) versus non-refractory status epilepticus (NRSE) and refractory status epilepticus (RSE). This work is a retrospective study. Clinical data of patients who were diagnosed with status epilepticus (SE) in the neurological ward and neuro-intensive care unit of West China Hospital from January 2009 to December 2012 were collected and analyzed. A total of 98 patients were included in the study. The percentages of NRSE, RSE, and SRSE were 67.3%, 20.4%, and 12.2%, respectively. Convulsive SE was the main seizure type among the three groups. The most common cause of NRSE was related to epilepsy (EP). However, 67.7% of SRSE cases were caused by acute encephalitis. Moreover, 47% of SE and 40% of RSE cases had a history of EP, whereas only 8.3% of SRSE cases had such history (P  0.05). The general mortality of SE was 7.1%, whereas that of SRSE was 50%. During follow-up, most SRSE patients who survived have developed symptomatic EP. This study was the first to use the statistical percentage of SRSE. Approximately 12.2% of SE cases will result in SRSE, which is a challenging medical situation for doctors. Patients with first episodes and acute encephalitis were also prone to develop SRSE. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Refractory experience in circulating fluidized bed combustors, Task 7

Energy Technology Data Exchange (ETDEWEB)

Vincent, R.Q.

1989-11-01

This report describes the results of an investigation into the status of the design and selection of refractory materials for coal-fueled circulating fluidized-bed combustors. The survey concentrated on operating units in the United States manufactured by six different boiler vendors: Babcock and Wilcox, Combustion Engineering, Foster Wheeler, Keeler Dorr-Oliver, Pyropower, and Riley Stoker. Information was obtained from the boiler vendors, refractory suppliers and installers, and the owners/operators of over forty units. This work is in support of DOE's Clean Coal Technology program, which includes circulating fluidized-bed technology as one of the selected concepts being evaluated.

Refractory metal component technology for in-core sensor design

International Nuclear Information System (INIS)

Cannon, C.P.

1986-02-01

Within recent years, an increasing concern over reactor safety has prompted tests that characterize reactor core environments during transient conditions. Such tests include the Loss-of-Fluid-Tests (Idaho National Engineering Lab (INEL)), Severe Fuel Damage Tests (INEL), Core Debris Rubble Tests (Sandia National Laboratories (SNL)), and similar tests performed by foreign nations. The in-core sensors for these tests require refractory metal components to be compatible with electrical insulator materials as well as materials comprising highly corrosive service mediums. This paper presents the refractory metal technology utilized to provide basic sensor designs in the above mentioned reactor tests

Mechanical activation of ceramic powders and its influence on the quality of the refractory linings

International Nuclear Information System (INIS)

Ceganac, Z.; Acimovic, Z.; Andric, Lj.; Petrov, M.; Mihajlovic, S.

2003-01-01

In the paper we present results of the investigation of the influence of mechanical activation of ceramic powders-talc and alumina, on the quality of refractory linings for casting applications. It is shown that additional fine grinding of ceramic powders increases the quality of the refractory lining. Grinding and activation of the particles with various granulations contributes to the creation of the homogenous continuous layer of refractory lining on the sand moulds and cores, as well as on the evaporating polystyrene patterns for applications in the Lost foam casting process. Refractory linings obtained within the activation of particles procedure have better adherence to moulds, cores and evaporating patterns. (Original)

High Throughput Drug Sensitivity Assay and Genomics- Guided Treatment of Patients With Relapsed or Refractory Acute Leukemia

Science.gov (United States)

2018-02-28

Acute Leukemia of Ambiguous Lineage; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Refractory Acute Myeloid Leukemia; Refractory Adult Acute Lymphoblastic Leukemia; Refractory Childhood Acute Lymphoblastic Leukemia

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr.; Alireza Rezaie

2003-12-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

Refractory for Black Liquor Gasifiers

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Alireza Rezaie

2003-12-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LFHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

Refractory for Black Liquor Gasifiers

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Alireza Rezaie; Xiaoting Liang; Musa Karakus; Jun Wei

2005-12-01

The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected or developed that reacted with the gasifier environment to form protective surfaces in

Refractory for Black Liquor Gasifiers

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang

2005-10-01

The University of Missouri-Rolla identified materials that permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project was to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study attempted to define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials were selected/developed that either react with the gasifier environment to form protective surfaces in

Refractory for Black Liquor Gasifiers

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick; Musa Karakus; Alireza Rezaie

2004-03-30

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

2004-07-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Alireza Rezaie

2004-10-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

2005-01-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang; Jun Wei

2005-04-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Liang

2005-07-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr.; Alireza Rezaie

2004-04-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the materials problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

Testing Consent Order on Refractory Ceramic Fibers

Science.gov (United States)

This notice announces that EPA has signed signed an enforceable testing consent order under the Toxic Substances Control Act (TSCA), 15 U.S.C. section 2601 at seq., with three of the primary producers of refractory ceramic fibers (RCF).

Improving outcomes of refractory celiac disease – current and emerging treatment strategies

Directory of Open Access Journals (Sweden)

Woodward J

2016-08-01

Full Text Available Jeremy Woodward Department of Gastroenterology and Clinical Nutrition, Addenbrooke’s Hospital, Cambridge, UK Abstract: Intestinal inflammation and symptoms of celiac disease (CD usually respond well to gluten withdrawal, but rare cases are refractory to diet. Two types of refractory CD are discriminated on the basis of the presence or absence of an atypical population of mucosal lymphocytes that may progress to enteropathy-associated T-cell lymphoma. Challenges remain in the secure diagnosis of both types of refractory disease, and evidence on which to base treatment recommendations is flawed by the small numbers of reported patients and the use of different diagnostic strategies. Recent advances in our understanding of the mechanisms of the condition in conjunction with the development of immunomodulatory agents for managing other inflammatory diseases are helping to shape future approaches to targeted therapy. Progression will depend on collaboration and recruitment to trials. In the meantime, there is evidence to suggest that earlier diagnosis and better follow-up and management of CD may prevent the development of refractoriness. Keywords: celiac disease, gluten, small intestine, lymphoma, lymphocytes

NOVEL REFRACTORY MATERIALS FOR HIGH ALKALI, HIGH TEMPERATURE ENVIRONMENTS

Energy Technology Data Exchange (ETDEWEB)

Hemrick, James Gordon [ORNL; Smith, Jeffrey D [ORNL; O' Hara, Kelley [University of Missouri, Rolla; Rodrigues-Schroer, Angela [Minteq International, Inc.; Colavito, [Minteq International, Inc.

2012-08-01

A project was led by Oak Ridge National Laboratory (ORNL) in collaboration with a research team comprised of the academic institution Missouri University of Science and Technology (MS&T), and the industrial company MINTEQ International, Inc. (MINTEQ), along with representatives from the aluminum, chemical, glass, and forest products industries. The project was to address the need for new innovative refractory compositions by developing a family of novel MgO-Al 2O3, MgAl2O4, or other similar spinel structured or alumina-based unshaped refractory compositions (castables, gunnables, shotcretes, etc.) utilizing new aggregate materials, bond systems, protective coatings, and phase formation techniques (in-situ phase formation, altered conversion temperatures, accelerated reactions, etc). This family of refractory compositions would then be tailored for use in high-temperature, high-alkaline industrial environments like those found in the aluminum, chemical, forest products, glass, and steel industries. Both practical refractory development experience and computer modeling techniques were used to aid in the design of this new family of materials. The newly developed materials were expected to offer alternative material choices for high-temperature, high-alkali environments that were capable of operating at higher temperatures (goal of increasing operating temperature by 100-200oC depending on process) or for longer periods of time (goal of twice the life span of current materials or next process determined service increment). This would lead to less process down time, greater energy efficiency for associated manufacturing processes (more heat kept in process), and materials that could be installed/repaired in a more efficient manner. The overall project goal was a 5% improvement in energy efficiency (brought about through a 20% improvement in thermal efficiency) resulting in a savings of 3.7 TBtu/yr (7.2 billion ft3 natural gas) by the year 2030. Additionally, new

Service life prediction for refractory materials

Czech Academy of Sciences Publication Activity Database

Boccaccini, D. N.; Cannio, M.; Volkov-Husović, T. D.; Kamseu, E.; Romagnoli, M.; Veronesi, P.; Leonelli, C.; Dlouhý, Ivo; Boccaccini, A. R.

2008-01-01

Roč. 43, č. 12 (2008), s. 4079-4090 ISSN 0022-2461 R&D Projects: GA ČR(CZ) GA106/05/0495 Institutional research plan: CEZ:AV0Z20410507 Keywords : refractory materials * ultrasonic velocity * fracture toughness Subject RIV: JH - Ceramics, Fire-Resistant Materials and Glass Impact factor: 1.181, year: 2008

Refractory chronic cluster headache

DEFF Research Database (Denmark)

Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H

2014-01-01

Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition...... for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years...

Study on the efficiency of ceramic coating for avoiding oxidation in carbon refractories

International Nuclear Information System (INIS)

Santos, I.M.G.; Cruz Junior, F.; Paskocimas, C.A.; Leite, E.R.; Longo, Elson; Varela, J.A.

1997-01-01

A ceramic coating made of sodium phosphossilicate and clay was developed to the protection of refractories against carbon oxidation during the pre-heating of siderurgical equipment. This search has the objective of comparing the refractory behaviour with and without coating, according to temperature, time and atmosphere. The results show that the coating is more efficient at higher temperatures. An important point is that the efficiency is smaller after long thermal is that the efficiency is smaller after long thermal treatments and at very aggressive conditions. In spite of this the oxidation is still smaller than in refractory without coating. (author)

Iron Refractory Iron Deficiency Anaemia: A Rare Cause of Iron Deficiency Anaemia

LENUS (Irish Health Repository)

McGrath, T

2018-01-01

We describe the case of a 17-month-old boy with a hypochromic microcytic anaemia, refractory to oral iron treatment. After exclusion of dietary and gastrointestinal causes of iron deficiency, a genetic cause for iron deficiency was confirmed by finding two mutations in the TMPRSS6 gene, consistent with a diagnosis of iron-refractory iron deficiency anaemia (IRIDA).

Effects of Temperature, Oxygen Partial Pressure, and Materials Selection on Slag Infiltration into Porous Refractories for Entrained-Flow Gasifiers

Science.gov (United States)

Kaneko, Tetsuya Kenneth

The penetration rate of molten mineral contents (slag) from spent carbonaceous feedstock into porous ceramic-oxide refractory linings is a critical parameter in determining the lifecycle of integrated gasification combined cycle energy production plants. Refractory linings that withstand longer operation without interruption are desirable because they can mitigate consumable and maintenance costs. Although refractory degradation has been extensively studied for many other high-temperature industrial processes, this work focuses on the mechanisms that are unique to entrained-flow gasification systems. The use of unique feedstock mixtures, temperatures from 1450 °C to 1600 °C, and oxygen partial pressures from 10-7 atm to 10-9 atm pose engineering challenges in designing an optimal refractory material. Experimentation, characterization, and modeling show that gasifier slag infiltration into porous refractory is determined by interactions between the slag and the refractory that either form a physical barrier that impedes fluid flow or induce an increased fluid viscosity that decelerates the velocity of the fluid body. The viscosity of the slag is modified by the thermal profile of the refractory along the penetration direction as well as reactions between the slag and refractory that alter the chemistry, and thereby the thermo-physical properties of the fluid. Infiltration experiments reveal that the temperature gradient inherently present along the refractory lining limits penetration. A refractory in near-isothermal conditions demonstrates deeper slag penetration as compared to one that experiences a steeper thermal profile. The decrease in the local temperatures of the slag as it travels deeper into the refractory increases the viscosity of the fluid, which in turn slows the infiltration velocity of fluid body into the pores of the refractory microstructure. With feedstock mixtures that exhibit high iron-oxide concentrations, a transition-metal-oxide, the oxygen

Productivity Costs Decrease After Endoscopic Sinus Surgery for Refractory Chronic Rhinosinusitis

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L.; Mace, Jess C.; Schlosser, Rodney J.; Hwang, Peter H.; Soler, Zachary M.

2015-01-01

Objective The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Study Design Prospective, multi-institutional, observational cohort study. Methods The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time was quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Results 27 patients with refractory CRS who underwent ESS were followed for a mean of 15 [SD 4.0] months (range: 8 – 25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS, $9,097 vs. $3,301, respectively (pproductivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. PMID:26371457

Productivity costs decrease after endoscopic sinus surgery for refractory chronic rhinosinusitis.

Science.gov (United States)

Rudmik, Luke; Smith, Timothy L; Mace, Jess C; Schlosser, Rodney J; Hwang, Peter H; Soler, Zachary M

2016-03-01

The primary objective of this pilot study was to define the change in productivity costs following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Secondary objectives were to identify CRS-related characteristics that may influence the degree of productivity improvement after ESS. Prospective, multi-institutional, observational cohort study. The human capital approach was used to define productivity costs. Annual absenteeism, presenteeism, and lost leisure time were quantified to define annual lost productive time (LPT). LPT was monetized using the annual daily wage rates obtained from the 2012 US Census and the 2013 US Department of Labor statistics. Twenty-seven patients with refractory CRS who underwent ESS were followed for a mean of 15 months (range, 8-25 months). Following ESS, there were improvements in annual absenteeism (22 days reduced to 3 days), annual presenteeism (41 days reduced to 19 days), and annual household days lost (12 days reduced to 6 days). Overall, the preoperative productivity costs were reduced after ESS ($9,190 vs. $3,373, respectively; P productivity is negatively impacted by the presence of CRS. The outcomes from this study provide the first insights into the reduced productivity costs associated with receiving ESS for refractory CRS. Future studies with larger sample sizes will need to validate the results from this pilot study. 2c Laryngoscope, 126:570-574, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

High dose phenobarbitone coma in pediatric refractory status epilepticus; a retrospective case record analysis, a proposed protocol and review of literature.

Science.gov (United States)

Gulati, Sheffali; Sondhi, Vishal; Chakrabarty, Biswaroop; Jauhari, Prashant; Lodha, Rakesh; Sankar, Jhuma

2018-04-01

Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus. Case records of patients, admitted with status epilepticus to the pediatric inpatient services of a tertiary care teaching hospital of North India between January 2014 and December 2016 were reviewed. Those with refractory status epilepticus who failed to respond to midaolam infusion and phenobarbitone coma was used were included for analysis. Overall, 108 children presented in status, of which 34 developed refractory status epilepticus. Of these 34, 21 responded to midazolam infusion and in 13 high dose phenobarbitone coma following a standardised protocol was used. Amongst these 13 (8 males and 5 females, median age 6 years, IQR: 2.5-9.5), 12 responded and 1 succumbed. The median time to clinical seizure resolution and desired electroencephalographic changes post phenobarbitone initiation were 16 (IQR: 12-25) and 72 h (IQR: 48-120) respectively. High dose phenobarbitone appears to be an effective therapeutic modality in pediatric refractory status epilepticus. The current study provides a protocol for its use which can be validated in future studies with larger sample size. Copyright © 2018 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Direct brazing of ceramics, graphite, and refractory metals

International Nuclear Information System (INIS)

Canonico, D.A.; Cole, N.C.; Slaughter, G.M.

1976-03-01

ORNL has been instrumental in the development of brazing filler metals for joining ceramics, graphite, and refractory metals for application at temperatures above 1000 0 C. The philosophy and techniques employed in the development of these alloys are presented. A number of compositions are discussed that have been satisfactorily used to braze ceramics, graphite, and refractory metals without a prior surface treatment. One alloy, Ti--25 percent Cr--21 percent V, has wet and flowed on aluminum oxide and graphite. Further, it has been utilized in making brazes between different combinations of the three subject materials. The excellent flowability of this alloy and alloys from the Ti--Zr--Ge system is evidenced by the presence of filler metal in the minute pores of the graphite and ceramics

Approaches to refractory epilepsy

Directory of Open Access Journals (Sweden)

Jerome Engel

2014-01-01

Full Text Available Epilepsy is one of the most common serious neurological conditions, and 30 to 40% of people with epilepsy have seizures that are not controlled by medication. Patients are considered to have refractory epilepsy if disabling seizures continue despite appropriate trials of two antiseizure drugs, either alone or in combination. At this point, patients should be referred to multidisciplinary epilepsy centers that perform specialized diagnostic testing to first determine whether they are, in fact, pharmacoresistant, and then, if so, offer alternative treatments. Apparent pharmacoresistance can result from a variety of situations, including noncompliance, seizures that are not epileptic, misdiagnosis of the seizure type or epilepsy syndrome, inappropriate use of medication, and lifestyle issues. For patients who are pharmacoresistant, surgical treatment offers the best opportunity for complete freedom from seizures. Surgically remediable epilepsy syndromes have been identified, but patients with more complicated epilepsy can also benefit from surgical treatment and require more specialized evaluation, including intracranial EEG monitoring. For patients who are not surgical candidates, or who are unwilling to consider surgery, a variety of other alternative treatments can be considered, including peripheral or central neurostimulation, ketogenic diet, and complementary and alternative approaches. When such alternative treatments are not appropriate or effective, quality of life can still be greatly improved by the psychological and social support services offered by multidisciplinary epilepsy centers. A major obstacle remains the fact that only a small proportion of patients with refractory epilepsy are referred for expert evaluation and treatment.

Refractory overactive bladder: Beyond oral anticholinergic therapy

Science.gov (United States)

Glinski, Ronald W.; Siegel, Steven

2007-01-01

Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB) that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS), have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or without

Refractory overactive bladder: Beyond oral anticholinergic therapy

Directory of Open Access Journals (Sweden)

Ronald W Glinski

2007-01-01

Full Text Available Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS, have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or

Development of diagnosis and repair system for steelmaking refractories; Seikoyo taikabutsu no shindan hoshu gijutsu no kakuritsu

Energy Technology Data Exchange (ETDEWEB)

Aso, S.; Harada, S.; Tsutsui, Y. [Nippon Steel Corp., Tokyo (Japan)

1996-06-01

The latest measurement equipment and repair method were introduced into the work area of all refractories in the process of torpedo cars, hot metal preliminary treatment, hot metal pans, secondary refining, and cast pans so as to improve the cost of the newest advanced steelmaking refractories. As a result, the refractory cost could be reduced by 10%. This paper introduces the improvement in RH refractories and refractories for hot metal preliminary treatment. As for basic items, in addition to the visual observation, the thickness of refractories was quantified using equipment (laser profile meter, thermotracer, and NS sensor) for the furnace stop in the minimum remaining length. An ITV was also installed in the facilities where the visual check is difficult to carry out. Repair is mainly done by spraying. A thermal spraying repair method with high durability was used for the repair. A method that relieves a thermal shock was used for preheating. Moreover, measures that make the temperature gradient in the thickness direction uniform by using newly developed microwave drying equipment were taken for drying of unburned refractories. 4 refs., 13 figs., 2 tabs.

Bone hydatid disease refractory to nitazoxanide treatment

NARCIS (Netherlands)

Schipper, Hans G.; Simsek, Suat; van Agtmael, Michiel A.; van Lienden, Krijn P.

2009-01-01

We report a patient with bone hydatid disease that was refractory to both long-term daily treatment with albendazole, combined with cimetidine or administered as monotherapy ( approximately 15 years) and a relatively short course of nitazoxanide combined with albendazole (3 months). Despite

Polyethylene (PE) based proton exchange membrane for use in fuel cell

International Nuclear Information System (INIS)

Moraes, Gilberto de Oliveira

2008-01-01

The irradiation - induced graft of styrene onto polyethylene (PE) in a Cobalt-60 source was carried out using direct (simultaneous) and indirect (preirradiation and peroxidation) methods at room temperature. The dose applied in both cases varied from 0,5 to 80 kGy; In the direct method, the films were immersed in a solution of styrene: methanol (30:70 v/v) and 30% of sulfuric acid(additive) in glass ampoules of 40 ml under inert atmosphere, and then irradiated. After irradiation process, the samples were kept in solution for 8 hours and taken off the ampoules, dried in oven at 60 deg C for another 8 hour period until constant weight. In pre-irradiation method, the samples were irradiated in dry and sealed ampoules, under inert atmosphere. The solution was then added to the samples, and after 8 hours, taken off, dried, sealed and weighted. In peroxidation method, the difference was not inert atmosphere but atmosphere of air (0 2 ).For each samples it was calculated the degree of grafting (DOG). The samples that showed some DOG were sulfonated, characterized (DSC, TGA and infrared) and the ion exchange capacity (IEC) was calculated. The samples processed by indirect method presented no DOG at all. The samples processed by direct method present grafting (best result was 80 kGy). These samples, after sulfonated, presented ion exchange properties. (author)

Toll-like receptor 2 expression in refractory periapical lesions.

Science.gov (United States)

Desai, S V; Love, R M; Rich, A M; Seymour, G J

2011-10-01

To investigate the expression of TLR2 in refractory periapical lesions. Refractory periapical lesion biopsies were histopathologically and clinically categorized into asymptomatic periapical granuloma (n=10), symptomatic periapical granuloma (n=10) or periapical cyst (n=10) and prepared for immunohistochemical staining using antibodies to TLR2, CD3 and CD19 or staining with methyl green pyronin. Sections were viewed under light microscopy and the presence or absence of the target cells was correlated with the histopathological and clinical data. Additionally, TLR2 expression was quantified by counting TLR(+) cells. Various mononuclear inflammatory cells in the bacteria-induced periapical lesions were reactive to TLR2 antibody, with many showing morphological similarities to lymphocytes and plasma cells. Lymphocytes were the most numerous cells in the inflammatory infiltrate. In refractory periapical granuloma, CD3(+) T cells were more numerous, whereas in periapical cysts, CD19(+) B cells were more numerous. There was a statistically significant (Pperiapical granuloma than asymptomatic periapical granuloma or periapical cyst. The presence of TLR-expressing cells in periapical granulomas and cysts provides further evidence that periapical cysts are likely to be sustained by the immune system via reaction to bacterial antigens. © 2011 International Endodontic Journal.

Morphometric brain characterization of refractory obsessive-compulsive disorder: diffeomorphic anatomic registration using exponentiated Lie algebra.

Science.gov (United States)

Tang, Wanjie; Li, Bin; Huang, Xiaoqi; Jiang, Xiaoyu; Li, Fei; Wang, Lijuan; Chen, Taolin; Wang, Jinhui; Gong, Qiyong; Yang, Yanchun

2013-10-01

Few studies have used neuroimaging to characterize treatment-refractory obsessive-compulsive disorder (OCD). This study sought to explore gray matter structure in patients with treatment-refractory OCD and compare it with that of healthy controls. A total of 18 subjects with treatment-refractory OCD and 26 healthy volunteers were analyzed by MRI using a 3.0-T scanner and voxel-based morphometry (VBM). Diffeomorphic anatomical registration using exponentiated Lie algebra (DARTEL) was used to identify structural changes in gray matter associated with treatment-refractory OCD. A partial correlation model was used to analyze whether morphometric changes were associated with Yale-Brown Obsessive-Compulsive Scale scores and illness duration. Gray matter volume did not differ significantly between the two groups. Treatment-refractory OCD patients showed significantly lower gray matter density than healthy subjects in the left posterior cingulate cortex (PCC) and mediodorsal thalamus (MD) and significantly higher gray matter density in the left dorsal striatum (putamen). These changes did not correlate with symptom severity or illness duration. Our findings provide new evidence of deficits in gray matter density in treatment-refractory OCD patients. These patients may show characteristic density abnormalities in the left PCC, MD and dorsal striatum (putamen), which should be verified in longitudinal studies. © 2013. Published by Elsevier Inc. All rights reserved.

Performance of refractory alloy-clad fuel pins

International Nuclear Information System (INIS)

Dutt, D.S.; Cox, C.M.; Millhollen, M.K.

1984-12-01

This paper discusses objectives and basic design of two fuel-cladding tests being conducted in support of SP-100 technology development. Two of the current space nuclear power concepts use conventional pin type designs, where a coolant removes the heat from the core and transports it to an out-of-core energy conversion system. An extensive irradiation testing program was conducted in the 1950's and 1960's to develop fuel pins for space nuclear reactors. The program emphasized refractory metal clad uranium nitride (UN), uranium carbide (UC), uranium oxide (UO 2 ), and metal matrix fuels (UCZr and BeO-UO 2 ). Based on this earlier work, studies presented here show that UN and UO 2 fuels in conjunction with several refractory metal cladding materials demonstrated high potential for meeting space reactor requirements and that UC could serve as an alternative but higher risk fuel

Medical versus surgical treatment for refractory or recurrent peptic ulcer.

Science.gov (United States)

Gurusamy, Kurinchi Selvan; Pallari, Elena

2016-03-29

Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to 12 weeks of medical treatment or those that are associated with complications despite medical treatment. Recurrent peptic ulcers are peptic ulcers that recur after healing of the ulcer. Given the number of deaths due to peptic ulcer-related complications and the long-term complications of medical treatment (increased incidence of fracture), it is unclear whether medical or surgical intervention is the better treatment option in people with recurrent or refractory peptic ulcers. To assess the benefits and harms of medical versus surgical treatment for people with recurrent or refractory peptic ulcer. We searched the specialised register of the Cochrane Upper GI and Pancreatic Diseases group, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and trials registers until September 2015 to identify randomised trials and non-randomised studies, using search strategies. We also searched the references of included studies to identify further studies. We considered randomised controlled trials and non-randomised studies comparing medical treatment with surgical treatment in people with refractory or recurrent peptic ulcer, irrespective of language, blinding, or publication status for inclusion in the review. Two review authors independently identified trials and extracted data. We planned to calculate the risk ratio, mean difference, standardised mean difference, or hazard ratio with 95% confidence intervals using both fixed-effect and random-effects models with Review Manager 5 based on intention-to-treat analysis. We included only one non-randomised study published 30 years ago in the review. This study included 77 participants who had gastric ulcer and in whom medical therapy (histamine H2 receptor blockers, antacids, and diet) had failed after an average duration of treatment of 29 months. The

Sorption techniques for production of high purity refractory metals

International Nuclear Information System (INIS)

Shatalov, V.V.; Peganov, V.A.; Logvinenko, I.A.; Molchanova, T.V.

2004-01-01

A consideration is given to potentialities of sorption processes tot provide a high quality of refractory metal and their alloys when using hydrometallurgical methods for raw material processing. The efficiency of application of ion exchange technology is shown for complex solutions reprocessing for various types of polymetallic raw materials, among them uranium ores, enriched concentrates of refractory metal ores, intermediate products, waste solutions. Based on investigation results on the behaviour of elements in process solutions and the mechanism of their sorption and elution, the process of pure chemical compounds production are developed which provide thereafter manufacturing compact metals. The flowsheets developed are mastered on a commercial scale [ru

Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia.

Science.gov (United States)

Akin, M; Sarbay, H; Guler, S; Balci, Y I; Polat, A

2016-04-01

We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia. This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study. Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis. © 2016 John Wiley & Sons Ltd.

Low-temperature plasma spheroidizing of polydisperse powders of refractory materials

International Nuclear Information System (INIS)

Tsymbalist, M.M.; Rudenskaya, N.A.; Kuz'min, B.P.; Pan'kov, V.A.

2003-01-01

A model is developed for heating and melting of a spherical particle, when powder processing in low temperature plasma, with the aim of estimation of the dependence of the degree of fusion on particle size for various materials. Spheroidizing of various refractory material powders close in shape and size composition is experimentally performed. Experimental and calculation estimates of spheroidizing criteria for the materials studied are in a satisfactory agreement. The influence of basic physical properties of refractory materials and plasma processing parameters on the degree of particle spheroidizing is analyzed [ru

Colonic exclusion and combined therapy for refractory constipation.

Science.gov (United States)

Peng, Hong-Yun; Xu, Ai-Zhong

2006-12-28

To investigate the therapeutic effectiveness of colonic exclusion and combined therapy for refractory constipation. Thirty-two patients with refractory constipation were randomly divided into treatment group (n = 14) and control group (n = 18). Fourteen patients in treatment group underwent colonic exclusion and end-to-side colorectal anastomosis. Eighteen patients in control group received subtotal colectomy and end-to-end colorectal anastomosis. The therapeutic effects of the operations were assessed by comparing the surgical time, incision length, volume of blood losses, hospital stay, recovery rate and complication incidence. All patients received long-term follow-up. All operations were successful and patients recovered fully after the operations. In comparison of treatment group and control group, the surgical time (h), incision length (cm), volume of blood losses (mL), hospital stay (d) were 87 +/- 16 min vs 194 +/- 23 min (t = 9.85), 10.4 +/- 0.5 cm vs 21.2 +/- 1.8 cm (t = 14.26), 79.5 +/- 31.3 mL vs 286.3 +/- 49.2 mL (t = 17.24), and 11.8 +/- 2.4 d vs 18.6 +/- 2.6 d (t = 6.91), respectively (P 0.05), 21.4% vs 33.3% (P = 0.73 > 0.05), respectively. Colonic exclusion has better therapeutic efficacy on refractory constipation. It has many advantages such as shorter surgical time, smaller incision, fewer blood losses and shorter hospital stay.

Lightweight cordierite–mullite refractories with low coefficients of ...

Indian Academy of Sciences (India)

of thermal conductivity and high mechanical properties ... compositions and microstructures of lightweight refractories were measured by X-ray .... of matrices were determined by calibration with EDAX ZAF .... Guzman I Ya 2003 Glass Ceram.

Testing refractory concretes and filling masses using laboratory gas dynamic bench

International Nuclear Information System (INIS)

Delkin, E.Ya.; Krasnikov, A.V.; Kurtepova, O.I.; Chubarov, Yu.I.

1983-01-01

Heat resistance of cylindrical models of refractory concretes on the base of different binding and filling masses at one-side heating is investigated. Heat resistance has been estimated by residual tensile strength. Concrete on the base of barium zirconate is shown to have the highest heat resistance. The effect of relation of the diameter and height of cylindrical samples on the value of thermal stresses arising at one-side heating is displayed on the example of concrete on phosphate binding. Tests of binding mass on the base of ZrO 2 reinforced with metallic honeycombs have revealed that use of copper honeycomb frame in elements of the design operating under the effect of strong thermal flows is rather effective

Treatment patterns, health state, and health care resource utilization of patients with radioactive iodine refractory differentiated thyroid cancer

International Nuclear Information System (INIS)

Gianoukakis, Andrew G; Flores, Natalia M; Pelletier, Corey L; Forsythe, Anna; Wolfe, Gregory R; Taylor, Matthew H

2016-01-01

Patients with differentiated thyroid cancer (DTC) often respond well to treatment but some become refractory to radioactive iodine (RAI) treatment, and treatment options are limited. Despite the humanistic and economic burden RAI refractory disease imposes on patients, published research concerning treatment patterns and health care resource utilization is sparse. Data were collected from an online retrospective chart review study in the US and five European Union (EU) countries (France, Germany, Italy, Spain, and UK) with physicians recruited from an online panel. Physicians (N=211) provided demographics, disease history, treatment information, and health care resource utilization for one to four of their patients with radioactive iodine refractory differentiated thyroid cancer (RR-DTC). The majority of the patients with RR-DTC (N=623) were female (56%), and their mean age was 58.2 years. In this sample, 63.2% had papillary thyroid cancer and 57.0% were in Stage IV when deemed RAI refractory. Patients with RR-DTC experienced regional recurrence in the thyroid bed/central neck area (25.3%) and had distant metastatic disease (53.6%). At the time data were collected, 50.7% were receiving systemic treatment. Of those, 78.5% were on first-line treatment and 62.7% were receiving multikinase inhibitors. Regional differences for prescribed treatments were observed; the US was more likely to have patients receiving multikinase inhibitors (79.2%) compared with UK (41.2%) and Italy (17.1%). Additional details regarding treatment patterns and resource utilization are discussed. The current study aimed to obtain a greater understanding of RR-DTC treatment globally. These results can assist in the development and implementation of treatment guidelines and ultimately enhance the care of patients with RR-DTC

Antipsychotic Polypharmacy in a Treatment-Refractory Schizophrenia Population Receiving Adjunctive Treatment With Electroconvulsive Therapy

DEFF Research Database (Denmark)

Kristensen, Diana; Hageman, Ida; Bauer, Jeanett

2013-01-01

Antipsychotic polypharmacy (APP) is frequent, but its pattern is unknown in treatment-refractory schizophrenia-spectrum patients receiving electroconvulsive therapy (ECT).......Antipsychotic polypharmacy (APP) is frequent, but its pattern is unknown in treatment-refractory schizophrenia-spectrum patients receiving electroconvulsive therapy (ECT)....

Hydration of refractory cements, with spinel phase generated in-situ

International Nuclear Information System (INIS)

Lavat, A.E; Grasselli, M.C; Giuliodori Lovecchio, E

2008-01-01

High alumina refractory materials with additions of synthetic spinel (MgAl 2 O 4 ) have good thermo mechanical and attack from slag properties, which are useful in many technological applications. The spinel phase generated in-situ, MA, has proven to be a suitable and economic alternative to the use of sintered or electrocast spinels. Prior studies have established synthesis conditions for refractory cements with the spinel phase generated in-situ (CCAMA) starting with alumina mixtures and Buenos Aires dolomites. The binding properties of the aluminous cements depend on the hydrated calcium aluminates that form in the setting and hardening stages of the pastes. To avoid breaks, the refractory material must undergo programmed heating before reaching the serviceable temperature. It should also include the present phases and the transformations that occur at different temperatures. In this context knowledge about the green mineral composition and its response to an increase in temperature is especially important. This work presents studies to define the composition of CCAMA cement mortars at different hydration ages, and to estimate phase proportions and behavior during dehydration. DRX and FTIR techniques are applied in order to follow the structural changes that take place during the hydration process. The evolution of the dehydration is also studied, mostly using FTIR. The mortars were prepared with a water/cement ration of 0.5, recommended for this kind of work. The hydration was carried out at room temperature and samples were analyzed at the following ages: 15 min.; 1 h.; 1, 3, 7, 14, 28, 60 and 90 days. With the results the evolution of the phases as a function of the age of the hydration were studied. The main hydrate that was formed was CAH 10 , with a significantly increased proportion during the first 14 days of hydration. Its carbonation was also observed by the presence of calcium carboaluminates and the formation of gibbsite. The MA phase is also

A comparative study of the density of defect states in bulk samples ...

Indian Academy of Sciences (India)

1. Introduction. Numerous potential applications of chalcogenide glasses are proposed in the civil, medi- cal and military areas [1–6]. ... rapidly by removing the ampoule from the furnace and dropping it to ice-cooled water. 2.2 Preparation of pellets and thin films. The glassy alloys of Se90Sb10 thus prepared are ground to a ...

Morphological differentiation of severe aplastic anaemia from hypocellular refractory cytopenia of childhood

DEFF Research Database (Denmark)

Baumann, Irith; Führer, Monika; Behrendt, Sonja

2012-01-01

To evaluate the reproducibility and reliability of the histomorphological criteria differentiating severe aplastic anaemia (SAA) and hypoplastic refractory cytopenia of childhood (RCC), the most frequently acquired hypocellular bone marrow conditions of childhood.......To evaluate the reproducibility and reliability of the histomorphological criteria differentiating severe aplastic anaemia (SAA) and hypoplastic refractory cytopenia of childhood (RCC), the most frequently acquired hypocellular bone marrow conditions of childhood....

Advances in multidisciplinary individualized treatment of refractory hepatic alveolar echinococcosis

Directory of Open Access Journals (Sweden)

ABUDUAINI Abulizi

2015-04-01

Full Text Available Hepatic alveolar echinococcosis (HAE is a zoonotic parasitic disease that seriously threatens the population in western China and compromises patients′ quality of life. With the continuous improvement in radical resection rate in recent years, late-stage HAE patients that were incurable in the past now have the opportunity for radical resection. However, patients who are not suitable candidates for radical resection still suffer from various complications and poor quality of life. Therefore, HAE is still considered a refractory and complex disease. The simple empirical treatment model provided by traditional professional discussion is unable to satisfy the treatment of advanced refractory HAE as it is unable to integrate specialized, standardized clinical skills for diagnosis and treatment. Multidisciplinary individualized treatment (MDT organically integrates the advantages of the available treatment into a reasonable individualized comprehensive treatment regimen. This review summarizes the advances in MDT for HAE as the best option to increase long-term survival, and suggests MDT as the first-line treatment for late-stage refractory hepatic alveolar echinococcosis.

Immunomodulatory therapy in refractory/recurrent ovarian cancer

Directory of Open Access Journals (Sweden)

Chao-Yu Chen

2015-04-01

Conclusion: IMT alone or add-on to palliative/salvage chemotherapy for refractory/recurrent EOC achieves a substantial disease stabilizing rate without severe toxicity, which might be a potential option in selected patients. The ALC 1 month after IMT could be an early indicator to disease stabilization.

Decision Making during the Psychological Refractory Period

NARCIS (Netherlands)

Zylberberg, Ariel; Ouellette, Brian; Sigman, Mariano; Roelfsema, Pieter R.

2012-01-01

In spite of its massively parallel architecture [1], the human brain is fundamentally limited if required to perform two tasks at the same time [2, 3]. This limitation can be studied with the psychological refractory period (PRP) paradigm, where two stimuli that require speeded responses occur in

Acute and chronic changes in brain activity with deep brain stimulation for refractory depression.

Science.gov (United States)

Conen, Silke; Matthews, Julian C; Patel, Nikunj K; Anton-Rodriguez, José; Talbot, Peter S

2018-04-01

Deep brain stimulation is a potential option for patients with treatment-refractory depression. Deep brain stimulation benefits have been reported when targeting either the subgenual cingulate or ventral anterior capsule/nucleus accumbens. However, not all patients respond and optimum stimulation-site is uncertain. We compared deep brain stimulation of the subgenual cingulate and ventral anterior capsule/nucleus accumbens separately and combined in the same seven treatment-refractory depression patients, and investigated regional cerebral blood flow changes associated with acute and chronic deep brain stimulation. Deep brain stimulation-response was defined as reduction in Montgomery-Asberg Depression Rating Scale score from baseline of ≥50%, and remission as a Montgomery-Asberg Depression Rating Scale score ≤8. Changes in regional cerebral blood flow were assessed using [ 15 O]water positron emission tomography. Remitters had higher relative regional cerebral blood flow in the prefrontal cortex at baseline and all subsequent time-points compared to non-remitters and non-responders, with prefrontal cortex regional cerebral blood flow generally increasing with chronic deep brain stimulation. These effects were consistent regardless of stimulation-site. Overall, no significant regional cerebral blood flow changes were apparent when deep brain stimulation was acutely interrupted. Deep brain stimulation improved treatment-refractory depression severity in the majority of patients, with consistent changes in local and distant brain regions regardless of target stimulation. Remission of depression was reached in patients with higher baseline prefrontal regional cerebral blood flow. Because of the small sample size these results are preliminary and further evaluation is necessary to determine whether prefrontal cortex regional cerebral blood flow could be a predictive biomarker of treatment response.

Ways to improve physical and thermal performance of refractory lining materials

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Khlystov A.I.

2017-01-01

Full Text Available Refractory lining materials, which include ceramic refractories and nonfired heat-resistant concretes, have a very short lifespan during the turnaround time measured in years and sometimes months. Therefore, increasing the service life of thermal generating units by 1.5-2 times will bring significant economic benefits. The main factor that determines the durability of refractory lining materials is the thermal resistance. It is possible to increase the thermal resistance by improving such physical and mechanical properties as strength and density. As for the ceramic refractory performance improvement, such technological methods as their structural and chemical modification by phosphate binder impregnation, as well as introduction of phosphate components into the ceramic batches during the molding process increase, in particular, their thermal stability. The use of aluminous and high-alumina cements contributes to a significant increase of not only strength, but also physical and thermal performance of heat-resistant concretes with different fillers. Switching to the use of chemical binders in the compositions of heat-resistant concretes (liquid glass with effective hardeners; silicate-block and phosphate binders enables to develop high-heat resistant materials which do not soften in a wide range of heating temperatures from 400 °С to 1600 °С. The positive results on increasing the thermal resistance of heat-resistant composites can be obtained by reinforcing them with high temperature fibers.

CAR-T cells and allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia.

Science.gov (United States)

Liu, Jun; Zhang, Xi; Zhong, Jiang F; Zhang, Cheng

2017-10-01

Relapsed/refractory acute lymphoblastic leukemia (ALL) has a low remission rate after chemotherapy, a high relapse rate and poor long-term survival even when allogeneic hematopoietic stem cell transplantation (allo-HSCT) is performed. Chimeric antigen receptors redirected T cells (CAR-T cells) can enhance disease remission with a favorable outcome for relapsed/refractory ALL, though some cases quickly relapsed after CAR-T cell treatment. Thus, treatment with CAR-T cells followed by allo-HSCT may be the best way to treat relapsed/refractory ALL. In this review, we first discuss the different types of CAR-T cells. We then discuss the treatment of relapsed/refractory ALL using only CAR-T cells. Finally, we discuss the use of CAR-T cells, followed by allo-HSCT, for the treatment of relapsed/refractory ALL.

Rate of primary refractory disease in B and T-cell non-Hodgkin's lymphoma: correlation with long-term survival.

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Corrado Tarella

Full Text Available BACKGROUND: Primary refractory disease is a main challenge in the management of non-Hodgkin's Lymphoma (NHL. This survey was performed to define the rate of refractory disease to first-line therapy in B and T-cell NHL subtypes and the long-term survival of primary refractory compared to primary responsive patients. METHODS: Medical records were reviewed of 3,106 patients who had undergone primary treatment for NHL between 1982 and 2012, at the Hematology Centers of Torino and Bergamo, Italy. Primary treatment included CHOP or CHOP-like regimens (63.2%, intensive therapy with autograft (16.9%, or other therapies (19.9%. Among B-cell NHL, 1,356 (47.8% received first-line chemotherapy with rituximab. Refractory disease was defined as stable/progressive disease, or transient response with disease progression within six months. RESULTS: Overall, 690 (22.2% patients showed primary refractory disease, with a higher incidence amongst T-cell compared to B-cell NHL (41.9% vs. 20.5%, respectively, p<0.001. Several other clinico-pathological factors at presentation were variably associated with refractory disease, including histological aggressive disease, unfavorable clinical presentation, Bone Marrow involvement, low lymphocyte/monocyte ration and male gender. Amongst B-cell NHL, the addition of rituximab was associated with a marked reduction of refractory disease (13.6% vs. 26.7% for non-supplemented chemotherapy, p<0.001. Overall, primary responsive patients had a median survival of 19.8 years, compared to 1.3 yr. for refractory patients. A prolonged survival was consistently observed in all primary responsive patients regardless of the histology. The long life expectancy of primary responsive patients was documented in both series managed before and after 2.000. Response to first line therapy resulted by far the most predictive factor for long-term outcome (HR for primary refractory disease: 16.52, p<0.001. CONCLUSION: Chemosensitivity to primary

Clinical observation on Ahmed glaucoma valve implantation for teenagers with refractory glaucoma

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Dong-Dao Song

2016-06-01

Full Text Available AIM:To observe the clinical effect of Ahmed glaucoma valve(AGVimplantation for teenagers with refractory glaucoma. METHODS: Twenty-seven patients(27 eyeswith refractory glaucoma were treated with AGV implantation in our hospital from October 2012 to October 2014. The patients were followed up for 12mo. The success rate of the operation, postoperative intraocular pressure, the best corrected visual acuity, as well as complications were recorded. RESULTS: The success rate of the operation was 85%. The intraocular pressure of the 27 patients decreased from 48.3±8.3mmHg before operations to 21.4±8.1mmHg(PPCONCLUSION: AGV implantation is characterized by a high success rate, simple operation, less complications and is an effective treatment for refractory glaucoma in adolescents.

Corrosion of K-3 glass-contact refractory in sodium-rich aluminosilicate melts

International Nuclear Information System (INIS)

Lu, X.D.; Gan, H.; Buechele, A.C.; Pegg, I.L.

1999-01-01

The corrosion of the glass-contact refractory Monofrax K-3 in two sodium-rich aluminosilicate melts has been studied at 1,208 and 1,283 C using a modified ASTM procedure with constant agitation of the melt by air bubbling. The results for the monolithic refractory indicate a fast initial stage involving phase dissolution and transformation and a later passivated stage in which the surface of the refractory has been substantially modified. The composition of the stable spinel phase in the altered layer on monolithic coupons of K-3 is almost identical to the equilibrium composition bracketed by the dissolution of powdered K-3 into under-saturated melts on the other. The temperature and melt shear viscosity were found to have significant effects on the rates of K-3 dissolution and transformation

A retrospective study on the management of patients with rituximab refractory follicular lymphoma.

Science.gov (United States)

Solal-Céligny, Philippe; Leconte, Pierre; Bardet, Aurélie; Hernandez, Juana; Troussard, Xavier

2018-01-01

Given that there are currently no clear recommendations regarding therapeutic options for rituximab refractory/relapsed follicular lymphoma patients, this study aimed to describe the real-life management of patients with refractory follicular lymphoma after systemic rituximab-containing regimens (rFL), and rFL patient characteristics. In this retrospective, national, multicentre study, descriptive analyses were mainly performed according to rituximab-containing regimen at rFL diagnosis [rituximab monotherapy (R-MONO), rituximab + chemotherapy (R-COMBO), and ongoing rituximab maintenance (R-MAINTAIN)]. The 459 analysed patients experienced rituximab-refractoriness between October 2013 and September 2015: R-MONO: 58 (13%), R-COMBO: 197 (43%), R-MAINTAIN: 204 (44%). Post-refractoriness strategies were heterogeneous: idelalisib ± rituximab (22%), without anti-lymphoma treatment (21%), rituximab-chemotherapy (21%) and stem cell transplantation (18%). Rituximab was continued in combination in 41% of cases. Chosen strategies varied according to patient age (without anti-lymphoma treatment: 28% of patients if ≥65 years vs. 12% if management and for the design of clinical trials in these patients. © 2017 John Wiley & Sons Ltd.

New applications and novel processing of refractory metal alloys

International Nuclear Information System (INIS)

Briant, C.L.

2001-01-01

Refractory metals have often been limited in their application because of their propensity to oxidize and to undergo a loos of yield strength at elevated temperatures. However, recent developments in both processing and alloy composition have opened the possibility that these materials might be used in structural applications that were not considered possible in the past. At the same time, the use of refractory metals in the electronics industry is growing, particularly with the use of tantalum as a diffusion barrier for copper metallization. Finally, the application of grain boundary engineering to the problem of intergranular fracture in these materials may allow processes to be developed that will produce alloys with a greater resistance to fracture. (author)

Classical management of refractory adult immune (idiopathic) thrombocytopenic purpura.

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McMillan, R

2002-03-01

Treatment of chronic immune (idiopathic) thrombocytopenic purpura with corticosteroids and/or splenectomy results in safe platelet counts in over 70% of patients without additional treatment. Therapy of patients who are refractory to these two treatments may be difficult. The treatment approach to refractory ITP patients, described in this report, is arbitrarily divided into four levels: levels 1 through 3 represent treatments with increasing side effects; level 4 therapy may be tried when the others have failed. Patients undergoing these treatments may require concomitant intravenous gammaglobulin, high-dose corticosteroids or platelets, to maintain the platelet count in the setting of mucosal bleeding or severe thrombocytopenia. Copyright 2002, Elsevier Science Ltd. All rights reserved.

Respiratory assessment of refractory ceramic fibers in a heating technician population.

Science.gov (United States)

Lucas, David; Clamagirand, Vincent; Capellmann, Pascale; Hervé, Agnès; Mauguen, Gilles; Le Mer, Yannik; Jegaden, Dominique

2018-04-01

Refractory ceramic fibers (RCF) have been extensively used for insulation in condensing boilers. The aim of this study was to evaluate the respiratory exposure to these fibers among maintenance heating technicians. We first created a working group (Carsat Brittany and Finistère Occupational Health Services) and carried out a sampling strategy. Atmospheric measurements were done during work tasks, and filters were analyzed by phase contrast microscopy (PCM) and scanning electron microscopy (SEM) in French approved laboratories. Four companies were included for a total of 15 days of work. During those 15 workdays, 12 SEM and 21 PCM samples were taken and analyzed. The phase contrast microscopy and SEM average results were 0.04 and 0.004 fibers/cm 3 , respectively. In conclusion, the study confirms heating technician RCF respiratory exposure during maintenance work for both condensation gas boilers and atmospheric boilers. Collective and individual prevention measures should be implemented along with appropriate medical follow-up.

Refractory Septic Shock Treated with Nephrectomy under the Support of Extracorporeal Membrane Oxygenation

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Young Kun Lee

2015-08-01

Full Text Available Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN, for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.

Thermionic emission of cermets made of refractory carbides

International Nuclear Information System (INIS)

Samsonow, G.W.; Bogomol, I.W.; Ochremtschuk, L.N.; Podtschernjajewa, I.A.; Fomenko, W.S.

1975-01-01

In order to improve the resistance to thermal variations of refractory carbides having good behavior for thermionic emission, they have been combined with transition metals d. Thermionic emission was studied with cermets in compact samples. Following systems were examined: TiC-Nb, TiC-Mo, TiC-W, ZrC-Nb, ZrC-Mo, ZrC-W, WC-Mo with compositions of: 75% M 1 C-25% M 2 , 50%M 1 C-50%M 2 , 25%M 1 C-75%M 2 . When following the variation of electron emission energy phi versus the composition, it appears that in the range of mixed crystals (M 1 M 2 )C, phi decreases and the resistance to thermal variations of these phases is higher than that of individual carbides. The study of obtained cermets shows that their resistance to thermal variations is largely superior to the one of starting carbides; TiC and ZrC carbides, combined with molybdenum and tungsten support the highest number of thermic cycles

Iatrogenic colorectal Kaposi sarcoma complicating a refractory ...

African Journals Online (AJOL)

Kaposi sarcoma is a mesenchymal tumor associated to a human herpes virus-8. It often occurs in human immunodeficiency virus-positive subjects. Colorectal localization is rare. We report the case of a colorectal Kaposi sarcoma complicating a refractory ulcerative colitis treated with surgery after the failure of ...

Efficacy and Safety of Rituximab in Children with Refractory Nephrotic Syndrome; A Multicenter Clinical Trial

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Yo Han Ahn

2014-06-01

Conclusions: In this interim analysis of clinical trial to evaluate the efficacy and safety of RTX in children with refractory NS, RTX treatment for refractory NS was safe and effective, especially in patients with DNS.

Evaluation of nutritional status in children with refractory epilepsy.

Science.gov (United States)

Bertoli, S; Cardinali, S; Veggiotti, P; Trentani, C; Testolin, G; Tagliabue, A

2006-04-26

children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 +/- 3,2 years; Body Mass Index 15,7 +/- 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) x 100] was nutritional assessment and management as part of their overall care.

Adalimumab for the treatment of refractory noninfectious paediatric uveitis.

Science.gov (United States)

Muñoz-Gallego, Alicia; Barral, Estefanía; Enríquez, Eugenia; Tejada, Pilar; Barceló, Ana; de Inocencio, Jaime

2017-06-01

To report the experience of our center with the use of adalimumab (ADA) for the treatment of severe refractory noninfectious paediatric uveitis. The study is a retrospective case series of all paediatric patients with refractory uveitis who were treated with ADA at the Paediatric Uveitis Unit of our center from 2008 to 2015. We present 12 patients (6 Juvenile idiopathic arthritis-associated uveitis, 4 idiopathic panuveitis, 1 early-onset sarcoidosis-associated panuveitis, and 1 intermediate uveitis), with uveitis in 19/24 eyes. Once ADA therapy was started, all the patients presented improved activity according to Standardization of Uveitis Nomenclature (SUN) criteria. Nine out of the 12 patients had structural damage before ADA could be started: cataract (n = 4), glaucoma (n = 2), cystic macular edema (n = 1), exudative retinal detachment (n = 1), and optic disk edema (n = 5). Visual acuity improved or maintained stable in 17/19 affected eyes, and only 2 eyes decreased its visual acuity because of structural damage, which was already present before ADA therapy. In our experience, ADA presents a good safety profile and is efficacious in the treatment of paediatric patients with different forms of refractory noninfectious uveitis.

Evaluation of nutritional status in children with refractory epilepsy

Science.gov (United States)

Bertoli, S; Cardinali, S; Veggiotti, P; Trentani, C; Testolin, G; Tagliabue, A

2006-01-01

Background children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy. Methods 17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 ± 3,2 years; Body Mass Index 15,7 ± 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age. Results 40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) × 100] was nutritional assessment and management as part of their overall care. PMID:16640779

Refractory metal particles in refractory inclusions in the Allende meteorite

International Nuclear Information System (INIS)

Fuchs, L.H.; Blander, M.

1980-01-01

An examination of refractory metal particles in five calcium-aluminum-rich inclusions in the Allende meteorite indicates a complex variety of compositions and large departures from equilibrium. These particles appear to have been primordial condensates which were isolated from the nebula and from each other at different times by cocondensing oxides. Selective diffusion and/or oxidation of the more oxidizable metals (Mo, W, Fe and Ni), phase segregations into different alloy phases (fcc, bcc, hcp and perhaps ordered phases) and the formation of metastable condensates appears to have been involved in the modification of these materials to their present state. Only a small fraction of our observations cannot be reconciled with this picture because of a lack of knowledge of some of the phase equilibria which might have bee involved

Wetting of refractory metals with copper base alloys

International Nuclear Information System (INIS)

Anikeev, E.F.; Kostikov, V.I.; Chepelenko, V.N.; Batov, V.M.

1978-01-01

The effect is studied of phosphorus upon the wetting of molybdenum, niobium and tantalum by an alloy of the system copper-silver (10%) as a function of contact time and phosphorus concentration. Experiments have been conducted in vacuum of 5x10 -4 mm Hg at 900 deg C. It is established that the introduction of phosphorus into a copper-silver alloy improves the wetting of molybdenum, niobium and tantalum. Formation of intermetallic compounds on the alloy-refractory metal interface can be avoided by adjusting the time of contact of the solder with molybdenum, niobium and tantalum. As a solder with 2.9% phosphorus spreads well over copper, it is suggested to use said solder for brazing copper and the investigated refractory metals in items intended for service at temperatures of up to 600 deg C

Refractory compounds for repairing coke-oven brickwork

Energy Technology Data Exchange (ETDEWEB)

Hanganu, M.; Dragomir, C. (and others)

1984-01-01

A number of refractory compounds are presented, based on aluminium phosphate, phosphoric acid, sodium silicate and fire-clay and mullitic zirconium mastic, including their composition, properties and application (by impregnation, spray application or pouring), which are suitable for repairing various types of coke-oven brickwork. The results obtained are given.

Treatment of refractory/relapsed adult acute lymphoblastic leukemia with bortezomib- based chemotherapy

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Zhao J

2015-06-01

Full Text Available Junmei Zhao,* Chao Wang,* Yongping Song, Yuzhang Liu, Baijun FangHenan Key Lab of Experimental Haematology, Henan Institute of Haematology, Henan Tumor Hospital, Zhengzhou University, Zhengzhou, People’s Republic of China  *These authors contributed equally to this work Abstract: Nine pretreated patients aged >19 years with relapsed/refractory acute lymphoblastic leukemia (ALL were treated with a combination of bortezomib plus chemotherapy before allogeneic hematopoietic stem cell transplantation (allo-HSCT. Eight (88.9% patients, including two Philadelphia chromosome-positive ALL patients, achieved a complete remission. Furthermore, the evaluable patients have benefited from allo-HSCT after response to this reinduction treatment. We conclude that bortezomib-based chemotherapy was highly effective for adults with refractory/relapsed ALL before allo-HSCT. Therefore, this regimen deserves a larger series within prospective trials to confirm these results. Keywords: acute lymphoblastic leukemia, refractory, relapsed, bortezomib

Long-term effects of electrical neurostimulation in patients with unstable angina : Refractory to conventional therapies

NARCIS (Netherlands)

de Vries, Jessica; DeJongste, Mike J. L.; Zijlstra, Felix; Staal, Michiel

2007-01-01

Background. Patients with unstable angina pectoris may become refractory to conventional therapies. Electrical neurostimulation with transcutaneous electrical stimulation and/or spinal cord stimulation has been shown to be effective for patients with refractory unstable angina pectoris in hospital

Degradation of Alumina and Magnesia Chrome refractory bricks in Portland cement kiln – Corrected version*

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Ben Addi K.

2014-05-01

Full Text Available In cement plants, the refractory products are particularly confronted to partially liquid oxide phases at temperature ranging between 900°C and 1700°C. All constituents of these products have to resist not only to thermal constraints, but also to the thermochemical solicitations which result from contact material/coating. In order to study the phenomenon of degradation of refractory bricks in cement kilns and to identify the causes of their degradation, we proceed to the examination of industrial cases in cement kiln. Many chemical tests of the degraded refractory bricks have been done and the results acquired were compared to the ones not used. The analysis of the results is doing using different techniques (Loss of ignition, X-ray Fluorescence, X-ray Diffraction. The results show that the degradation of the used bricks in the clinkering and cooling zone is due to the infiltration of aggressive elements such us sulphur, alkali (Na2O, K2O .... The chemical interaction between the Portland clinker phases and refractory material has also an importance on the stability of the coating and consequently on the life of the refractories.

Pembrolizumab and Vorinostat in Treating Patients With Relapsed or Refractory Diffuse Large B-Cell Lymphoma, Follicular Lymphoma, or Hodgkin Lymphoma

Science.gov (United States)

2018-04-23

Grade 3a Follicular Lymphoma; Grade 3b Follicular Lymphoma; Recurrent Classical Hodgkin Lymphoma; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Mediastinal (Thymic) Large B-Cell Cell Lymphoma; Refractory Classical Hodgkin Lymphoma; Refractory Diffuse Large B-Cell Lymphoma; Refractory Follicular Lymphoma; Refractory Mediastinal (Thymic) Large B-Cell Cell Lymphoma

Energy conservation in industrial furnaces with vertical radiation roofs of reinforced refractory concrete

Energy Technology Data Exchange (ETDEWEB)

Grafe, E

1981-01-01

The paper discusses static systems for furnaces of reinforced refractory concrete, the temperature field over the finned-plate cross section, the calculation of the reinforced refractory concrete, experimental application in a flat open-hearth pusher furnace, a pack heating furnace, and a sinker furnace. There are cantilever beam plates, frames, and drop ceiling elements particularly suited for efficient use of high-performance burners.

MgAl2O4 spinel refractory as containment liner for high-temperature alkali salt containing environments

Science.gov (United States)

Peascoe-Meisner, Roberta A [Knoxville, TN; Keiser, James R [Oak Ridge, TN; Hemric, James G [Knoxville, TN; Hubbard, Camden R [Oak Ridge, TN; Gorog, J Peter [Kent, WA; Gupta, Amul [Jamestown, NY

2008-10-21

A method includes containing a high-temperature alkali salt containing environment using a refractory containment liner containing MgAl.sub.2O.sub.4 spinel. A method, includes forming a refractory brick containing MgAl.sub.2O.sub.4 spinel having an exterior chill zone defined by substantially columnar crystallization and an interior zone defined by substantially equiaxed crystallization; and removing at least a portion of the exterior chill zone from the refractory brick containing MgAl.sub.2O.sub.4 spinel by scalping the refractory brick containing MgAl.sub.2O.sub.4 spinel to define at least one outer surface having an area of substantially equiaxed crystallization. A product of manufacture includes a refractory brick containing MgAl.sub.2O.sub.4 spinel including an interior zone defined by substantially equiaxed crystallization; and at least one outer surface having an area of substantially equiaxed crystallization.

In-situ development of carbon nanotubes network and graphitic carbon by catalytic modification of phenolic resin binder in Al2O3–MgO–C refractories

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Atul V. Maldhure

2017-09-01

Full Text Available In-situ formation of cross-linked carbon nanotubes network reinforced the refractory matrix and helps to improve the mechanical properties at elevated temperature. In this paper, the effect of modified phenol-formaldehyde (PF resin binder on the various mechanical properties of alumina–magnesia–carbon (AMC refractories was investigated. Initially, PF resin was modified by adding a different proportion of nickel catalyst. The AMC specimens (with the 7% carbon were prepared by using 5% of modified PF resin. The pressed samples were cured at 180 °C for 24 h and characterized by XRD, Raman spectroscopy, and FE-SEM. The characterisation shows that, in-situ formation of graphitic carbon and carbon nanotubes network in the specimens due to modification of PF resin. In-situ formation of phases leads to enhancement of density and mechanical properties of refractory at elevated temperature due to the reinforcing effect.

Performance Evaluation of Refractory Composite Coatings in Potassium Rich Environment

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Kristina BRINKIENĖ

2016-09-01

Full Text Available A laboratory scale method was used to study the performance of reinforced cement composites in potassium rich environment of biomass combustion. Buckwheat husk (BH was used as potential source of unexploited biomass product applicable as biomass derived fuel. In order to enhance the alkali effect on the properties of the investigated materials, the solution of potassium carbonate (K2CO3 was selected as potassium rich aggressive environment. Two reinforced cement composites as potential repair coatings for restoration of damaged refractory surfaces with different composition of aggregate were used in corrosion tests. Performance of refractory coatings was evaluated by analysing the microstructure of the treated composites as well as mechanical properties. Energy-dispersive X-ray spectroscopy (SEM/EDS and optical microscopy were used to study the microstructure in the corroded region of the refractory coatings. Long term studies in the solution of 1M K2CO3 for 56 months have demonstrated that composite with the additive of fluid cracking catalyst of oil refinery and petrochemical industries is more durable in the potassium rich environment.DOI: http://dx.doi.org/10.5755/j01.ms.22.3.8348

Corrosion assessment of refractory materials for high temperature waste vitrification

International Nuclear Information System (INIS)

Marra, J.C.; Congdon, J.W.; Kielpinski, A.L.

1995-01-01

A variety of vitrification technologies are being evaluated to immobilize radioactive and hazardous wastes following years of nuclear materials production throughout the Department of Energy (DOE) complex. The compositions and physical forms of these wastes are diverse ranging from inorganic sludges to organic liquids to heterogeneous debris. Melt and off-gas products can be very corrosive at the high temperatures required to melt many of these waste streams. Ensuring material durability is required to develop viable treatment processes. Corrosion testing of materials in some of the anticipated severe environments is an important aspect of the materials identification and selection process. Corrosion coupon tests on typical materials used in Joule heated melters were completed using glass compositions with high salt contents. The presence of chloride in the melts caused the most severe attack. In the metal alloys, oxidation was the predominant corrosion mechanism, while in the tested refractory material enhanced dissolution of the refractory into the glass was observed. Corrosion testing of numerous different refractory materials was performed in a plasma vitrification system using a surrogate heterogeneous debris waste. Extensive corrosion was observed in all tested materials

Treatment of refractory chylothorax with externalized pleuroperitoneal shunts in children.

Science.gov (United States)

Wolff, A B; Silen, M L; Kokoska, E R; Rodgers, B M

1999-09-01

Traditional therapy for refractory chylothorax in the pediatric population has included pleurodesis and thoracic duct ligation. These procedures are associated with high morbidity and questionable success rates. We retrospectively reviewed our experience with 15 patients who underwent treatment for chylous effusions using pleuroperitoneal shunts with exteriorized pump chambers. Mean patient age at time of shunt placement was 2.1 (0.1 to 11.5) years and the most common indication (7 of 15) was refractory chylothorax following surgical correction of congenital heart disease. Mean chylothorax duration before shunt placement was 76 (5 to 810) days and shunts were in place for an average of 104 (12 to 365) days. A total of 19 chylous effusions (pleural or pericardial) were treated with shunts. Nine of 11 right-sided chylothoraces, 5 of 6 left-sided chylothoraces, and 2 of 2 chylopericardia resolved with shunt therapy (84% total). Pleuroperitoneal shunting failed to clear the effusion in 3 children. There were six episodes of shunt malfunction that were repaired and two episodes of infection. Inguinal or umbilical hernia developed in 4 patients. Externalized pleuroperitoneal shunting is a safe, effective, and minimally invasive treatment for children with refractory chylous effusions.

Tocilizumab for refractory organising pneumonia associated with Sjögren's disease.

Science.gov (United States)

Justet, Aurelien; Ottaviani, Sebastien; Dieudé, Philippe; Taillé, Camille

2015-05-14

Lung involvement in primary Sjögren syndrome occurs in approximately 10-20% of patients. Tocilizumab, an anti-interleukin-6 receptor antibody, has demonstrated efficacy and safety in small series of systemic sclerosis, and systemic lupus erythematosus, but its effect on interstitial lung manifestations of connective tissue diseases is not well known. We report the use of tocilizumab in a refractory organising pneumonia associated with Sjögren's disease. Our observation suggests that tocilizumab could be an alternative therapeutic in refractory organising pneumonia. 2015 BMJ Publishing Group Ltd.

Rikkunshito improves globus sensation in patients with proton-pump inhibitor-refractory laryngopharyngeal reflux.

Science.gov (United States)

Tokashiki, Ryoji; Okamoto, Isaku; Funato, Nobutoshi; Suzuki, Mamoru

2013-08-21

To investigate the effect of rikkunshito on laryngopharyngeal reflux (LPR) symptoms and gastric emptying in patients with proton-pump inhibitor (PPI)-refractory LPR. In total, 22 patients with LPR were enrolled. Following a 2-wk treatment with PPI monotherapy, PPI-refractory LPR patients were randomly divided into two treatment groups (rikkunshito alone or rikkunshito plus the PPI, lansoprazole). LPR symptoms were assessed using a visual analog scale (VAS) score, gastrointestinal symptoms were assessed using the gastrointestinal symptom rating scale (GSRS), and gastric emptying was assessed using the radio-opaque marker method prior to and 4 wk following treatments. The 4-wk treatment with rikkunshito alone and with rikkunshito plus the PPI significantly decreased the globus sensation VAS scores. The VAS score for sore throat was significantly decreased following treatment with rikkunshito plus PPI but not by rikkunshito alone. Neither treatment significantly changed the GSRS scores. Rikkunshito improved delayed gastric emptying. We found a significant positive correlation between improvements in globus sensation and in gastric emptying (r² = 0.4582, P sensation in patients with PPI-refractory LPR, in part, because of stimulation of gastric emptying. Thus, rikkunshito is an effective treatment for PPI-refractory LPR.

[Nursing management of a refractory cardiac death donor].

Science.gov (United States)

Kaufmann, Marion

2016-09-01

The nursing management of a refractory circulatory death donor is a new procedure which forms an integral part of patient care. It comprises technical and organisational aspects, and requires a conceptual, ethical and deontological effort. Copyright © 2016. Published by Elsevier Masson SAS.

Pulsed radiofrequency of brachial plexus under ultrasound guidance for refractory stump pain: a case report

Directory of Open Access Journals (Sweden)

Zheng B

2017-11-01

Full Text Available Bixin Zheng, Li Song, Hui Liu Department of Pain Management, West China Hospital of Sichuan University, Chengdu, China Abstract: The post-amputation (pain syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain. Keywords: ultrasound guidance, pulsed radiofrequency, brachial plexus, refractory stump pain 

Development of industrial x-ray computed tomography and its application to refractories

International Nuclear Information System (INIS)

Aiba, Yoshiro; Oki, Kazuo; Nakamura, Shigeo; Fujii, Masashi.

1985-01-01

An industrial X-ray computed tomography was developed under the influence of the rapid spread of the use of the X-ray CT scanner in the medical field and improvements of the equipment. Although current nondestructive testing machines of refractories use the ultrasonic inspection method or the X-ray fluoroscopic method, these equipments cannot produce a tomogram or cannot carry out quantitative evaluation. By using an industrial X-ray computed tomography, submerged nozzles for continuous casting of steel were analyzed with interesting results. The features of the industrial X-ray computed tomography applied for refractory nozzles are as follows: (1) It promptly detects interior defects. (2) It can measure dimensions and shapes. (3) It can numerically express the distribution of density. Accordingly, it is expected that the industrial X-ray computed tomography will widely be used in the fields of development and quality control of refractories and advanced ceramic materials. (author)

Optimization of the Technological Synthesis of Refractory Compounds

Science.gov (United States)

Gaidar, S. M.; Karelina, M. Yu.; Prikhod'ko, V. M.; Volkov, A. A.

2017-12-01

The results of experimental studies, which are related to the regulation of the fractional composition of refractory compounds by roll milling in using controlled roll opening and unbalanced peripheral speeds of rollers, are reported. The content of prepared fine, middle, and coarse fractions is within 50-80%; in this case, the milling time of synthesis products is less than the time of ball milling by an order of magnitude. The application of roll milling for refining the products of self-propagating high-temperature synthesis can be most efficient in using together with heat-generating reactor to solve the main problem of self-propagating synthesis (SHS), which is a problem for recent several decades (the problem is the creation of intense automated production of refractory compounds in using continuous manufacturing cycle within a energotechnological system with the recovery of a great quantity of heat released during SHS).

Diode and Nd:YAG laser in a case of refractory acne keloidalis nuchae

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Ravi Kumar Chittoria

2015-03-01

Full Text Available Acne keloidalis nuchae (AKN is a disease of unclear etiology that mainly affects males. Medical treatment of AKN is difficult, with refractory cases often requiring ablation by laser or surgical resection. We report herein, a 23-year-old male with refractory AKN treated successfully with combined laser ablation, using an 810-nm diode laser and a 1064-nm Nd:YAG laser.

Outcomes of Ahmed valve surgery for refractory glaucoma in Dhahran, Saudi Arabia

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Tariq Alasbali

2015-06-01

Full Text Available AIM:To evaluate the outcomes of Ahmed glaucoma valve (AGV implantation surgery for refractory glaucoma.METHODS:This one-armed historical cohort study was conducted in 2011. Refractory glaucoma was defined as eyes with an intraocular pressure (IOP greater than 21 mm Hg with maximally tolerated glaucoma medications, failed surgeries, or both. For all eyes with refractory glaucoma that underwent AGV implantation, data were collected on IOP, the best corrected visual acuity (BCVA and glaucoma medications preoperatively and 4, 6, 12, 24 and 56wk postoperatively. Logarithm values of IOP were calculated and compared.RESULTS: The study group was comprised of 30 patients (30 eyes, 16 males and 14 females with refractory glaucoma. Mean preoperative IOP was 39.3±13.8 mm Hg. Postoperative mean IOP was 15.7±7.1 mm Hg, 19.6±12.8 mm Hg and 13.9±14.2 mm Hg at 12, 24 and 56wk respectively. BCVA was ≥ 6/60 in 11 eyes preoperatively, and five eyes had BCVA≥6/60 at 56wk postoperatively. Preoperatively, more than four medications were used to treat glaucoma in 21 eyes. At 12wk postoperatively, no medications were required to control IOP in 20 eyes. At 56wk postoperatively, at least one medication was required to control IOP in 10 eyes. Over the entire follow up period, four eyes were treated with yttrium aluminium garnet (YAG laser and 14 eyes required a second surgery. The AGV was removed in four eyes.CONCLUSION: AGV implantation reduced IOP and the number of medications required to control refractory glaucoma. However, there was a higher risk of decreased vision. Long-term follow up and prompt intervention are recommended.

Determination of the resistance to tensile fracture of refractory mixtures of gunite

International Nuclear Information System (INIS)

Gomez Sanchez, A; Tomba Martinez, A.G

2004-01-01

The determination of the mechanical properties of cooled refractory mixtures is useful since it allows the materials to be compared for the purposes of selection and reports on their degree of internal cohesion, green or calcination, so that their structural ability can be estimated, especially during installation. Given the testing difficulties originating in the fragility of the ceramic materials, the tension test is not generally used in refractories. However, ASTM C-307 94 determines the tensile strength of cured chemical-resistant materials, for which this work considered the possibility of testing cement-based monolithic refractories in this non conventional condition. The tensile resistance to the fracture of three different refractory mixtures (A, B 1 and B 2 ), used in heat repairing by gunite in coking ovens, that were characterized by chemical, granulometric, and mineralogical analysis pycnometric density measurements. The pieces for the tests ('bone' type: length = 75 mm, maximum width = 40 mm, minimum width = 25 mm, thickness = 10 - 25 mm) were prepared by ramming of mixtures of material/water in a metallic mold; they were sinterized (1200 o C, 1h) and characterized by measures of bulk density, porosity and observation of the surface texture, in green and calcinated. The tensile tests, based on ASTM C-307 94, were performed in an Instron model 4467 machine in open air, at room temperature and position control (0.5 mm/min). The following values were obtained, in kPa: AW347±308; B 1 W738±130; B 2 W604±64. These values were lower than those for the tensile fracture module (MOR), although they displayed an equivalent order: A≤B 2 ≤B 1 . This was related to the characteristics of each refractory mixture and at the end of the pieces tested (CW)

An unusual case of refractory wheeze

OpenAIRE

Ramesh, Venkat; Acharya, Vishak; Pai, Narasimha; Krishnan, Ananda

2015-01-01

A 37-year-old man presented with a history of episodic wheeze and breathlessness of 3?years? duration refractory to treatment. Physical examination revealed diffuse expiratory polyphonic rhonchi while the remainder of the examination including the cardiac examination was reported as normal. Pulmonary function testing revealed mild obstruction with bronchodilator reversibility. The patient was discharged on a 6-month course of antitubercular treatment (ATT) as bronchial brush cytology (obtaine...

Supra-Tenon Capsule Implantation of the Ahmed Glaucoma Valve in Refractory Pediatric Glaucoma.

Science.gov (United States)

Elhefney, Eman M; Al-Sharkawy, Hossam T; Kishk, Hanem M

2016-09-01

To evaluate the efficacy of supra-Tenon capsule implantation of an Ahmed glaucoma valve (AGV) as a measure to decrease the fibrotic potential of the Tenon capsule on bleb formation and its subsequent effect on intraocular pressure (IOP) control in children with refractory glaucoma. Mansoura Ophthalmic Centre, Faculty of Medicine, Mansoura University, Egypt. A prospective interventional study. Twenty-two eyes of 12 children with refractory glaucoma underwent supra-Tenon capsule implantation of AGV. Ophthalmic examinations under general anesthesia including measurement of the corneal diameter and the IOP with Perkin's tonometer were performed preoperatively, on the first postoperative day, the first postoperative week, weekly for the first month, 2-weekly for the following 3 months, and monthly for at least 18 months. Postoperative complications and the number of glaucoma medications used preoperatively and postoperatively were recorded. The paired Student t test was used to compare preoperative and postoperative data. There were 12 eyes (54.6%) with refractory congenital glaucoma, 7 eyes (31.8%) with refractory pseudophakic glaucoma, and 3 eyes (13.6%) with refractory aphakic glaucoma. Patients included 10 male (83.3%) and 2 female (16.7%) children with a mean age of 16.3±9.7 months. The mean follow-up duration was 24.1±4.3 months. There was a statistically significant difference between the mean preoperative IOP (30.7±2.88 mm Hg) and the mean postoperative IOP (16.1±3.60 mm Hg) (t=16.22 and P=0.000, with a mean decrease in the IOP by 47.6%). The difference between the mean number of antiglaucoma medications before surgery (1.86±0.4) and after surgery (1.0±0.9) was also statistically significant (t=4.31 and P=0.000). Total success was achieved in 18 eyes (81.9%). Postoperative complications included tube exposure and slippage (10%), hypotony (10%), and hyphema (5%). Supra-Tenon capsule implantation of the AGV was successful in controlling the IOP with few

Refractory chronic migraine

DEFF Research Database (Denmark)

Martelletti, Paolo; Katsarava, Zaza; Lampl, Christian

2014-01-01

The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs...... and in the uncontrolled application of therapeutic techniques not yet validated.The European Headache Federation Expert Group on rCM presents hereby the updated definition criteria for this harmful subset of headache disorders. This attempt wants to be the first impulse towards the correct identification...... of these patients, the correct application of innovative therapeutic techniques and lastly aim to be acknowledged as clinical entity in the next definitive version of the International Classification of Headache Disorders 3 (ICHD-3 beta)....

Influence of phase transformations on the mechanical behaviour of refractory ceramics at high temperature

International Nuclear Information System (INIS)

Schmitt, N.; Poirier, J.

2009-01-01

Refractories used at high temperature are subjected to high chemical and mechanical stresses. The mastery of their microstructure as well as the phase changes occurring in service is essential to ensure resistance to wear and failure of refractory linings. Great progress has been made: combining efficient techniques for the investigation of the microstructure with powerful numerical tools (thermochemical and thermo-mechanical computations) provides information (e.g., degradation mechanisms) that cannot be obtained directly. Also multi-physical and multi-scale models developing materials with high-performance for higher temperature and with longer lifetime. In this paper, through several examples we show some interactions between the mechanical behavior and the microstructure transformations of refractory ceramics. The tools developed to characterize their microstructure change in situ (e.g., at high temperature) and to identify their kinetics are described. Some methodologies and tools developed in recent years, today, provide a better understanding of in-service behavior of refractories while identifying the critical material and process parameters likely to increase life-time. (authors)

Primary pulmonary lymphoma mimicking a refractory lung abscess: A case report.

Science.gov (United States)

Matsumoto, Takeshi; Otsuka, Kojiro; Funayama, Yuki; Imai, Yukihiro; Tomii, Keisuke

2015-04-01

The current study presents a case of primary pulmonary lymphoma (PPL) mimicking refractory lung abscess that was diagnosed at autopsy. An 80-year-old male with clinically inapparent aspiration presented with a large cavitated mass and pleural effusion. A lung abscess and empyema was diagnosed, therefore, antibiotics were administered and the pleural effusion was drained. Various examinations, including a biopsy, yielded no specific diagnosis. The lesion was considered inoperable due to the poor general condition of the patient. Subsequently, the mass that had been diagnosed as a refractory lung abscess became enlarged and a repeat biopsy resulted in a diagnosis of diffuse large B-cell lymphoma. The patient succumbed to sudden respiratory failure, and the final diagnosis of PPL was confirmed at autopsy. PPL is a rare disease that accounts for 0.45% of all pulmonary malignant tumors and is difficult to diagnose in inoperable cases. Therefore, patients with PPL who do not undergo surgery can be misdiagnosed and consequently treated inappropriately. PPL should therefore be considered in the differential diagnosis of a refractory lung abscess.

Benefit–risk assessment of golimumab in the treatment of refractory ulcerative colitis

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Pugliese D

2016-02-01

Full Text Available Daniela Pugliese, Carla Felice, Rosario Landi, Alfredo Papa, Luisa Guidi, Alessandro Armuzzi Inflammatory Bowel Disease Unit, Complesso Integrato Columbus, Catholic University, Rome, Italy Abstract: Significant advances in the management of patients with ulcerative colitis (UC have been made since the introduction of anti-tumor necrosis factor (TNF-alpha agents, especially for those who fail or do not tolerate conventional therapies. Two drugs, infliximab first, then adalimumab afterward, showed effectiveness in inducing and maintaining long-term remission both in pivotal trials as well as in clinical practice. However, approximately 25% of patients with UC, who fail or do not tolerate all available therapies, require a colectomy for refractory disease. The therapeutic scenario of UC has been recently upgraded by the introduction of golimumab, the latest anti TNF-alpha agent to be approved. Golimumab is a totally humanized monoclonal antibody, administered by a subcutaneous injection every 4 weeks. Treatment with golimumab has shown to be effective to induce sustained clinical benefit in tough-to-treat patients with UC, including steroid and/or immunosuppressive refractory and steroid-dependent patients. In this review, we summarize all available efficacy and safety data of golimumab in UC, analyzing the potential therapeutic position for the treatment of refractory patients with UC. Keywords: ulcerative colitis, refractoriness, anti-TNF-alpha, golimumab 

Anaesthesia for left thoracoscopic sympathectomy for refractory long ...

African Journals Online (AJOL)

... mutations including life-threatening cardiac arrhythmias and sudden death. Left thoracoscopic sympathectomy is an effective treatment for patients who are refractory to medical therapy or who need frequent epicardial internal cardio defibrillator intervention. The authors report three cases, one adult and two children, who ...

Unusual cause of respiratory distress misdiagnosed as refractory asthma

Directory of Open Access Journals (Sweden)

Al-Otair Hadil

2006-01-01

Full Text Available We report a young lady, who was labeled as a case of refractory asthma for a few years, based on history of shortness of breath on minimal exertion, noisy breathing and normal chest radiograph. Repeated upper airway exam by an otolaryngologist and computerized tomography scan, were normal. On presentation to our hospital, she was diagnosed to have fixed upper airway obstruction, based on classical flow-volume loop findings. Fibroptic bronchoscopy revealed a web-shaped subglottic stenosis. The histopathology of a biopsy taken from that area, showed non-specific inflammation. No cause for this stenosis could be identified. The patient was managed with rigid bronchoscopy dilatation, without recurrence. We report this case as idiopathic subglottic stenosis, that was misdiagnosed as refractory bronchial asthma, stressing the importance of performing spirometry in the clinic.

Percutaneous radiofrequency treatment for refractory anteromedial pain of osteoarthritic knees.

Science.gov (United States)

Ikeuchi, Masahiko; Ushida, Takahiro; Izumi, Masashi; Tani, Toshikazu

2011-04-01

Although severe knee osteoarthritis with refractory pain is commonly treated surgically, this is often not an option for patients with poor health status or unwillingness to undergo major surgery. We examined the efficacy of radiofrequency application to sensory nerves as a novel alternative treatment for refractory knee pain. This study was an open-label, nonrandomized, and controlled study. Patients complaining of refractory anteromedial knee pain associated with radiological osteoarthritis (moderate or severe) were included. They were assigned to one of two groups: those receiving radiofrequency thermocoagulation (N = 18) or those receiving nerve block (N = 17), depending on the time period that they were referred to the clinic. Radiofrequency current or local anesthetics was applied to the medial retinacular nerve and the infrapatellar branch of the saphenous nerve. Western Ontario McMaster Universities osteoarthritis index score, pain visual analog scale (VAS), and patient's global assessment were assessed with a minimum follow-up of 6 months.   Radiofrequency treatment significantly decreased knee pain as measured by VAS for 12 weeks compared with the control group. In terms of responders, more patients in the RF group responded to the treatment than in the control group. The differences were statistically significant at 4 weeks, 8 weeks, and 12 weeks in pain VAS. Eight patients (44%) treated with radiofrequency rated excellent or good but only three (18%) in the control group rated good, although the difference was not statistically significant. Some patients were able to benefit substantially from radiofrequency treatment. Even if its effective period is limited, radiofrequency application is a promising treatment to alleviate refractory anteromedial knee pain with osteoarthritis. Further experience and technical improvements are needed to establish its role in the management of knee osteoarthritis. Wiley Periodicals, Inc.

Pembrolizumab in Treating Younger Patients With Recurrent, Progressive, or Refractory High-Grade Gliomas, Diffuse Intrinsic Pontine Gliomas, Hypermutated Brain Tumors, Ependymoma or Medulloblastoma

Science.gov (United States)

2018-06-18

Constitutional Mismatch Repair Deficiency Syndrome; Lynch Syndrome; Malignant Glioma; Progressive Ependymoma; Progressive Medulloblastoma; Recurrent Brain Neoplasm; Recurrent Childhood Ependymoma; Recurrent Diffuse Intrinsic Pontine Glioma; Recurrent Medulloblastoma; Refractory Brain Neoplasm; Refractory Diffuse Intrinsic Pontine Glioma; Refractory Ependymoma; Refractory Medulloblastoma

Handbook of industrial refractories technology principles, types, properties and applications

CERN Document Server

Caniglia, Stephen

1989-01-01

Encompasses the entire range of industrial refractory materials and forms: properties and their measurement, applications, manufacturing, installation and maintenance techniques, quality assurance, and statistical process control.

The ketogenic diet in two paediatric patients with refractory myoclonic status epilepticus.

Science.gov (United States)

Caraballo, Roberto Horacio; Valenzuela, Gabriela Reyes; Armeno, Marisa; Fortini, Sebastian; Mestre, Graciela; Cresta, Araceli

2015-12-01

We describe two patients with refractory myoclonic status epilepticus treated with the ketogenic diet. Between May 1, 2014 and January 1, 2015, two patients who met the diagnostic criteria for refractory myoclonic status epilepticus, seen at our department, were placed on the ketogenic diet and followed for a minimum of six months. One patient with myoclonic epilepsy of unknown aetiology had a 75-90% seizure reduction, and the other with progressive encephalopathy associated with myoclonic epilepsy had a 50% seizure reduction. Both patients retained good tolerability for the diet. At the last control, one patient had isolated myoclonias and EEG showed occasional generalized spike-and-polyspike waves; the patient is now successfully attending kindergarten. The quality of life of the second patient improved significantly. In both cases, the number of antiepileptic drugs was reduced. The ketogenic diet is an effective and well-tolerated treatment option for patients with refractory myoclonic status epilepticus and should be considered earlier in the course of treatment.

Refractory experience in circulating fluidized bed combustors, Task 7. Final report

Energy Technology Data Exchange (ETDEWEB)

Vincent, R.Q.

1989-11-01

This report describes the results of an investigation into the status of the design and selection of refractory materials for coal-fueled circulating fluidized-bed combustors. The survey concentrated on operating units in the United States manufactured by six different boiler vendors: Babcock and Wilcox, Combustion Engineering, Foster Wheeler, Keeler Dorr-Oliver, Pyropower, and Riley Stoker. Information was obtained from the boiler vendors, refractory suppliers and installers, and the owners/operators of over forty units. This work is in support of DOE`s Clean Coal Technology program, which includes circulating fluidized-bed technology as one of the selected concepts being evaluated.

Intraarticular Pulsed Radiofrequency to Treat Refractory Lumbar Facet Joint Pain in Patients with Low Back Pain.

Science.gov (United States)

Chang, Min Cheol; Cho, Yun-Woo; Ahn, Da Hyun; Do, Kyung Hee

2018-04-01

Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intra-articular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Twenty patients with refractory lumbar facet joint pain were recruited, and each patient was treated via intra-articular pulsed radiofrequency. The treatment effects were measured with a numerical rating scale, and the technical accuracy of intra-articular pulsed radiofrequency treatment was evaluated independently by 2 radiologists. Any adverse events or complications also were checked. We performed intra-articular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients (5 men and 15 women; mean age, 64.50 ± 10.65 years) with refractory lumbar facet joint pain. Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment (P radiofrequency results in all 20 patients, without any serious adverse effects. Treatment using intra-articular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Copyright © 2018 Elsevier Inc. All rights reserved.

Study of new occurrences of plastic (ball) clays from northeastern Brazil for use in refractory ceramics; Estudo de novas ocorrencias de argilas plasticas (ball clays) do nordeste do Brasil para uso em ceramicas refratarias

Energy Technology Data Exchange (ETDEWEB)

Cartaxo, J.M.; Bastos, P. de M.; Santana, L.N.L.; Menezes, R.R.; Neves, G.A.; Ferreira, H.C., E-mail: julianamelo25@gmail.com, E-mail: paulos@cstr.ufcg.edu.br, E-mail: lisiane.navarro@ufcg.edu.br, E-mail: romualdo.menezes@ufcg.edu.br, E-mail: gelmires.neves@ufcg.edu.br, E-mail: heber.ferreira@ufcg.edu.br [Universidade Federal de Campina Grande (UFCG), PB (Brazil). Programa de Pos-Graduacao em Ciencia e Engenharia de Materiais

2016-10-15

The northeast of Brazil has large deposits of ball clays generally situated in Barreiras Formation and are used in white ceramic and refractory materials. These clays are composed of secondary kaolinite and organic matter, being very plastic and when subjected to elevated temperatures burn with white colors and present phase transformations showing mainly crystals formation of mullite and cristobalite. This work aims to study new deposits of ball clays in order to use them to refractory materials production. The clays were characterized by laser diffraction, X-ray diffraction (XRD), X-ray fluorescence, refractoriness, thermal analysis, and scanning electron microscopy (SEM). The samples were pressed and sintered at 1000, 1150, 1250, 1280 and 1400 °C. The characterization after firing was carried out by XRD and SEM. Then, the physical and mechanical properties - absorption, porosity and flexural strength, were determined. The results showed that the clays presented formation of mullite crystals with physical, chemical and mineralogical properties suitable for use in refractory ceramics. (author)

Processing of Refractory Metal Alloys for JOYO Irradiations

International Nuclear Information System (INIS)

RF Luther; ME Petrichek

2006-01-01

This is a summary of the refractory metal processing experienced by candidate Prometheus materiats as they were fabricated into specimens destined for testing within the JOYO test reactor, ex-reactor testing at Oak Ridge National Laboratory (ORNL), or testing within the NRPCT. The processing is described for each alloy from the point of inception to the point where processing was terminated due to the cancellation of Naval Reactor's involvement in the Prometheus Project. The alloys included three tantalum-base alloys (T-111, Ta-10W, and ASTAR-811C), a niobium-base alloy, (FS-85), and two molybdenum-rhenium alloys, one containing 44.5 w/o rhenium, and the other 47.5 w/o rhenium. Each of these alloys was either a primary candidate or back-up candidate for cladding and structural applications within the space reactor. Their production was intended to serve as a forerunner for large scale production ingots that were to be procured from commercial refractory metal vendors such as Wah Chang

Determination of Unit Pressure Force in Material Volume in the Course of Refractory Stamping Press Moulding

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Orłowicz A.W.

2016-06-01

Full Text Available The paper presents results of assessment of the unit pressure force within the refractory material volume in the course press-moulding of stampings for refractory precast shapes. The force was evaluated with the use of physical simulation of deformation undergone by lead balls placed in the raw refractory mass subjected to pressing in a metal die. To determine the value of unit pressure force applied to the aggregate grains in the course of stamping press-moulding, physical model of deformation of a sphere induced by the uniaxial stress state was used.

Normal and refractory concretes for LMFBR applications. Volume 1. Review of literature on high-temperature behavior of portland cement and refractory concretes. Final report

International Nuclear Information System (INIS)

Bazant, Z.P.; Chern, J.C.; Abrams, M.S.; Gillen, M.P.

1982-06-01

The extensive literature on the properties and behavior at elevated temperature of portland cement concrete and various refractory concretes was reviewed to collect in concise form the physical and chemical properties of castable refractory concretes and of conventional portland cement concretes at elevated temperature. This survey, together with an extensive bibliography of source documents, is presented in Volume 1. A comparison was made of these properties, the relative advantages of the various concretes was evaluated for possible liquid metal fast breeder reactor applications, and a selection was made of several materials of interest for such applications. Volume 2 concludes with a summary of additional knowledge needed to support such uses of these materials together with recommendations on research to provide that knowledge

Time-resolved analysis of particle emissions from residential biomass combustion - Emissions of refractory black carbon, PAHs and organic tracers

Science.gov (United States)

Nielsen, Ingeborg E.; Eriksson, Axel C.; Lindgren, Robert; Martinsson, Johan; Nyström, Robin; Nordin, Erik Z.; Sadiktsis, Ioannis; Boman, Christoffer; Nøjgaard, Jacob K.; Pagels, Joakim

2017-09-01

Time-resolved particle emissions from a conventional wood stove were investigated with aerosol mass spectrometry to provide links between combustion conditions, emission factors, mixing state of refractory black carbon and implications for organic tracer methods. The addition of a new batch of fuel results in low temperature pyrolysis as the fuel heats up, resulting in strong, short-lived, variable emission peaks of organic aerosol-containing markers of anhydrous sugars, such as levoglucosan (fragment at m/z 60). Flaming combustion results in emissions dominated by refractory black carbon co-emitted with minor fractions of organic aerosol and markers of anhydrous sugars. Full cycle emissions are an external mixture of larger organic aerosol-dominated and smaller thinly coated refractory black carbon particles. A very high burn rate results in increased full cycle mass emission factors of 66, 2.7, 2.8 and 1.3 for particulate polycyclic aromatic hydrocarbons, refractory black carbon, total organic aerosol and m/z 60, respectively, compared to nominal burn rate. Polycyclic aromatic hydrocarbons are primarily associated with refractory black carbon-containing particles. We hypothesize that at very high burn rates, the central parts of the combustion zone become air starved, leading to a locally reduced combustion temperature that reduces the conversion rates from polycyclic aromatic hydrocarbons to refractory black carbon. This facilitates a strong increase of polycyclic aromatic hydrocarbons emissions. At nominal burn rates, full cycle emissions based on m/z 60 correlate well with organic aerosol, refractory black carbon and particulate matter. However, at higher burn rates, m/z 60 does not correlate with increased emissions of polycyclic aromatic hydrocarbons, refractory black carbon and organic aerosol in the flaming phase. The new knowledge can be used to advance source apportionment studies, reduce emissions of genotoxic compounds and model the climate impacts of

Method of Promoting Single Crystal Growth During Melt Growth of Semiconductors

Science.gov (United States)

Su, Ching-Hua (Inventor)

2013-01-01

The method of the invention promotes single crystal growth during fabrication of melt growth semiconductors. A growth ampoule and its tip have a semiconductor source material placed therein. The growth ampoule is placed in a first thermal environment that raises the temperature of the semiconductor source material to its liquidus temperature. The growth ampoule is then transitioned to a second thermal environment that causes the semiconductor source material in the growth ampoule's tip to attain a temperature that is below the semiconductor source material's solidus temperature. The growth ampoule so-transitioned is then mechanically perturbed to induce single crystal growth at the growth ampoule's tip.

Removal of Refractory Organics from Biologically Treated Landfill Leachate by Microwave Discharge Electrodeless Lamp Assisted Fenton Process

Directory of Open Access Journals (Sweden)

Jiuyi Li

2015-01-01

Full Text Available Biologically treated leachate usually contains considerable amount of refractory organics and trace concentrations of xenobiotic pollutants. Removal of refractory organics from biologically treated landfill leachate by a novel microwave discharge electrodeless lamp (MDEL assisted Fenton process was investigated in the present study in comparison to conventional Fenton and ultraviolet Fenton processes. Conventional Fenton and ultraviolet Fenton processes could substantially remove up to 70% of the refractory organics in a membrane bioreactor treated leachate. MDEL assisted Fenton process achieved excellent removal performance of the refractory components, and the effluent chemical oxygen demand concentration was lower than 100 mg L−1. Most organic matters were transformed into smaller compounds with molecular weights less than 1000 Da. Ten different polycyclic aromatic hydrocarbons were detected in the biologically treated leachate, most of which were effectively removed by MDEL-Fenton treatment. MDEL-Fenton process provides powerful capability in degradation of refractory and xenobiotic organic pollutants in landfill leachate and could be adopted as a single-stage polishing process for biologically treated landfill leachate to meet the stringent discharge limit.

Role of rectal myomectomy in refractory chronic constipation ...

African Journals Online (AJOL)

Background: To assess the role of diagnostic and therapeutic value of anorectal myectomy in cases of chronic refractory constipation. Materials and Methods: Twenty-eight patients 11 months to 9 years of age presenting with chronic constipation, with contrast enema showing dilated rectum and sigmoid colon were included ...

Solidification of refractory materials processed in the ultra high vacuum drop tube at the CEREM-Grenoble

International Nuclear Information System (INIS)

Vinet, B.; Cini, E.; Tournier, S.; Cortella, L.

1994-01-01

Undercooling experiments have been performed on refractory materials by processing in a high drop-tube. Emphasis is put on general aspects of surface and bulk microstructures of solidified droplets, including pure metals (W, Re, Ta, Mo, Nb, Ir, Zr) and alloys (W-Re, Mo-Re, Ta-Zr). It is shown that recrystallization often causes polycrystallinity. Moreover, the microstructure is closely related to undercooling amount prior solidification. The effect of secondary cooling on microstructure can also be studied by quenching the samples in solid tin at the end of free-fall. (authors). 20 refs., 11 figs

Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.

Science.gov (United States)

Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A

2015-01-01

Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.

Transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites

International Nuclear Information System (INIS)

Zhu Wenke; Shan Hong; Zhu Kangshun; Jiang Zaibo; Li Zhengran; Huang Mingsheng; Guan Shouhai; Shen Xinying

2004-01-01

Objective: To assess the clinical efficacy of TIPS in the treatment of patients with refractory ascites and investigate the clinical factors associated with TIPS. Methods: 21 consecutive patients with refractory ascites, 16 men and 5 women with mean age of 45 years (range 22-69 years) were followed up for an average of 337 days (range 50-1323 days). Ascites/abdomen circumference, serum parameters, stents function, time of followed up and survival rate were analyzed. Results: The ascites was significantly reduced as compared with basal values (P<0.05). 81% and 91% patients had no or mild ascites during 3 to 6 months and 9 to 12 after TIPS respectively. According to responses to treatment within 3 months, using Logistic regression predicated the control of ascites with relation to Child class C for severe prognosis (P<0.05). There were significant change in serum sodium, serum creatinine as compared with baseline at follow-up (P<0.05). Their mortality were 14% during follow-up for 3 months, 20% in 6 and the survival rate was 72% at 1 year. According to COX regression analysis showed that age, Child class C, serum albumin, hepatic encephalopathy, serum total bilirubin were related to severe prognosis; but only hepatic encephalopathy and Child class C had an effect on survival rate. Conclusion: TIPS is an effective method for refractory ascite caused by hepatitis cirrhosis, and also effective for patients with functional renal failure but retaining of liver compensation

Hydrocortisone administration for the treatment of refractory hypotension in critically ill newborns.

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Baker, C F W; Barks, J D E; Engmann, C; Vazquez, D M; Neal, C R; Schumacher, R E; Bhatt-Mehta, V

2008-06-01

The purpose of this observation was to evaluate the safety and efficacy of hydrocortisone (HC) for the treatment of refractory hypotension in term and preterm infants. A secondary purpose was to determine the utility of serum cortisol concentrations in predicting the response to treatment. This is a retrospective observational study of 117 infants treated with a standardized HC protocol for refractory hypotension. Refractory hypotension was defined as a mean arterial pressure (MAP) less than the gestational age (GA) despite a total inotrope dose of 20 microg per kg per min. Baseline serum cortisol concentrations were determined prior to treatment with stress dose HC. Treatment with HC increased the MAP at 2, 6, 12 and 24 h after initiation, decreased the total inotrope dose at 6, 12 and 24 h, and was associated with resolution of oliguria. There was no correlation between the pretreatment baseline cortisol concentration and GA, birth weight or the response to treatment. The incidence of grades III to IV intraventricular hemorrhage, periventricular leukomalacia, bacterial or fungal sepsis and spontaneous intestinal perforation (SIP) after HC treatment was similar to institutional historic controls prior to institution of this standardized HC protocol. HC treatment was associated with a rapid resolution of cardiovascular compromise. The incidence of significant side effects was similar to that in previously published reports, including a comparable incidence of SIP. On the basis of our results, measuring baseline serum cortisol concentration to guide the management of refractory hypotension is unwarranted.

When all seems lost: management of refractory constipation-Surgery, rectal irrigation, percutaneous endoscopic colostomy, and more.

Science.gov (United States)

Wilkinson-Smith, V; Bharucha, A E; Emmanuel, A; Knowles, C; Yiannakou, Y; Corsetti, M

2018-05-01

While the pharmacological armamentarium for chronic constipation has expanded over the past few years, a substantial proportion of constipated patients do not respond to these medications. This review summarizes the pharmacological and behavioral options for managing constipation and details the management of refractory constipation. Refractory constipation is defined as an inadequate improvement in constipation symptoms evaluated with an objective scale despite adequate therapy (ie, pharmacological and/or behavioral) that is based on the underlying pathophysiology of constipation. Minimally invasive (ie, rectal irrigation and percutaneous endoscopic colostomy) and surgical therapies are used to manage refractory constipation. This review appraises these options, and in particular, percutaneous endoscopic colostomy, which as detailed by an article in this issue, is a less invasive option for managing refractory constipation than surgery. While these options benefit some patients, the evidence of the risk: benefit profile for these therapies is limited. © 2018 John Wiley & Sons Ltd.

Evaluation of two different operations to implant the Ahmed glaucoma valve in patients with refractory glaucoma

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Yue Wu

2016-04-01

Full Text Available AIM:To evaluate the efficacy and safety of Ahmed glaucoma valve(AGVimplantation surgery using different methods. METHODS:This was a retrospective study of patients with refractory glaucoma in whom AGV implantation was performed between June 2011 and September 2014. According to the method of tube insertion into the anterior chamber, the sample was divided into two groups, needle-generated scleral tunnel and scleral flap. The surgical success rate, intraocular pressure(IOP, number of antiglaucoma medications used, best correct visual acuity, postoperative complications, and operation duration were analyzed between the two groups. RESULTS:Compared with preoperative data, the two groups showed statistically significant decrease on IOP and the number of antiglaucoma medication used at all follow-up points(PP=0.932; however, statistically significant differences were detected when flat anterior chamber complications between the needle-generated scleral tunnel group(6%and the scleral flap group(24%were compared(P=0.032. CONCLUSION:AGV implantation may be an effective method in managing refractory glaucoma, since the two methods have similar efficacy. However, the needle-generated scleral tunnel technique application could greatly decrease the incidence of flat anterior chamber complications and decrease the duration of the operation.

Palbociclib in Treating Patients With Relapsed or Refractory Rb Positive Advanced Solid Tumors, Non-Hodgkin Lymphoma, or Histiocytic Disorders With Activating Alterations in Cell Cycle Genes (A Pediatric MATCH Treatment Trial)

Science.gov (United States)

2018-05-15

Advanced Malignant Solid Neoplasm; RB1 Positive; Recurrent Childhood Ependymoma; Recurrent Ewing Sarcoma; Recurrent Glioma; Recurrent Hepatoblastoma; Recurrent Kidney Wilms Tumor; Recurrent Langerhans Cell Histiocytosis; Recurrent Malignant Germ Cell Tumor; Recurrent Malignant Glioma; Recurrent Medulloblastoma; Recurrent Neuroblastoma; Recurrent Non-Hodgkin Lymphoma; Recurrent Osteosarcoma; Recurrent Peripheral Primitive Neuroectodermal Tumor; Recurrent Rhabdoid Tumor; Recurrent Rhabdomyosarcoma; Recurrent Soft Tissue Sarcoma; Refractory Ependymoma; Refractory Ewing Sarcoma; Refractory Glioma; Refractory Hepatoblastoma; Refractory Langerhans Cell Histiocytosis; Refractory Malignant Germ Cell Tumor; Refractory Malignant Glioma; Refractory Medulloblastoma; Refractory Neuroblastoma; Refractory Non-Hodgkin Lymphoma; Refractory Osteosarcoma; Refractory Peripheral Primitive Neuroectodermal Tumor; Refractory Rhabdoid Tumor; Refractory Rhabdomyosarcoma; Refractory Soft Tissue Sarcoma

Intravenous ketogenic diet therapy for treatment of the acute stage of super-refractory status epilepticus in a pediatric patient.

Science.gov (United States)

Lin, Jainn-Jim; Lin, Kuang-Lin; Chan, Oi-Wa; Hsia, Shao-Hsuan; Wang, Huei-Shyong

2015-04-01

A ketogenic diet has been used successfully to treat intractable epilepsy. However, the role of early intravenous initiation of ketogenic diet in the acute phase of super-refractory status epilepticus is not well-described. An intravenous ketogenic diet was administered to a boy with super-refractory status epilepticus. At 24 hours after intravenous ketogenic diet, moderate ketosis appeared, and thiamylal was successfully weaned at 70 hours after admission. An intravenous ketogenic regimen led to subsequent ketosis and seizure control in a child with super-refractory status epilepticus. Early induction of ketosis may be a novel strategy to effectively treat super-refractory status epilepticus. Although there are few data regarding the early use of intravenous ketogenic diet in the treatment of super-refractory status epilepticus, it may be considered an alternative option. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of refractory lining wear of Companhia Siderurgica Nacional (CSN) blast furnaces

International Nuclear Information System (INIS)

Santos, N.J. dos; Mello, A.H.B. de; Pereira, C.L.; Paula Sarkis, D. de; Martins Filho, D.I.; Banados Perez, H.E.; Carvalho, G.; Daltro, T.F.L.

1984-01-01

The blast furnace refractory linings are submitted to unfavourable conditions such as alkalis attack, temperature, top pressure, abrasion and so forth... After studies on distribution and installation of radioactive sources with low activities in the refractory lining, it was possible to develop a new technique of thickness evaluation and attendance of wearing in the furnace lining. The viability analysis, simulated laboratory tests, localization, identification, installations and periodical measurements of the radioactive sources are described, as well the results obtained on the present campaign of CSN Blast Furnaces. (Author) [pt

Extracorporeal membrane oxygenation for refractory cardiac arrest

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Steven A Conrad

2017-01-01

Full Text Available Extracorporeal cardiopulmonary resuscitation (ECPR is the use of rapid deployment venoarterial (VA extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR. Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates. Percutaneous cannulation where feasible is rapid and can be performed by nonsurgeons (emergency physicians, intensivists, cardiologists, and interventional radiologists. Modern extracorporeal systems are easy to prime and manage and are technically easy to manage with proper training and experience. ECPR can be deployed in the emergency department for out-of-hospital arrest or in various inpatient units for in-hospital arrest. ECPR should be considered for patients with refractory cardiac arrest in hospitals with an existing extracorporeal life support program, able to provide rapid deployment of support, and with resources to provide postresuscitation evaluation and management.

Control of the refractory lining wear in blast furnaces, using a radiotracer technique

International Nuclear Information System (INIS)

Carvalho, G.; Vieira, J.M.; Daltro, T.F.L.; Banados Perez, H.E.

1984-01-01

Small metal 60 Co sources, double encapsulated with quartz and alumina, were inserted (at different depths and levels) into the refractory bricks of the blast furnace walls, and the initial radioactivity emerging at each location recorded as a reference data for future measurements. The displacement of the charge inside the blast furnace originates a progressive wear of the refractory lining and after certain time, the inner sources will begin to be scaped off from the wall and then dissolved in the molten iron. By periodically monitoring the radiation level at the points where the sources were placed, it is possible to know if some of them was removed by the wearing process. This, in turn, will indicate the thickness of refractory material lost in each location making of the blast furnace, as a function of time. The practical application of this method in the Brazilian steel industry is reported. (Author) [pt

Mechanical properties correlation to processing parameters for advanced alumina based refractories

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Dimitrijević Marija M.

2012-01-01

Full Text Available Alumina based refractories are usually used in metallurgical furnaces and their thermal shock resistance is of great importance. In order to improve thermal shock resistance and mechanical properties of alumina based refractories short ceramic fibers were added to the material. SEM technique was used to compare the microstructure of specimens and the observed images gave the porosity and morphological characteristics of pores in the specimens. Standard compression test was used to determine the modulus of elasticity and compression strength. Results obtained from thermal shock testing and mechanical properties measurements were used to establish regression models that correlated specimen properties to process parameters.

Experimental investigation of the thermal conductivity of the green refractory concrete

International Nuclear Information System (INIS)

Santos, W.N. dos; Sylos Cintra Filho, J. de; Baldo, J.B.

1989-01-01

In this work the thermal conductivity of an aluminous refractory concrete, cured at 22 0 C and dried at 110 0 C is experimentally measured and the resulting behaviour is analysed as a function of temperature, from room temperature up to 1000 0 C. The experimental technique employed was the hot wire parallel technique, and the calculations which lead the the material thermal conductivity are carried out by using a non linear least squares fitting method. Experimental results show, among others, the strong influence of the adsorbed water in the behaviour of the thermal conductivity of the green refractory concrete, at temperatures below 200 0 C [pt

Proceedings of the Conference on Refractory Alloying Elements in Superalloys

International Nuclear Information System (INIS)

1984-01-01

Some papers about the use of refractory metals in superalloys are presented. Mechanical properties, thermodynamics properties, use for nuclear fuels and corrosion resistance of those alloys are studied. (E.G.) [pt

Engineering data bases for refractory alloys

International Nuclear Information System (INIS)

Cooper, R.H. Jr.; Harms, W.O.

1985-01-01

Refractory alloys based on niobium, molybdenum, tantalum, and tungsten are required for the multi-100kW(e) space nuclear reactor power concepts that have been assessed in the SP-100 Program because of the extremely high temperatures involved. A review is presented of the technology efforts on the candidate refractory alloys in the areas of availability/fabricability, mechanical properties, irradiation effects, and compatibility. Of the niobium-base alloys, only Nb-1Zr has a data base that is sufficiently comprehensive for the high level of confidence required in the reference-alloy selection process for the reactor concept to be tested in the Ground Engineering System (GES) Phase of the SP-100 Program. Based on relatively short-term tests, the alloy PWC-11 (Nb-1Zr-0.1C) appears to have significantly greater creep strength than Nb-1Zr; however, concerns as to whether this precipitation-hardened alloy will remain thermally stable during seven years of full-power reactor operation need to be resolved. Additional information on the reference GES alloy will be needed for the detailed engineering design of a space power system and the fabrication of prototypical GES test components. Expedient development and demonstration of an adequate total manufacturing capability will be required if a high risk of significant schedule slippages and cost overruns is to be avoided. 4 refs., 1 fig., 3 tabs

Azacitidine and lenalidomide as an alternative treatment for refractory acute myeloid leukemia: a case report.

Science.gov (United States)

Todaro, Juliana; Bollmann, Patrícia Weinschenker; Rother, Edna Terezinha; del Giglio, Auro

2015-01-01

Refractory acute myeloid leukemia (AML) is a difficult disease to control with second or third-line chemotherapy regimens. In this report, we describe using azacitidine in combination with lenalidomide as salvage therapy. 52-year-old female was diagnosed with refractory AML and high-risk cytogenetics: complex monosomal karyotype consisting of t (3, 3) in association with monosomy 7 and del 5q. Morphological remission associated with maintenance of the cytogenetic abnormality of chromosome 3 and disappearance of the abnormalities relating to chromosomes 5 and 7 was achieved after three cycles of combination therapy with azacitidine and lenalidomide. Azacitidine plus lenalidomide can be a therapeutic option for patients with refractory AML, as illustrated in this case.

Mechanical properties of refractory concretes for boilers; Propriedades mecanicas de concretos refratarios para caldeiras

Energy Technology Data Exchange (ETDEWEB)

Angioletto, E.; Pelisser, F.; Peterson, M.; Angioletto, E.; Rocha, M.R.; Arnt, A.B.C. [Universidade do Estado de Santa Catarina (UDESC), Criciuma, SC (Brazil)], E-mail: ean@unesc.net; Coelho, R. [Tractebel Energia, Florianpolis, SC (Brazil)

2010-07-01

Refractory concretes are used in extremely physically demanding conditions. An important example is concretes used as sealing systems in boilers, where their dimensional stability at high temperatures is fundamental to durability and has a strong impact on maintenance costs and system idleness. In this work, refractory concretes with different compositions were characterized and then tested by dilatometry, for compressive strength and in assays involving adherence between tensile concrete/metal inserts, simulating the fixing system in boilers. Analysis of the results showed that refractory concretes do not present retraction due to air during drying, eliminating the possibility of cracking. While casting the plate/prototype with metal inserts, satisfactory concrete/metal adherence was verified and surface cracking occurred that did not influence the tensile bond strength between the insert and the concrete. (author)

Refractory for Black Liquor Gasifiers

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Xiaoting Laing

2005-10-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

REFRACTORY FOR BLACK LIQUOR GASIFIERS

Energy Technology Data Exchange (ETDEWEB)

William L. Headrick Jr; Musa Karakus; Jun Wei

2005-03-01

The University of Missouri-Rolla will identify materials that will permit the safe, reliable and economical operation of combined cycle gasifiers by the pulp and paper industry. The primary emphasis of this project will be to resolve the material problems encountered during the operation of low-pressure high-temperature (LPHT) and low-pressure low-temperature (LPLT) gasifiers while simultaneously understanding the materials barriers to the successful demonstration of high-pressure high-temperature (HPHT) black liquor gasifiers. This study will define the chemical, thermal and physical conditions in current and proposed gasifier designs and then modify existing materials and develop new materials to successfully meet the formidable material challenges. Resolving the material challenges of black liquor gasification combined cycle technology will provide energy, environmental, and economic benefits that include higher thermal efficiencies, up to three times greater electrical output per unit of fuel, and lower emissions. In the near term, adoption of this technology will allow the pulp and paper industry greater capital effectiveness and flexibility, as gasifiers are added to increase mill capacity. In the long term, combined-cycle gasification will lessen the industry's environmental impact while increasing its potential for energy production, allowing the production of all the mill's heat and power needs along with surplus electricity being returned to the grid. An added benefit will be the potential elimination of the possibility of smelt-water explosions, which constitute an important safety concern wherever conventional Tomlinson recovery boilers are operated. Developing cost-effective materials with improved performance in gasifier environments may be the best answer to the material challenges presented by black liquor gasification. Refractory materials may be selected/developed that either react with the gasifier environment to form protective

Pembrolizumab Alone or With Idelalisib or Ibrutinib in Treating Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia or Other Low-Grade B-Cell Non-Hodgkin Lymphomas

Science.gov (United States)

2017-06-30

Recurrent Chronic Lymphocytic Leukemia; Recurrent Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Lymphoplasmacytic Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Nodal Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Recurrent Splenic Marginal Zone Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; Refractory Follicular Lymphoma; Refractory Lymphoplasmacytic Lymphoma; Refractory Nodal Marginal Zone Lymphoma; Refractory Small Lymphocytic Lymphoma; Refractory Splenic Marginal Zone Lymphoma; Richter Syndrome; Waldenstrom Macroglobulinemia

Treatment of refractory organic pollutants in industrial wastewater by wet air oxidation

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Mingming Luan

2017-02-01

Full Text Available Wet air oxidation (WAO is one of the most economical and environmentally-friendly advanced oxidation processes. It makes a promising technology for the treatment of refractory organic pollutants in industrial wastewaters. In wet air oxidation aqueous waste is oxidized in the liquid phase at high temperatures (125–320 °C and pressures (0.5–20 MPa in the presence of an oxygen-containing gas (usually air. The advantages of the process include low operating costs and minimal air pollution discharges. The present review is concerned about the literature published in the treatment of refractory organic pollutants in industrial wastewaters, such as dyes. Phenolics were taken as model pollutants in most cases. Reports on effect of treatment for the WAO of refractory organic pollutants in industrial wastewaters are reviewed, such as emulsified wastewater, TNT red water, etc. Discussions are also made on the mechanism and kinetics of WAO and main technical parameters influencing WAO. Finally, development direction of WAO is summed up.

Ketamine infusion for refractory status epilepticus: A case report of cardiac arrest.

Science.gov (United States)

Koffman, Lauren; Yan Yiu, Ho; Farrokh, Salia; Lewin, John; Geocadin, Romergryko; Ziai, Wendy

2018-01-01

Refractory status epilepticus (RSE) has a high mortality rate and is often difficult to treat. When traditional therapies fail ketamine may be considered. There are limited reports of adverse cardiac events with the use of ketamine for RSE and no reports of cardiac arrest in this context. Evaluate the occurrence of cardiac arrhythmias associated with the use of ketamine for RSE. Retrospective chart review of nine patients who underwent ketamine infusion for RSE. Etiology of refractory status epilepticus included autoimmune/infectious process (Zeiler et al., 2014), ischemic stroke (Bleck, 2005) and subarachnoid hemorrhage (Bleck, 2005). Of the nine patients who received ketamine, two had documented cardiac events; one remained clinically stable and the other developed multiple arrhythmias, including recurrent episodes of asystole. Once ketamine was discontinued the latter patient stabilized with the addition of anti arrhythmic therapy. Ketamine is utilized to treat refractory status epilepticus, but should be used with caution in patients with subarachnoid hemorrhage, as there may be an increased risk of life threatening arrhythmias and cardiac arrest. Copyright © 2017 Elsevier Ltd. All rights reserved.

Usefulness of a pleuroperitoneal shunt for treatment of refractory pleural effusion in a patient receiving maintenance hemodialysis.

Science.gov (United States)

Habuka, Masato; Ito, Toru; Yoshizawa, Yuta; Matsuo, Koji; Murakami, Shuichi; Kondo, Daisuke; Kanazawa, Hiroshi; Narita, Ichiei

2018-03-23

Refractory pleural effusion can be a life-threatening complication in patients receiving maintenance hemodialysis. We report successful treatment of refractory pleural effusion using a Denver® pleuroperitoneal shunt in one such patient. A 54-year-old Japanese man, who had previously undergone left nephrectomy, was admitted urgently to our department because of a high C-reactive protein (CRP) level, right pleural effusion, and right renal abscess. Because antibiotics proved ineffective and his general state was deteriorating, he underwent emergency insertion of a thoracic drainage tube and nephrectomy, and hemodialysis was started. Although his general state improved slowly thereafter, the pleural effusion, which was unilateral and transudative, remained refractory and therefore he needed to be on oxygenation. To control the massive pleural effusion, a pleuroperitoneal shunt was inserted. Thereafter, his respiratory condition became stable without oxygenation and he was discharged. His general condition has since been well. Although pleural effusion is a common complication of maintenance hemodialysis, few reports have documented the use of pleuroperitoneal shunt to control refractory pleural effusion. Pleuroperitoneal shunt has been advocated as an effective and low-morbidity treatment for refractory pleural effusion, and its use for some patients with recurrent pleural effusion has also been reported, without any severe complications. In the present case, pleuroperitoneal shunt improved the patient's quality of life sufficiently to allow him to be discharged home without oxygenation. Pleuroperitoneal shunt should be considered a useful treatment option for hemodialysis patients with refractory pleural effusion.

Recent materials compatibility studies in refractory metal-alkali metal systems for space power applications.

Science.gov (United States)

Harrison, R. W.; Hoffman, E. E.; Davies, R. L.

1972-01-01

Advanced Rankine and other proposed space power systems utilize refractory metals in contact with both single-phase and two-phase alkali metals at elevated temperatures. A number of recent compatibility experiments are described which emphasize the excellent compatibility of refractory metals with the alkali metals, lithium, sodium, and potassium, under a variety of environmental conditions. The alkali metal compatibilities of tantalum-, columbium-, molybdenum-, and tungsten-base alloys are discussed.

Refractory pulmonary sarcoidosis - proposal of a definition and recommendations for the diagnostic and therapeutic approach.

Science.gov (United States)

Korsten, Peter; Strohmayer, Katharina; Baughman, Robert P; Sweiss, Nadera J

2016-03-01

Patients with sarcoidosis undergo spontaneous remission or may be effectively controlled with glucocorticoids alone in many cases. Progressive and refractory pulmonary sarcoidoisis constitute more than 10% of patients seen at specialized centers. Pulmonary fibrosis and associated complications, such as infections and pulmonary hypertension are leading causes of mortality. No universal definition of refractoriness exists, we therefore propose classifying patients as having refractory disease when the following criteria are fulfilled: (1) progressive disease despite at least 10 mg of prednisolone or equivalent for at least three months and need for additional disease-modifying anti-sarcoid drugs due to lack of efficacy, drug toxicity or intolerability and (2) treatment started for significant impairment of life due to progressive pulmonary symptoms. Both criteria should be fulfilled. Treatment options in addition to or instead of glucocorticoids for these patients include second- (methotrexate, azathioprine, leflunomide) and third-line agents (infliximab, adalimumab). Other immunmodulating agents can be used, but the evidence is very limited. Newer agents with anti-fibrotic properties, such as pirfenidone or nintedanib, might hold promise also for the pulmonary fibrosis seen in sarcoidosis. Treating physicians have to actively look for potentially treatable complications, such as pulmonary hypertension, cardiac disease or infections before patients should be classified as treatment-refractory. Ultimately, lung transplantation has to be considered as treatment option for patients not responding to medical therapy. In this review, we aim to propose a new definition of refractoriness, describe the associated clinical features and suggest the therapeutic approach.

Rapid clozapine titration in treatment-refractory bipolar disorder.

Science.gov (United States)

Ifteni, Petru; Correll, Christoph U; Nielsen, Jimmi; Burtea, Victoria; Kane, John M; Manu, Peter

2014-09-01

Clozapine is effective in treatment-refractory bipolar disorder (BD). Guidelines recommend slow titration to prevent seizures, hypotension and myocarditis, but this stance is not supported by comparative data. To evaluate the safety and effectiveness of rapid clozapine titration in BD. Analysis of a consecutive cohort of treatment-refractory BD patients with mixed/manic episode admitted on alternate days to one of two units of a psychiatric hospital. On one unit, clozapine was started at 25mg followed by 25-50mg as needed every 6h (maximum=100mg/day) on day 1, followed by increases of 25-100mg/day. On the other unit, clozapine was initiated with 25mg in day 1, followed by increases of 25-50mg/day. The primary outcome was the number of days from starting clozapine until readiness for discharge, adjusted in logistic regression for the number of antipsychotics tried during the hospitalization, psychotropic co-treatments and presence of psychotic features. Patients subject to rapid (N=44) and standard (N=23) titration were similar in age, gender, smoking status, body mass index, illness severity at baseline and discharge, and highest clozapine dose. Clozapine was discontinued due to hypotension (N=1) and pneumonia (N=1) during rapid titration, and for excessive sedation (N=1) in each titration group. The number of hospital days from starting clozapine until readiness for discharge was 3.8 days shorter in the rapid titration group (12.7±6.3 vs. 16.5±5.8, p=0.0077). Rapid clozapine titration appeared safe and effective for treatment-refractory BD. The potential for shorter hospital stays justifies prospective trials of this method. Copyright © 2014 Elsevier B.V. All rights reserved.

Refractory gastroesophageal reflux disease

Science.gov (United States)

Subramanian, Charumathi Raghu; Triadafilopoulos, George

2015-01-01

Gastroesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach contents into the esophagus causes troublesome symptoms, esophageal injury, and/or complications. Use of proton pump inhibitors (PPI) remains the standard therapy for GERD and is effective in most patients. Those whose symptoms are refractory to PPIs should be evaluated further and other treatment options should be considered, according to individual patient characteristics. Response to PPIs could be total (no symptoms), partial (residual breakthrough symptoms), or absent (no change in symptoms). Patients experiencing complete response do not usually need further management. Patients with partial response can be treated surgically or by using emerging endoscopic therapies. Patients who exhibit no response to PPI need further evaluation to rule out other causes. PMID:25274499

Higher order aberrations in amblyopic children and their role in refractory amblyopia

Directory of Open Access Journals (Sweden)

Arnaldo Dias-Santos

2014-12-01

Full Text Available Objective: Some studies have hypothesized that an unfavourable higher order aberrometric profile could act as an amblyogenic mechanism and may be responsible for some amblyopic cases that are refractory to conventional treatment or cases of “idiopathic” amblyopia. This study compared the aberrometric profile in amblyopic children to that of children with normal visual development and compared the aberrometric profile in corrected amblyopic eyes and refractory amblyopic eyes with that of healthy eyes. Methods: Cross-sectional study with three groups of children – the CA group (22 eyes of 11 children with unilateral corrected amblyopia, the RA group (24 eyes of 13 children with unilateral refractory amblyopia and the C group (28 eyes of 14 children with normal visual development. Higher order aberrations were evaluated using an OPD-Scan III (NIDEK. Comparisons of the aberrometric profile were made between these groups as well as between the amblyopic and healthy eyes within the CA and RA groups. Results: Higher order aberrations with greater impact in visual quality were not significantly higher in the CA and RA groups when compared with the C group. Moreover, there were no statistically significant differences in the higher order aberrometric profile between the amblyopic and healthy eyes within the CA and RA groups. Conclusions: Contrary to lower order aberrations (e.g., myopia, hyperopia, primary astigmatism, higher order aberrations do not seem to be involved in the etiopathogenesis of amblyopia. Therefore, these are likely not the cause of most cases of refractory amblyopia.

Diverting Ileostomy for the Treatment of Severe, Refractory, Pediatric Inflammatory Bowel Disease.

Science.gov (United States)

Maxwell, Elizabeth C; Dawany, Noor; Baldassano, Robert N; Mamula, Petar; Mattei, Peter; Albenberg, Lindsey; Kelsen, Judith R

2017-09-01

Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD. Clinical variables were compared in the 1 year before ileostomy and 1 year after diversion. Surgical and disease outcomes including changes in diagnosis were reviewed through 2015. Twenty-four patients underwent diverting ileostomy for refractory colonic disease. Initial diagnoses were Crohn disease in 10 (42%), ulcerative colitis in 1 (4%), and IBD-unclassified in 13 patients (54%). Comparing data before and after surgery, there were statistically significant improvements in height and weight velocities, height velocity z score, blood transfusion requirement, hemoglobin, and hospitalization rates. Chronic steroid use decreased from 71% to 22%. At the conclusion of the study, 10 patients had undergone subsequent colectomy, 7 had successful bowel reanastomosis, and 7 remain diverted. Seven patients (29%) had a change in diagnosis. There were 13 surgical complications in 7 subjects, including prolapse reduction, stoma revision, and resection of ischemic bowel. In pediatric patients with refractory colonic IBD, diverting ileostomy can be a successful intervention to induce clinical stability. Importantly, diversion is a steroid-sparing therapy and allows additional time to clarify the diagnosis.

A refractory metal gate approach for micronic CMOS technology

International Nuclear Information System (INIS)

Lubowiecki, V.; Ledys, J.L.; Plossu, C.; Balland, B.

1987-01-01

In the future, devices scaling down, integration density and performance improvements are going to bring a number of conventional circuit design and process techniques to their fundamental limits. To avoid any severe limitations in MOS ULSI (Ultra Large Scale Integration) technologies, interconnection materials and schemes are required to emerge, in order to face the Megabits memory field. Among those, the gate approach will obviously take a keyrole, when the operating speed of ULSI chips will reach the practical upper limits imposed by parasitic resistances and capacitances which stem from the circuit interconnect wiring. Even if fairly suitable for MOS process, doped polycrystalline silicon is being gradually replaced by refractory metal silicide or polycide structures, which match better with low resistivity requirements. However, as we approach the submicronic IC's, higher conductivity materials will be paid more and more attention. Recently, works have been devoted and published on refractory metal gate technologies. Molybdenum or tungsten, deposited either by CVD or PVD methods, are currently reported even if some drawbacks in their process integration still remain. This paper is willing to present such an approach based on tungsten (more reliable than Molybdenum deposited by LPCVD (giving more conductive and more stable films than PVD). Deposition process will be first described. Then CMOS process flow will allow us to focus on specific refractory metal gate issues. Finally, electrical and physical properties will be assessed, which will demonstrate the feasibility of such a technology as well as the compatibility of the tungsten with most of the usual techniques

Primary Refractory and Relapsed Classical Hodgkin Lymphoma - Significance of Differential CD15 Expression in Hodgkin-Reed-Sternberg Cells

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Daniel Benharroch, Shai Pilosof, Jacob Gopas, Itai Levi

2012-01-01

Full Text Available We recognized a few possible complications of classical Hodgkin lymphoma therapy in a cohort of 209 patients: 8 developed a primary refractory disease (primary progression, 36 showed an early relapse and 21 showed a late relapse. Sialyl-CD15 expression in Hodgkin-Reed-Sternberg cells was significantly more positive in primary refractory Hodgkin lymphoma, which confirms our previously published findings. Bcl-2 showed a significantly lower level of expression in primary refractory disease than in the other follow-up groups. This is in contrast with a previous finding of Bcl-2, associated with a poor prognosis in primary refractory illness. Another category of variables, old age and advanced stages, was significantly different in the various complications but this finding is probably to be expected. We could not demonstrate a difference between the sequels and the control group with regard to several clinical and immunohistochemical markers. Sialyl-CD15 and Bcl-2 expression, in contrast, were confirmed as prognostic factors, mainly of tumor progression into primary refractory disease.

Modern approaches for management of the refractory immune thrombocytopenia in pregnancy

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Davydova Iu.

2017-01-01

Full Text Available Background. Thrombocytopenia per se is one of the hematological diseases, which demands the repeated thrombocytes infusion. The last tendencies in the management of this disease show the enhanced amount of the necessary thrombocytes doses for treatment and the worldwide trend for the declining of donors. Considerably to these facts the new approaches for the thrombocytopenia treatment have been organized within last two decades. One of them is the finding of the safe, appropriate and effective growth factor for platelets, which could significantly improve the level of thrombocytes. The article describes the case of refractory ITP management in pregnancy. ITP diagnosed at 26 weeks of gestation, the platelet number at the time of diagnostics 20000. The other bone marrow disorders excluded by bone marrow biopsy. The in-patient of the High Risk Pregnancy Department (Obstetric Issues of the Extragenital Pathology from the 28 weeks of pregnancy. Modern approaches for treatment of ITP was describe in the article. Pregnant received therapy according to the latest guidelines. Delivery in term of 33–34 weeks. Integrated treatment of thrombocytopenia. Conclusions. The refractory ITP is a rare disease and could be occasionally seen during pregnancy, but the hemorrhagic complications could be extremely harmful for both mother and child and demand the preterm pregnancy termination. The management of refractory ITP during pregnancy should be performed according to the International recommendations for the thrombocytopenia treatment with all the reserve of the medications. The positive result of the ITP management and perinatal and obstetric outcomes has been achieved through the use of the entire arsenal of drugs, correct tactics of delivery with hemorrhage prevention be using the 4 T strategy and the adequate doses of the tranexamic acid (sangera and rhTPO (Emaplug (Yuriya-Farm, Ukraine. It was the first implementation of the subcutaneous rhTPO in

Efficacy of infliximab in refractory posterior uveitis in Behcet's disease patients

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Ayman K. El Garf

2018-04-01

Full Text Available Aim of the work: Ocular manifestations are the main cause of morbidity in Behcet's disease (BD. Infliximab (IFX, a chimeric monoclonal antibody directed against tumor necrosis factor-alpha, may be efficient in refractory uveitis due to BD. The aim of this study was to assess the efficacy and safety of IFX in the treatment of patients with BD-associated refractory posterior uveitis (PU. Patient and Methods: Twenty patients with refractory Behcet's PU received IFX therapy as intravenous infusions at the dose of 5 mg/kg at weeks 0,2, 6 (induction and every 8 weeks for a maximum of 6 infusions. Results: The mean age of the patients was 31.8 ± 9.1 years, disease duration was 8 ± 6 years and 17 (85% were males. After the third IFX infusion (week 8 a complete remission of PU was recorded in 8/20 (40% patients and partial remission in 12/20 (60% patients. At the end of week 32 a complete remission of PU was recorded in a total of 14 (70% patients. The visual acuity of the 36 affected eyes (16 bilateral and 4 unilateral showed a significant improvement at the week 8, and at week 32, while there was no additional improvement at week 56. Relapse occurred in 6 patients (30% between week 9 and week 18 with a mean of 13.5 weeks. Conclusion: IFX infusion should be considered for the control of acute PU, whereas repeated long-term IFX infusions were effective in reducing the number of episodes in refractory PU with fast regression and complete remission of complications. Keywords: Behçet’s disease, Posterior uveitis, Retinal vasculitis, Infliximab

Response to rituximab in a refractory case of thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus

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Niaz Faraz

2010-01-01

Full Text Available Thrombotic thrombocytopenic purpura (TTP is a serious disorder with a significant morbidity and mortality. Majority of cases of TTP are idiopathic, but some cases may be secon-dary to connective tissue diseases. TTP has been rarely associated with systemic lupus erythe-matosus (SLE and may be refractory to treatment with plasma exchange, requiring immuno-suppressive therapy. We describe a patient with TTP and SLE who was refractory to plasma exchange and corticosteroids but responded to anti-CD20 antibody rituximab with continued re-mission after eight months of follow-up. Rituximab appears to be an effective treatment in re-fractory cases of TTP associated with SLE.

Presentation of the Nuclear Material Metrology Laboratory (LAMMAN)

International Nuclear Information System (INIS)

Arpigny, S.; Biscarrat, C.; Ruas, A.; Viallesoubranne, C.; Hanssens, A.; Roche, C.

2008-01-01

The EQRAIN Uranium or Plutonium programmes (Evaluation of the Quality of Analysis Results in the Nuclear Industry) have led to the creation of round-robins, which require reference solutions of uranyl nitrate or of plutonium nitrate to be made available. The samples are fabricated and packaged, and their benchmark values determined, by the Nuclear Material Metrology Laboratory in the Atalante facility. All the operations are carried out by highly precise weighing, including correction for air buoyancy. In order to guarantee the preservation of reference samples, a laser-sealing apparatus is used to condition the final solutions in ampoules. Random tests to check the concentration of uranium or plutonium are carried out on a certain number of ampoules after the sealing step. The analysis are performed on a photo-gravimetric analysis line (in glove box for Pu) based on the titanium potentiometric analysis method. The ampoules are then packaged and delivered to the participating laboratories. The French nuclear laboratories participating in the EQRAIN programs belong to the Cea and to the AREVA Group, with activities covering the entire fuel cycle. They have been joined by new participants from European, Japanese and South American laboratories

Presentation of the Nuclear Material Metrology Laboratory (LAMMAN)

Energy Technology Data Exchange (ETDEWEB)

Arpigny, S.; Biscarrat, C.; Ruas, A.; Viallesoubranne, C. [CEA/DEN/DRCP/SE2A/LAMM, Marcoule, BP 17171, 30207 Bagnols sur Ceze (France); Hanssens, A.; Roche, C. [CEA/DEN/DRCP/CETAMA Marcoule, BP 17171, 30207 Bagnols sur Ceze (France)

2008-07-01

The EQRAIN Uranium or Plutonium programmes (Evaluation of the Quality of Analysis Results in the Nuclear Industry) have led to the creation of round-robins, which require reference solutions of uranyl nitrate or of plutonium nitrate to be made available. The samples are fabricated and packaged, and their benchmark values determined, by the Nuclear Material Metrology Laboratory in the Atalante facility. All the operations are carried out by highly precise weighing, including correction for air buoyancy. In order to guarantee the preservation of reference samples, a laser-sealing apparatus is used to condition the final solutions in ampoules. Random tests to check the concentration of uranium or plutonium are carried out on a certain number of ampoules after the sealing step. The analysis are performed on a photo-gravimetric analysis line (in glove box for Pu) based on the titanium potentiometric analysis method. The ampoules are then packaged and delivered to the participating laboratories. The French nuclear laboratories participating in the EQRAIN programs belong to the Cea and to the AREVA Group, with activities covering the entire fuel cycle. They have been joined by new participants from European, Japanese and South American laboratories.

A phase I study of vorinostat combined with bortezomib in Japanese patients with relapsed or refractory multiple myeloma.

Science.gov (United States)

Ogawa, Yoshiaki; Ogura, Michinori; Tobinai, Kensei; Ando, Kiyoshi; Suzuki, Tatsuya; Watanabe, Takashi; Ohmachi, Ken; Uchida, Toshiki; Hanson, Mary E; Tanaka, Yoshinobu; Koh, Yasuhiro; Shimamoto, Takashi; Hotta, Tomomitsu

2016-01-01

This study was undertaken to evaluate safety and pharmacokinetics and to determine treatment doses of vorinostat plus bortezomib in Japanese patients with relapsed or refractory multiple myeloma (MM). Of 9 originally enrolled patients, 2 were refractory to bortezomib, and both experienced dose-limiting toxicity (DLT), prompting a protocol amendment to exclude bortezomib-refractory individuals. Patients not considered bortezomib refractory (N = 7) received 21-day cycles of 1.3 mg/m(2) intravenous bortezomib (Days 1, 4, 8, and 11) and oral vorinostat 400 mg (Days 1 through 14) and were further evaluated. Vorinostat and bortezomib treatment doses were determined by DLT and safety, tolerability, and treatment response were assessed. Of 7 enrolled patients, 6 were evaluated, and one developed DLTs. The most common adverse events were leukopenia, neutropenia, thrombocytopenia, diarrhea, nausea, decreased appetite, and vomiting. Combination of vorinostat plus bortezomib did not increase vorinostat exposure at Day 11 [AUC0-24 h ratio (95% CI) = 1.08 (0.80, 1.45)]; geometric mean AUC0-24 h ratio for bortezomib (90% CI) was 1.96 (1.24-3.12). Objective therapeutic response occurred in 3 patients, including 1 complete response and 2 partial responses. Vorinostat 400 mg plus bortezomib 1.3 mg/m(2) was safe and well-tolerated in Japanese patients with relapsed or refractory MM not considered bortezomib refractory (NCT00858234).

Review of alkali metal and refractory alloy compatibility for Rankine cycle applications

International Nuclear Information System (INIS)

DiStefano, J.R.

1989-01-01

The principal corrosion mechanisms in refractory metal-alkali systems are dissolution, mass transfer, and impurity reactions. In general, niobium, tantalum, molybdenum, and tungsten have low solubilities in the alkali metals, even to very high temperatures, and static corrosion studies have verified that the systems are basically compatible. Loop studies with niobium and tantalum based alloys do not indicate any serious problems due to temperature gradient mass transfer. Above 1000 K, dissimilar metal mass transfer is noted between the refractory metals and iron or nickel based alloys. The most serious corrosion problems encountered are related to impurity reactions associated with oxygen

Repeat Intravitreal Dexamethasone Implant for Refractory Cystoid Macular Edema in Syphilitic Uveitis

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Cassandra C. Lautredou

2018-01-01

Full Text Available Purpose. To report the successful utilization of adjunctive repeat intravitreal corticosteroid therapy for the treatment of cystoid macular edema in syphilis-related uveitis. Methods/Patients. An HIV-positive patient with treated ocular syphilis who developed refractory cystoid macular edema (CME was treated with repeat intravitreal corticosteroid therapy including dexamethasone intravitreal implants. Results. Treatment led to the resolution of CME and improvement in visual acuity. Conclusions. Intravitreal corticosteroid therapy may be a viable adjunctive treatment for refractory CME in patients with treated syphilitic uveitis. Corticosteroid-induced exacerbation of infection is unlikely in patients with an adequate serologic treatment response.

Molecular Determinants of Hormone Refractory Prostate Cancer

Science.gov (United States)

2017-07-01

receptor is no longer essential for survival, collectively termed androgen pathway independent prostate cancer (APIPC) (Nelson, 2012). A subset of these...Reciprocal feedback regulation of PI3K and androgen receptor signaling in PTEN-deficient prostate cancer . Cancer Cell. 2011 May 17;19(5):575-86. Chen J, Li...2005a). The androgen receptor and signal-transduction pathways in hormone-refractory prostate cancer . Part 1: Modifications to the androgen receptor

Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina?

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Daniela Benedetto

2016-10-01

Full Text Available Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and / or revascularization (percutaneous or surgical. In addition the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus Reducer (CSR is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

DEFF Research Database (Denmark)

Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

2010-01-01

Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report...... successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...... for refractory angina pectoris can be performed in patients implanted with cardioverter defibrillators without interference. However, individual testing during implantation or re-programming the devices is mandatory in order to assess optimal safety in each patient....

Azacitidine and lenalidomide as an alternative treatment for refractory acute myeloid leukemia: a case report

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Juliana Todaro

Full Text Available CONTEXT:Refractory acute myeloid leukemia (AML is a difficult disease to control with second or third-line chemotherapy regimens. In this report, we describe using azacitidine in combination with lenalidomide as salvage therapy.CASE REPORT:52-year-old female was diagnosed with refractory AML and high-risk cytogenetics: complex monosomal karyotype consisting of t (3, 3 in association with monosomy 7 and del 5q. Morphological remission associated with maintenance of the cytogenetic abnormality of chromosome 3 and disappearance of the abnormalities relating to chromosomes 5 and 7 was achieved after three cycles of combination therapy with azacitidine and lenalidomide.CONCLUSION:Azacitidine plus lenalidomide can be a therapeutic option for patients with refractory AML, as illustrated in this case.

DESIGN OF EXPERIMENTS IN THE STUDY OF BAUXITE REFRACTORY CASTABLE PROPERTIES

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Ilona Kieliba

2017-07-01

Full Text Available This paper presents results of an investigation of the influence of preparation conditions of low-cement refractory castables on their service properties using experiment planning methods. Using the orthogonal Plackett-Burman design, the influence of the amount of water, vibration time, curing conditions and firing conditions on the service properties of the finished refractory castable (apparent density, open porosity, permanent linear changes, Young's modulus, bending strength and compressive strength at ambient temperature is demonstrated. It is found that, among the investigated properties under the conditions of the conducted experiment, only the mixing time is a negligible factor that has no significant influence on the process of developing service properties of low-cement bauxite castables.

iTRAQ-based Quantitative Proteomics Study in Patients with Refractory Mycoplasma pneumoniae Pneumonia.

Science.gov (United States)

Yu, Jia-Lu; Song, Qi-Fang; Xie, Zhi-Wei; Jiang, Wen-Hui; Chen, Jia-Hui; Fan, Hui-Feng; Xie, Ya-Ping; Lu, Gen

2017-09-25

Mycoplasma pneumoniae (MP) is a leading cause of community-acquired pneumonia in children and young adults. Although MP pneumonia is usually benign and self-limited, in some cases it can develop into life-threating refractory MP pneumonia (RMPP). However, the pathogenesis of RMPP is poorly understood. The identification and characterization of proteins related to RMPP could provide a proof of principle to facilitate appropriate diagnostic and therapeutic strategies for treating paients with MP. In this study, we used a quantitative proteomic technique (iTRAQ) to analyze MP-related proteins in serum samples from 5 patients with RMPP, 5 patients with non-refractory MP pneumonia (NRMPP), and 5 healthy children. Functional classification, sub-cellular localization, and protein interaction network analysis were carried out based on protein annotation through evolutionary relationship (PANTHER) and Cytoscape analysis. A total of 260 differentially expressed proteins were identified in the RMPP and NRMPP groups. Compared to the control group, the NRMPP and RMPP groups showed 134 (70 up-regulated and 64 down-regulated) and 126 (63 up-regulated and 63 down-regulated) differentially expressed proteins, respectively. The complex functional classification and protein interaction network of the identified proteins reflected the complex pathogenesis of RMPP. Our study provides the first comprehensive proteome map of RMPP-related proteins from MP pneumonia. These profiles may be useful as part of a diagnostic panel, and the identified proteins provide new insights into the pathological mechanisms underlying RMPP.

Refractories for steelmaking in Japan; Seikoyo taikabutsu no genjo (Nippon ni okeru seikoyo taikabutsu no hensen)

Energy Technology Data Exchange (ETDEWEB)

Kataoka, S. [Kurosaki Refractories Co. Ltd., Fukuoka (Japan)

1996-05-01

This paper describes changes and the current state of refractories for steel making in Japan. Refractories used for torpedo cars have undergone material improvement and diagnostic technology progress in alumina-SiC-C brick that serve in extending life and reducing unit requirement in furnace materials. The improvement and progress have been achieved under diversification in the methods of preliminary treatment of molten pig iron. In refractories for converters, the MgO-C brick had epoch-making improvement in life because of its excellent spalling and corrosion resistance resulting in expansion of its use. Refractories for iron ladles have been changed largely keeping the pace with progress in steelmaking technologies. Attempts have been made from using acidic refractories including zircon brick material to applying neutral and basic bricks. On the other hand, application of monolithic materials has begun, which has led to realizing the totally monolithic lining together with the progress in the repairing technologies including spraying. Plate materials for sliding gate nozzle to control flow rate of molten steel from an iron ladle now use Al2O3-C as the mainstream after having gone through a number of improvements. Alumina graphite material is used as the mainstream for immersion nozzles and shrouds which are important for continuous casting. 57 refs., 37 figs., 19 tabs.

Longstanding refractory pseudophakic cystoid macular edema resolved using intravitreal 0.7 mg dexamethasone implants

DEFF Research Database (Denmark)

Brynskov, Troels; Laugesen, Caroline Schmidt; Halborg, Jakob

2013-01-01

Refractory pseudophakic cystoid macular edema (PCME) following cataract surgery has long posed a challenge to clinicians, but intravitreal injections with a sustained delivery 0.7 mg dexamethasone implant has emerged as a promising therapy for this condition.......Refractory pseudophakic cystoid macular edema (PCME) following cataract surgery has long posed a challenge to clinicians, but intravitreal injections with a sustained delivery 0.7 mg dexamethasone implant has emerged as a promising therapy for this condition....

Association of interleukin 17 / angiotensin II with refractory ...

African Journals Online (AJOL)

Table 2 Multiple linear regression analysis showing relationship between IL 17, Ang II and mean arterial pressure in hemodialysis patients. Variables. B t value. P value. IL 17. 6.320. 10.221. 0.000. Ang II. 0.143. 2.442. 0.017. Discussion. This study aimed to investigate the association between. IL 17 and the risk of refractory ...

The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences in Southwest Ethiopia.

Science.gov (United States)

Gessesse, Girum W

2015-07-01

The management of refractory glaucoma is a challenging task for any glaucoma surgeon. This study is aimed to evaluate the efficacy of Ahmed Glaucoma Valve implantation in refractory glaucomas in South-West Ethiopia. A retrospective review was conducted on the charts of consecutive patients treated with Ahmed glaucoma valve implantation at Jimma University Specialized Hospital between August 2012 and August 2014. Success was defined as Intraocular Pressure (IOP) less than 22 mm Hg and greater than 5mm Hg at 6 months, with at least 30% reduction from baseline, without medical therapy (complete success) or either with or without medication (qualified successes). A total of 12 eyes of 11 patients were included. The mean age of patients was 40.7 (SD= 19.0) years; 63.6% of them were males. The main types of glaucoma were pseudoexfoliative (3 eyes), uveitic (2 eyes), chronic angle closure (2 eyes) and Juvenile Open Angle (JOAG) (2 eyes). The mean IOP was reduced from preoperative level (32.75±7.14 mmHg) to (15.75 ±4.35 mmHg) at six postoperative months, (PAhmed glaucoma valve implant appears to be effective and relatively safe for treating complicated glaucomas with success rate comparable with those reported from other studies. Ahmed glaucoma valve, refractory glaucoma, complications, Ethiopia.

Radioactive iodine-refractory differentiated thyroid cancer: an uncommon but challenging situation

Energy Technology Data Exchange (ETDEWEB)

Schmidt, Angelica; Iglesias, Laura; Schlumberger, Martin J. [Institut Gustave Roussy, Univ. Paris-Saclay, Villejuif (France); Klain, Michele [Univ. Federico II di Napoli (Italy); Pitoia, Fabian [Division of Endocrinology, Hospital de Clinicas, Univ. of Buenos Aires (Argentina)

2017-01-15

Radioiodine (RAI)-refractory thyroid cancer is an uncommon entity, occurring with an estimated incidence of 4-5 cases/year/million people. RAI refractoriness is more frequent in older patients, in those with large metastases, in poorly differentiated thyroid cancer, and in those tumors with high 18-fluorodeoxyglucose uptake on PET/CT. These patients have a 10-year survival rate of less than 10%. In recent years, new therapeutic agents with molecular targets have become available, with multi kinase inhibitors (MKIs) being the most investigated drugs. Two of these compounds, sorafenib and lenvatinib, have shown significant objective response rates and have significantly improved the progression-free survival in the two largest published prospective trials on MKI use. However, no overall survival benefit has been achieved yet. This is probably related to the crossover that occurs in most patients who progress on placebo treatment to the open treatment of these studies. In consequence, the challenge is to correctly identify which patients will benefit from these treatments. It is also crucial to understand the appropriate timing to initiate MKI treatment and when to stop it. The purpose of this article is to define RAI refractoriness, to summarize which therapies are available for this condition, and to review how to select patients who are suitable for them. (author)

Nab-paclitaxel/Rituximab-coated Nanoparticle AR160 in Treating Patients With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma

Science.gov (United States)

2018-04-17

Aggressive Non-Hodgkin Lymphoma; CD20 Positive; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Small Lymphocytic Lymphoma

Issues Impacting Refractory Service Life in Biomass/Waste Gasification

Energy Technology Data Exchange (ETDEWEB)

Bennett, J.P.; Kwong, K.-S.; Powell, C.A.

2007-03-01

Different carbon sources are used, or are being considered, as feedstock for gasifiers; including natural gas, coal, petroleum coke, and biomass. Biomass has been used with limited success because of issues such as ash impurity interactions with the refractory liner, which will be discussed in this paper.

Trans-jugular intrahepatic porto-systemic shunt placement for refractory ascites: a 'real-world' UK health economic evaluation.

Science.gov (United States)

Parker, Matthew J; Guha, Neil; Stedman, Brian; Hacking, Nigel; Wright, Mark

2013-07-01

To assess the benefit of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement for refractory ascites. A retrospective observational study of all patients undergoing TIPS for refractory ascites in our hospital between 2003 and 2012. Secondary care. Cirrhotic patients with refractory ascites. We examined direct real-world (National Health Service) health related costs in the year before and after the TIPS procedure took place. Data were collected relating to the need for reintervention and hepatic encephalopathy. Data were available for 24 patients who underwent TIPS for refractory ascites (86% of eligible patients). TIPS was technically successful in all cases. Mean number of bed days in the year prior to TIPS was 30.3 and 14.3 in the year following (p=0.005). No patient had ascites at the end of the year after the TIPS with less requirement for paracentesis over the course of the year (p<0.001). Mean reduction in cost was £2759 per patient. TIPS was especially cost-effective in patients requiring between 6 and 12 drains per year with a mean saving of £9204 per patient. TIPS is both a clinically effective and economically advantageous therapeutic option for selected patients with refractory ascites.

ELABORATION PROCESS OF REFRACTORY MATERIALS BY REACTIVE PROJECTION OF OXIDE, PEROXIDE AND METALS

OpenAIRE

Pilatti , M.; Cransveld , J.; Raymond , G.; Plumat , E.; Duvigneaud , P.

1986-01-01

A device has been set up for spraying with accuracy a compound having a controlled grain size of refractory oxide, peroxide and metals. The refractory material is obtained by melting and recristallisation on a preheated substrate. Composition in the CaO.Al2O3 system and in the CaO-Al2O3-ZrO2 system have been synthesized. They have been analysed by X-ray diffraction and SEM. Dense and well cristallized materials have been deposited. This process can be successfully applied for the repair of a ...

A one-year prospective study of refractory status epilepticus in Modena, Italy.

Science.gov (United States)

Giovannini, Giada; Monti, Giulia; Polisi, Michela M; Mirandola, Laura; Marudi, Andrea; Pinelli, Giovanni; Valzania, Franco; Girardis, Massimo; Nichelli, Paolo F; Meletti, Stefano

2015-08-01

Refractory status epilepticus (RSE) is a particular critical condition characterized by seizures that continue despite the use of first- and second-line therapies and by high mortality. To date, only one prospective study investigated clinical features and prognostic factors in RSE. In this study, we performed a one-year prospective survey to identify clinical features, outcomes, and variables associated with the development of RSE in the adolescent and adult population of Modena, northern Italy. We observed 83 episodes of SE in 83 patients. In 31% of the cases, third-line therapy (anesthetic drug) was needed. Among this group, 14% resolved and were classified as RSE, while, in 17%, seizures recurred at withdrawal of anesthetics and were classified as super-RSE. The development of RSE/super-RSE was associated with a stuporous/comatose state at presentation and with the absence of a previous history of epilepsy. Refractory status epilepticus/super-refractory status epilepticus showed a worse outcome compared with responsive SE: 54% versus 21% for 30-day mortality; 19% versus 56% for a return to baseline condition. This prospective study confirms stupor/coma at onset as a relevant clinical factor associated with SE refractoriness. We observed a rate of RSE comparable with previous reports, with high mortality and morbidity. Mortality in the observed RSE was higher than in previous studies; this result is probably related to the low rate of a previous epilepsy history in our population that reflects a high incidence of acute symptomatic etiologies, especially the inclusion of patients with postanoxic SE who have a bad prognosis per se. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015 Elsevier Inc. All rights reserved.

Safety, efficacy, and biomarkers of nivolumab with vaccine in ipilimumab-refractory or -naive melanoma.

Science.gov (United States)

Weber, Jeffrey S; Kudchadkar, Ragini Reiney; Yu, Bin; Gallenstein, Donna; Horak, Christine E; Inzunza, H David; Zhao, Xiuhua; Martinez, Alberto J; Wang, Wenshi; Gibney, Geoffrey; Kroeger, Jodi; Eysmans, Cabell; Sarnaik, Amod A; Chen, Y Ann

2013-12-01

Nivolumab, a human immunoglobulin G4-blocking antibody against the T-cell programmed death-1 checkpoint protein, has activity against metastatic melanoma. Its safety, clinical efficacy, and correlative biomarkers were assessed with or without a peptide vaccine in ipilimumab-refractory and -naive melanoma. In this phase I study, 90 patients with unresectable stage III or IV melanoma who were ipilimumab naive and had experienced progression after at least one prior therapy (cohorts 1 to 3, 34 patients) or experienced progression after prior ipilimumab (cohorts 4 to 6, 56 patients) received nivolumab at 1, 3, or 10 mg/kg every 2 weeks for 24 weeks, then every 12 weeks for up to 2 years, with or without a multipeptide vaccine. Nivolumab with vaccine was well tolerated and safe at all doses. The RECIST 1.1 response rate for both ipilimumab-refractory and -naive patients was 25%. Median duration of response was not reached at a median of 8.1 months of follow-up. High pretreatment NY-ESO-1 and MART-1-specific CD8(+) T cells were associated with progression of disease. At week 12, increased peripheral-blood T regulatory cells and decreased antigen-specific T cells were associated with progression. PD-L1 tumor staining was associated with responses to nivolumab, but negative staining did not rule out a response. Patients who experienced progression after nivolumab could respond to ipilimumab. In patients with ipilimumab-refractory or -naive melanoma, nivolumab at 3 mg/kg with or without peptide vaccine was well tolerated and induced responses lasting up to 140 weeks. Responses to nivolumab in ipilimumab-refractory patients or to ipilimumab in nivolumab-refractory patients support combination or sequencing of nivolumab and ipilimumab.

REFRACTORY HYPERTENSION: EVIDENCE OF HEIGHTENED SYMPATHETIC ACTIVITY AS A CAUSE OF ANTIHYPERTENSIVE TREATMENT FAILURE

Science.gov (United States)

Dudenbostel, Tanja; Acelajado, Maria C.; Pisoni, Roberto; Li, Peng; Oparil, Suzanne; Calhoun, David A.

2015-01-01

Refractory hypertension is an extreme phenotype of treatment failure defined as uncontrolled blood pressure (BP) in spite of ≥5 classes of antihypertensive agents, including chlorthalidone and a mineralocorticoid receptor antagonist. A prospective evaluation of possible mechanisms of refractory hypertension has not been done. The goal of this study was to test for evidence of heightened sympathetic tone as indicated by 24-hr urinary (U-) normetanephrine levels, clinic and ambulatory heart rate (HR), HR variability (HRV), arterial stiffness as indexed by pulse wave velocity (PWV), and systemic vascular resistance (SVR) compared to patients with controlled resistant hypertension. Forty-four consecutive patients, 15 with refractory and 29 with controlled resistant hypertension, were evaluated prospectively. Refractory hypertensive patients were younger (48±13.3 vs. 56.5±14.1 years, p=0.038) and more likely female (80.0 vs 51.9 %, p=0.047) compared to patients with controlled resistant hypertension. They also had higher U-normetanephrine levels (464.4±250.2 vs. 309.8±147.6 μg/24h, p=0.03), higher clinic HR (77.8±7.7 vs. 68.8±7.6 bpm, p=0.001) and 24-hr ambulatory HR (77.8±7.7 vs 68.8±7.6, p=0.0018), higher PWV (11.8±2.2 vs. 9.4±1.5 m/s, p=0.009), reduced HRV (4.48 vs. 6.11, p=0.03), and higher SVR (3795±1753 vs. 2382±349 dyne·sec·cm5·m2, p=0.008). These findings are consistent with heightened sympathetic tone being a major contributor to antihypertensive treatment failure and highlight the need for effective sympatholytic therapies in patients with refractory hypertension. PMID:25987662

Interferon alpha-2a treatment for refractory Behcet uveitis in Korean patients.

Science.gov (United States)

Lee, Ji Hwan; Lee, Christopher Seungkyu; Lee, Sung Chul

2018-02-20

To evaluate therapeutic outcomes of interferon alpha-2a (IFNα2a) treatment in patients with Behcet's disease who were refractory to immunosuppressive agents. This retrospective case series reviewed the medical records of 5 patients with refractory Behcet uveitis from January 2011 to February 2017. IFNα2a was administered at a dose of 3 million IU 3 times per week. Clinical response, relapse rate, and change of visual acuity were evaluated. The mean age of patients was 39.60 ± 9.21 years, and the median treatment duration was 6 months. Four of the 5 patients (80%) presented with responses to IFNα2a without any uveitis attack during the treatment period. The mean number of uveitis attacks/year per patient during the treatment was 0.40 ± 0.89. The mean log of the Minimum Angle of Resolution visual acuity improved from 1.44 ± 0.38 at baseline to 1.02 ± 0.58 at the final follow up. IFNα2a is an effective therapy for Behcet uveitis refractory to conventional immunosuppressants in Korean patients.

Comparing the Effect of Intravenous Midazolam with Rectal Sodium Valproate in Controlling of Children with Refractory Status Epilepticus

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T Mahmoudian

2006-01-01

Full Text Available Background: Refractory status epilepticus usually defined as a seizure lasting at least 60 minutes which is uncontrollable by Diazepam, Phenytoin, or Phenobarbital. The aim of this study was to compare the effect of interavenous Midazolam and rectal Sodium valproate in controlling refractory status epilepticus. Methods: In this case-control study; 76 children with (mean age of 37± 20 months with refractory status epilepticus were randomly divided into two groups to receive IV Midazolam and rectal Sodium Valproate. The effect of the two drugs were compared in control of seizure during first 20 minutes of treatment. Results: In 84.2 percent of children treated with IV Midazolam, the seizure was under control within 4.5 ± 0.5 minutes, while in 63 percent of those receiving Sodium Valproate, the seizure was completely controlled within 16.5 ± 0.8 minutes (P < 0.00001. Conclusion: The IV Midazolam was more effective than Sodium valproate, but the latter can be used in hospitals or pediatric emergency wards without ICU for controlling of refractory status epilepticus. Key words: refractory status epilepticus, midazolam, sodium valproate

Omeprazole for Refractory Gastroesophageal Reflux Disease during Pregnancy and Lactation

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John K Marshall

1998-01-01

Full Text Available Symptomatic gastroesophageal reflux is a common complication of pregnancy and lactation. However, the safety of many effective medical therapies, including oral proton pump inhibitors, has not been well defined. The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride failed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to continue omeprazole therapy (20 mg/day while breastfeeding. Peak omeprazole concentrations in breast milk (58 nM, 3 h after ingestion were less than 7% of the peak serum concentration (950 nM at 4 h, indicating minimal secretion. Although omeprazole is a potentially useful therapy for refractory gastroesophageal reflux during pregnancy and lactation, further data are needed to define better its safety and efficacy.

New sol–gel refractory coatings on chemically-bonded sand cores for foundry applications to improve casting surface quality

DEFF Research Database (Denmark)

Nwaogu, Ugochukwu Chibuzoh; Poulsen, T.; Stage, R.K.

2011-01-01

Foundry refractory coatings protect bonded sand cores and moulds from producing defective castings during the casting process by providing a barrier between the core and the liquid metal. In this study, new sol–gel refractory coating on phenolic urethane cold box (PUCB) core was examined. The coa......Foundry refractory coatings protect bonded sand cores and moulds from producing defective castings during the casting process by providing a barrier between the core and the liquid metal. In this study, new sol–gel refractory coating on phenolic urethane cold box (PUCB) core was examined......–gel coated cores have better surface quality than those from uncoated cores and comparable surface quality with the commercial coatings. Therefore, the new sol–gel coating has a potential application in the foundry industry for improving the surface finish of castings thereby reducing the cost of fettling...

Positron annihilation studies of China's and Japan's magnesite refractory in different degree

International Nuclear Information System (INIS)

Zou Lin-Juan; Zhang Cai-Guo; Zhu Xiu-Ying; Sun Quin-Ying

1989-01-01

Studying the magnesite refractories by positron annihilation technique, the obtained results show that China's and Japan's magnesite refractories in different degree form positron lifetime results have no obvious differences in microscopical properties. According to the positron annihilation lifetime results it was found that 1650 0 C is the best sintering temperature for this material. At this temperature positive ions in MgO are replaced by impurities, the solid solubility is higher. The positron average lifetime is more even and smooth with crystallization grain size changing. When grains increase, the positron average lifetime trends towards decreasing, which is in agreement with the crystal boundary theory of ceramic material. (author)

Successful management of refractory cases of canine demodicosis with homeopathy medicine Graphitis.

Science.gov (United States)

Ranjan, Rakesh; Dua, Kirti; Turkar, Sujata; Singh, Harkirat; Singla, L D

2014-12-01

Canine demodicosis is a refractory skin disease caused by excessive proliferation of mite Demodex canis. Despite availability of several treatment options, the disease poses a great challenge to clinicians for its long term management as some drugs may be ineffective or toxic. Present report describes successful treatment of two refractory cases of canine demodicosis using homeopathy medicine. After oral administration of Graphitis 200 C two drops once daily for 2 months, complete cure from the disease was observed. No adverse health effects of the medication were recorded during the treatment. Thus, it may be concluded that homeopathy medicine may be used safely for long-term management of canine demodicosis.

The ketogenic diet and other dietary treatments for refractory epilepsy in children

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Suvasini Sharma

2014-01-01

Full Text Available The ketogenic diet is a high-fat, low-carbohydrate, and restricted protein diet that is useful in patients with refractory epilepsy. The efficacy of the ketogenic diet is better than most of the new antiepileptic drugs. Other modifications of the diet are also beneficial, such as the modified Atkins diet and the low glycemic index treatment. There is a lack of awareness of the ketogenic diet as a treatment modality for epilepsy amongst pediatricians and neurologists. In this review, the use of the ketogenic diet and other dietary treatments in refractory epilepsy is discussed. The Indian experience with the use of these dietary treatments is also briefly reviewed.

The ketogenic diet and other dietary treatments for refractory epilepsy in children

Science.gov (United States)

Sharma, Suvasini; Jain, Puneet

2014-01-01

The ketogenic diet is a high-fat, low-carbohydrate, and restricted protein diet that is useful in patients with refractory epilepsy. The efficacy of the ketogenic diet is better than most of the new antiepileptic drugs. Other modifications of the diet are also beneficial, such as the modified Atkins diet and the low glycemic index treatment. There is a lack of awareness of the ketogenic diet as a treatment modality for epilepsy amongst pediatricians and neurologists. In this review, the use of the ketogenic diet and other dietary treatments in refractory epilepsy is discussed. The Indian experience with the use of these dietary treatments is also briefly reviewed. PMID:25221391

Refractory primary immune thrombocytopenia with subsequent del(5q) MDS

DEFF Research Database (Denmark)

Bech Mortensen, Thomas; Frederiksen, Henrik; Marcher, Claus Werenberg

2017-01-01

A patient with refractory primary immune thrombocytopenia (ITP) characterised by severe skin and mucosal bleedings was treated with several ITP-directed therapies including cyclophosphamide. He later developed therapy-related del(5q) myelodysplastic syndrome with no dysplastic morphological featu...

Refractory castables Al2O3-MgO advanced boron-containing

International Nuclear Information System (INIS)

Morbioli, G.G.; Braulio, M.A.L.; Pandolfelli, V.C.

2011-01-01

Alumina-magnesia refractory castables present high corrosion resistance mainly due to the in situ spinel (MgAl 2 O 4 ) formation. For the steel industry, the earlier its generation the best would be the castable's working performance. Taking this aspect into account, alternatives to replace silica fume, which is the most traditional liquid former inducer in this system, were evaluated in this study, by adding boron-containing compounds. Faster spinel and calcium hexaaluminate (CA 6 ) formation was attained through a transient liquid, ensuring remarkable castable's creep resistance and hot modulus of rupture. In this context, a novel route to design in situ spinel forming castable is presented, with great potential to increase the performance of this class of refractory. (author)

Application of metal oxide refractories for melting and casting reactive metals

International Nuclear Information System (INIS)

Jessen, N.C. Jr.; Holcombe, C.E. Jr.; Townsend, A.B.

1979-01-01

Extensive investigations have been conducted to develop metal oxide refractories for containment of molten uranium and uranium alloys. Since uranium and uranium alloys are readily susceptable to the formation of complex oxides, carbides, nitrides, intermetallic compounds, and suboxide reactions, severe problems exist for the production of quality castings. These contamination reactions are dependent on temperature, pressure, and molten metal interfacial reactions. The need for high purity metals to meet specification repeatedly has resulted in the development of improved metal oxide refractories and sophisticated furnace controls. Applications of Y 2 O 3 for use as a crucible and mold coating, precision molds and cores, and high temperature castable ceramics are discussed. Experimental results on melt impurity levels, thermal controls during melting, surface interactions and casting quality are presented

Analysis of renal impairment in MM-003, a phase III study of pomalidomide + low - dose dexamethasone versus high - dose dexamethasone in refractory or relapsed and refractory multiple myeloma

Science.gov (United States)

Weisel, Katja C.; Dimopoulos, Meletios A.; Moreau, Philippe; Lacy, Martha Q.; Song, Kevin W.; Delforge, Michel; Karlin, Lionel; Goldschmidt, Hartmut; Banos, Anne; Oriol, Albert; Alegre, Adrian; Chen, Christine; Cavo, Michele; Garderet, Laurent; Ivanova, Valentina; Martinez-Lopez, Joaquin; Knop, Stefan; Yu, Xin; Hong, Kevin; Sternas, Lars; Jacques, Christian; Zaki, Mohamed H.; Miguel, Jesus San

2016-01-01

Pomalidomide + low-dose dexamethasone is effective and well tolerated for refractory or relapsed and refractory multiple myeloma after bortezomib and lenalidomide failure. The phase III trial MM-003 compared pomalidomide + low-dose dexamethasone with high-dose dexamethasone. This subanalysis grouped patients by baseline creatinine clearance ≥ 30 − < 60 mL/min (n=93, pomalidomide + low-dose dexamethasone; n=56, high-dose dexamethasone) or ≥ 60 mL/min (n=205, pomalidomide + low-dose dexamethasone; n=93, high-dose dexamethasone). Median progression-free survival was similar for both subgroups and favored pomalidomide + low-dose dexamethasone versus high-dose dexamethasone: 4.0 versus 1.9 months in the group with baseline creatinine clearance ≥ 30 − < 60 mL/min (P<0.001) and 4.0 versus 2.0 months in the group with baseline creatinine clearance ≥ 60 mL/min (P<0.001). Median overall survival for pomalidomide + low-dose dexamethasone versus high-dose dexamethasone was 10.4 versus 4.9 months (P=0.030) and 15.5 versus 9.2 months (P=0.133), respectively. Improved renal function, defined as an increase in creatinine clearance from < 60 to ≥ 60 mL/min, was similar in pomalidomide + low-dose dexamethasone and high-dose dexamethasone patients (42% and 47%, respectively). Improvement in progression-free and overall survival in these patients was comparable with that in patients without renal impairment. There was no increase in discontinuations of therapy, dose modifications, and adverse events in patients with moderate renal impairment. Pomalidomide at a starting dose of 4 mg + low-dose dexamethasone is well tolerated in patients with refractory or relapsed and refractory multiple myeloma, and of comparable efficacy if moderate renal impairment is present. This trial was registered with clinicaltrials.gov identifier 01311687 and EudraCT identifier 2010-019820-30. PMID:27081177

Recovering uranium and/or aluminium from refractory silico-aluminous material

International Nuclear Information System (INIS)

Livesey-Goldblatt, E.; Nagy, I.F.; Tunley, T.H.

1983-01-01

A process for recovering uranium and/or aluminium from a refractory silico-aluminous material comprises leaching the material in one or more stages, obtaining a pregnant solution which contains little or no acid and recovering the desired metal from the solution

Multi-scale modelling of thermal shock damage in refractory materials

NARCIS (Netherlands)

Özdemir, I.

2009-01-01

Refractories are high-temperature resistant materials used extensively in many engineering structures and assemblies in a wide spectrum of applications ranging from metallurgical furnace linings to thermal barrier coatings. Such structures are often exposed to severe thermal loading conditions in

Aborted and refractory status epilepticus in children : A comparative analysis

NARCIS (Netherlands)

Lambrechtsen, Florise A. C. P.; Buchhalter, Jeffrey R.

Purpose: The aims of this retrospective study were: (1) to compare the demographics, clinical characteristics, etiology, and EEG findings of status epilepticus aborted with medication (ASE) and refractory status epilepticus (RSE), (2) to describe the treatment response of status epilepticus (SE),

Damage Detection of Refractory Based on Principle Component Analysis and Gaussian Mixture Model

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Changming Liu

2018-01-01

Full Text Available Acoustic emission (AE technique is a common approach to identify the damage of the refractories; however, there is a complex problem since there are as many as fifteen involved parameters, which calls for effective data processing and classification algorithms to reduce the level of complexity. In this paper, experiments involving three-point bending tests of refractories were conducted and AE signals were collected. A new data processing method of merging the similar parameters in the description of the damage and reducing the dimension was developed. By means of the principle component analysis (PCA for dimension reduction, the fifteen related parameters can be reduced to two parameters. The parameters were the linear combinations of the fifteen original parameters and taken as the indexes for damage classification. Based on the proposed approach, the Gaussian mixture model was integrated with the Bayesian information criterion to group the AE signals into two damage categories, which accounted for 99% of all damage. Electronic microscope scanning of the refractories verified the two types of damage.

Clinical Significance of Human Metapneumovirus in Refractory Status Epilepticus and Encephalitis: Case Report and Review of the Literature

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Aysel Vehapoglu

2015-01-01

Full Text Available Encephalitis is a complex neurological disease that is associated with significant morbidity and mortality, and the etiology of the disease is often not identified. Human metapneumovirus (hMPV is a common cause of upper and lower respiratory tract infections in children. Few reports are available showing possible involvement of hMPV in development of neurologic complications. Here, we describe an infant, the youngest case in literature, with refractory status epilepticus and severe encephalitis in whom hMPV was detected in respiratory samples and review diagnostic workup of patient with encephalitis.

Amrubicin therapy improves patients with refractory small-cell lung cancer: A single-arm confirmatory Chinese clinical study

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Mengli Zheng

2016-09-01

Full Text Available Our objective was to evaluate an open-label, multicenter, single-arm study to appraise whether amrubicin therapy improves patients with refractory small-cell lung cancer in Chinese clinical study. Patients (n=95 with refractory small-cell lung cancer received 3 consecutive days amrubicin therapy for 21 days. Overall response rate of response to amrubicin was 39%. Anemia, febrile neutropenia, thrombocytopenia, hyperglycemia, hyponatremia, infection, elevated serum transaminases levels were appeared, but the incidences of adverse events were very few. Our results suggest amrubicin therapy can improve patients with refractory small-cell lung cancer and may be an effective and safe treatment option.

Retrospective analysis of rituximab therapy and splenectomy in childhood chronic and refractory immune thrombocytopenic purpura.

Science.gov (United States)

Ay, Yilmaz; Karapinar, Tuba H; Oymak, Yesim; Toret, Ersin; Demirag, Bengu; Ince, Dilek; Ozcan, Esin; Moueminoglou, Nergial; Koker, Sultan A; Vergin, Canan

2016-06-01

Immune thrombocytopenic purpura (ITP) results from accelerated platelet destruction mediated by autoantibodies to platelet glycoproteins. Some patients with chronic ITP are refractory to all therapies [steroids, intravenous immunoglobulin (IVIG), anti-D and immunosuppresive drugs] and have chronic low platelet counts and episodic bleeding. We retrospectively evaluated the efficacy and safety of rituximab treatment and splenectomy in paediatric patients diagnosed with chronic and refractory ITP who were unresponsive to steroids, IVIG, cyclosporine and mycophenolate mofetil. Records of patients with chronic and refractory ITP in 459 patients with primary ITP who were followed up in our hospital from January 2005 to December 2014 were reviewed. Fifteen of patients received rituximab and/or applied splenectomy. Fifteen chronic ITP patients (10 boys, five girls) with a mean age of 10 years were enrolled in the study. Two of these patients were suffering from Evans syndrome. The median time since diagnosis of ITP was 10 years. The median follow-up duration after starting Rituximab and splenectomy were 13 and 9.5 months, respectively.None of the seven patients who were treated with rituximab achieved a response. A splenectomy was performed in six of the seven patients who had been treated with rituximab. Complete and partial responses were achieved in 67 and 33% of the patients, respectively. We evaluated the clinical characteristics and responses of chronic ITP patients who did not receive rituximab therapy and underwent a splenectomy. The success rate was 100% in the eight patients with chronic and refractory ITP. Rituximab therapy might not be beneficial for some children with severe chronic ITP who are refractory to standard agents. A splenectomy might be useful and preferable to rituximab.

Study on blast furnace cooling stave for various refractory linings based on numerical modeling

International Nuclear Information System (INIS)

Mohanty, T R; Sahoo, S K; Moharana, M K

2016-01-01

Cooling technology for refractory lining of blast furnace is very important for the metallurgical industry, because it can substantially increase output and operation life of furnaces. A three dimensional mathematical model for the temperature field of the blast furnace stave cooler with refractory lining has been developed and analyzed. The temperature and heat dissipated by stave cooler is examined by using the finite element method. The cast steel stave is studied and computational analysis is made to know the effect of the cooling water velocity, temperature, and the lining material on the maximum temperature of the stave hot surface. The refractory lining materials, which are used in this experiment, are high alumina bricks with different stave materials (copper, aluminum and cast iron). The obtained numerical calculations are compared with that obtained from experiments performed at Rourkela Steel Plant, Odisha taking a stave in belly zone having maximum heat load shows very good agreement. (paper)

[Application of 1% lauromacrogol in the treatment of facial refractory hemangioma and vascular malformations].

Science.gov (United States)

Wang, Yin; Zhu, Fei; Ning, Jin-long; Li, Xiao-jing; Liu, Ye

2012-11-01

To investigate the clinical effect of 1% lauromacrogol for the treatment of facial refractory hemangioma and vascular malformation. From Sept 2009 to Nov 2011, 55 patients (20 male, 35 female, 1 month to 30 years) with different types of facial hemangiorwa and vascular malformation about 1.0 cm x (0. 5-5.0) cm x 10.0 cm in size, underwent 1% lauromacrogol intratumor injection therapy. Generally, the injection dose, concentration, frequency were determined by the age of the patients, the volume and depth of the lesion. The dose was limited to 10 mg every time. The injection interval is 14 weeks. After followed up for 3-16 months, 41 cases were cured, 9 cases were greatly improved, and 5 were partially improved. Skin necrosis happened in only 2 cases. Lauromacrogol is safe, simple and effective as a sderosing agent for the treatment of facial refractory hemangioma and vascular malformation. It provides a new and alternative way for the treatment of facial refractory hemangioma and vascular malformation.

The effects of classic ketogenic diet on serum lipid profile in children with refractory seizures.

Science.gov (United States)

Zamani, Gholam Reza; Mohammadi, Mahmoud; Ashrafi, Mahmoud Reza; Karimi, Parviz; Mahmoudi, Maryam; Badv, Reza Shervin; Tavassoli, Ali Reza; Azizi Malamiri, Reza

2016-12-01

More than 25 % of children with epilepsy develop refractory seizures unresponsive to both old and new generation anticonvulsants. Since such seizures have a serious negative impact on the quality of life, other treatment options are considered. The ketogenic diet is a well-known treatment for managing refractory seizures, although its mechanism of action is unknown. Studies have shown that this diet is as good as, or better than, any of the newer medications in reducing seizure frequency. However, concerns about adverse effects have been raised. We conducted an open label trial to show the effects of this diet on serum lipid profile. Thirty-three children with refractory epilepsy were treated with the ketogenic diet and were followed for 6 months. Their serum lipid profile was assessed at baseline, and at 3 and 6 months after initiating the diet. Seizure frequency was reduced in 63 % of children (no seizures in 2/33 and reduced >50 % in 19/33). However, after 6 months of administering the diet, median triglyceride was significantly increased (from 84 to 180 mg/dl, P ketogenic diet in children with refractory seizures is effective in seizure reduction, but leads to development of hypercholesterolemia and hypertriglyceridemia.

Phase II study of concomitant chemoradiotherapy in bulky refractory or chemoresistant relapsed lymphomas

International Nuclear Information System (INIS)

Girinsky, Theodore; Lapusan, Simona; Ribrag, Vincent; Koscielny, Serge; Ferme, Christophe; Carde, Patrice

2005-01-01

Purpose: To evaluate the local efficacy of concomitant chemoradiotherapy in patients with mostly refractory lymphoma. Methods and materials: Patients with refractory or chemoresistant-relapsed lymphoma and bulky life-threatening masses were included in this study. A split course of concomitant radiotherapy and chemotherapy (mostly cisplatin and etoposide) was delivered during a 6-week period. Weekly blood tests and a clinical examination using the Radiation Therapy Oncology Group guidelines were performed to assess acute toxicity. The tumor response was evaluated 1-3 months after treatment and at regular follow-up visits. Results: We enrolled 21 patients in the study between January 1998 and April 2003. Of the 21 patients, 60% had disseminated disease with bulky tumor masses and 85% had refractory lymphoma, of which most had been treated with at least two different chemotherapy regimens before concomitant chemoradiotherapy. Seventy-five percent received regimens containing cisplatinum and etoposide. The median radiation dose was 40 Gy (range, 12-62.5 Gy). Grade 3-4 hematologic toxicity and mucositis was observed in 70% and 30% of cases respectively, without any deaths. The overall response and complete remission rate was 70% and 20%, respectively. The 1-year overall survival and local progression-free survival rate was 20.4% and 54%, respectively. Three patients with localized disease were still alive 16, 33, and 48 months after treatment. Conclusion: Concomitant chemoradiotherapy for refractory or chemoresistant-relapsed lymphoma induced high hematologic toxicity, but seemed adequate for controlling local bulky tumor masses. No toxicity-related death was observed

Ibrutinib in Treating Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma in Patients With HIV Infection

Science.gov (United States)

2015-08-18

Adult B Acute Lymphoblastic Leukemia; Chronic Lymphocytic Leukemia; Cutaneous B-Cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; HIV Infection; Intraocular Lymphoma; Multicentric Angiofollicular Lymphoid Hyperplasia; Nodal Marginal Zone Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Plasma Cell Myeloma; Small Intestinal Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Retrospective analysis of the efficacy of omalizumab in chronic refractory urticaria

Science.gov (United States)

Viswanathan, Ravi K.; Moss, Mark H.

2013-01-01

Omalizumab has been shown to be effective in chronic urticaria (CU) patients in numerous reports. However, it remains unknown whether there are specific phenotypes of CU that are more responsive to omalizumab therapy. We sought to identify CU phenotypes responsive to treatment with omalizumab by characterizing patients and their response patterns. A retrospective chart review analysis of refractory CU patients unresponsive to high-dose H1-blockers and immunomodulators and subsequently treated with omalizumab at the University of Wisconsin Allergy Clinic was performed with particular focus on their autoimmune characteristics, response to therapy, and dosing parameters. We analyzed 19 refractory CU patients (16 patients failed or had toxic side effects to immunomodulators) treated with omalizumab with an overall response rate of 89% (17/19). Of these 19 patients, 9 patients (47%) had a complete response, 8 patients (42%) had a partial response, and 2 patients (11%) had no response. In comparing the response patterns to omalizumab, we found no statistically significant differences among “autoimmune positive” versus “autoimmune negative” patients. No statistically significant differences in responses were observed when comparing demographic parameters including age, gender, IgE levels, or dosing regimen. Our study shows that omalizumab has robust efficacy in refractory CU patients regardless of their autoimmune status, age, gender, IgE levels, or dosing protocol. PMID:23998242

Role of Epinephrine and Extracorporeal Membrane Oxygenation in the Management of Ischemic Refractory Ventricular Fibrillation

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Jason A. Bartos, MD, PhD

2017-06-01

Full Text Available Summary: Extracorporeal membrane oxygenation (ECMO is used in cardiopulmonary resuscitation (CPR of refractory cardiac arrest. The authors used a 2 × 2 study design to compare ECMO versus CPR and epinephrine versus placebo in a porcine model of ischemic refractory ventricular fibrillation (VF. Pigs underwent 5 min of untreated VF and 10 min of CPR, and were randomized to receive epinephrine versus placebo for another 35 min. Animals were further randomized to left anterior descending artery (LAD reperfusion at minute 45 with ongoing CPR versus venoarterial ECMO cannulation at minute 45 of CPR and subsequent LAD reperfusion. Four-hour survival was improved with ECMO whereas epinephrine showed no effect. Key Words: advanced cardiopulmonary life support, cardiac arrest, cardiopulmonary resuscitation, ECMO, extracorporeal membrane oxygenation, ischemic refractory ventricular fibrillation, ST-segment elevation myocardial infarction, ventricular fibrillation

Production of small diameter high-temperature-strength refractory metal wires

Science.gov (United States)

Petrasek, D. W.; Signorelli, R. A.; King, G. W.

1973-01-01

Special thermomechanical techniques (schedules) have been developed to produce small diameter wire from three refractory metal alloys: colombian base alloy, tantalum base alloy, and tungsten base alloy. High strengths of these wires indicate their potential for contributing increased strength to metallic composites.

CLINICAL FEATURES OF REFRACTORY FORMS OF ANEMIA IN CHILDREN WITH CHRONIC HEPATITIS В

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F. I. Inoyаtova

2013-01-01

Full Text Available Examination of 125 children with chronic hepatitis В and concomitant anemia has determined the frequency of refractory forms of anemia (52,5%. The disease progressed more severely on the background of anemia, which was indicated by the prevalence of CHВ forms with severe activity (71,4%. The pathognomonic symptoms of anemic processes were revealed. Two pathogenetic variants of the anemia genesis in children with CHВ are being considered: the first is defined by veritable iron deficiency with ferrokinetic markers of iron-deficiency anemia; the second — by relocationable iron deficit that is typical for hemosiderosis and refractoriness development.

High density crystalline boron prepared by hot isostatic pressing in refractory metal containers

Science.gov (United States)

Hoenig, C.L.

1993-08-31

Boron powder is hot isostatically pressed in a refractory metal container to produce a solid boron monolith with a bulk density at least 2.22 g/cc and up to or greater than 2.34 g/cc. The refractory metal container is formed of tantalum, niobium, tungsten, molybdenum or alloys thereof in the form of a canister or alternatively plasma sprayed or chemical vapor deposited onto a powder compact. Hot isostatic pressing at 1,800 C and 30 PSI (206.8 MPa) argon pressure for four hours produces a bulk density of 2.34 g/cc. Complex shapes can be made.

Usefulness of high-dose intravenous human immunoglobulins treatment for refractory recurrent pericarditis.

Science.gov (United States)

Moretti, Michele; Buiatti, Alessandra; Merlo, Marco; Massa, Laura; Fabris, Enrico; Pinamonti, Bruno; Sinagra, Gianfranco

2013-11-01

The management of refractory recurrent pericarditis is challenging. Previous clinical reports have noted a beneficial effect of high-dose intravenous human immunoglobulins (IvIgs) in isolated and systemic inflammatory disease-related forms. In this article, we analyzed retrospectively our clinical experience with IvIg therapy in a series of clinical cases of pericarditis refractory to conventional treatment. We retrospectively analyzed 9 patients (1994 to 2010) with refractory recurrent pericarditis, who received high-dose IvIg as a part of their medical treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine treatment was not discontinued during IvIg treatment. No patients had a history of autoimmune or connective tissue diseases. During an average period of 11 months from the first recurrence, patients had experienced a mean of 5 relapses before the first IvIg treatment. In 4 cases, patients showed complete clinical remission with no further relapse after the first IvIg cycle. Two patients experienced a single minor relapse, responsive to short-term nonsteroidal anti-inflammatory drugs. In 2 patients, we performed a second cycle of IvIg after a recurrence of pericarditis, with subsequent complete remission. One patient did not respond to 3 cycles of IvIg and subsequently underwent pericardial window and long-term immunosuppressive treatment. No major adverse effect was observed in consequence of IvIg administration in all the cases. In conclusion, although IvIg mode of action is still poorly understood in this setting, this treatment can be considered as an option in patients with recurrent pericarditis refractory to conventional medical treatment and, in our small series, has proved to be effective in 8 of 9 cases. Copyright © 2013 Elsevier Inc. All rights reserved.

Corrosão de refratários utilizados na siderurgia. Parte III: caracterização de refratários comerciais Corrosion of refractories used in steel metallurgy. Part III: characterization of commercial refractories

Directory of Open Access Journals (Sweden)

S. R. Bragança

2013-03-01

Full Text Available Foi realizada uma revisão dos principais aspectos encontrados na literatura especializada sobre corrosão de refratários, avaliando-se a viabilidade de determinados ensaios e relacionando-se com resultados experimentais. As propriedades físicas e microestruturais de refratários comerciais foram estudadas, considerando-se as diferenças entre elas e implicações com a qualidade e provável vida útil do refratário. Assim, investigou-se os diversos tipos de refratários utilizados como revestimento em uma panela de aço, como de sobre-linha (freeboard, linha de escória e linha de metal. Os refratários magnésia-carbono e doloma-carbono foram avaliados, destacando-se também as diferenças entre eles. Os materiais analisados mostraram características favoráveis a uma elevada resistência ao processo de corrosão, apresentando uma série de propriedades a serem escolhidas de acordo com a prática industrial.The main aspects found in the literature about refractories corrosion were reviewed, evaluating the feasibility of certain tests and relating them with experimental results. The physical properties and microstructure of commercial refractories were analyzed, considering the differences between them and the quality implications and probable life of the refractory. Thus, this study comprised various types of refractories used as lining on steel ladle, as on freeboard, slag line and metal line. Magnesia-carbon and doloma-carbon refractories were analyzed, highlighting the differences between them. The examined materials showed characteristics favoring high resistance to corrosion process, presenting a series of properties to be selected in accordance with industry practice.

Trans-jugular intrahepatic porto-systemic shunt placement for refractory ascites: a ‘real-world’ UK health economic evaluation

Science.gov (United States)

Parker, Matthew J; Guha, Neil; Stedman, Brian; Hacking, Nigel; Wright, Mark

2013-01-01

Objective To assess the benefit of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement for refractory ascites. Design A retrospective observational study of all patients undergoing TIPS for refractory ascites in our hospital between 2003 and 2012. Setting Secondary care. Patients Cirrhotic patients with refractory ascites. Main outcome measures We examined direct real-world (National Health Service) health related costs in the year before and after the TIPS procedure took place. Data were collected relating to the need for reintervention and hepatic encephalopathy. Results Data were available for 24 patients who underwent TIPS for refractory ascites (86% of eligible patients). TIPS was technically successful in all cases. Mean number of bed days in the year prior to TIPS was 30.3 and 14.3 in the year following (p=0.005). No patient had ascites at the end of the year after the TIPS with less requirement for paracentesis over the course of the year (p<0.001). Mean reduction in cost was £2759 per patient. TIPS was especially cost-effective in patients requiring between 6 and 12 drains per year with a mean saving of £9204 per patient. Conclusions TIPS is both a clinically effective and economically advantageous therapeutic option for selected patients with refractory ascites. PMID:28839725

Esquizofrenia refratária Refractory schizophrenia

Directory of Open Access Journals (Sweden)

Helio Elkis

2007-10-01

Full Text Available OBJETIVO: O propósito deste artigo é o de revisar vários aspectos da esquizofrenia refratária levando em conta questões relacionadas à definição, aspectos clínicos, correlatos psicobiológicos, tratamentos farmacológicos e não farmacológicos, assim como preditores de resposta terapêutica. MÉTODO: Pesquisa no Medline, assim como artigos dos autores. RESULTADOS E CONCLUSÕES: Pelo menos um terço dos pacientes com esquizofrenia são refratários a tratamento com antipsicóticos e as evidências apontam a clozapina em monoterapia como a principal opção nesses casos. A politerapia com antipsicóticos não tem apoio em evidências. Ensaios clínicos recentes mostraram que a potencialização da clozapina com outros antipsicóticos não é superior ao placebo.OBJECTIVE: The aim of the present paper is to review the various aspects of refractory schizophrenia regarding issues such as definitions, clinical aspects, psychobiological correlates, pharmacological and non-pharmacological treatment options and predictors of treatment response. METHOD: Medline search as well as articles of the authors. RESULTS AND CONCLUSIONS: Refractory schizophrenia affects at least one third of patients with schizophrenia and the best evidence shows that is monotherapy with clozapine remains the mainstay for the treatment of such condition. Antipsychotic polipharmacy is not supported by current evidence and recent clinical trials have shown that clozapine augmentation with antipsychotics has no benefit over placebo.

Correlation between Corneal Thickness and Degree of Myopic Refractory Error

Directory of Open Access Journals (Sweden)

A Mortazavi

2005-01-01

Full Text Available Background: corneal thickness is an important factor in refractive surgeries such as Radial Keratotomy (RK, Photo Refractive Keratotomy (PRK and Laser Insitu Keratomileusis (LASIK. This study evaluated the correlation between this factor and the degree of myopic refractory error. Methods: In this cross-sectional study, 224 myopic eyes (112 patients which had undergone LASIK operation were assessed. These patients had referred to Aban Eye Clinic, Isfahan, Iran, during August and September 2002. Corneal thickness was measured by ORB SCAN Topoghraphy, and cycloplegic refraction was performed with autorefratometery and retinoscopy. Suspected keratoconus cases and hyperopic patients were excluded. Results: The patients' age was 27.2 ± 1.36 in men (N = 35 and 30.13 ± 1.04 in women (N = 77. Mean value of myopic refractory error in male patients was 5.1 ± 0.24D and in female patients was 3.8 ± 0.36D. Mean of corneal thickness was 540 ± 5.25 µM and 530 ± 5.88 µM in male and female patients respectively. There was no correlation between the degree of myopia and corneal thickness in any of the patients. Also in this research, no relations between the age and myopia were found. Right eye (P > 0.5, r = 0.124 Left eye (P > 0.5, r = 0.104. Conclusion: Based on our findings, corneal thickness and myopic refectory error do not seem to have any relations. (r = 0.039, p = 0.684. Keywords: Corneal Thickness, Cornea, Myopia, LASIK, Refractory Error

Iodine I 131 Monoclonal Antibody BC8 Before Autologous Stem Cell Transplant in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin Lymphoma

Science.gov (United States)

2017-11-15

Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Hodgkin Lymphoma; Recurrent T-Cell Non-Hodgkin Lymphoma; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Hodgkin Lymphoma; Refractory T-Cell Non-Hodgkin Lymphoma

[Results of fistulizing and Ahmed valve surgery for treatment of refractory glaucoma].

Science.gov (United States)

Bikbov, M M; Babushkin, A E; Chaĭka, O V; Orenburkina, O I; Matiukhina, E N

2014-01-01

Surgical results of 76 patients (76 eyes) aged 25-79 years with secondary refractory glaucoma were analyzed. The best hypotensive effect and visual functions integrity were achieved with Ahmed valve implantation (86.7% and 83.3% of cases respectively); after conventional fistulizing surgery the hypotensive effect was observed in 45.5%, noncompromised vision--in 54.5% of cases. Tunnel trabeculectomy with iridocycloretraction led to normalization of intraocular pressure and stabilization of visual functions in 81.3% and 68.8% of cases respectively and thus can be considered as an alternative to fistulizing surgery in patients with secondary refractory glaucoma. Uveal glaucoma is a relative contraindication to Ahmed valve implantation, while neovascular glaucoma is that to tunnel trabeculectomy with iridocycloretraction.

Benefit from autologous stem cell transplantation in primary refractory myeloma? Different outcomes in progressive versus stable disease

Science.gov (United States)

Rosiñol, Laura; García-Sanz, Ramón; Lahuerta, Juan José; Hernández-García, Miguel; Granell, Miquel; de la Rubia, Javier; Oriol, Albert; Hernández-Ruiz, Belén; Rayón, Consuelo; Navarro, Isabel; García-Ruiz, Juan Carlos; Besalduch, Joan; Gardella, Santiago; Jiménez, Javier López; Díaz-Mediavilla, Joaquín; Alegre, Adrián; Miguel, Jesús San; Bladé, Joan

2012-01-01

Background Several studies of autologous stem cell transplantation in primary refractory myeloma have produced encouraging results. However, the outcome of primary refractory patients with stable disease has not been analyzed separately from the outcome of patients with progressive disease. Design and Methods In the Spanish Myeloma Group 2000 trial, 80 patients with primary refractory myeloma (49 with stable disease and 31 with progressive disease), i.e. who were refractory to initial chemotherapy, were scheduled for tandem transplants (double autologous transplant or a single autologous transplant followed by an allogeneic transplant). Patients with primary refractory disease included those who never achieved a minimal response (≥25% M-protein decrease) or better. Responses were assessed using the European Bone Marrow Transplant criteria. Results There were no significant differences in the rates of partial response or better between patients with stable or progressive disease. However, 38% of the patients with stable disease at the time of transplantation remained in a stable condition or achieved a minimal response after transplantation versus 7% in the group with progressive disease (P=0.0017) and the rate of early progression after transplantation was significantly higher among the group with progressive disease at the time of transplantation (22% versus 2%; P=0.0043). After a median follow-up of 6.6 years, the median survival after first transplant of the whole series was 2.3 years. Progression-free and overall survival from the first transplant were shorter in patients with progressive disease (0.6 versus 2.3 years, P=0.00004 and 1.1 versus 6 years, P=0.00002, respectively). Conclusions Our results show that patients with progressive refractory myeloma do not benefit from autologous transplantation, while patients with stable disease have an outcome comparable to those with chemosensitive disease. (ClinicalTrials.gov:NCT00560053) PMID:22058223

An Interesting Case of Retropharyngeal Lymph Nodal Metastases in a Case of Iodine-Refractory Thyroid Cancer.

Science.gov (United States)

Harisankar, Chidambaram Natrajan Balasubramanian; Vijayabhaskar, Ramakrishnan

2018-01-01

Metastases to cervical lymph node are fairly common in differentiated thyroid cancer. In iodine-refractory disease, the disease may persist in the thyroid bed, cervical lymph nodes, lungs, or the bones commonly. Retropharyngeal lymph nodal involvement in thyroid cancer is unusual and may even be the presenting complaint. We represent a case of iodine-refractory thyroid cancer with retropharyngeal lymph nodal involvement in addition to lung metastases.

Use of sedation to relieve refractory symptoms in dying patients ...

African Journals Online (AJOL)

Indications. Agitated delirium was the most common reason (45%) for using sedation, followed by intractable vomiting due to inoperable malignant intestinal obstruction in 25% of patients. Three patients with persistent convulsions or myoclonic jerking and 2 patients with severe refractory dyspnoea required some sedation.

Refractory reverse amblyopia with atropine penalization

Directory of Open Access Journals (Sweden)

Preeti Ajit Patil

2010-01-01

Full Text Available Pharmacological penalization with atropine has been shown to be equally effective as conventional occlusion therapy in the treatment of amblyopia in children. Reverse amblyopia of the sound eye with atropine penalization has been reported before, but is more common in cases where the effect is augmented with optical penalization and is mostly reversible. We report a case of reverse amblyopia with atropine penalization, in a 4-year-old girl, which was refractory to treatment. This report highlights the need for strict monitoring of the vision in the sound eye and regular follow-up in children undergoing amblyopia treatment.

Manifestation of magnetic source imaging in patients with refractory epilepsy and encephalomalacia

International Nuclear Information System (INIS)

Sun Jilin; Wu Jie; Li Sumin; Liu Lianxiang; Wu Yujin; Liu Changlin

2005-01-01

Objective: To evaluate the epileptic focus localization value of MSI in patients with refractory epilepsy and encephalomalacia. Method: MSI examination was proceeded in 11 patients with refractory epilepsy and encephalomalacia. Five of them were treated with gamma-knife; the others were treated with surgery. Results: In the five patients treated with gamma-knife, the result was satisfied in 3 patients, one patient improved significantly, the other one useless. The distance between the encephalomalacia and the epileptic focus was 4cm in one patient; one patient's encephalomalacia was located in right frontal-parietal lobe but the epileptic focus mainly located in right temporal lobe, only a little located around the encephalomalacia. Overall agreement among VEEG, ECoG and MEG (presence of concordant spikes with the same localization shown by three techniques) was obtained in three patients, the areas localized by ECoG were larger than VEEG and MSI in two patients. The localization was different in VEEG, MSI and ECoG in one patient, then he was given a resection of bilateral occipital epileptic focus. The results of patients treated with surgery were satisfied. Conclusion: The MSI localization of epileptic focus in patients with refractory epilepsy and encephalomalacia is precise, and it can direct the advanced clinical treatment. (authors)

Effect of the exposure time in coke making atmosphere on the microstructure and properties of a refractory castable used in the petrochemical industry

International Nuclear Information System (INIS)

Cabrelon, M.D.; Pereira, A.H.A.; Rodrigues, J.A.; Medeiros, J.; Toledo-Filho, R.D.

2012-01-01

Refractory castables used in Fluidized Catalytic Cracking Units (FCCU) are said to deteriorate due coke formation during the production of light hydrocarbons, causing a shortening in the operating time of the reactor. Consequently, a significant financial loss for the petrochemical will occur. Several studies have been carried out, but none of them showed clearly how much is the contribution of the coke for the concrete final deterioration. It still remains the doubt if the coke is the responsible for the damage observed macroscopically in a FCCU's riser. In this way, this work aimed to study the effect of the time in a coke making atmosphere on an anti-erosive class-C refractory castable, seeking for microstructural changes or on physical properties that indicate degradation mechanisms and give support to the understanding of the phenomenon. Samples of an industrial refractory castable used in petrochemical units were prepared and subjected to a forced coke making process in a simulation reactor. The temperature and the heating rate were kept constant at 540 deg C and 50 deg C/h, respectively. The values of 10, 60, 120, 240 and 480 h were used for the time of exposition to the propene gas. The microstructure of the samples was characterized through optical and scanning electron microscopy and its mineralogical phases through X-ray diffraction. Complementary analyses were necessary to a better understanding of the phenomenon. The results show that the surface and the microstructure are gradually impregnated by coke, which fills up pores, microcracks and cracks. Evidences of microcracking around the coke filled pores were not found. However, many aggregates present some type of deterioration related to the time of exposition to propene. Those damages are not necessarily caused by coke directly (author)

Activation analysis of rare-earth elements in opium and cannabis samples

International Nuclear Information System (INIS)

Henke, G.

1977-01-01

Rare-earth concentrations in 65 Opium, Cannabis and Cannabis resin samples seized from various parts of the world were determined by destructive NAA. Because of the greater concentrations of Ca, P, K, Fe, Na and Si in plant materials, rare-earth elements were isolated after neutron irradiation and determined by gamma-spectrometry. The main steps of the method are: Preashing of 1 g Cannabis resin, 2.5 g Cannabis or 7.5 g Opium, respectively, in quartz ampoules (5 h, 500 deg C). Neutron irradiation, 24 h at 5x10 13 n cm -2 sec -1 . Cooling period 2-3 days. After addition of 0.1 μCi 139 Ce and rare-earth carriers wet ashing of irradiated samples with H 2 SO 4 /HNO 3 , followed by alternate addition of HNO 3 and H 2 O 2 (30%). Precipitation and removal of silicates, precipitation of fluorides, precipitation of hydroxides. Dissolution of hydroxides in HCl. Extraction with di-(2-ethylhexyl)phosphate (DEHP)/toluene and twice back-extraction of rare earths, gamma-spectrometry of HCl phase. Due to sample activity and half-life of nuclides, three measurements were made on each sample: 2 days (for La, Sm, Gd, Ho, Er, Yb); 14 days (for Nd, Lu) and 30 days after irradiation (for Ce, Eu, Tb). Great variations in absolute element concentrations, but only small significant differences of rare earth concentration ratios were found, indicating inconsiderable biogeochemical fractionation. The mean values of these ratios correspond to the relative abundances of the rare earths in the upper continental earth's crust. (T.G.)

Effect of small-scale biomass gasification at the state of refractory lining the fixed bed reactor

Energy Technology Data Exchange (ETDEWEB)

Janša, Jan, E-mail: jan.jansa@vsb.cz; Peer, Vaclav, E-mail: vaclav.peer@vsb.cz; Pavloková, Petra, E-mail: petra.pavlokova@vsb.cz [VŠB – Technical University of Ostrava, Energy Research Center, 708 33 Ostrava (Czech Republic)

2016-06-30

The article deals with the influence of biomass gasification on the condition of the refractory lining of a fixed bed reactor. The refractory lining of the gasifier is one part of the device, which significantly affects the operational reliability and durability. After removing the refractory lining of the gasifier from the experimental reactor, there was done an assessment how gasification of different kinds of biomass reflected on its condition in terms of the main factors affecting its life. Gasification of biomass is reflected on the lining, especially through sticking at the bottom of the reactor. Measures for prolonging the life of lining consist in the reduction of temperature in the reactor, in this case, in order to avoid ash fusion biomass which it is difficult for this type of gasifier.

The recovery of gold from refractory ores by the use of carbon-in-chlorine leaching

Science.gov (United States)

Greaves, John N.; Palmer, Glenn R.; White, William W.

1990-09-01

Recently, the U.S. Bureau of Mines examined the recovery of gold by chlorination of refractory carbonaceous and sulfidic ores, comparing various treatment methods in which a ground ore pulp is contacted with chlorine gas and activated carbon is added to the pulp for a carbon-in-chlorine leach (CICL). The objective of this research was to demonstrate the basic feasibility of CICL technology. Results showed that the organic carbon deactivating environment of CICL lowers, but does not eliminate, the adsorption of gold on activated carbon. In this environment, the refractory ore is altered, and gold is extracted and then recovered on activated carbon. With highly carbonaceous ores, CICL achieved a higher recovery than with primarily sulfidic refractory ores. Basic cyanide amenability testing of two carbonaceous ores achieved recoveries of only 5.5% and 46%. With CICL treatment, recoveries on carbon were 90% and 92%.

Beneficiation and leaching study of a muti-Au carrier and low grade refractory gold ore

Science.gov (United States)

Li, W. J.; Song, Y. S.; Chen, Y.; Cai, L. L.; Zhou, G. Y.

2017-09-01

Detailed mineralogy and beneficiation and leaching study of a muti-Au carrier, low grade refractory gold ore from a beneficiation plant in Henan Province, China, was investigated. Mineral liberation analysis, scanning electron microscopy, element phase analysis and etc. by a mineral liberation analyser were used for mineralogical characterization study of this ore. The present work describes an experimental study on the effect of traditional parameters (such as grinding fineness and reagent regimes), middling processing method and flowsheet construction on the total recovery and the assay of the floatation concentrate. Two-step floatation and part of middling combined to the floatation tailing for gold leaching process resulted in high gold grade (g.t-1) and gold recovery (%) for this refractory gold ore. This process opens the possibilities of maximizing Au grade and recoveries in a muti-Au carrier and low grade refractory gold ore where low recoveries are common.

Corrosion behavior of Al-Fe-sputtering-coated steel, high chromium steels, refractory metals and ceramics in high temperature Pb-Bi

International Nuclear Information System (INIS)

Abu Khalid, Rivai; Minoru, Takahashi

2007-01-01

Corrosion tests of Al-Fe-coated steel, high chromium steels, refractory metals and ceramics were carried out in high temperature Pb-Bi at 700 C degrees. Oxygen concentrations in this experiment were 6.8*10 -7 wt.% for Al-Fe-coated steels and 5*10 -6 wt.% for high chromium steels, refractory metals and ceramics. All specimens were immersed in molten Pb-Bi in a corrosion test pot for 1.000 hours. Coating was done with using the unbalanced magnetron sputtering (UBMS) technique to protect the steel from corrosion. Sputtering targets were Al and SUS-304. Al-Fe alloy was coated on STBA26 samples. The Al-Fe alloy-coated layer could be a good protection layer on the surface of steel. The whole of the Al-Fe-coated layer still remained on the base surface of specimen. No penetration of Pb-Bi into this layer and the matrix of the specimen. For high chromium steels i.e. SUS430 and Recloy10, the oxide layer formed in the early time could not prevent the penetration of Pb-Bi into the base of the steels. Refractory metals of tungsten (W) and molybdenum (Mo) had high corrosion resistance with no penetration of Pb-Bi into their matrix. Penetration of Pb-Bi into the matrix of niobium (Nb) was observed. Ceramic materials were SiC and Ti 3 SiC 2 . The ceramic materials of SiC and Ti 3 SiC 2 had high corrosion resistance with no penetration of Pb-Bi into their matrix. (authors)

A method to eliminate wetting during the homogenization of HgCdTe

Science.gov (United States)

Su, Ching-Hua; Lehoczky, S. L.; Szofran, F. R.

1986-01-01

Adhesion of HgCdTe samples to fused silica ampoule walls, or 'wetting', during the homogenization process was eliminated by adopting a slower heating rate. The idea is to decrease Cd activity in the sample so as to reduce the rate of reaction between Cd and the silica wall.

Venous Sinus Stent-Assisted Angioplasty for Refractory Benign Intracranial Hypertension

OpenAIRE

Zhongrong, M.; Feng, L.; Shengmao, L.; Fengshui, Z.

2003-01-01

Two patients with dural sinus stenosis of different causes presenting with refractory benign intracranial hypertension were confirmed by angiogram. Stent-assistant angioplasty was used to dilate the stenosed sinusesand led to prompt clinical improvement. Relative long-term follow-up showed good patency of the stented sinuses.

Stimulus intensity and the psychological refractory period II auditive stimuli

NARCIS (Netherlands)

Koster, W.G.; Schuur, van R.

1970-01-01

In experiments in which stimuli are presented closely spaced in time, subjects exhibit a limitation in the transmission of the signals. The result is either a delayed response or a less accurate response. This phenomenon has been called the psychological refractory phase (Telford, 1931). It is

Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health

Energy Technology Data Exchange (ETDEWEB)

Wang, Anbo [Center for Photonics Technology, Blacksburgh, VA (United States); Yu, Zhihao [Center for Photonics Technology, Blacksburgh, VA (United States)

2015-11-30

This report summarizes technical progress on the program “Distributed Fiber Optic Sensor for On-Line Monitoring of Coal Gasifier Refractory Health,” funded by the National Energy Technology Laboratory of the U.S. Department of Energy, and performed by the Center for Photonics Technology of the Bradley Department of Electrical and Computer Engineering at Virginia Tech. The scope of work entails analyses of traveling grating generation technologies in an optical fiber, as well as the interrogation of the gratings to infer a distributed temperature along the fiber, for the purpose of developing a real-time refractory health condition monitoring technology for coal gasifiers. During the project period, which is from 2011-2015, three different sensing principles were studied, including four-wave mixing (FWM), coherent optical time-domain reflectometer (C-OTDR) and Brillouin optical time-domain analysis (BOTDA). By comparing the three methods, the BOTDA was selected for further development into a complete bench-top sensing system for the proposed high-temperature sensing application. Based on the input from Eastman Chemical, the industrial collaborator on this project, a cylindrical furnace was designed and constructed to simulate typical gasifier refractory temperature conditions in the laboratory, and verify the sensor’s capability to fully monitor refractory conditions on the back-side at temperatures up to 1000°C. In the later stages of the project, the sensing system was tested in the simulated environment for its sensing performance and high-temperature survivability. Through theoretical analyses and experimental research on the different factors affecting the sensor performance, a sensor field deployment strategy was proposed for possible future sensor field implementations.

Outcomes in Children Treated with Pentobarbital Infusion for Refractory and Super-Refractory Status Epilepticus.

Science.gov (United States)

Erklauer, Jennifer; Graf, Jeanine; McPherson, Mona; Anderson, Anne; Wilfong, Angus; Minard, Charles G; Loftis, Laura

2018-03-26

Functional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined. Retrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC). Potential patient characteristics associated with functional neurologic outcome including age, sex, ethnicity, etiology of the status epilepticus, and duration of pentobarbital infusion were evaluated. Forty children met inclusion criteria. In-hospital mortality was 30% (12/40). Of survivors, 21% (6/28) returned to baseline PCPC while half (14/28) declined in function ≥ 2 PCPC categories at hospital discharge. 25% (7/28) of survivors required tracheostomy and 27% (7/26) required new gastrostomy. Seizures persisted at discharge for most patients with new onset status epilepticus while the majority of patients with known epilepsy returned to baseline seizure frequency. Etiology (p = 0.015), PCPC at admission (p = 0.0006), new tracheostomy (p = 0.012), and new gastrostomy tube (p = 0.012) were associated with increase in PCPC score ≥ 2 categories in univariable analysis. Duration of pentobarbital infusion (p = 0.005) and length of hospital stay (p = 0.056) were longer in patients who demonstrated significant decline in neurologic function. None of these variables maintained statistical significance when multiple logistic regression model adjusting for PCPC score at admission was applied. At long-term follow-up, 36% (8/22) of children demonstrated improvement in PCPC compared to discharge and 23% (5/22) showed deterioration including three additional deaths. Mortality in this population was high. The majority of children experienced some degree of disability at discharge. Despite

Enrichment of Gold in Antimony Matte by Direct Smelting of Refractory Gold Concentrate

Science.gov (United States)

Yang, Tianzu; Xie, Boyi; Liu, Weifeng; Zhang, Duchao; Chen, Lin

2018-06-01

Conventional cyanidation technology achieves low gold recovery when used to process refractory gold concentrate. Based on the geochemical characteristics of gold deposit mineralization, a new method is proposed herein for gold enrichment in antimony matte by smelting of refractory gold concentrate. The effects of the FeO/SiO2 and CaO/SiO2 ratios, smelting temperature, and smelting time on the gold recovery were investigated in detail. The optimum conditions were determined to be FeO/SiO2 ratio of 1.2, CaO/SiO2 ratio of 0.4, smelting temperature of 1200°C, and smelting time of 45 min. The gold content in antimony matte and smelting slag was 96.68 and 1.13 g/t, respectively. The gold, antimony, and arsenic recovery was 97.72%, 26.89%, and 6.56%, respectively, with most of the antimony and arsenic volatilized into dust. Mineral liberation analyzer results showed that the antimony matte mainly consisted of FeS and FeO, with three phases, viz. FeAs, SbAs, and AuSb, embedded between them, indicating that gold was easily enriched with antimony and arsenic during smelting of refractory gold concentrate.

Enrichment of Gold in Antimony Matte by Direct Smelting of Refractory Gold Concentrate

Science.gov (United States)

Yang, Tianzu; Xie, Boyi; Liu, Weifeng; Zhang, Duchao; Chen, Lin

2018-04-01

Conventional cyanidation technology achieves low gold recovery when used to process refractory gold concentrate. Based on the geochemical characteristics of gold deposit mineralization, a new method is proposed herein for gold enrichment in antimony matte by smelting of refractory gold concentrate. The effects of the FeO/SiO2 and CaO/SiO2 ratios, smelting temperature, and smelting time on the gold recovery were investigated in detail. The optimum conditions were determined to be FeO/SiO2 ratio of 1.2, CaO/SiO2 ratio of 0.4, smelting temperature of 1200°C, and smelting time of 45 min. The gold content in antimony matte and smelting slag was 96.68 and 1.13 g/t, respectively. The gold, antimony, and arsenic recovery was 97.72%, 26.89%, and 6.56%, respectively, with most of the antimony and arsenic volatilized into dust. Mineral liberation analyzer results showed that the antimony matte mainly consisted of FeS and FeO, with three phases, viz. FeAs, SbAs, and AuSb, embedded between them, indicating that gold was easily enriched with antimony and arsenic during smelting of refractory gold concentrate.

Mechanical and Physicochemical Evaluation of Alkaleri Fireclay for Refractory Application

Directory of Open Access Journals (Sweden)

Job Ajala Amkpa

2017-04-01

Full Text Available The mechanical, chemical and physical property of Alkaleri fireclay was investigated for its appropriateness for refractory application. The chemical composition was performed and analyzed using the X-ray fluorescence (XRF spectrometer Bench top XRF analyzer technique. Chemical property result indicated that the clay contained 67.4 % silica (SiO2, 30.06 % aluminum (Al2O3, and other impurities. The clay was subjected to mechanical activation through sintering process at varied sintering temperatures of 900 °C, 1000 °C, 1100 °C and 1200 °C. At the best sintering temperature of 1200 °C, the cold crushing strength (CCS was 17.82 MPa, in the physical properties; apparent porosity was 22.8 %, bulk density was 1.8 g/cm3, and firing shrinkage was 8.9 %. The Alkaleri clay belongs to alumino-silicate fireclay group and therefore, suitable materials for refractory application of ladle, kiln dryer, boilers, cook stoves, furnace lining and bricks.

Recognition and management of platelet-refractory bleeding in patients with Glanzmann’s thrombasthenia and other severe platelet function disorders

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Chitlur M

2017-04-01

Full Text Available Meera Chitlur,1 Madhvi Rajpurkar,1 Michael Recht,2 Michael D Tarantino,3 Donald L Yee,4 David L Cooper,5 Sriya Gunawardena5 1Carman and Ann Adams Department of Pediatrics, Wayne State University and Children’s Hospital of Michigan, Detroit, MI, USA; 2Oregon Health and Science University, Portland, OR, USA; 3Bleeding and Clotting Disorders Institute, Peoria, IL, USA; 4Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; 5Clinical Development, Medical and Regulatory Affairs, Novo Nordisk Inc., Plainsboro, NJ, USA Abstract: Patients with rare qualitative platelet disorders or platelet function disorders (PFDs may present to the hospital physician with severe bleeding episodes or excessive surgical bleeding. Although standard treatment consists of platelet transfusions, repeated transfusions may result in the development of antiplatelet antibodies (APA or clinical refractoriness, rendering further platelet therapy ineffective. In such settings, an approved treatment option for patients with Glanzmann’s thrombasthenia (GT, one of the well-known rare PFDs, is recombinant activated coagulation factor VII (rFVIIa. Data regarding the efficacy of rFVIIa in patients with GT and platelet refractoriness are available from a large patient registry, an international survey, and multiple case reports and demonstrate efficacy in patients with and without refractoriness or APA. This article reviews the rFVIIa clinical data in patients with GT and platelet refractoriness and discusses clinical implications relevant to the hospital-based physician. Because uncontrolled bleeding can be life-threatening, hospital physicians should be alert to the signs of platelet refractoriness, be able to recognize continued internal or external bleeding, and know how to adapt treatment regimens for the effective management of bleeding. The management of patients who receive rFVIIa should occur in consultation with a hematologist with experience in PFDs, and

HA-1 T TCR T Cell Immunotherapy for the Treating of Patients With Relapsed or Refractory Acute Leukemia After Donor Stem Cell Transplant

Science.gov (United States)

2018-04-30

HLA-A*0201 HA-1 Positive Cells Present; Minimal Residual Disease; Recurrent Acute Biphenotypic Leukemia; Recurrent Acute Undifferentiated Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Refractory Acute Myeloid Leukemia; Refractory Adult Acute Lymphoblastic Leukemia; Refractory Childhood Acute Lymphoblastic Leukemia

Optimization of phase analysis of refractory alloys in the gas-ion-reaction chamber

International Nuclear Information System (INIS)

Blumenkamp, H.J.; Hoven, H.; Koizlik, K.; Nickel, H.

1980-04-01

Reactor components outside the core which are under high thermal and mechanical stresses are made from refractory alloys. For basic research and for quality control, these materials are investigated by metallography, which is an independent group of characterization procedures as well as basis for many other methods. An important way of increasing the information about a material yielded by metallography is the expansions of phase contrast, in particular the phase contrasting in the gas-ion-reaction chamber. In this paper, the experimental procedure is described and the process of optimizing the procedure with respect to the Ni- and Fe-based refractory alloys examined in the IRW is discussed. (orig.) [de

The use of a formula-based ketogenic diet in children with refractory epilepsy

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Letícia Pereira de Brito Sampaio

Full Text Available ABSTRACT The ketogenic diet (KD is a nonpharmacologic treatment that has been used for refractory epilepsy since 1921. The KD is a high-fat, low-carbohydrate, and restricted protein diet, which is calculated and weighed for each individual patient. Introducing and maintaining the diet for a long time remains a challenge. In this study, we evaluated the acceptability, tolerance, and efficacy of a formula-based KD in 10 children with refractory epilepsy. The ketogenic formula tested herein caused only mild KD-related adverse events and adequate adherence. Moreover, 60% of patients had more than 50% seizure frequency reduction and 10% were seizure-free.

Autologous transplantation of the internal limiting membrane for refractory macular holes.

Science.gov (United States)

Morizane, Yuki; Shiraga, Fumio; Kimura, Shuhei; Hosokawa, Mio; Shiode, Yusuke; Kawata, Tetsuhiro; Hosogi, Mika; Shirakata, Yukari; Okanouchi, Toshio

2014-04-01

To determine the effectiveness of autologous transplantation of the internal limiting membrane (ILM) for refractory macular holes. Prospective, interventional case series. Ten eyes of 10 consecutive patients who underwent autologous transplantation of the ILM for the treatment of refractory macular holes were studied. The primary diseases in these patients were large idiopathic macular holes that had existed for more than 1 year (4 eyes), a traumatic macular hole (1 eye), myopic foveoschisis (2 eyes), foveoschisis resulting from pit-macular syndrome (2 eyes), and proliferative diabetic retinopathy (1 eye). Apart from the 5 eyes with idiopathic or traumatic macular holes, macular holes developed in the other 5 eyes after initial vitrectomies with ILM removal. In all eyes, regular macular hole surgery failed to achieve closure. The main outcome measures used in this study were macular hole closure and best-corrected visual acuity (BCVA). Macular holes were closed successfully in 9 eyes (90%) after autologous transplantation of the ILM. The postoperative BCVAs were significantly better than the preoperative BCVAs (P = .007, paired t test). Postoperative BCVAs improved by more than 0.2 logarithm of the minimal angle of resolution units in 8 eyes (80%) and were unchanged in 2 eyes (20%). Although this is a pilot study, the results suggest that autologous transplantation of the ILM may contribute to improved anatomic and visual outcomes in the treatment of refractory macular holes and may warrant further investigation. Copyright © 2014 Elsevier Inc. All rights reserved.

Genomic Instability: The Driving Force behind Refractory/Relapsing Hodgkin’s Lymphoma

International Nuclear Information System (INIS)

Knecht, Hans; Righolt, Christiaan; Mai, Sabine

2013-01-01

In classical Hodgkin’s lymphoma (HL) the malignant mononuclear Hodgkin (H) and multinuclear, diagnostic Reed-Sternberg (RS) cells are rare and generally make up <3% of the total cellular mass of the affected lymph nodes. During recent years, the introduction of laser micro-dissection techniques at the single cell level has substantially improved our understanding of the molecular pathogenesis of HL. Gene expression profiling, comparative genomic hybridization analysis, micro-RNA expression profiling and viral oncogene sequencing have deepened our knowledge of numerous facets of H- and RS-cell gene expression deregulation. The question remains whether disturbed signaling pathways and deregulated transcription factors are at the origin of refractory/relapsing Hodgkin’s lymphoma or whether these hallmarks are at least partially related to another major factor. We recently showed that the 3D nuclear organization of telomeres and chromosomes marked the transition from H- to RS-cells in HL cell lines. This transition is associated with progression of telomere dysfunction, shelterin disruption and progression of complex chromosomal rearrangements. We reported analogous findings in refractory/relapsing HL and identified the shelterin proteins TRF1, TRF2 and POT1 as targets of the LMP1 oncogene in post-germinal center B-cells. Here we summarize our findings, including data not previously published, and propose a model in which progressive disruption of nuclear integrity, a form of genomic instability, is the key-player in refractory/relapsing HL. Therapeutic approaches should take these findings into account

Unique opportunities in powder injection molding of refractory and hard materials

International Nuclear Information System (INIS)

German, R.M.

2001-01-01

Powder injection molding (PIM) is a relatively new manufacturing process for the creation of complicated net-shapes outside the range usually possible via powder metallurgy technologies. This new process is now in production at more than 550 sites around the world. Although a small industry, PIM will soon pass $1 billion dollars (USA) in annual sales. This presentation overviews the PIM process, some of the new developments and some of the successes that have occurred with both refractory metals and hard metals. Example applications are seen in medical and dental devices, industrial components, wristwatches, jet engines, firearms, automotive components, and even hand tools. To help establish the novel growth opportunities, PIM is compared to other fabrication routes to better understand the design features arising with this new approach, providing a compelling case for substantial opportunities in the refractory and hard materials. Illustrations are provided of several components in production. New opportunities abound for the technology, since it eliminates the shape complexity barrier associated with die compaction and the cost of machining associated with complicated or dimensionally precise components. Further, a relative cost advantage exists for refractory and hard materials because PIM can use the same powders at the same prices as employed in alternative processes. Future successes will occur by early identification of candidate materials and designs. Early examples include tungsten heavy alloy components now reaching production rates of six million per month. (author)

Trace Element Abundances in Refractory Inclusions from Antarctic Micrometeorites

Science.gov (United States)

Greshake, A.; Hoppe, P.; Bischoff, A.

1995-09-01

Refractory inclusions are charcteristic components in carbonaceous chondrites. Therefore, refractory inclusions found in micrometeorites can give important hints about the relationship between micrometeorites and carbonaceous chondrites. So far, only a few inclusions were found in micrometeorites [1-4]. In this study we report the first trace element analysis of perovskite and fassaite found in micrometeorites. We studied two Antarctic micrometeorites by ASEM, EMP, and SIMS. The first particle is 120 micrometers in size mainly consisting of a fine-grained matrix of dehydrated former phyllosilikates that enclose a 5 micrometers sized perovskite [5]. The perovskite is surrounded by a 1 micrometers thick rim of ilmenite and contains up to 1.3 wt% FeO as determined by EMP. The trace element abundances were determined by SIMS following the procedure described by [6]. The REE pattern of the perovskite is shown in Fig. 1. The pattern is closely related to the Group II pattern with its typical depletion of the more refractory REEs [7]. It is also very similar to the REE abundances of perovskite from Murchison (CM) [8] and CH-chondrites [9]. This may indicate a relationship between this micrometeorite and components in carbonaceous chondrites. The second micrometeorite is 100 micrometers in size consisting of a fine-grained (20 micrometers across) and a coarse-grained (80 micrometers across) area. Both areas contain fassaite with different chemical compositions. The particle was previously analyzed by Lindstrom and Kloeck [1] without knowing the mineralogy. We carried out SIMS analysis of each area of the micrometeorite separately. The TEE patterns of these two areas are similar and show in general a Group III pattern (20-30x CI) in which the more refractory REEs are not fractionated. The negative Eu anomaly is much more apparent in the coarse-grained area and no Yb anomaly is apparent in one of the areas. This is the first CAI of a micrometeorite showing a Group III REE

Carbothermic reduction of refractory metals

International Nuclear Information System (INIS)

Anderson, R.N.; Parlee, N.A.D.

1976-01-01

The reduction of stable refractory metal oxides by carbon is generally unacceptable since the product is usually contaminated with carbides. The carbide formation may be avoided by selecting a solvent metal to dissolve the reactive metal as it is produced and reduce its chemical activity below that required for carbide formation. This approach has been successfully applied to the oxides of Si, Zr, Ti, Al, Mg, and U. In the case where a volatile suboxide, a carbonyl reaction, or a volatile metal occur, the use of the solvent metal appears satisfactory to limit the loss of material at low pressures. In several solute--solvent systems, vacuum evaporation is used to strip the solvent metal from the alloy to give the pure metal

Refractory concentrate gold leaching: Cyanide vs. bromine

Science.gov (United States)

Dadgar, Ahmad

1989-12-01

Gold extraction, recovery and economics for two refractory concentrates were investigated using cyanide and bromine reagents. Gold extractions for cyanide leaching (24-48 hours) and bromine leaching (six hours) were the same and ranged from 94 to 96%. Gold recoveries from bromine pregnant solutions using carbon adsorption, ion exchange, solvent extraction, and zinc and aluminum precipitation methods were better than 99.9%. A preliminary economic analysis indicates that chemical costs for cyanidation and bromine process are 11.70 and 11.60 respectively, per tonne of calcine processed.

Refractory materials based on compounds of Mg, Zr, Si and Ca

International Nuclear Information System (INIS)

Drygalska, E.; Piech, J.; Szczerba, J.

2003-01-01

Basic refractory materials modified with zirconium oxide or calcium zirconate find application in metallurgy and ceramic industry. Fundamental raw material for ZrO 2 production is zirconia sand, while synthetic calcium zirconate is produced in reaction of zirconium oxide with calcium oxide. Regarding these facts new highly refractory composite materials CZ and DZ were obtained from mixtures of zirconia sand and limestone of dolomite. These composite materials may contain stabilised ZrO 2 and/or calcium zirconate. Among other important components are periclase and calcium orthosilicates. All these phases have high melting points (above 2000 o C). This work describes thermal and technological properties and microstructure of CZ and DZ materials. The use of calcareous raw materials (limestone and dolomite) yields materials with good hydration resistance. These composites may be used as an additive modifying properties of magnesia products. (author)

Frequency-Modulated Continuous-Wave Fm-Cw Radar for Evaluation of Refractory Structures Used in Glass Manufacturing Furnaces

Science.gov (United States)

Carroll, B.; Kharkovsky, S.; Zoughi, R.; Limmer, R.

2009-03-01

A frequency-modulated continuous-wave (FM-CW) handheld radar operating in the frequency range of 8-18 GHz, resulting in a relatively fine range resolution was designed and constructed for on-site inspection of refractory structure thickness. This paper presents the design of the radar and the results of measurements conducted on typical refractory furnace structures assembled in the laboratory.

Estimation of sensing characteristics for refractory nitrides based gain assisted core-shell plasmonic nanoparticles

Science.gov (United States)

Shishodia, Manmohan Singh; Pathania, Pankaj

2018-04-01

Refractory transition metal nitrides such as zirconium nitride (ZrN), hafnium nitride (HfN) and titanium nitride (TiN) have emerged as viable alternatives to coinage metals based plasmonic materials, e.g., gold (Au) and silver (Ag). The present work assesses the suitability of gain assisted ZrN-, HfN- and TiN-based conventional core-shell nanoparticles (CCSNPs) and multilayered core-shell nanoparticles (MCSNPs) for refractive index sensing. We report that the optical gain incorporation in the dielectric layer leads to multifold enhancement of the scattering efficiency (Qsca), substantial reduction of the spectral full width at half maximum, and a higher figure of merit (FOM). In comparison with CCSNPs, the MCSNP system exhibits superior sensing characteristics such as higher FOM, ˜ 45% reduction in the critical optical gain, response shift towards the biological window, and higher degree of tunability. Inherent biocompatibility, growth compatibility, chemical stability and flexible spectral tuning of refractory nitrides augmented by superior sensing properties in the present work may pave the way for refractory nitrides based low cost sensing.

Development of a New Ferrous Aluminosilicate Refractory Material for Investment Casting of Aluminum Alloys

Science.gov (United States)

Yuan, Chen; Jones, Sam; Blackburn, Stuart

2012-12-01

Investment casting is a time-consuming, labour intensive process, which produces complex, high value-added components for a variety of specialised industries. Current environmental and economic pressures have resulted in a need for the industry to improve current casting quality, reduce manufacturing costs and explore new markets for the process. Alumino-silicate based refractories are commonly used as both filler and stucco materials for ceramic shell production. A new ceramic material, norite, is now being produced based on ferrous aluminosilicate chemistry, having many potential advantages when used for the production of shell molds for casting aluminum alloy. This paper details the results of a direct comparison made between the properties of a ceramic shell system produced with norite refractories and a typical standard refractory shell system commonly used in casting industry. A range of mechanical and physical properties of the systems was measured, and a full-scale industrial casting trial was also carried out. The unique properties of the norite shell system make it a promising alternative for casting aluminum based alloys in the investment foundry.

Commercial low-Btu coal-gasification plant. Feasibility study: General Refractories Company, Florence, Kentucky. Volume I. Project summary. [Wellman-Galusha

Energy Technology Data Exchange (ETDEWEB)

None

1981-11-01

In response to a 1980 Department of Energy solicitation, the General Refractories Company submitted a Proposal for a feasibility study of a low Btu gasification facility for its Florence, KY plant. The proposed facility would substitute low Btu gas from a fixed bed gasifier for natural gas now used in the manufacture of insulation board. The Proposal from General Refractories was prompted by a concern over the rising costs of natural gas, and the anticipation of a severe increase in fuel costs resulting from deregulation. The proposed feasibility study is defined. The intent is to provide General Refractories with the basis upon which to determine the feasibility of incorporating such a facility in Florence. To perform the work, a Grant for which was awarded by the DOE, General Refractories selected Dravo Engineers and Contractors based upon their qualifications in the field of coal conversion, and the fact that Dravo has acquired the rights to the Wellman-Galusha technology. The LBG prices for the five-gasifier case are encouraging. Given the various natural gas forecasts available, there seems to be a reasonable possibility that the five-gasifier LBG prices will break even with natural gas prices somewhere between 1984 and 1989. General Refractories recognizes that there are many uncertainties in developing these natural gas forecasts, and if the present natural gas decontrol plan is not fully implemented some financial risks occur in undertaking the proposed gasification facility. Because of this, General Refractories has decided to wait for more substantiating evidence that natural gas prices will rise as is now being predicted.

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study.

Science.gov (United States)

Chevallier, P; Labopin, M; Turlure, P; Prebet, T; Pigneux, A; Hunault, M; Filanovsky, K; Cornillet-Lefebvre, P; Luquet, I; Lode, L; Richebourg, S; Blanchet, O; Gachard, N; Vey, N; Ifrah, N; Milpied, N; Harousseau, J-L; Bene, M-C; Mohty, M; Delaunay, J

2011-06-01

A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19-70) receiving a combination of intensive chemotherapy+Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36±4%, respectively. Disease status (relapse Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.

On calculation of lattice parameters of refractory metal solid solutions

International Nuclear Information System (INIS)

Barsukov, A.D.; Zhuravleva, A.D.; Pedos, A.A.

1995-01-01

Technique for calculating lattice periods of solid solutions is suggested. Experimental and calculation values of lattice periods of some solid solutions on the basis of refractory metals (V-Cr, Nb-Zr, Mo-W and other) are presented. Calculation error was correlated with experimental one. 7 refs.; 2 tabs

Evolution of Cerebral Atrophy in a Patient with Super Refractory Status Epilepticus Treated with Barbiturate Coma

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Christopher R. Newey

2017-01-01

Full Text Available Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma. Methods. Case report and review of the literature. Case. A 19-year-old male with a prior history of epilepsy presented with focal clonic seizures. His seizures were refractory to multiple anticonvulsants and eventually required pentobarbital coma for 62 days and midazolam coma for 33 days. Serial brain magnetic resonance imaging (MRI showed development of cerebral atrophy at 31 days after admission to our facility and progression of the atrophy at 136 days after admission. Conclusion. This case highlights the development and progression of generalized cerebral atrophy in super refractory status epilepticus. The cerebral atrophy was noticeable at 31 days after admission at our facility which emphasizes the urgency of definitive treatment in patients who present with super refractory status epilepticus. Further research into direct effects of therapeutic coma is warranted.

Fluid Force-Induced Detachment Criteria for Nonmetallic Inclusions Adhered to a Refractory/Molten Steel Interface

Science.gov (United States)

Dieguez Salgado, Uxia; Weiß, Christian; Michelic, Susanne K.; Bernhard, Christian

2018-05-01

Since nonmetallic inclusions (NMIs) in steel cannot be completely avoided, a greater understanding of their development and evolution during the steelmaking process is required. In particular, this includes the adhesion of microinclusions to the refractory/steel interface in the flow control system between the tundish and the mold. This phenomenon, commonly referred to as clogging, causes losses in productivity and product quality. Inclusions transported from the bulk melt to the boundary layer may adhere to the refractory/steel interface due to formation of a fluid cavity. A detailed model was derived for the detachment of NMIs adhering to a nozzle wall and is based on the local hydrodynamic conditions combined with the specific interfacial properties in the system consisting of the inclusions, the refractories, and the steel. The model is evaluated for three different application-oriented cases. This study has been focused on providing a better understanding of fluid flow in the near-wall region in order to reduce clogging during steelmaking.

Oral cyclosporine therapy for refractory severe vernal keratoconjunctivitis

Directory of Open Access Journals (Sweden)

Nikhil S Gokhale

2012-01-01

Full Text Available We report the success of oral cyclosporine therapy in a patient with severe vision-threatening vernal keratoconjunctivitis. A child presented with severe allergy which was not controlled with topical steroids, cyclosporine and mast cell stabilizers. Oral steroids were required repeatedly to suppress inflammation. Child showed a dramatic improvement and stabilization with oral cyclosporine therapy. Oral cyclosporine therapy can be tried in severe vision-threatening allergy refractory to conventional therapy.

Development of a Refractory High Entropy Superalloy (Postprint)

Science.gov (United States)

2016-03-17

hardened with HfC precipitates [2], Co-Re- or Co-Al-W-based alloys [3] or two-phase ( FCC + L12) refractory superalloys based on platinum group metals...Ni-based superalloys consisting of cuboids with the ordered L12 structure embedded in an FCC solid-solution matrix. Based on this microstructural...and 5). A comparison of the average atomic radii with the measured lattice parameters allows us to conclude that the disordered BCC phase forming

PARTITIONING OF THE REFRACTORY METALS, NICKEL AND CHROMIUM, IN COMBUSTION SYSTEMS

Science.gov (United States)

The partitioning of nickel (Ni) and Chromium (Cr) in combustion systems was investigated theoretically and experimentally. In comparison to other volatile and semi-volatile metals, both Ni and Cr are usually considered to be refractory (non-volatile). Theoretical predictions ba...

Pharmacological analysis of postictal refractoriness after cortical epileptic seizures in rats

Czech Academy of Sciences Publication Activity Database

Mareš, Pavel; Kubová, Hana

2007-01-01

Roč. 59, Suppl.1 (2007), s. 12-13 ISSN 1734-1140. [Day of neuropsychopharmacology /16./. 06.09.2007-08.09.2007, Wroclaw] Institutional research plan: CEZ:AV0Z50110509 Keywords : postictal refractoriness * epileptic afterdischarges * rat Subject RIV: ED - Physiology

Immunotoxin – a new treatment option in patients with relapsed and refractory Hodgkin lymphoma

Directory of Open Access Journals (Sweden)

Novakovic Barbara Jezersek

2015-12-01

Full Text Available Background. Even though Hodgkin lymphoma is a highly curable disease, some of the patients have either a refractory disease or experience a relapse following a successful primary therapy. Durable responses and remissions in patients with relapsed or refractory disease may be achieved in approximately one-half with salvage chemotherapy followed by high dose chemotherapy (HDT and autologous hematopoietic cell rescue (SCT. On the other hand, patients who relapse after HDT and autologous SCT or those who have failed at least two prior multi-agent chemotherapy regimens and are not candidates for HDT have limited treatment options.

Using Laboratory Methods to Better Understand Refractory Cloud Formation in Exoplanet Atmospheres

Science.gov (United States)

Kohler, E.; Ferguson, F.

2017-12-01

The high number of extrasolar planets found in recent years has brought a new importance to planetary atmospheres. These recently discovered planets show a large diversity in their masses, temperatures, orbital periods, and other properties. With such a diverse mix of planetary parameters, it is safe to assume that the atmospheric properties are just as varied. Recent literature suggests silicates and metals as possible condensates in extrasolar planetary atmospheres as well as the atmospheres of brown dwarfs. While theoretical studies have laid the foundation of cloud formation analysis, their findings still need to be validated via experiments. A verification of the condensation and vaporization predictions of refractory materials needs to be found in order to assist global circulation models in being as accurate as possible. The stability of minerals identified in the literature as potential candidates, will be tested in a thermogravimetric balance. The minerals will be pumped under vacuum for twenty-four hours under room temperature and then heated to a predetermined high temperature, dependent on the expected vaporization temperature of that sample. If there is apparent mass loss, then the temperature will be lowered at preset durations and mass measurements will be taken in similar measured increments. The data will be processed by a computer program in order to calculate the mass loss as a function of temperature. The current cloud formation and global circulation models are very important to the field of planetary science but their accuracy is hindered by the lack of experimental data. The aim of this work is to investigate the mineral stability of potential condensates in an effort to explain the formation of refractory clouds in the atmospheres of extrasolar planets and brown dwarfs.

Glatiramer Acetate-associated Refractory Immune Thrombocytopenic Purpura

Directory of Open Access Journals (Sweden)

Iftach Sagy

2016-04-01

Full Text Available We present a case of glatiramer acetate-associated refractory immune thrombocytopenic purpura (ITP in a female patient with multiple sclerosis. A search of MEDLINE/PubMed did not find any connection between glatiramer acetate and thrombocytopenia, specifically ITP. The autoimmune reaction was resistant to conservative ITP treatment, and was eventually managed only by splenectomy. To the best of our knowledge, this is the first report of glatiramer acetate-associated ITP. Physicians should be aware of this condition, and consider performing routine blood counts at the beginning of glatiramer acetate treatment.

Brazilian mineral resources of refractory metals: Nb, Ta, W and Mo

International Nuclear Information System (INIS)

Barbosa, F.M.; Manso, G.C.

1984-01-01

A brief outlook of selected Brazilian refractory metals resources is presented. The metals are dealt separately with topics covering resources availability, production, Brazilian foreign trade, apparent consumption, and supply-demand balance with emphasis varying according to the specific metal characteristics. (E.G.) [pt

High-temperature Young’s moduli and dilatation behavior of silica refractories

Czech Academy of Sciences Publication Activity Database

Pabst, W.; Gregorová, E.; Kloužek, Jaroslav; Kloužková, A.; Zemenová, P.; Kohoutková, M.; Sedlářová, I.; Lang, K.; Kotouček, M.; Nevřivová, L.; Všianský, D.

2016-01-01

Roč. 36, č. 1 (2016), s. 209-220 ISSN 0955-2219 Institutional support: RVO:67985891 Keywords : silica refractories * Young’s modulus * elastic modulus * dilatation * dilatometry Subject RIV: JH - Ceramic s, Fire-Resistant Materials and Glass Impact factor: 3.411, year: 2016

Luminescence properties of Eu2+- and Ce3+-doped CaAl2S4 and application in white LEDs

International Nuclear Information System (INIS)

Yu Ruijin; Wang Jing; Zhang Jianhui; Yuan Haibin; Su Qiang

2008-01-01

The Eu 2+ - and Ce 3+ -doped CaAl 2 S 4 phosphors were comparatively synthesized by conventional solid-state reaction and the evacuated sealed quartz ampoule. The X-ray diffraction (XRD) patterns show that the sample with better crystalline quality was prepared by the evacuated sealed quartz ampoule, resulting in the enhancement of the emission intensity of Eu 2+ ion by a factor of 1.7. The intensive green LEDs were also fabricated by combining CaAl 2 S 4 :Eu 2+ with near-ultraviolet InGaN chips (λ em =395 nm). The dependence of as-fabricated green LEDs on forward-bias currents shows that it presents good chromaticity stability and luminance saturation, indicating that CaAl 2 S 4 :Eu 2+ is a promising green-emitting phosphor for a near-UV InGaN-based LED. In addition, the optical properties of CaAl 2 S 4 :Ce 3+ were systematically investigated by means of diffuse reflectance, photoluminescence excitation and emission, concentrating quenching and the decay curve. - Graphical abstract: The Eu 2+ - and Ce 3+ -doped CaAl 2 S 4 phosphors were comparatively synthesized by two methods. The emission intensity of Eu 2+ ion in sample synthesized by the evacuated sealed quartz ampoule method is by a factor of 1.7 as strong as that of Eu 2+ ion in sample prepared by the conventional solid-state reaction method

Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy.

Science.gov (United States)

Lin, Lung-Chang; Lee, Wei-Te; Wang, Chien-Hua; Chen, Hsiu-Lin; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Mok, Hin-Kiu; Weng, Chia-Fen; Lee, Mei-Wen; Yang, Rei-Cheng

2011-03-01

Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy. Copyright © 2011 Elsevier Inc. All rights reserved.

Spanish consensus for the management of patients with advanced radioactive iodine refractory differentiated thyroid cancer.

Science.gov (United States)

Riesco-Eizaguirre, Garcilaso; Galofré, Juan Carlos; Grande, Enrique; Zafón Llopis, Carles; Ramón y Cajal Asensio, Teresa; Navarro González, Elena; Jiménez-Fonseca, Paula; Santamaría Sandi, Javier; Gómez Sáez, José Manuel; Capdevila, Jaume

2016-04-01

Approximately one third of the patients with differentiated thyroid cancer (DTC) who develop structurally-evident metastatic disease are refractory to radioactive iodine (RAI). Most deaths from thyroid cancer occur in these patients. The main objective of this consensus is to address the most controversial aspects of management of these patients. On behalf of the Spanish Society of Endocrinology & Nutrition (SEEN) and the Spanish Group for Orphan and Infrequent Tumors (GETHI), the Spanish Task Force for Thyroid Cancer, consisting of endocrinologists and oncologists, reviewed the relevant literature and prepared a series of clinically relevant questions related to management of advanced RAI-refractory DTC. Ten clinically relevant questions were identified by the task force. In answering to these 10 questions, the task force included recommendations regarding the best definition of refractoriness; the best therapeutic options including watchful waiting, local therapies, and systemic therapy (e.g. kinase inhibitors), when sodium iodide symporter (NIS) restoration may be expected; and how recent advances in molecular biology have increased our understanding of the disease. In response to our appointment as a task force by the SEEN and GHETI, we developed a consensus to help in clinical management of patients with advanced RAI-refractory DTC. We think that this consensus will provide helpful and current recommendations that will help patients with this disorder to get optimal medical care. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

New-Onset Refractory Status Epilepticus: More Investigations, More Questions

Directory of Open Access Journals (Sweden)

Philippe Dillien

2016-06-01

Full Text Available A 27-year-old previously healthy woman was admitted to the hospital with recurrent seizures. Status epilepticus developed that became refractory to third-line therapy with propofol and barbiturates. The patient had a very extensive diagnostic workup including autoimmune, viral and genetic investigations. A tentative immune therapy was proposed with high doses of steroids and plasma exchanges. Our patient had an inherited heterozygous single nucleotide variant in the sequence c.1280A>G [p.Lys427Arg] of the SMC3 gene that was insufficient to explain the seizures. Surprisingly, IgM antibodies against Japanese encephalitis virus were positive on the serum drawn 11 days after symptom onset, as detected by ELISA and the immunofluorescence antibody (IFA technique. IgG antibodies were also positive using the IFA technique, but not with ELISA. The same investigations as well as the detection of the viral genome by the q-RT-PCR technique were negative on cerebrospinal fluid. Despite the suspicion of a viral infection, we concluded that our patient had a new-onset refractory status epilepticus of cryptogenic origin. Termination of the status epilepticus was obtained after 47 days, with a possible benefit from the introduction of ketamine.

Brazing Refractory Metals Used In High-Temperature Nuclear Instrumentation

International Nuclear Information System (INIS)

Palmer, A.J.; Woolstenhulme, C.J.

2009-01-01

As part of the U. S. Department of Energy (DOE) sponsored Next Generation Nuclear Project (NGNP) currently ongoing at Idaho National Laboratory (INL), the irradiation performance of candidate high-temperature gas reactor fuels and materials is being evaluated at INL's Advanced Test Reactor (ATR). The design of the first Advanced Gas Reactor (AGR 1) experiment, currently being irradiated in the ATR, required development of special techniques for brazing niobium and molybdenum. Brazing is one technique used to join refractory metals to each other and to stainless steel alloys. Although brazing processes are well established, it is difficult to braze niobium, molybdenum, and most other refractory metals because they quickly develop adherent oxides when exposed to room-temperature air. Specialized techniques and methods were developed by INL to overcome these obstacles. This paper describes the techniques developed for removing these oxides, as well as the ASME Section IX-qualified braze procedures that were developed as part of the AGR-1 project. All brazes were made using an induction coil with an inert or reducing atmosphere at low pressure. Other parameters, such as filler metals, fluxes used, and general setup procedures, are also discussed

Brazing refractory metals used in high-temperature nuclear instrumentation

Energy Technology Data Exchange (ETDEWEB)

Palmer, A. J. [Idaho National Laboratory, MS 3840, P.O. Box 1625, Idaho Falls, ID 83415-3840 (United States); Woolstenhulme, C. J. [EG and G Services, Inc., (United States)

2009-07-01

As part of the U. S. Department of Energy (DOE)-sponsored Next Generation Nuclear Project (NGNP) currently ongoing at Idaho National Laboratory (INL), the irradiation performance of candidate high-temperature gas reactor fuels and materials is being evaluated at INL's Advanced Test Reactor (ATR). The design of the first Advanced Gas Reactor (AGR-1) TRISO fuel experiment, currently being irradiated in the ATR, required development of special techniques for brazing niobium and molybdenum. Brazing is one technique used to join refractory metals to each other and to stainless steel alloys. Although brazing processes are well established, it is difficult to braze niobium, molybdenum, and most other refractory metals because they quickly develop adherent oxides when exposed to room-temperature air. Specialized techniques and methods were developed by INL to overcome these obstacles. This paper describes the techniques developed for removing these oxides, as well as the ASME Section IX-qualified braze procedures that were developed as part of the AGR-1 project. All brazes were made using an induction coil with an inert or reducing atmosphere at low pressure. Other parameters, such as filler metals, fluxes used, and general setup procedures, are also discussed. (authors)

Brazing refractory metals used in high-temperature nuclear instrumentation

International Nuclear Information System (INIS)

Palmer, A. J.; Woolstenhulme, C. J.

2009-01-01

As part of the U. S. Department of Energy (DOE)-sponsored Next Generation Nuclear Project (NGNP) currently ongoing at Idaho National Laboratory (INL), the irradiation performance of candidate high-temperature gas reactor fuels and materials is being evaluated at INL's Advanced Test Reactor (ATR). The design of the first Advanced Gas Reactor (AGR-1) TRISO fuel experiment, currently being irradiated in the ATR, required development of special techniques for brazing niobium and molybdenum. Brazing is one technique used to join refractory metals to each other and to stainless steel alloys. Although brazing processes are well established, it is difficult to braze niobium, molybdenum, and most other refractory metals because they quickly develop adherent oxides when exposed to room-temperature air. Specialized techniques and methods were developed by INL to overcome these obstacles. This paper describes the techniques developed for removing these oxides, as well as the ASME Section IX-qualified braze procedures that were developed as part of the AGR-1 project. All brazes were made using an induction coil with an inert or reducing atmosphere at low pressure. Other parameters, such as filler metals, fluxes used, and general setup procedures, are also discussed. (authors)

High-Temperature Monitoring of Refractory Wall Recession Using Frequency-Modulated Continuous-wave (FM-CW) Radar Techniques

International Nuclear Information System (INIS)

Varghese, B.; DeConick, C.; Cartee, G.; Zoughi, R.; Velez, M.; Moore, R.

2005-01-01

Furnaces are among the most crucial components in the glass and metallurgical industry. Nowadays, furnaces are being operated at higher temperatures and for longer periods of time thus increasing the rate of wear on the furnace refractory lining. Consequently, there is a great need for a nondestructive tool that can accurately measure refractory wall thickness at high temperatures. In this paper the utility of a frequency-modulated continuous-wave (FM-CW) radar is investigated for this purpose

Symposium on refractory organic substances in the environment - Rose II. Abstracts of oral and poster papers

Energy Technology Data Exchange (ETDEWEB)

Frimmel, F H; Abbt-Braun, G [eds.

2000-07-01

Again the Deutsche Forschungsgemeinschaft has generously supported the 25 research projects working together on Refractory Organic Substances in the Environment (ROSE). Numerous researchers from universities and research institutes all over Germany focused upon the characterization of refractory organic material from brown water, soil seepage water as well as treated and untreated waste water through the compilation of analytical and biochemical data on the genesis and transformation of the isolated organic material and its interactions with other water constituents. (orig.)

Refractory thermowell for continuous high temperature measurement of molten metal

International Nuclear Information System (INIS)

Thiesen, T.J.

1992-01-01

This patent describes a vessel for handling molten metal having an interior refractory lining, apparatus for continuous high temperature measurement of the molten metal. It comprises a thermowell; the thermowell containing a multiplicity of thermocouples; leads being coupled to a means for continuously indicating the temperature of the molten metal in the vessel

Investigation of magnetic resonance imaging texture analysis as an aid tool for characterization of refractory epilepsies

Directory of Open Access Journals (Sweden)

Mauricio Martins Baldissin

2013-12-01

Full Text Available Refractory epilepsies are syndromes for which therapies that employ two or more antiepileptic drugs, separately or in association, do not result in control of crisis. Patients may present focal cortical dysplasia or diffuse dysplasia and/or hippocampal atrophic alterations that may not be detectable by a simple visual analysis in magnetic resonance imaging. The aim of this study was to evaluate MRI texture in regions of interest located in the hippocampi, limbic association cortex and prefrontal cortex of 20 patients with refractory epilepsy and to compare them with the same areas in 20 healthy individuals, in order to find out if the texture parameters could be related to the presence of the disease. Of the 11 texture parameters calculated, three indicated the existence of statistically significant differences between the studied groups. Such findings suggest the possibility of this technique contributing to studies of refractory epilepsies.

Coal-oil gold agglomeration assisted flotation to recover gold from refractory ore

Science.gov (United States)

Otsuki, A.; Yue, C.

2017-07-01

This study aimed to investigate the applicability of coal-oil gold agglomeration (CGA) assisted flotation to recover gold from a refractory ore. The ore with the grade of 2-5 g/t was tested with the CGA-flotation process in six different size fractions from 38 to 300 urn using different collector types and dosages. In addition, the flotation without CGA was performed under the same condition for comparison. The results showed that the higher gold grade and recovery were achieved by applying the CGA-flotation, compared with the flotation without CGA. More than 20-60 times grade increase from the head grade was obtained with CGA-flotation. The elemental analysis of gold and sulphur explained their relationship with gold recovery. The results well indicated the applicability of CGA to upgrade the refractory gold ore.

Multifunctional Metallic and Refractory Materials for Energy Efficient Handling of Molten Metals

Energy Technology Data Exchange (ETDEWEB)

Xingbo Liu; Ever Barbero; Bruce Kang; Bhaskaran Gopalakrishnan; James Headrick; Carl Irwin

2009-02-06

The goal of the project was to extend the lifetime of hardware submerged in molten metal by an order of magnitude and to improve energy efficiency of molten metal handling process. Assuming broad implementation of project results, energy savings in 2020 were projected to be 10 trillion BTU/year, with cost savings of approximately $100 million/year. The project team was comprised of materials research groups from West Virginia University and the Missouri University of Science and Technology formerly University of Missouri – Rolla, Oak Ridge National Laboratory, International Lead and Zinc Research Organization, Secat and Energy Industries of Ohio. Industry partners included six suppliers to the hot dip galvanizing industry, four end-user steel companies with hot-dip Galvanize and/or Galvalume lines, eight refractory suppliers, and seven refractory end-user companies. The results of the project included the development of: (1) New families of materials more resistant to degradation in hot-dip galvanizing bath conditions were developed; (2) Alloy 2020 weld overlay material and process were developed and applied to GI rolls; (3) New Alloys and dross-cleaning procedures were developed for Galvalume processes; (4) Two new refractory compositions, including new anti-wetting agents, were identified for use with liquid aluminum alloys; (5) A new thermal conductivity measurement technique was developed and validated at ORNL; (6) The Galvanizing Energy Profiler Decision Support System (GEPDSS)at WVU; Newly Developed CCW Laser Cladding Shows Better Resistance to Dross Buildup than 316L Stainless Steel; and (7) A novel method of measuring the corrosion behavior of bath hardware materials. Project in-line trials were conducted at Southwire Kentucky Rod and Cable Mill, Nucor-Crawfordsville, Nucor-Arkansas, Nucor-South Carolina, Wheeling Nisshin, California Steel, Energy Industries of Ohio, and Pennex Aluminum. Cost, energy, and environmental benefits resulting from the project

Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application.

Science.gov (United States)

Thapa, Deepak; Ahuja, Vanita; Dass, Christopher; Verma, Parul

2015-01-01

Trigeminal neuralgia (TN) produces incapacitating facial pain that reduces quality of life in patients. Thermal radiofrequency (RF) ablation of gasserian ganglion (GG) is associated with masseter weakness and unpleasant sensations along the distribution of the ablated nerve. Pulsed radiofrequency (PRF) of GG has minimal side effects but literature is inconclusive regarding its benefit in refractory TN. Increasing the duration of PRF application to 6 minutes in TN produced encouraging results. PRF application to the saphenous nerve for 8 minutes reported improved pain relief and patient satisfaction. We report successful management of two patients of classic TN, which were refractory to medical management and interventional nerve blocks. The lesion site were confirmed with motor and sensory stimulation through a 22 G, 10 cm RF needle with 5 mm active tip. Both the patients received four cycles of PRF at 42 °C with each cycle of 120 seconds (8 minutes). The visual analogue scale (VAS) in case 1 reduced from pre-block score of 80 to score 10 post-block, while in case 2 the VAS reduced from pre-block score of 85 to score 15 post-block. During follow up both the patients are now pain free with minimal dose of carbamazepine at 12 and 6 months respectively. We used PRF for longer duration (8 minutes) in these patients, which resulted in improved VAS and WHOQOL-BREF score in these patients. PRF of mandibular division of GG for extended duration provided long-term effective pain relief and quality of life in patients of refractory classic TN.

Evaluation of technological properties of alumina refractory systems-zirconia and zirconia-silica-alumina; Avaliacao das propriedades tecnologicas de refratarios dos sistemas alumina-zirconia e alumina-zirconia-silica

Energy Technology Data Exchange (ETDEWEB)

Marinho, A.R.O.; Carvalho, T.U.S.; Fagury Neto, E.; Rabelo, A.A., E-mail: adriano@unifesspa.edu.br [Universidade Federal do Sul e Sudeste do Para (UFSSPA), Maraba, PA (Brazil)

2014-07-01

Alumina-zirconia refractories are noted for being products of excellent cost-effective, however, zirconia may limit its use due to decreasing resistance to thermal shock. This study aims to evaluate these refractories with the addition of microsilica, which can greatly improve their properties. Were used the following starting materials: calcined alumina, zirconia (stabilized and monoclinic) in amounts of 2%, 4% and 6% by weight, plus microsilica (5%w.). The powders were milled together with binder and lubricant for conformation bodies by uniaxial pressing. The samples were dried, calcined and sintered at 1400 °C/2h were characterized using the methods of Archimedes, and scanning electron microscopy (SEM), chemical analysis using energy dispersive X-ray (EDS), and mechanical flexural strength tests at room temperature. Formulations with the presence of microsilica showed satisfactory results and optimized properties. (author)

Adrenaline in cardiac arrest: Prefilled syringes are faster.

Science.gov (United States)

Helm, Claire; Gillett, Mark

2015-08-01

Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Increased thiol levels in antimony-resistant Leishmania infantum isolated from treatment-refractory visceral leishmaniasis in Brazil.

Science.gov (United States)

Magalhães, Lucas S; Bomfim, Lays Gs; Mota, Sthefanne G; Cruz, Geydson S; Corrêa, Cristiane B; Tanajura, Diego M; Lipscomb, Michael W; Borges, Valéria M; Jesus, Amélia R de; Almeida, Roque P de; Moura, Tatiana R de

2018-02-01

BACKGROUND Treatment-refractory visceral leishmaniasis (VL) has become an important problem in many countries. OBJECTIVES We evaluated the antimony-resistance mechanisms of Leishmania infantum isolated from VL patients refractory or responsive to treatment with pentavalent antimony. METHODS Strains isolated from antimony-refractory patients (in vitro antimony-resistant isolates) and antimony-responsive patients (in vitro antimony-sensitive isolates) were examined. Morphological changes were evaluated by transmission electron microscopy after trivalent antimony exposure. P-glycoprotein (P-gp) efflux pump activity was evaluated using the pump-specific inhibitor verapamil hydrochloride, and the role of thiol in trivalent antimony resistance was investigated using the enzymatic inhibitor L-buthionine sulfoximine. FINDINGS Antimony treatment induced fewer alterations in the cellular structure of L. infantum resistant isolates than in that of sensitive isolates. P-gp efflux activity was not involved in antimony resistance in these isolates. Importantly, the resistant isolates contained higher levels of thiol compared to the sensitive isolates, and inhibition of thiol synthesis in the resistant isolates recovered their sensitivity to trivalent antimony treatment, and enhanced the production of reactive oxygen species in promastigotes exposed to the drug. MAIN CONCLUSIONS Our results demonstrate that isolates from patients with antimony-refractory VL exhibited higher thiol levels than antimony-sensitive isolates. This indicates that redox metabolism plays an important role in the antimony-resistance of New World VL isolates.

Meta-analysis of adjunctive levetiracetam in refractory partial sei

Directory of Open Access Journals (Sweden)

ZHANG Ying

2012-10-01

Full Text Available Objective To evaluate the effects and tolerability of adjunctive levetiracetam (LEV in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive LEV in refractory partial seizures from January 1998 to December 2010 were retrieved from Cochrane Library, MEDLINE, EMbase, Social Sciences Citation Index (SSCI, VIP, Chinese National Knowledge Infrastructure (CNKI database, China Biology Medicine (CBM. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted by using RevMan 5.0 software. Results According to the enrollment criteria, eleven prospective, randomized controlled clinical trials with a total of 1192 in LEV group and 789 in placebo group were finally selected. The reduction in three endpoints (a 50% or greater reduction of partial seizure frequency per week, a 75% or greater reduction of partial seizure frequency per week and seizure free was significant in LEV group than placebo group. There was no significance between LEV group and placebo group in the withdrawl rate (1000 mg/d: OR = 1.180, 95%CI: 0.690-2.010, P = 0.540; 2000 mg/d: OR = 1.530, 95%CI: 0.770-3.030, P = 0.230; 3000 mg/d: OR = 1.000, 95% CI: 0.620-1.600, P = 1.000. The following adverse events were associated with LEV: somnolence (OR = 1.720, 95%CI: 1.280-2.310, P = 0.000, dizziness (OR = 1.490, 95%CI: 1.000-2.220, P = 0.050, asthenia (OR = 1.670, 95%CI: 1.140-2.240, P = 0.008, nasopharyngitis (OR = 1.120, 95% CI: 0.710-1.760, P = 0.630, psychiatric and behavioral abnormalities (OR = 2.120, 95% CI: 1.370-3.280, P = 0.000. Conclusion LEV is effective and well tolerated when added to existing therapy in patients with refractory partial seizures compared with control drugs. Further studies are needed to identify the effects of monotherapy of LEV in partial seizures.

Proposed consensus definitions for new-onset refractory status epilepticus (NORSE), febrile infection-related epilepsy syndrome (FIRES), and related conditions.

Science.gov (United States)

Hirsch, Lawrence J; Gaspard, Nicolas; van Baalen, Andreas; Nabbout, Rima; Demeret, Sophie; Loddenkemper, Tobias; Navarro, Vincent; Specchio, Nicola; Lagae, Lieven; Rossetti, Andrea O; Hocker, Sara; Gofton, Teneille E; Abend, Nicholas S; Gilmore, Emily J; Hahn, Cecil; Khosravani, Houman; Rosenow, Felix; Trinka, Eugen

2018-04-01

We convened an international group of experts to standardize definitions of New-Onset Refractory Status Epilepticus (NORSE), Febrile Infection-Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in-person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care. The proposed consensus definitions are as follows: NORSE is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause. FIRES is a subcategory of NORSE, applicable for all ages, that requires a prior febrile infection starting between 2 weeks and 24 hours prior to onset of refractory status epilepticus, with or without fever at onset of status epilepticus. Proposed consensus definitions are also provided for Infantile Hemiconvulsion-Hemiplegia and Epilepsy syndrome (IHHE) and for prolonged, refractory and super-refractory status epilepticus. This document has been endorsed by the Critical Care EEG Monitoring Research Consortium. We hope these consensus definitions will promote improved communication, permit multicenter research, and ultimately improve understanding and treatment of these conditions. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

Backward Response-Level Crosstalk in the Psychological Refractory Period Paradigm

Science.gov (United States)

Miller, Jeff; Alderton, Mark

2006-01-01

Bottleneck models of psychological refractory period (PRP) tasks suggest that a Task 1 response should be unaffected by the Task 2 response in the same trial, because selection of the former finishes before selection of the latter begins. Contrary to this conception, the authors found backward response-level crosstalk effects in which Task 2…

Viscosity measurements of molten refractory metals using an electrostatic levitator

International Nuclear Information System (INIS)

Ishikawa, Takehiko; Paradis, Paul-François; Okada, Junpei T; Watanabe, Yuki

2012-01-01

Viscosities of several refractory metals (titanium, nickel, zirconium, niobium, ruthenium, rhodium, hafnium, iridium and platinum) and terbium have been measured by the oscillation drop method with an improved procedure. The measured data were less scattered than our previous measurements. Viscosities at their melting temperatures showed good agreement with literature values and some predicted values. (paper)

Olanzapine is effective for refractory chemotherapy-induced nausea and vomiting irrespective of chemotherapy emetogenicity.

Science.gov (United States)

Vig, Sierra; Seibert, Laurel; Green, Myke R

2014-01-01

The role of olanzapine added to a dopamine antagonist and benzodiazepine for the treatment of refractory chemotherapy-induced nausea and vomiting (CINV) is incompletely characterized in all levels of chemotherapy emetogenicity. This retrospective study evaluated the efficacy of the addition of olanzapine in adults experiencing refractory CINV stratified by chemotherapy emetogenicity. Thirty-three adults who experienced CINV refractory to guideline-recommended prophylaxis and breakthrough antiemetics (dopamine antagonists and benzodiazepines) and received at least one dose of olanzapine 5-10 mg per os were evaluated. Failure was defined as >5 emesis events in 24 h or more than 10 cumulative doses of rescue antiemetics following first olanzapine dose per treatment cycle. Post hoc analyses investigated variables impacting olanzapine efficacy. The addition of olanzapine demonstrated an overall success rate of 70 %. This success rate did not differ between chemotherapy regimens of high versus low-to-moderate emetogenicity (p = 0.79), prophylaxis with serotonin antagonist plus corticosteroid and aprepitant versus serotonin antagonist alone (p = 0.77), or age over 50 versus ≤50 years (p > 0.99). A trend toward greater benefit was seen in women (p = 0.08). The addition of olanzapine to a dopamine antagonist and benzodiazepine demonstrated high efficacy rates for refractory CINV irrespective of chemotherapy emetogenicity. The high success rates among all groups suggests that incomplete resolution of CINV with prophylactic serotonin antagonists and breakthrough dopamine antagonists plus benzodiazepine may benefit from the addition of olanzapine regardless of gender, degree of chemotherapy emetogenicity, number of prophylactic antiemetics, or age. The trend toward greater control of emesis in women merits further investigation.

MRI-negative refractory partial epilepsy: role for diffusion tensor imaging in high field MRI.

Science.gov (United States)

Chen, Qin; Lui, Su; Li, Chun-Xiao; Jiang, Li-Jun; Ou-Yang, Luo; Tang, He-Han; Shang, Hui-Fang; Huang, Xiao-Qi; Gong, Qi-Yong; Zhou, Dong

2008-07-01

Our aim is to use the high field MR scanner (3T) to verify whether diffusion tensor imaging (DTI) could help in locating the epileptogenic zone in patients with MRI-negative refractory partial epilepsy. Fifteen patients with refractory partial epilepsy who had normal conventional MRI, and 40 healthy volunteers were recruited for the study. DTI was performed on a 3T MR scanner, individual maps of mean diffusivity (MD) and fractional anisotropy (FA) were calculated, and Voxel-Based Analysis (VBA) was performed for individual comparison between patients and controls. Voxel-based analysis revealed significant MD increase in variant regions in 13 patients. The electroclinical seizure localization was concurred to seven patients. No patient exhibited regions of significant decreased MD. Regions of significant reduced FA were observed in five patients, with two of these concurring with electroclinical seizure localization. Two patients had regions of significant increase in FA, which were distinct from electroclinical seizure localization. Our study's results revealed that DTI is a responsive neuroradiologic technique that provides information about the epileptogenic areas in patients with MRI-negative refractory partial epilepsy. This technique may also helpful in pre-surgical evaluation.

Thermodynamics of carbon deoxidation and aluminium deoxidation of refractory metals

International Nuclear Information System (INIS)

Garg, S.P.; Sundaram, C.V.

1975-01-01

Carbon has been used for removing the last traces of oxygen from many refractory metals by evaporation of CO at high temperature and vacuum. Similar purification can also be achieved employing aluminium deoxidation by evaporation of Al 2 Osub(g). In the present paper a theoretical thermodynamic approach has been attempted to evaluate the deoxidation tendencies of refractory metals of groups IV to VI by these two processes. Expressions have been theoretically derived, relating the concentration product of carbon and oxygen in the metal (which is a measure of the carbon deoxidation tendency of the metal) with temperature and pressure, for various M-C-O systems. Similarly the relative vapour pressure values of Alsub(2)Osub(g),Alsub(g)andMO(g) (suboxide of the metal) over various M-Al-O systems have been calculated as a function of aluminium and oxygen contents of the metal. From these analyses, it has been shown that a substantial amount of oxygen can be removed from M-Al-O alloys by aluminium deoxidation. The estimated values are compared with the reported values based on experiment. (author)

Prevalent material parameters governing spalling of a slag-impregnated refractory

Energy Technology Data Exchange (ETDEWEB)

Blond, E.; Schmitt, N.; Arnould, O.; Hild, F. [LMT-Cachan (ENS de Cachan / CNRS-UMR 8535 / Univ. Paris 6), Cachan (France); Blumenfeld, P. [CRDM / ARCELOR Grande Synthe, Dunkerque (France); Poirier, J. [CRDM / ARCELOR Grande Synthe, Dunkerque (France); CRMHT-CNRS, Orleans (France)

2004-07-01

In steel ladle linings, bauxite refractories in contact with iron and steel slag are subjected to complex loadings. To identify the causes of degradation in different reactor linings, a coupling diagram made up of three poles is established: namely, slag impregnation (I), Thermomechanics (TM) and phase transformations (P). The variation of the microstructure and the gradient of the chemical composition resulting from the (I-P) coupling are characterized by microprobe analyses; a natural impregnation tracer is identified. The (I-T) coupling is studied by modeling the refractory lining behavior subjected to a cyclic thermal loading within the framework of the mechanics of porous continua. Parameters governing the location and amplitude of the maximum pore pressure are obtained and their influences are studied. The analysis of the (TM) pole leads to the identification of a thermo-elasto-viscoplastic model for bauxite in various states of slag impregnation. Numerical simulations show that the stress state developed during the heating stages can induce spalling, probably generated by a localized over-pressure of slag. (orig.)