53 research outputs found

    Combined Off-Pump Coronary Revascularization and Lung Resection

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    Challenges and solutions from certification testing and their implications for the practical implementation of ballast water management

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    2007-2012<span style="font-size:9.0pt;font-family: " times="" new="" roman";mso-fareast-font-family:calibri;mso-bidi-font-family:"times="" roman";="" mso-ansi-language:en-gb;mso-fareast-language:en-us;mso-bidi-language:ar-sa"="" lang="EN-GB">The existing guideline G8 of the International Maritime Organisation (IMO) is a generic document that has been compiled based on expert knowledge. Since its first release in 2005, and the revision in 2008, it has proved to be a workable document. However, practical experience gained from certification testing has shown a number of short-comings. Some of these have been addressed and amended in later regulations while other issues are still unresolved. In this paper the topic is addressed from the point of view of a test facility. Common challenges faced by test facilities and possible solutions thereof are presented in the context of practical application of ballast water management systems on board of ships. The relevance and meaning of taxonomy, organism numbers, temperature, salinity and sediment load, are discussed. Lessons learned from the past 7 years of land-based testing and their relevance for future shipboard operation and compliance control are evaluated. </span

    Comparison of normal bladder damage after PDT with oral or intravesical administration of 5-ALA

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    5-Aminolaevulinic-acid (ALA) can be used as an alternative drug in photodynamic therapy of the bladder, since the selective formation of protoporphyrin IX (PpIX) in the tumour and the virtual absence of induced skin photosensitivity are theoretically advantageous for clinical use. A preclinical study was performed, using an in vivo normal piglet bladder model, in order to determine the maximum drug and light doses for reversible tissue damage. Various ALA doses were administered either orally or instilled in the bladder and different radiant exposures were applied. Bladder biopsies were taken at regular intervals and tissue damage was investigated histologically. After oral ALA-administration the PpIX concentration was determined in plasma, erythrocytes and various tissues. In the case of oral administration, reversible bladder damage was observed using 60-75 mg/kg ALA combined with a radiant exposure of 100 J/cm(2) (direct radiant exposure plus scattered 632 nm light) 5-7 h later. For an oral ALA dose of up to 150 mg/kg, the maximum PpIX concentration is reached at approximately 5 h following administration and in neither skin nor bladder tissue is PpIX present at 10-11 h after administration. This ALA dose combined with a radiant exposure of 200 J/cm(2) produces irreversible bladder damage (extensive necrosis and ulceration). In the case of intravesical instillation for 4-4.75 h, an ALA dose of 2.5 g in 50 ml phosphate buffered saline and a radiant exposure of 100 J/cm(2) are still too high to obtain reversible tissue damage; at this dose one of the 13 pigs developed a shrunken bladder with a fibrotic, thickened bladder wall. These drug and light combinations reported above should be regarded as upper limits in pigs and can serve as an indication for the toxicity of the treatment in a clinical settin
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