Search results for: intra operative radiotherapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1002

Search results for: intra operative radiotherapy

552 An Unusual Presentation of Uveal Melanoma

Authors: Natasha Goh, Sebastian Brown

Abstract:

Purpose: This case report describes an unusual presentation of uveal melanoma. Method: Case notes, imaging, and histopathological specimen were reviewed for this case report. Result: The patient is a 62-year-old lady of Chinese heritage who had been receiving follow-up at the eye clinic of a tertiary hospital. She had a longstanding history of poor vision in her right eye after sustaining trauma to the eye at age 3. She was found to have a carotid-cavernous sinus fistula in the right eye in 2009 and underwent stenting in China. Unfortunately, this was unsuccessful and resulted in a painful blind eye. She had represented with headaches, worsening eye pain, and ptosis in Sydney in 2016. Her CT angiogram showed a calcified vascular structure in the orbit and globe, and she was offered a digital subtraction angiography by the neurosurgical team, which she ultimately declined. She had since been followed up at the eye clinic for the pthisical eye. Due to chronic ocular pain and recurrent conjunctivitis, the decision was made for an evisceration in 2021. The specimen was sent for routine histopathological examination and returned positive for uveal melanoma. The patient was subsequently referred to a melanoma center for further follow-up, which comprised serial imaging and radiotherapy treatment. Conclusion: Clinicians should bear in mind that uveal melanomas may present in a longstanding phthisical eye and in patients with no or little apparent risk factors.

Keywords: uveal melanoma, pthisical eye, carotid cavernous fistula, uveal melanoma risk factors

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551 Nanotechnology-Based Treatment of Liver Cancer

Authors: Lucian Mocan

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We present method of Nanoparticle enhanced laser thermal ablation of HepG2 cells (Human hepatocellular liver carcinomacell line), using gold nanoparticles combuned with a specific growth factor and demonstrate its selective therapeutic efficacy usig ex vivo specimens. Ex vivo-perfused liver specimens were obtained from hepatocellular carcinoma patients similarly to the surgical technique of transplantation. Ab bound to GNPs was inoculated intra-arterially onto the resulting specimen and determined the specific delivery of the nano-bioconjugate into the malignant tissue by means of the capillary bed. The extent of necrosis was considerable following laser therapy and at the same time surrounding parenchyma was not seriously affected. The selective photothermal ablation of the malignant liver tissue was obtained after the selective accumulation of Ab bound to GNPs into tumor cells following ex-vivo intravascular perfusion. These unique results may represent a major step in liver cancer treatment using nanolocalized thermal ablation by laser heating.

Keywords: HepG2 cells, gold nanoparticles, nanoparticle functionalization, laser irradiation

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550 Wind Direction and Its Linkage with Vibrio cholerae Dissemination

Authors: Shlomit Paz, Meir Broza

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Cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. It has a short incubation period and produces an enterotoxin that causes copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given. In an epidemic, the source of the contamination is usually the feces of an infected person. The disease can spread rapidly in areas with poor treatment of sewage and drinking water. Cholera remains a global threat and is one of the key indicators of social development. An estimated 3-5 million cases and over 100,000 deaths occur each year around the world. The relevance of climatic events as causative factors for cholera epidemics is well known. However, the examination of the involvement of winds in intra-continental disease distribution is new. The study explore the hypothesis that the spreading of cholera epidemics may be related to the dominant wind direction over land by presenting the influence of the wind direction on windborn dissemination by flying insects, which may serve as vectors. Chironomids ("non-biting midges“) exist in the majority of freshwater aquatic habitats, especially in estuarine and organic-rich water bodies typical to Vibrio cholerae. Chironomid adults emerge into the air for mating and dispersion. They are highly mobile, huge in number and found frequently in the air at various elevations. The huge number of chironomid egg masses attached to hard substrate on the water surface, serve as a reservoir for the free-living Vibrio bacteria. Both male and female, while emerging from the water, may carry the cholera bacteria. In experimental simulation, it was demonstrated that the cholera-bearing adult midges are carried by the wind, and transmit the bacteria from one body of water to another. In our previous study, the geographic diffusions of three cholera outbreaks were examined through their linkage with the wind direction: a) the progress of Vibrio cholerae O1 biotype El Tor in Africa during 1970–1971 and b) again in 2005–2006; and c) the rapid spread of Vibrio cholerae O139 over India during 1992–1993. Using data and map of cholera dissemination (WHO database) and mean monthly SLP and geopotential data (NOAA NCEP-NCAR database), analysis of air pressure data at sea level and at several altitudes over Africa, India and Bangladesh show a correspondence between the dominant wind direction and the intra-continental spread of cholera. The results support the hypothesis that aeroplankton (the tiny life forms that float in the air and that may be caught and carried upward by the wind, landing far from their origin) carry the cholera bacteria from one body of water to an adjacent one. In addition to these findings, the current follow-up study will present new results regarding the possible involvement of winds in the spreading of cholera in recent outbreaks (2010-2013). The findings may improve the understanding of how climatic factors are involved in the rapid distribution of new strains throughout a vast continental area. Awareness of the aerial transfer of Vibrio cholerae may assist health authorities by improving the prediction of the disease’s geographic dissemination.

Keywords: cholera, Vibrio cholerae, wind direction, Vibrio cholerae dissemination

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549 Photoluminescence Study of Erbium-Mixed Alkylated Silicon Nanocrystals

Authors: Khamael M. Abualnaja, Lidija Šiller, Benjamin R. Horrocks

Abstract:

Alkylated silicon nanocrystals (C11-SiNCs) were prepared successfully by galvanostatic etching of p-Si(100) wafers followed by a thermal hydrosilation reaction of 1-undecene in refluxing toluene in order to extract C11-SiNCs from porous silicon. Erbium trichloride was added to alkylated SiNCs using a simple mixing chemical route. To the best of our knowledge, this is the first investigation on mixing SiNCs with erbium ions (III) by this chemical method. The chemical characterization of C11-SiNCs and their mixtures with Er3+ (Er/C11-SiNCs) were carried out using X-ray photoemission spectroscopy (XPS). The optical properties of C11-SiNCs and their mixtures with Er3+ were investigated using Raman spectroscopy and photoluminescence (PL). The erbium-mixed alkylated SiNCs shows an orange PL emission peak at around 595 nm that originates from radiative recombination of Si. Er/C11-SiNCs mixture also exhibits a weak PL emission peak at 1536 nm that originates from the intra-4f transition in erbium ions (Er3+). The PL peak of Si in Er/C11-SiNCs mixture is increased in the intensity up to three times as compared to pure C11-SiNCs. The collected data suggest that this chemical mixing route leads instead to a transfer of energy from erbium ions to alkylated SiNCs.

Keywords: photoluminescence, silicon nanocrystals, erbium, Raman spectroscopy

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548 Sensitivity and Specificity of Clinical Testing for Digital Nerve Injury

Authors: Guy Rubin, Ravit Shay, Nimrod Rozen

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The accuracy of a diagnostic test used to classify a patient as having disease or being disease-free is a valuable piece of information to be used by the physician when making treatment decisions. Finger laceration, suspected to have nerve injury is a challenging decision for the treating surgeon. The purpose of this study was to evaluate the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of digital nerve injury. The six clinical tests included light touch, pin prick, static and dynamic 2-point discrimination, Semmes Weinstein monofilament and wrinkle test. Data comparing pre-surgery examination with post-surgery results of 42 patients with 52 digital nerve injury was evaluated. The subjective examinations, light touch, pin prick, static and dynamic 2-point discrimination and Semmes-Weinstein monofilament were not sensitive (57.6, 69.7, 42.4, 40 and 66.8% respectively) and specific (36.8, 36.8, 47.4, 42.1 and 31.6% respectively). Wrinkle test, the only objective examination, was the most sensitive (78.1%) and specific (55.6%). This result gives no pre-operative examination the ability to predict the result of explorative surgery.

Keywords: digital nerve, injury, nerve examination, Semmes-Weinstein monofilamen, sensitivity, specificity, two point discrimination, wrinkle test

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547 The Anatomy of Inter-Religious Conflict in Northern Nigeria: A Conflict without Peace Education

Authors: Shehu Hashimu

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Ever since the independence, Northern Nigeria has been experiencing a flashpoint of all sorts of conflict ranging from ethnoreligious, intra-religious, and inter-religious violence; many people are of the view and worrisome that indeed the region (North) is becoming a religious-political battle-ground. The trends of violence associated with these conflicts are a reflection of high level of misunderstanding, misinform unpolitical zeal toward uplifting peace education for greater enhancement among the religious, ethnic group or sects in the northern region. The aims of this paper, among other things, are to outline the misconception on the term inter-religious conflict. It is justifiable to state the brief historical antecedence of the making of contemporary Northern Nigeria and how conflict is fluctuating over and over without concrete resolution is another concern of the paper. The desirability of peace education in enhancing cordial relations and cementing potholes among various religious sects in the region (Northern Nigeria) cannot over emphasized considering the pivotal role play toward national cohesion; therefore, this paper strategically made a lengthy discourse for elaborations. In the conclusion aspect of it, the paper outline some relevant recommendation and suggestions for viable co-existence if properly implemented.

Keywords: anatomy, inter-religious, conflict, peace education

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546 Simultaneous Determination of p-Phenylenediamine, N-Acetyl-p-phenylenediamine and N,N-Diacetyl-p-phenylenediamine in Human Urine by LC-MS/MS

Authors: Khaled M. Mohamed

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Background: P-Phenylenediamine (PPD) is used in the manufacture of hair dyes and skin decoration. In some developing countries, suicidal, homicidal and accidental cases by PPD were recorded. In this work, a sensitive LC-MS/MS method for determination of PPD and its metabolites N-acetyl-p-phenylenediamine (MAPPD) and N,N-diacetyl-p-phenylenediamine (DAPPD) in human urine has been developed and validated. Methods: PPD, MAPPD and DAPPD were extracted from urine by methylene chloride at alkaline pH. Acetanilide was used as internal standard (IS). The analytes and IS were separated on an Eclipse XDB- C18 column (150 X 4.6 mm, 5 µm) using a mobile phase of acetonitrile-1% formic acid in gradient elution. Detection was performed by LC-MS/MS using electrospray positive ionization under multiple reaction-monitoring mode. The transition ions m/z 109 → 92, m/z 151 → 92, m/z 193 → 92, and m/z 136 → 77 were selected for the quantification of PPD, MAPPD, DAPPD, and IS, respectively. Results: Calibration curves were linear in the range 10–2000 ng/mL for all analytes. The mean recoveries for PPD, MAPPD and DAPPD were 57.62, 74.19 and 50.99%, respectively. Intra-assay and inter-assay imprecisions were within 1.58–9.52% and 5.43–9.45% respectively for PPD, MAPPD and DAPPD. Inter-assay accuracies were within -7.43 and 7.36 for all compounds. PPD, MAPPD and DAPPD were stable in urine at –20 degrees for 24 hours. Conclusions: The method was successfully applied to the analysis of PPD, MAPPD and DAPPD in urine samples collected from suicidal cases.

Keywords: p-Phenylenediamine, metabolites, urine, LC-MS/MS, validation

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545 Identification and Quantification of Phenolic Compounds In Cassia tora Collected from Three Different Locations Using Ultra High Performance Liquid Chromatography – Electro Spray Ionization – Mass Spectrometry (UHPLC-ESI-MS-MS)

Authors: Shipra Shukla, Gaurav Chaudhary, S. K. Tewari, Mahesh Pal, D. K. Upreti

Abstract:

Cassia tora L. is widely distributed in tropical Asian countries, commonly known as sickle pod. Various parts of the plant are reported for their medicinal value due to presence of anthraquinones, phenolic compounds, emodin, β-sitosterol, and chrysophanol. Therefore a sensitive analytical procedure using UHPLC-ESI-MS/MS was developed and validated for simultaneous quantification of five phenolic compounds in leaf, stem and root extracts of Cassia tora. Rapid chromatographic separation of compounds was achieved on Acquity UHPLC BEH C18 column (50 mm×2.1 mm id, 1.7µm) column in 2.5 min. Quantification was carried out using negative electrospray ionization in multiple-reaction monitoring mode. The method was validated as per ICH guidelines and showed good linearity (r2 ≥ 0.9985) over the concentration range of 0.5-200 ng/mL. The intra- and inter-day precisions and accuracy were within RSDs ≤ 1.93% and ≤ 1.90%, respectively. The developed method was applied to investigate variation of five phenolic compounds in the three geographical collections. Results indicated significant variation among analyzed samples collected from different locations in India.

Keywords: Cassia tora, phenolic compounds, quantification, UHPLC-ESI-MS/MS

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544 Molecular and Phytochemical Fingerprinting of Anti-Cancer Drug Yielding Plants in South India

Authors: Alexis John de Britto

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Studies were performed to select the superior genotypes based on intra-specific variations, caused by phytogeographical, climatic and edaphic parameters of three anti cancer drug yielding mangrove plants such as Acanthus ilicifolius L., Calophyllum inophyllum L. and Excoecaria agallocha L. using ISSR (Inter Simple Sequence Repeats) markers and phytochemical analysis such as preliminary phytochemical tests, TLC, HPTLC, HPLC and antioxidant tests. The plants were collected from five different geographical locations of the East Coast of south India. Genetic heterozygosity, Nei’s gene diversity, Shannon’s information index and Percentage of polymorphism between the populations were calculated using POPGENE software. Cluster analysis was performed using UPGMA algorithm. AMOVA and correlations between genetic diversity and soil factors were analyzed. Combining the molecular and phytochemical variations superior genotypes were selected. Conservation constraints and methods of efficient exploitation of the species are discussed.

Keywords: anti-cancer drug yielding plants, DNA fingerprinting, phytochemical analysis, selection of superior genotypes

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543 Hydraulic Resources Management under Imperfect Competition with Thermal Plants in the Wholesale Electricity Market

Authors: Abdessalem Abbassi, Ahlem Dakhlaoui, Lota D. Tamini

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In this paper, we analyze infinite discrete-time games between hydraulic and thermal power operators in the wholesale electricity market under Cournot competition. We consider a deregulated electrical industry where certain demand is satisfied by hydraulic and thermal technologies. The hydraulic operator decides the production in each season of each period that maximizes the sum of expected profits from power generation with respect to the stochastic dynamic constraint on the water stored in the dam, the environmental constraint and the non-negative output constraint. In contrast, the thermal plant is operated with quadratic cost function, with respect to the capacity production constraint and the non-negativity output constraint. We show that under imperfect competition, the hydraulic operator has a strategic storage of water in the peak season. Then, we quantify the strategic inter-annual and intra-annual water transfer and compare the numerical results. Finally, we show that the thermal operator can restrict the hydraulic output without compensation.

Keywords: asymmetric risk aversion, electricity wholesale market, hydropower dams, imperfect competition

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542 The Nation as Brand: Postcolonial Construction of National Identity in Late 20th/21st Century Qatar

Authors: Ryunhye Kim

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Despite its relatively short history as an independent state, Qatar has emerged as a highly regarded Gulf state and global power. Since its independence in September 1971, the state has employed deliberate policy initiatives designed to put Qatar on the map and distinguish it from other Gulf states. Because Qatar and its neighbors are resource-poor apart from energy, whoever is first to introduce a unique aspect of branding not only takes the lead but assumes what is often an insurmountable advantage. This study examines three specific modes of branding undertaken by Qatar: (1) energy policies to utilize its natural gas to become a dominant supplier; (2) the deliberate construction of a distinct cultural brand utilizing sports, architecture, museums, and media; and (3) ‘niche diplomacy’ to serve as a mediator in regional and intra-national conflicts, especially as interlocutor between the United States and Arab regimes and Muslim groups. Gleaning data from a range of sources, this study analyzes the effectiveness and significance of Qatar’s place branding on the global stage, as well as potential disadvantages and limits in this branding, including problems encountered before and after the ‘Qatar crisis.’

Keywords: national branding, national-identity, Qatar, soft-power

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541 Design and Analysis of Metamaterial Based Vertical Cavity Surface Emitting Laser

Authors: Ishraq M. Anjum

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Distributed Bragg reflectors are used in vertical-cavity surface-emitting lasers (VCSELs) in order to achieve very high reflectivity. Use of metamaterial in place of distributed Bragg reflector can reduce the device size significantly. A silicon-based metamaterial near perfect reflector is designed to be used in place of distributed Bragg reflectors in VCSELs. Mie resonance in dielectric microparticles is exploited in order to design the metamaterial. A reflectivity of 98.31% is achieved using finite-difference time-domain method. An 808nm double intra-cavity contacted VCSEL structure with 1.5 λ cavity is proposed using this metamaterial near perfect reflector. The active region is designed to be composed of seven GaAs/AlGaAs quantum wells. Upon numerical investigation of the designed VCSEL structure, the threshold current is found to be 2.96 mA at an aperture of 40 square micrometers and the maximum output power is found to be 71 mW at a current of 141 mA. Miniaturization of conventional VCSELs is possible using this design.

Keywords: GaAs, LASER, metamaterial, VCSEL, vertical cavity surface emitting laser

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540 Removal of Basic Dyes from Aqueous Solutions with a Treated Spent Bleaching Earth

Authors: M. Mana, M. S. Ouali, L. C. de Menorval

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A spent bleaching earth from an edible oil refinery has been treated by impregnation with a normal sodium hydroxide solution followed by mild thermal treatment (100°C). The obtained material (TSBE) was washed, dried and characterized by X-ray diffraction, FTIR, SEM, BET, and thermal analysis. The clay structure was not apparently affected by the treatment and the impregnated organic matter was quantitatively removed. We have investigated the comparative sorption of safranine and methylene blue on this material, the spent bleaching earth (SBE) and the virgin bleaching earth (VBE). The kinetic results fit the pseudo second order kinetic model and the Weber & Morris, intra-particle diffusion model. The pH had no effect on the sorption efficiency. The sorption isotherms followed the Langmuir model for various sorbent concentrations with good values of determination coefficient. A linear relationship was found between the calculated maximum removal capacity and the solid/solution ratio. A comparison between the results obtained with this material and those of the literature highlighted the low cost and the good removal capacity of the treated spent bleaching earth.

Keywords: basic dyes, isotherms, sorption, spent bleaching earth

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539 Unexpected Acute Respiratory Failure following Administration of Rocuronium Bromide during Cesarean Delivery in a Severely Preeclamptic Parturient Treated with Magnesium Sulfate

Authors: Joseph Carl Macalintal, Erlinda Armovit

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Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

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538 Challenges for Implementing Standards Compliant with Iso/Iec 17025, for Narcotics and DNA Laboratory’s

Authors: Blerim Olluri

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A forensic science laboratory in Kosovo has never been organized at the level of most modern forensic science laboratories. This was made possible after the war of 1999 with the help and support from the United States. The United States Government/ICITAP provided 9.5 million dollars to support this project, this support have greatly benefitted law enforcement in Kosovo. With the establishment of Operative Procedures of Work and the law for Kosovo Agency of Forensic, the accreditation with ISO/IEC 17025 of the KAF labs it becomes mandatory. Since 2012 Laboratory’s DNA/Serology and Narcotics has begun reviewing and harmonizing their procedures according to ISO/IEC 17025. The focus of this work was to create quality manuals, procedures, work instructions, quality documentation and quality records. Furthermore, during this time is done the validation of work methods from scientific qualified personnel of KAF, without any help from other foreign agencies or accreditation body.In October 2014 we had the first evaluation based on ISO 17025 standards. According to the initial report of this assessment we have non conformity in test and Calibration methods method’s, and accommodation and environmental conditions. We identified several issues that are of extreme importance to KAF. One the most important issue is to create a professional group with experts of KAF, which will work in all the obligations, requested from ISO/IEC 17025. As conclusions that we earn in this path of accreditation, are that laboratory’s need to take corrective action, and all nonconformance’s must be addressed and corrective action taken before accreditation can be granted.

Keywords: accreditation, assessment, narcotics, DNA

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537 Use of a Laparoscopic Approach in Urgent Adhesive Small Bowel Obstructions

Authors: Nuhi Arslani, Aleks Brumec

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Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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536 Epidemiology of Primary Bronchopulmonary Cancer in Tunisia

Authors: Melliti Rihab, Zaeid Sonia, Khechine Wiem, Daldoul Amira

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Introduction: Lung cancer is the leading cause of cancer death. Its incidence is increasing, and its prognosis remains pejorative. We present the clinical, pathological, and therapeutic characteristics of bronchopulmonary cancer (BPC) in Tunisia. Methods: Retrospective study including patients followed in the oncology department of the University Hospital of Monastir between April 2014 and December 2021 suffering from lung cancer. Results: These are 117 patients, including 86.3% men and 13.7% women (sex ratio 6.3). The average age was 64 years ± 9 (37-83), with 95.7% being over 50 years old. Patients were smokers in 82% of cases. The clinical signs were dominated by chest pain (27.5%) and dyspnea in 21.1% of cases. In 6 patients, an episode of COVID-19 infection revealed the diagnosis. Half of the patients had a PS between 0 and 1. Small cell lung cancer was present in 18 patients (15.4%). The majority of non small cell lung cancer was of the adenocarcinoma type (68.7%). The diagnosis was late (stage IV) in 62.4% of cases. BPC was metastatic to bone (52%), contralateral lung (25.9%), and brain (27.3%). Patients were oligometastatic in 26% of cases. Surgery and radiotherapy were performed respectively in 14.5% and 23.1% of cases. Three-quarters of the patients had had nutrition (75.2%). The ROS1 mutation was present in 1 patient. PDL-1 expression was >40% in 2 patients. Survival was mean eight months ± 7.4. Conclusion: Lung cancer is diagnosed at a late stage in Tunisia. The lack of molecular study for non-small cell PBC and the lack of marketing authorization for tyrosine kinase inhibitors in Tunisia make the management incomplete.

Keywords: SCLC, NCSLC, ROS1, PDL1

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535 Identifying the True Extend of Glioblastoma Based on Preoperative FLAIR Images

Authors: B. Shukir, L. Szivos, D. Kis, P. Barzo

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Glioblastoma is the most malignant brain tumor. In general, the survival rate varies between (14-18) months. Glioblastoma consists a solid and infiltrative part. The standard therapeutic management of glioblastoma is maximum safe resection followed by chemo-radiotherapy. It’s hypothesized that the pretumoral hyperintense region in fluid attenuated inversion recovery (FLAIR) images includes both vasogenic edema and infiltrated tumor cells. In our study, we aimed to define the sensitivity and specificity of hyperintense FLAIR images preoperatively to examine how well it can define the true extent of glioblastoma. (16) glioblastoma patients included in this study. Hyperintense FLAIR region were delineated preoperatively as tumor mask. The infiltrative part of glioblastoma considered the regions where the tumor recurred on the follow up MRI. The recurrence on the CE-T1 images was marked as the recurrence masks. According to (AAL3) and (JHU white matter labels) atlas, the brain divided into cortical and subcortical regions respectively. For calculating specificity and sensitivity, the FLAIR and the recurrence masks overlapped counting how many regions affected by both . The average sensitivity and specificity was 83% and 85% respectively. Individually, the sensitivity and specificity varied between (31-100)%, and (100-58)% respectively. These results suggest that despite FLAIR being as an effective radiologic imaging tool its prognostic value remains controversial and probabilistic tractography remain more reliable available method for identifying the true extent of glioblastoma.

Keywords: brain tumors, glioblastoma, MRI, FLAIR

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534 Case Report: Rare Case of Endometrial Stromal Sarcoma with Omental Metastasis in a 19-Year Old Girl

Authors: Mukurdipi Ray, Seema Singh

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Extrauterine endometrial stromal sarcoma (ESS) is a rare entity and typified by delayed recurrence of primary ESS. Here, we present an unusual case of uterine ESS in a woman with a history of hysterectomy. A 19-year-old girl, underwent a hysterectomy and bilateral salpingo-oophorectomy for uterine ESS 12 months ago and now after remaining disease free for nine months ago she presented with ascites along with pelvic and peritoneal mass. Intraoperatively, the large omental mass was found, and optimal cytoreduction with total omentomy (supracolic and infracolic ) total peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) was offered to the patient. Final histopathology report showed the involvement of only omentum by ESS cells. Immunohistochemistry (IHC) and receptor study were done and it was positive for CD-10 and desmin and negative for CK- 7. This case highlights the rarity of extrauterine ESS in the omentum with a known history of primary uterine ESS which was treated successfully with the above-mentioned procedure. Though active and long-term surveillance is recommended to monitor for late recurrences.

Keywords: endrometrial stromal sarcoma, complete cytoreduction, hyperthermic intra peritoneal chemotherapy, total omentectomy

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533 Concept to Enhance the Project Success and Promote the Implementation of Success Factors in Infrastructure Projects

Authors: A. Elbaz, K. Spang

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Infrastructure projects are often subjected to delays and cost overruns and mistakenly described as unsuccessful projects. These projects have many peculiarities such as public attention, impact on the environment, subjected to special regulations, etc. They also deal with several stakeholders with different motivations and face unique risks. With this in mind we need to reconsider our approach to manage them, define their success factors and implement these success factors. Infrastructure projects are not only lacking a unified meaning of project success or a definition of success factors, but also a clear method to implement these factors. This paper investigates this gap and introduces a concept to implement success factors in an efficient way, taking into consideration the specific characteristics of infrastructure projects. This concept consists of six enablers such as project organization, project team, project management workflow, contract management, communication and knowledge transfer and project documentations. These enablers allow other success factors to be efficiently implemented in projects. In conclusion, this paper provides project managers as well as company managers with a tool to define and implement success factors efficiently in their projects, along with upgrading their assets for the coming projects. This tool consists of processes and validated checklists to ensure the best use of company resources and knowledge. Due to the special features of infrastructure projects this tool will be tested in the German infrastructure market. However, it is meant to be adaptable to other markets and industries.

Keywords: infrastructure projects, operative success factors, project success, success factors, transportation projects

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532 Burnback Analysis of Star Grain Using Level-Set Technique

Authors: Ali Yasin, Ali Kamran, Muhammad Safdar

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In order to reduce the hefty cost involved in terms of time and project cost, the development and application of advanced numerical tools to address the burn-back analysis problem in solid rocket motor design and development is the need of time. Several advanced numerical schemes have been developed in recent times, but their usage in the design of propellant grain of solid rocket motors is very rare. In this paper, an advanced numerical technique named the Level-Set method has been utilized for the burn-back analysis of star grain to study the effect of geometrical parameters on ballistic performance indicators such as solid loading, neutrality, and sliver percentage. In the level set technique, simple finite difference methods may fail quickly and require more sophisticated non-oscillatory schemes for feasible long-time simulation. For internal ballistic calculations, a simplified equilibrium pressure method is utilized. Preliminary results of the operative conditions, for all the combustion time, of star grain burn-back using level set techniques are compared with published results using CAD technique to test the developed numerical model.

Keywords: solid rocket motor, internal ballistic, level-set technique, star grain

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531 Laparoscopic Management of Small Bowel Obstruction: An Unusual Case of Mechanical Obstruction Due to Appendiceal Adhesions

Authors: Veera J. Allu, Shreya Pal, Anang Pangeni

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Introduction: Adhesive small bowel obstruction (ASBO) is usually managed conservatively. Failed conservative management leads to operative intervention by an open approach. However, laparoscopic management of ASBO is increasingly being reported in the literature. We report an unusual case of ASBO secondary to a band from the appendicular tip which was managed laparoscopically. Case Description: This patient was a 61-year-old female, otherwise fit and healthy, presenting with abdominal pain and mild distension with vomiting of 3 days duration. She had undergone ultrasound-guided drainage of an appendicular abscess three months ago and laparoscopic right inguinal hernia repair (TEP) in the past. CTAP showed small bowel obstruction with a transition point in the pelvis and the possible cause being adhesions. She was initially managed conservatively; however, as she was not improving for two days, she was consented to diagnostic laparoscopy. Intraoperatively, an adhesive band was found between the appendicular tip and distal ileum around 100cm proximal to the ileocolic junction, resulting in mechanical bowel obstruction. Laparoscopic division of band was performed, followed by appendicectomy, and the patient had an uneventful recovery and was discharged on postoperative day 1. Conclusion: In highly selected patients and with appropriate expertise, laparoscopic management of ASBO is feasible and safe.

Keywords: bowel obstruction, adhesions, laparoscopy, open procedure

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530 Effect of Fenugreek Seed with Aerobic Exercise Training on Insulin Resistance in Women with Type 2 Diabetes

Authors: M. Nasiri

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Aim: Considering the hypoglisimic ad hipolipidimic effect of the fenugreek seed and aerobic exercise training, this study was conducted to evaluate the effect of fenugreek and aerobic exercise training on insulin resistance in women with type 2 diabetes. Methodology: 32 patients with type II diabetes were selected and randomly divided into four groups: control, fenugreek, training and fenugreek - training. Fenugreek groups used 10 grams of fenugreek seeds daily for eight weeks on two occasions before noon and evening meal. Training of groups is also performed a regular program of aerobic exercise 65-55% of maximum heart rate (4 days per week).Two days before and after the training period, blood samples were taken from their brachial veins in a fasting state (12 hours prior to the test) in a sitting position. The data was analyzed used of t-independent and ANOVA at a significance level of α < 0.05. Results: Intra-group changes in all experimental groups showed that significant decrease insulin resistance, and the difference between groups showed significant difference between the groups of fenugreek - training than other groups there. Conclusions: According to the research findings to fenugreek combined with aerobic exercise more beneficial effect on the inhibition of insulin resistance in women with diabetes are recommended to them.

Keywords: fenugreek, training, insulin resistance, diabetes

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529 Craniopharyngiomas: Surgical Techniques: The Combined Interhemispheric Sub-Commissural Translaminaterminalis Approach to Tumors in and Around the Third Ventricle: Neurological and Functional Outcome

Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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528 Optimized Simultaneous Determination of Theobromine and Caffeine in Fermented and Unfermented Cacao Beans and in Cocoa Products Using Step Gradient Solvent System in Reverse Phase HPLC

Authors: Ian Marc G. Cabugsa, Kim Ryan A. Won

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Fast, reliable and simultaneous HPLC analysis of theobromine and caffeine in cacao and cocoa products was optimized in this study. The samples tested were raw, fermented, and roasted cacao beans as well as commercially available cocoa products. The HPLC analysis was carried out using step gradient solvent system with acetonitrile and water buffered with H3PO4 as the mobile phase. The HPLC system was optimized using 273 nm wavelength at 35 °C for the column temperature with a flow rate of 1.0 mL/min. Using this method, the theobromine percent recovery mean, Limit of Detection (LOD) and Limit of Quantification (LOQ) is 118.68(±3.38)%, 0.727 and 1.05 respectively. The percent recovery mean, LOD and LOQ for caffeine is 105.53(±3.25)%, 2.42 and 3.50 respectively. The inter-day and intra-day precision for theobromine is 4.31% and 4.48% respectively, while 7.02% and 7.03% was for caffeine respectively. Compared to the standard method in AOAC using methanol in isocratic solvent system, the results of the study produced lesser chromatogram noise with emphasis on theobromine and caffeine. The method is readily usable for cacao and cocoa substances analyses using HPLC with step gradient capability.

Keywords: cacao, caffeine, HPLC, step gradient solvent system, theobromine

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527 Solutions for Strengthening China-Japan-South Korea (CJK) Trilateral Cooperation: Focusing on the Management of Historical Conflicts

Authors: Yongmei Li, Chang-Gun Park

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China-Japan-South Korea (CJK) trilateral cooperation has experienced historical challenges in recent years, which negatively influenced the development of their relationship. Results of the interviews with three citizens on trilateral relations illustrate that most people are concerned with the historical conflicts among CJK. This paper specifically focuses on managing historical issues, including comfort women issues, territorial disputes, and divergence in historical education. Accordingly, the effectiveness of management of tensions productively provides a method for detecting historical concerns, managing issues, and connecting the three countries and citizens through advocating for fair media reporting, effective network institutionalization, and active local government cooperation. Furthermore, this paper contributes to providing government solutions for reinforcing the CJK partnership. It specially involves history education, East Asian identity and mutual trust establishment, East Asia intra-regional exchange programs, and reorganization of the role of the Trilateral Cooperation Secretariat (TCS).

Keywords: China-Japan-South Korea, trilateral cooperation, government solutions, effectiveness of management, historical conflicts

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526 Batch Kinetic, Isotherm and Thermodynamic Studies of Copper (II) Removal from Wastewater Using HDL as Adsorbent

Authors: Nadjet Taoualit, Zoubida Chemat, Djamel-Eddine Hadj-Boussaad

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This study aims the removal of copper Cu (II) contained in wastewater by adsorption on a perfect synthesized mud. It is the materials Hydroxides Double Lamellar, HDL, prepared and synthesized by co-precipitation method at constant pH, which requires a simple titration assembly, with an inexpensive and available material in the laboratory, and also allows us better control of the composition of the reaction medium, and gives well crystallized products. A characterization of the adsorbent proved essential. Thus a range of physic-chemical analysis was performed including: FTIR spectroscopy, X-ray diffraction… The adsorption of copper ions was investigated in dispersed medium (batch). A systematic study of various parameters (amount of support, contact time, initial copper concentration, temperature, pH…) was performed. Adsorption kinetic data were tested using pseudo-first order, pseudo-second order, Bangham's equation and intra-particle diffusion models. The equilibrium data were analyzed using Langmuir, Freundlich, Tempkin and other isotherm models at different doses of HDL. The thermodynamics parameters were evaluated at different temperatures. The results have established good potentiality for the HDL to be used as a sorbent for the removal of Copper from wastewater.

Keywords: adsoption, copper, HDL, isotherm

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525 Modeling the Time Dependent Biodistribution of a 177Lu Labeled Somatostatin Analogues for Targeted Radiotherapy of Neuroendocrine Tumors Using Compartmental Analysis

Authors: Mahdieh Jajroudi

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Developing a pharmacokinetic model for the neuroendocrine tumors therapy agent 177Lu-DOTATATE in nude mice bearing AR42J rat pancreatic tumor to investigate and evaluate the behavior of the complex was the main purpose of this study. The utilization of compartmental analysis permits the mathematical differencing of tissues and organs to become acquainted with the concentration of activity in each fraction of interest. Biodistribution studies are onerous and troublesome to perform in humans, but such data can be obtained facilely in rodents. A physiologically based pharmacokinetic model for scaling up activity concentration in particular organs versus time was developed. The mathematical model exerts physiological parameters including organ volumes, blood flow rates, and vascular permabilities; the compartments (organs) are connected anatomically. This allows the use of scale-up techniques to forecast new complex distribution in humans' each organ. The concentration of the radiopharmaceutical in various organs was measured at different times. The temporal behavior of biodistribution of 177Lu labeled somatostatin analogues was modeled and drawn as function of time. Conclusion: The variation of pharmaceutical concentration in all organs is characterized with summation of six to nine exponential terms and it approximates our experimental data with precision better than 1%.

Keywords: biodistribution modeling, compartmental analysis, 177Lu labeled somatostatin analogues, neuroendocrine tumors

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524 How Addictive Are They: Effects of E-Cigarette Vapor on Intracranial Self-Stimulation Compared to Nicotine Alone

Authors: Annika Skansberg

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Electronic cigarettes (e-cigarettes) use vapor to deliver nicotine, have recently become popular, especially amongst adolescents. Because of this, the FDA has decided to regulate e-cigarettes, and therefore would like to determine the abuse liability of the products compared to traditional nicotine products. This will allow them to determine the impact of regulating them on public health and shape the decisions they make when creating new laws. This study assessed the abuse liability of Aroma E-juice Dark Honey Tobacco compared to nicotine using an animal model. This e-liquid contains minor alkaloids that may increase abuse liability compared to nicotine alone. The abuse liability of nicotine alone and e-juice liquid were compared in rats using intracranial self-stimulation (ICSS) thresholds. E-liquid had less aversive effects at high nicotine doses in the ICSS model, suggesting that the minor alkaloids in the e-liquid allow users to use higher doses without experiencing the negative effects felt when using high doses of nicotine alone. This finding could mean that e-cigarettes have a higher abuse liability than nicotine alone, but more research is needed before this can be concluded. These findings are useful in observing the abuse liability of e-cigarettes and will help inform the FDA while regulating these products.

Keywords: electronic cigarettes, intra-cranial self stimulation, abuse liability, anhedonia

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523 The Twelfth Rib as a Landmark for Surgery

Authors: Jake Tempo, Georgina Williams, Iain Robertson, Claire Pascoe, Darren Rama, Richard Cetti

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Introduction: The twelfth rib is commonly used as a landmark for surgery; however, its variability in length has not been formally studied. The highly variable rib length provides a challenge for urologists seeking a consistent landmark for percutaneous nephrolithotomy and retroperitoneoscopic surgery. Methods and materials: We analysed CT scans of 100 adults who had imaging between 23rd March and twelfth April 2020 at an Australian Hospital. We measured the distance from the mid-sagittal line to the twelfth rib tip in the axial plane as a surrogate for true rib length. We also measured the distance from the twelfth rib tip to the kidney, spleen, and liver. Results: Length from the mid-sagittal line to the right twelfth rib tip varied from 46 (percentile 95%CI 40 to 57) to 136mm (percentile 95%CI 133 to 138). On the left, the distances varied from 55 (percentile 95%CI 50 to 64) to 134mm (percentile 95%CI 131 to 135). Twenty-three percent of people had an organ lying between the tip of the twelfth rib and the kidney on the right, and 11% of people had the same finding on the left. Conclusion: The twelfth rib is highly variable in its length. Similar variability was recorded in the distance from the tip to intra-abdominal organs. Due to the frequency of organs lying between the tip of the rib and the kidney, it should not be used as a landmark for accessing the kidney without prior knowledge of an individual patient’s anatomy, as seen on imaging.

Keywords: PCNL, rib, anatomy, nephrolithotomy

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