Effective Procedure For Evaluation Research Articles

Ex vivo lung perfusion in lung transplantation

Introduction. The number of lung transplants performed worldwide is not enough because of a shortage of suitable (ideal) donors, missed chances to use lungs from donors who died of cardiac arrest, the lack of resources to perform this technically complex operation in poor, developing countries and due to a number of other reasons.) The world literature sources contain information about an increase in the number of lung transplantations by using organs from non-ideal (suboptimal and marginal) donors. This became possible thanks to the technology of ex vivo normothermic perfusion of donor lungs.Aim. To demonstrate the possibilities in the assessment, therapy and restoration of the function of non-ideal (suboptimal and marginal) donor lungs by using the technique of ex vivo lung perfusion.Material and methods. We reviewed scientific articles published in the period from 2003 to 2023 in the PubMed and Google Scholar databases for the key query "ex vivo lung perfusion".Conclusion. The ex vivo lung perfusion technique is a promising and effective procedure for lung evaluation, recondition and regeneration for) transplantation. A rapid development of technologies for this treatment modality makes it possible to increase the number of lungs suitable for transplantation, reduce the number of post-transplant complications and mortality rates on the waiting list, and improve the outcomes of lung transplantations.

Comparision of Efficacy of FNAC with Histopathological Examination of Parotid Swellings

Introduction : Parotid gland swellings are of histologically diverse group. Fine needle aspiration cytology (FNAC) is a rapid, simple, cost effective diagnostic procedure for evaluation of such swellings. The main aim of the study is to determine specificity, sensitivity, accuracy of FNAC in parotid swellings by taking histopathological examination (HPE) as gold standard. Materials and methods: Retrospective study done from April 2018 – July 2018. Data was collected from medical records of 50 cases who came with parotid swellings. All have undergone preoperative FNAC for swellings followed by surgery and HPE of specimen postoperatively. Results: In FNAC most of parotid swellings were benign in nature with pleomorphic adenoma most common. The sensitivity, specificity and accuracy of FNAC for parotid swellings in our study are 62.5%; 94%; 84% respectively. Conclusion: Even though FNAC is rapid, simple, it is may not be completely reliable deciding factor for patient counselling and for further management according to present study as it shows less sensitivity of 62.5%.The FNAC may be considered as a best possible initial investigation but may not be as to provide a definitive diagnosis on which management decisions can be made.

Addressing topology optimization with overhang constraints for structures subjected to self-weight loads

This paper investigates the topology optimization of structures subjected to self-weight loads with self-supporting constraints for additive manufacturing. The integration of topology optimization procedures and additive manufacturing techniques can make the most of their advantages, and there is significant interest today in integrating both approaches. Imposing overhang constraints in topology optimization has been addressed, but primarily for classical topology optimization problems with fixed external loads, not design-dependent loads. This work combines an effective numerical procedure for contour evaluation with a modified version of the power-law model for low densities to eliminate the problems that arise when self-weight loads are considered. The overhang edge detection is based on the Smallest Univalue Segment Assimilating Nucleus (SUSAN) method, and a variable mask size technique is used to avoid eventual dripping problems. The proposed constraint function evaluates the overhang globally and allows control of the formation of unsupported contours for maximum stiffness design problems when self-weight loads are present. Several numerical experiments demonstrate the proposed method's effectiveness and robustness.

Correlation of laparoscopic finding with ultrasonography and hysterosalpingography findings in females with infertility

Infertility is best defined as the inability to conceive after one year of unprotected regular intercourse or many couples, infertility and its treatment cause a serious strain on their interpersonal relationship, and cause disturbed relationships with other people.Diagnostic laparoscopy is generally not a part of initialinfertility evaluation, however, number of reports haveshown that it is effective procedure for evaluation of long- term infertility. A total of 207 patients were studied from at GMCH, Gondia, Maharashtra. Total 207 patients had primary/secondary infertility and 5 patients had primary amenorrhea were selected for study. Uterus, ovaries, tubes and cul de sac were inspected and findings noted. Next chromopertubation test was done with 10-15 ml of 1% aqueous methylene blue via the leech-Wilkinson cannula was inserted and findings noted and statistical Analysis was done.India showed the mean age of infertility was 28.4years. 81.16% subjects had primary whereas 16.43% had secondary infertility.In the present study maximum 165 (79.7%) had normal size uterus. Out of which 8 (3.86%) had bicornuate uterus.6.28% subjects had large size uterus. Out of which 5.80% had fibroid and 0.48% had adenomyosis.Diagnostic Laparoscopy and hysteroscopy is a better modality for diagnosing uterine, tubal and ovarian causes of infertility compared to hysterosalpingography and ultrasonography. Most of the patients had normal ultrasonographic, hysterosalpingographic and laparoscopic findings. Out of the rest, Structural adhesions were the most common cause of infertility among women in reproductive group.

Pediatric sialendoscopy indications and outcomes

Chronic sialadenitis can affect patients of all age ranges and typically presents as recurrent or chronic painful swelling of the salivary glands. In children, the most common cause of sialadenitis is juvenile recurrent parotitis. Salivary stones, or sialolithiasis, are a much less common cause. Historically, for patients with chronic sialadenitis who failed conservative management, salivary gland removal was the standard treatment option. Recently, however, sialendoscopy has emerged as an effective gland-preserving procedure for sialadenitis evaluation and treatment in adults and children. The aim of this review is to discuss pediatric sialadenitis evaluation and treatment, including sialendoscopy indications, technique, and outcomes. Sialendoscopy is a well tolerated and effective treatment for sialadenitis Sialendoscopy and salivary duct irrigation have been shown to improve frequency and severity of sialadenitis episodes in patients with juvenile recurrent parotitis. Salivary stones are managed successfully with endoscopic and combined endoscopic-assisted open approaches. Minimally invasive approaches with sialendoscopy have improved the ability to preserve salivary glands in patients with recurrent sialadenitis. Sialendoscopy is a well tolerated and effective procedure for recurrent sialadenitis in children.

Late Axillary Recurrence After Negative Sentinel Lymph Node Biopsy is Uncommon.

This study was designed to determine the incidence of late axillary recurrence (AR) in patients with negative sentinel lymph node biopsy (SLNB) and provide a comparison with SLNB positive patients who underwent axillary lymph node dissection (ALND). Retrospective analysis of prospectively collected data on all breast cancer patients with negative SLNB from January 1997 to December 2000 was performed on a large, institutional database. Primary outcome was cumulative incidence of AR as a first event with/without concurrent local recurrence. SLNB positive patients who went on to ALND during the same timeframe were comparatively analyzed. A total of 1529 eligible patients were identified (median age 58years, median tumor size 1.0cm): 1297 (85%) underwent lumpectomy; 1099 (75%) received adjuvant radiation; and 874 (80%) were estrogen receptor-positive. At 10.8 (range 0-16) years median follow-up, overall incidence of AR as a first event was low (n=13). Cumulative incidence was 0.6% [95% confidence interval (CI) 0.2-0.9] 5years after SLNB, and 0.9% (95% CI 0.4-1.4, 95% CI 0.5-1.6) at 10 and 15years. Late AR (>5years after surgery) occurred in five patients. Median overall survival after AR was 4.6years; median distant disease-free survival after AR was 3.8years. Late AR was also low in a contemporaneous group of SLNB positive patients undergoing ALND. In this group, cumulative incidence of AR was 0.7% (95% CI 0.1-1.3) 5years after surgery, and 0.8% (95% CI 0.2-1.5) at 10 and 15years. Late AR after negative SLNB is rare; the majority of ARs are in the first 5years after surgery. Prognosis after these events is poor. SLNB remains a safe and effective procedure for axillary evaluation in breast cancer.

Rare Case of Sigmoid Volvulus Following Single Balloon Enteroscopy

Introduction: Single balloon enteroscopy (SBE) has revolutionized visualization of the small bowel. Common complications include perforation, abdominal pain, and mucosal tears. In this case report, we describe sigmoid volvulus (SV) presenting 48 hours after SBE. Clinical Case: A 69 year-old man received an outpatient SBE for evaluation of small bowel polyps. The procedure lasted 29 minutes and 71 liters of CO2 were used. No therapeutic intervention was performed. Forty-eight hours after discharge, the patient noted severe left lower quadrant pain. His past history was significant for irritable bowel syndrome - diarrhea predominant, appendicitis s/p appendectomy, and inguinal hernia repair. Physical exam showed a soft, distended abdomen with hyperactive bowel sounds and no peritoneal signs. Rectal exam had normal anal sphincter tone without masses. A CT scan revealed a dilated sigmoid colon to 12 cm due to SV. Laboratory values revealed white count of 8.0, creatinine of 0.71, and lactate of 2.7. Flexible sigmoidoscopy for decompression was attempted, but unsuccessful. On hospital day 2, a segmental resection of the sigmoid colon with end colostomy was performed. Intraoperatively, the sigmoid colon was found to be significantly dilated; however, no redundant bowel, long mesentery, or adhesions were noted. The patient was discharged home 5 days after surgery. Discussion: SBE has been shown to be a safe and effective procedure for evaluation of the small bowel. Complication rates in SBE are reported to be similar to double balloon enteroscopy (DBE). Generally, complications are reported in 1% of SBE cases. Of those, the most serious are perforation (1.3-2.7%) and mucosal tears. In this case report, we describe sigmoid volvulus presenting after SBE. Sigmoid volvulus is responsible for 8% of all intestinal obstruction in Western countries, and is particularly common in the elderly. Other predisposing factors include male gender, chronic constipation, redundant bowel/mesentery, and adhesions. Sigmoid volvulus after SBE has not been reported. As this patient's only risk factors were his gender and age, it is unclear if his sigmoid volvulus was a direct complication of the SBE or simply a coincidental occurrence. As balloon assisted enteroscopy becomes a more common method of evaluating the small bowel, physicians should be aware that sigmoid volvulus may be an unexpected but potentially life threatening complication of this procedure.

Performance Evaluation of a Stone Masonry–Arch Railway Bridge under Increased Axle Loads

AbstractMany of the masonry arch bridges in the network of railway bridge stock belong to the civil engineering heritage of the railways. Therefore, their maintenance and management require careful consideration. An effective procedure for performance evaluation should promote solutions that are directed toward preservation and restoration of arch bridges by evaluating their existing structural capacity. In this paper, experimental methodologies adopted for the performance evaluation of a stone masonry–arch railway bridge are presented. One of the primary objectives of the current study was to evaluate the longitudinal force exerted on the bridge due to increased axle loads of freight wagons. An innovative technique using a flat jack was implemented for the evaluation of longitudinal stress due to increased axle load. Three-dimensional numerical modeling and analysis was carried out to identify the critical locations for fixing the flat jacks for evaluation of live-load stresses. A special instrumentation...

Early Experience with Unsedated Ultrathin 4.9 mm Transnasal Gastroscopy: A Pilot Study

Unsedated transnasal gastroscopy is a technique with unverified clinical advantages. To evaluate the efficacy and procedure times with transnasal gastroscopy by physicians with no previous experience in transnasal endoscopy. Unsedated transnasal gastroscopy using 4.9 mm ultrathin transnasal gastroscopes with randomization to two different biopsy forceps was prospectively evaluated during a single day in January 2008. The outcomes included patient tolerance (scale: 1, no discomfort; 10, severe discomfort), physician technical assessment (1, excellent; 10, very poor), gastric biopsy quality, adverse events and procedure times. Twenty patients underwent transnasal gastroscopy. Nineteen patients (95%) successfully completed transnasal gastroscopy. The patient-reported mean (+/- SD) overall discomfort level during the procedure was 4.0+/-1.9 compared with a physician-estimated level of 3.2+/-1.7 (P=0.04). Only 10% (n=2) reported they would have preferred sedated over unsedated gastroscopy. Mean total encounter time from anesthesia to discharge was 33.5+/-9.3 min. The time from anesthesia to insertion was 7.0+/-5.3 min and from room exit to discharge 6.2+/-2.9 min. No patients who had gastric biopsies taken (zero of 14) had any of unacceptable quality. The only adverse event was distressing sensations (dyspnea, dizziness) in one patient that started during pre-endoscopy anesthetic application, persisting postendoscopy, but without any abnormalities in vital signs. Assuming the adverse event was a rare reaction, early experience with unsedated ultrathin transnasal gastroscopy was an efficient, effective and well-tolerated procedure for evaluation of the upper gastrointestinal tract.

Laparoscopic treatment of blunt splenic injuries: initial experience with 11 patients

Nonoperative treatment of splenic injuries is the current standard of care for hemodynamically stable patients. However, uncertainty exists about its efficacy for patients with major polytrauma, a high Injury Severity Score (ISS), a high grade of splenic injury, a low Glasgow Coma Score (GCS), and important hemoperitoneum. In these cases, the videolaparoscopic approach could allow full abdominal cavity investigation, hemoperitoneum evacuation with autotransfusion, and spleen removal or repair. This study investigated 11 hemodynamically stable patients with severe polytrauma who underwent emergency laparoscopy. The mean ISS was 29.0 +/- 3.9, and the mean GCS was 12.1 +/- 1.6. A laparoscopic splenectomy was performed for six patients, whereas splenic hemostasis was achieved for five patients, involving one electrocoagulation, one polar resection, and three polyglycolic mesh wrappings. The average length of the operation was 121.4 +/- 41.6 min. There were two complications (18.2%), with one conversion to open surgery (9.1%), and no mortality. Laparoscopy is a safe, feasible, and effective procedure for evaluation and treatment of hemodynamically stable patients with splenic injuries for whom nonoperative treatment is controversial.

Progressive Analysis Procedure for Progressive Collapse

Following the collapse of the World Trade Center towers in September 2001, there has been heightened interest among building owners and government entities in evaluating the progressive collapse potential of existing buildings and in designing new buildings to resist this type of collapse. The General Services Administration and Department of Defense have issued general guidelines for evaluating a building’s progressive collapse potential. However, little detailed information is available to enable engineers to confidently perform a systematic progressive collapse analysis satisfying these guidelines. In this paper, we present four successively more sophisticated analysis procedures for evaluating the progressive collapse hazard: linear-elastic static; nonlinear static; linear-elastic dynamic; and nonlinear dynamic. We discuss the advantages and disadvantages of each method. We conclude that the most effective analysis procedure for progressive collapse evaluation incorporates the advantageous parts of all four procedures by systematically applying increasingly comprehensive analysis procedures to confirm that the possibility of progressive collapse is high.

Characteristics of a Group of Adolescents Undergoing Loop Electrical Excision Procedure (LEEP)

Study Objective: To describe the sociodemographic characteristics of a cohort of adolescents undergoing loop electrosurgical excision procedure (LEEP) of the cervix, and to determine if LEEP is a safe and effective procedure for evaluation and treatment of high-grade squamous intraepithelial lesions (HSIL) of the cervix in adolescents. Setting: Case series of all adolescents who underwent LEEP between 1995 and 1997 at Children's Hospital, Boston, MA. Design: Medical and laboratory records were reviewed to assess baseline characteristics and the following outcomes: (1) LEEP pathology results, (2) postoperative complications, (3) pregnancy outcomes, (4) compliance with follow-up appointments, and (5) recurrence of disease over a 12- to 37-month period. Participants: Thirty-five adolescents underwent LEEP. The mean age of the adolescents at the time of LEEP was 17.9 ± 1.5 yrs. Results: The mean interval between coitarche and LEEP was 3.69 ± 2.09 yrs. On preoperative colposcopy, 28 (80%) had HSIL on biopsy, 3 (8.6%) had HSIL on Pap smear with a discordant biopsy demonstrating low-grade squamous intraepithelial lesion (LSIL), 1 (2.9%) had a persistent LSIL, 2 (5.6%) had diffuse LSIL with an unsatisfactory colposcopy, and 1 (2.9%) had a HSIL Pap smear with a normal biopsy. LEEP specimen histopathology results were: HSIL in 19 (54%), LSIL in 10 (29%), SIL difficult to grade in 3 (9%), and no residual disease in 3 (9.0%). Postoperative complications were bleeding in 2 (5.7%), pain in 1 (2.9%), vaginal discharge in 1 (2.9%), cervicitis in 3 (8.6%), and endometritis in 2 (5.7%). Fourteen pregnancies were diagnosed after LEEP; no spontaneous abortions occurred. Mean follow-up period was 21.1 ± 9.4 months. Compliance with follow-up appointments was 51% in the first 12 months post-LEEP and 26% in the second 12 months post-LEEP. Of the 28 patients followed for 12 months or more, there was one recurrence of HSIL confirmed by colposcopy and biopsy. Conclusions: Outcome and complications of LEEP in adolescent females are similar to those reported in larger series of adult women. LEEP appears to be a safe and effective procedure for the evaluation and treatment of HSIL of the cervix in adolescents, but additional long-term data are needed.

The Evaluation of Pulp and Paper Mill Effluents Using Biological Assessment

The effect of pulp and paper mill effluents on the environment should be understood accurately, because the quantity of water discharged from a mill is very large. Current effluent regulations are based on biological oxygen demand (BOD) or chemical oxygen demand (COD), but these measures do not reflect the actual environmental effect of effluent.Bioassay are already used to determine the effect of effluent discharge on the environment in several foreign countries, and even in Japan it is expected that a bioassay will be introduced in the future. The type of bioassay used in nearly every country is the sublethal toxicity test, using fish, water frea, or green algae, although test conditions are slightly different in each country.The bioassay is not only for effluent monitaring ; it is also an effective procedure for toxicity identification evaluation (TIE) and toxicity reduction evaluation (TRE). By using TRE method, we would be able to further decrease the environmental effect. Although a total effluent free (TEF) system is the ideal, that is difficult to realize right away.We should aim at sustainable development while balancing considerations of risk and benefit.

Percutaneous transthoracic needle biopsy in AIDS: analysis in 32 patients.

A retrospective study was performed to determine the success of percutaneous transthoracic needle biopsy (TNB) as an aid in diagnosing focal chest and mediastinal disease in patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). The study group was composed of 32 patients seropositive for HIV; 31 of these patients had known AIDS. The subjects underwent chest radiography, computed tomography, and TNB. In 27 of the 32 patients a specific diagnosis was enabled by TNB. Bronchogenic carcinoma was diagnosed most frequently, although infectious agents were isolated in most patients. TNB is a safe and effective procedure for evaluation of focal thoracic disease in this patient population and provides information that is often unavailable from alternative diagnostic procedures.

Renal Adenocarcinoma Associated With Multiple Simple Cysts

THE MOST effective procedure for evaluation and treatment of a newly discovered renal mass lesion has been a topic of controversy for many years.1-5Following the discovery of an asymptomatic renal mass with excretory urography, some authors have suggested that echography be used to determine if the mass is of solid or cystic composition. Based on the echographic characteristics, solid or complex lesions are then evaluated by angiography, and cystic lesions are evaluated with cyst puncture, cystography, and chemical and cytologic analysis of cyst fluid.1,2Although the nonoperative evaluation of an asymptomatic renal mass has a reported diagnostic accuracy of approximately 97%,1,2there has been continuing debate about the nonsurgical evaluation differentiating between benign cysts and renal adenocarcinoma.1-3,5Others have stressed the importance of surgical exploration of documented avascular renal masses3,5and have described patients with cystic renal lesions who have undergone full radiological and

A Preliminary Evaluation for Primary Aldosteronism

Oral administration of 400μg of fludrocortisone acetate for three days suppresses aldosterone production in normal subjects with minimal effect on the excretion of Porter-Silber chromogens. Administration of fludrocortisone acetate to hypertensive patients with hyperaldosteronism suppressed aldosterone production into the normal range in all patients with essential hypertension and in one patient with adrenal nodular hyperplasia, but failed to do so in the patients with aldosterone-producing adenoma or nodular hyperplasia, confirmed subsequently. Administration of fludrocortisone acetate to hypertensive outpatients with hyperaldosteronism is an effective screening procedure for further evaluation of primary adrenal disease.