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  • 1
    Electronic Resource
    Electronic Resource
    Gastrostomy for enteral access (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 991-994 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Gastrostomy — Laparotomy — Laparoscopy — Endoscopy — Stomach — Enteral feeding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Access to the stomach for long-term enteral feeding can be achieved via laparotomy (open GT), laparoscopy (lap GT) or endoscopy (PEG). We compared the three methods of gastrostomy to determine whether any one has an advantage over the others. Methods: A retrospective analysis was done of 356 gastrostomies performed between January 1990 and June 1995. Results: Of these 356 gastrostomies, 214 were open GT, 60 were lap GT, and 82 were PEG. The completion rate was high, 98.1% to 100%. The perioperative mortality rates were low and similar among the 3 methods; 4.2% for open GT, 5.3% for lap GT, and 4.9% for PEG (p= 0.87, Chi square test). Cardiac arrest was the predominant immediate cause of all perioperative deaths (68.8%). Overall, none of the deaths was directly related to the gastrostomy procedure. Major complications occurred in 24.9% of patients receiving open GT, in 18.3% of patients with lap GT, and in 17.1% of patients with PEG. Long-term complications developed in 25.9% of open GT, 25.6% of lap GT, and 30.4% of PEG. The revision rates were similar for all 3 methods, 6.7% for open GT, 10% for lap GT, and 6.1% for PEG. Conclusions: Gastrostomy can be performed safely by all three techniques, with similar outcomes. PEG is our method of choice. Lap GT is preferred in patients with head and neck carcinoma, patients with obstructing esophageal carcinoma, and patients who have problems with overlying liver or colon. Open GT is reserved for cases with extensive intraabdominal adhesions or those where the procedure is done during an ongoing laparotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901153
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Application of Non-Conventional Filtration Technologies in Pollution Control (1997)
    Springer
    Environmental monitoring and assessment 44 (1997), S. 231-240 
    Details
    ISSN: 1573-2959
    Source: Springer Online Journal Archives 1860-2000
    Topics: Energy, Environment Protection, Nuclear Power Engineering
    Notes: Abstract Deep bed filtration is becoming increasing important in wastewater treatment particularly in tertiary treatment as stringent water quality standards are emphasized. A detailed pilot-scale filtration study conducted with secondary effluent in a sewage treatment plant indicated that tertiary filtration with prior alum flocculation is capable of producing high quality effluent, particularly an effluent with phosphorus content of less than 0.3 mg/L (Vigneswaran and Ngo, 1994). Main problem of dual media filter has been rapid headloss development thus frequent backwash requirement. To overcome this problem two independent experimental studies were conducted: one with mobile bed filtration (MBF) and the other with combined downflow floating medium flocculator/prefilter (DFF) and coarse sand filter (CSF) system. A semi-pilot scale mobile bed filtration study conducted using oxidation pond effluent indicated that MBF with contact-flocculation arrangement was good in removing COD, T-P and turbidity with practically no headloss development. Sand of 0.6-0.84 nm dia and 50 cm depth was sufficient to reduce the COD and P from 55 mg/L and 4.5 mg/L to 15 mg/L and 0.5 mg/L respectively at a filtration rate of 7.5 m3/m2.h. Another experimental study with combined DFF-CSF system indicated that the DFF with in-line flocculation addition is a good pretreatment unit to reduce the phosphate upto 80-90%. The fact that DFF resulted in uniform filterable-flocs, it can also successfully be used as a static flocculator/prefilter unit. The introduction of DFF on top of a coarse sand filter increased the filter run time and removal efficiency (more 90-95% of NH3-N and T-P removal respectively). Most importantly, the backwashing of this system was achieved with small quantity of water at low backwash indicated that the removal efficiency was also superior with this system apart from the major advantage of low operating cost.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005736607572
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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