New drugs, including immune checkpoint inhibitors and targeted therapy, have changed the prognosis in a subset of patients with advanced lung cancer, and are now actively investigated in a number of ...trials with neoadjuvant and adjuvant regimens. However, no phase III randomized studies were published yet. The current narrative review proves that targeted therapies are safe in neoadjuvant approach. Unsurprisingly, administration of therapy is related to an acceptable toxicity profile. Severe adverse events' rate that rarely compromises outcomes of patients with advanced lung cancer is not that commonly accepted in early lung cancer as it may lead to missing the chance of curative surgery. Among those complications, the most important factors that may limit the use of targeted therapies are severe respiratory adverse events precluding the resection occurring after treatment with some anaplastic lymphoma kinase and rarely after epidermal growth factor receptor tyrosine kinase inhibitors. At this point, in the presented literature assessing the feasibility of neoadjuvant therapies with anaplastic lymphoma kinase and epidermal growth factor receptor tyrosine kinase inhibitors, we did not find any unexpected intraoperative events that would be of special interest to a thoracic surgeon. Moreover, the postoperative course was associated with typical rate of complications.
While chromium–nickel steel is known to be extremely resistant to corrosion, the occurrence of certain factors can unfortunately initiate an uncontrolled corrosion process. This paper presents ...samples made of 304 stainless steel containing delta ferrite that have been exposed to wastewater for 18 months. Samples placed above the surface of the wastewater (A-series) were intensively corroded. Samples half-submerged in the wastewater and periodically fully submerged at higher effluent flows through the screenings and grit separator (B-series) only suffered minor mechanical erosion. No significant changes in the tested surface were observed on samples fully submerged in wastewater (C-series). The results indicated that the observed pitting corrosion of samples placed above the surface of the wastewater was a consequence of the presence of bacteria in a wet hydrogen sulfide environment. The fluorescence in situ hybridization method showed that either the sludge taken from the wastewater, or from the surface of samples submerged in wastewater exhibited increased amounts of bacteria from the δ-proteobacteria class, indicating the presence of microorganisms involved in the reduction of sulfur or sulfate compounds. A new approach to microbiological evaluation by determining classes of bacteria may be a promising tool for evaluating wastewater in terms of aggressiveness and recognizing favorable corrosive conditions.
Laser Polishing (LP) is a well-defined technology that has recently been applied to improve three-dimensional (3D) printed Inconel 718 (IN718) parts. However, the necessity to conduct the process in ...an argon chamber is one of its major drawbacks, which is associated with an increase in the costs of production and the limitations of the technology regarding the size of parts that can be polished. This article investigates the possibility to conduct LP of IN718 in an air atmosphere and compares the results with those from an argon chamber setup. The experiment was carried out in the context of the influence of overlap on the final surface. The improvement of surface quality was defined through the evaluation of average areal roughness parameters, material relocation, periodic surface components, and the categorization of process-induced structures. It was found that LP allows for the average roughness to be reduced by 82.8% and 87.9% for an air and argon atmosphere, respectively. The oxidation layer was characterized using Energy-Dispersive X-ray Spectroscopy (EDS) analysis. The formation of overlap with regards to Ti and Al oxides had a vital influence on surface quality.
Despite the significant potential advantages of processing Ti-5Al-5Mo-5V-1Cr-1Fe alloy (Ti-55511) using Electron Beam Melting (PBF-EB/M), when compared to conventional manufacturing technologies, the ...resulting internal defects are an important characteristic of such additive technologies and can highly decrease mechanical properties. One of the most dangerous defects formed during metal additive manufacturing processes are material discontinuities such as a lack of fusion. Defects of this type, due to their "flat" nature, are difficult to characterize. For cycle-loaded specimens, where the loading force acts perpendicular to the lack-of-fusion plane, defects of this type can significantly reduce fatigue properties. This paper presents the results of research aimed at improving the fatigue properties of Ti55511 alloy by reducing the influence of the lack-of-fusion defect on fatigue damage. The static and fatigue properties of specimens in the as-built state, as well as after hot isostatic pressing (HIP) treatment, were analyzed. The effect of HIP on both the reduction of pores and the degree of sphericity when using the X-ray computed tomography (XCT) system was presented. The change in the microstructure after HIP was analyzed in terms of the change in the size of individual phases, as well as the change in the phase ratio. This paper also contains a fractographic analysis of the samples after tensile and fatigue tests.
The recently introduced Coaxial Laser Wire Deposition technology can become a new promising method for remanufacturing high-complexity and expensive cutting tools (e.g., flat broach), which will have ...a significant impact on their service life. In addition, it is an innovative approach to tool management. An analysis of the feasibility of processing cobalt-added HSS powder steels was carried out for single clads and multilayer structures. The effect of process parameters (laser, beam power, travel speed, wire feed rate) on geometric properties, hardness and microstructure was discussed. In order to avoid cracking during multilayer deposition, an additional preheating to 320 °C was applied. Two sets of process parameters with high and low heat input were obtained. Both sets lead to crack-free structures that fulfill geometric (≥2.5 mm in height) and hardness (≥700 HV) requirements.
Due to its debilitating character pneumonectomy this is last-resort procedure. Preoperative results of the 6-min walking test (6MWT) help to identify high risk of postoperative complications and ...increased mortality in patients undergoing lobectomy for lung cancer. The aim of the study was to validate the value of 500 m in 6MWT as an indicator, which differentiates risk of complications in patients undergoing pneumonectomy. 125 patients who underwent pneumonectomy at Thoracic Surgery Department between 2009 and 2018. On the day preceding the surgery, patients underwent 6MWT. The patients were in median age of 63 years. The cut-off value of 500 m identified patients with increased 90-day mortality 17.9% vs. 3.5%, odds ratio (OR) 6.271, 95% confidence interval (CI) 1.528-25.739, first-year mortality (30.7% vs. 11.6%, OR 3.378, 95%CI 1.310-8.709), and overall survival (
= 0.02). Patients who covered a distance ≤ 500 m had an increased risk of atrial fibrillation (35.9% vs. 16.3%, OR 2.880, 95%CI 1.207-6.870) and cardiac complications (38.4% vs. 19.8%, OR 2.537, 95%CI 1.100-5.849). Patients unable to reach 500 m in 6MWT are in a high risk of postoperative death after pneumonectomy, what may be a result of increased frequency of postoperative cardiac complications. Poor result of 6MWT is a predictor of worse overall survival.
Treatment of superior sulcus tumors (SST) using concurrent chemoradiation followed by surgery is a current standard. However, due to the rarity of this entity, clinical experience in its treatment ...remains scarce. Here, we present the results of a large consecutive series of patients treated with concurrent chemoradiation followed by surgery at a single academic institution.
The study group included 48 patients with pathologically confirmed SST. The treatment schedule consisted of preoperative 6-MV photon-beam radiotherapy (45-66 Gy delivered in 25-33 fractions over 5-6.5 weeks) and concurrent two cycles of platinum-based chemotherapy. Five weeks after completion of chemoradiation, pulmonary and chest wall resection was performed.
From 2006 to 2018, 47 of 48 consecutive patients meeting protocol criteria underwent two cycles of cisplatin-based chemotherapy and concurrent radiotherapy (45-66 Gy) followed by pulmonary resection. One patient did not undergo surgery due to brain metastases that occurred during induction therapy. The median follow-up was 64.7 months. Chemoradiation was well tolerated, with no toxicity-related deaths. Twenty-one patients (44%) developed grade 3-4 side effects, of which the most common was neutropenia (17 patients; 35.4%). Seventeen patients (36.2%) had postoperative complications, and 90-day mortality was 2.1%. Three- and five-year overall survival (OS) were 43.6% and 33.5%, respectively, and three- and five-year recurrence-free survival were 42.1% and 32.4%, respectively. Thirteen (27.7%) and 22 (46.8%) patients had a complete and major pathological response, respectively. Five-year OS in patients with complete tumor regression was 52.7% (95% CI 29.4-94.5). Predictive factors of long-term survival included age below 70 years, complete resection, pathological stage, and response to induction treatment.
Chemoradiation followed by surgery is a relatively safe method with satisfactory outcomes.
Abstract Fibre metal laminates (FMLs) consisting of layers made of PA6 polyamide prepregs reinforced with glass and carbon fibres and an aluminium alloy core are the new variant of the other types ...used by aerospace FML materials such as GLARE or CARALL. By using a thermoplastic matrix, they can be shaped by stamping processes, which allows for a more efficient production process than classical laminating methods such as vacuum bagging. In addition to the improved impact energy absorption efficiency, the metallic core can be utilised to effectively bond the composite part to adjacent metallic structures. This article presents the influence of the material configuration of fibre-metal laminates consisting of continuous fibre-reinforced thermoplastic outer layers integrated with a layer of metallic aluminium alloy inserts—a number of layers, type and direction of reinforcing fibres—on the static and fatigue flexural properties. In this study, eight laminate configurations were prepared using a one-step variothermal consolidation process. The results showed that in the three-point flexural fatigue test, the samples exceeded 10 6 cycles at stresses <30% of the static bending strength. Laminates with predominantly longitudinally reinforced layers showed the highest fatigue strength among the FML samples analysed. The type of reinforcing fibres and the number of layers were less affected on the analysed mechanical properties.
Laser cladding technology is a well-established process, commonly used for deposition of improved-property coatings, repair of machine parts and additive manufacturing. Currently, in terms of ...application of laser cladding, the method based on powder deposition is much more common, as the use of an adapted nozzle allows the coaxial and direction-independent feeding of additional material into the weld pool. However, laser cladding with powder also has some significant drawbacks, e.g., limited powder feeding and melting efficiency, lower productivity and the resulting dust that poses a health risk to operators. The solution to these limitations is the use of additional material in the form of wire. To maintain the ability to coaxially feed the wire to the laser beam interaction point, a specialized cladding head is necessary. In mentioned system the laser beam, while being passed through the optical system, is divided into three separate beams that are focused on the substrate on the working point of the head. In this study, the COAXwire cladding head was integrated into the robot station and laser cladding process was carried out to determine the influence of the processing parameters on the deposition results. The parameters of the cladding system were identified, including the measurement of laser beam caustic. The experimental trials were carried out using AISI 316L wire deposited on S420MC substrate. The effect of the processing parameters on the geometry of the clad was determined with particular emphasis on the wire feeding.
The speed function (SF) parameter, which is a unique combination of beam speed and beam current, is one of the most important parameters of the electron beam melting (PBF-EB) production process. It ...allows the same process conditions (size of the melt pool, process temperature, etc.) to be maintained for parts with different geometries and sizes. The aim of this research was to understand the effect of SF on the Ti-5Al-5Mo-5V-1Cr-1Fe alloy produced by electron beam melting technology. The results showed that increasing the SF from 86 to 116 resulted in a decrease in the average process temperature, a decrease in the length of the α phase plates, and change in the proportion of α and β phases from 53% (SF 86) to 50% (SF 116) of the β phases. Differences in microstructure (column diameters, thickness, and length of α-phase plates), phase composition, microhardness, porosity at the bottom, and top of the samples were observed on all samples. The mechanical property analysis did not show a significant effect of SF on elongation, but an increase in SF from 86 to 96 resulted in an increase in ultimate tensile strength (UTS) of approximately 7%, whilst an additional increase to 116 resulted in a decrease in UTS of approximately 8.5% compared to SF 96. From the results, it can be seen that the microstructural and mechanical properties of the material strongly depend on the SF. Based on it, SF 86 can be considered as the recommended value for the manufacture of Ti-55511 alloy parts.
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