Search results for: Rare vascular phenomenon

Authors: Mohammed A. Abutalib

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Papillary thyroid carcinoma (PTC) accounts for the most common type of thyroid cancer, a well-differentiated type. PTC is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. PTC can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet the distant spread is very uncommon. Herein, we discussed an early 50-year-old male patient with a history of PTC that presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination, together with immune-histochemical staining and molecular studies of pleural effusion aspiration, concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. PTC seldom causes metastatic niches in the pleural space, and this is a rare clinical presentation; nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded.

Keywords: thyroid cancer, malignant pleural effusion, cytology aspiration, papillary thyroid carcinoma

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Authors: Bernadett Henn, Katalin Tálos, Éva Kováss Széles

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During the last 50 years, the worldwide permeation of the nuclear techniques induces several new problems in the environmental and in the human life. Nowadays, due to the increasing of the risk of terrorism worldwide, the potential occurrence of terrorist attacks using also weapon of mass destruction containing radioactive or nuclear materials as e.g. dirty bombs, is a real threat. For instance, the uranium pellets are one of the potential nuclear materials which are suitable for making special weapons. The nuclear forensics mainly focuses on the determination of the origin of the confiscated or found nuclear and other radioactive materials, which could be used for making any radioactive dispersive device. One of the most important signatures in nuclear forensics to find the origin of the material is the determination of the rare earth element patterns (REE) in the seized or found radioactive or nuclear samples. The concentration and the normalized pattern of the REE can be used as an evidence of uranium origin. The REE are the fourteen Lanthanides in addition scandium and yttrium what are mostly found together and really low concentration in uranium pellets. The problems of the REE determination using ICP-MS technique are the uranium matrix (high concentration of uranium) and the interferences among Lanthanides. In this work, our aim was to develop an effective chemical sample preparation process using extraction chromatography for separation the uranium matrix and the rare earth elements from each other following some publications can be found in the literature and modified them. Secondly, our purpose was the optimization of the ICP-MS measuring process for REE concentration. During method development, in the first step, a REE model solution was used in two different types of extraction chromatographic resins (LN® and TRU®) and different acidic media for environmental testing the Lanthanides separation. Uranium matrix was added to the model solution and was proved in the same conditions. Methods were tested and validated using REE UOC (uranium ore concentrate) reference materials. Samples were analyzed by sector field mass spectrometer (ICP-SFMS).

Keywords: extraction chromatography, nuclear forensics, rare earth elements, uranium

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Authors: Raid Hommady, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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The iliolumbar artery is a regular branch of posterior division of the internal iliac artery. The present study investigate 82 specimens to identify the origin of iliolumbar artery. The present study targets the sciatic nerve root supply from iliolumbar artery based on its origin and course. In present study, the ililumbar artery arose from the posterior division of internal iliac artery in 52.2%. In few cases, it arose from dorsomedial aspect of the internal iliac artery in 28.8%. In few cases, the iliolumbar artery arose from the dorsal aspects of the internal iliac artery as well as from the common and external iliac artery 1.7%. Also, the iliolumbar artery arose from the sciatic artery as well as from superior and inferior gluteal arteries in 5.1%. Conversely, it found to be congenital absent in 8.5%. Therefore, the posterior trunk of the internal iliac artery is the most common origin of the iliolumbar artery. With the origin variability of the iliolumbar artery, there is a vascular supply variability of the lumbosacral trunk and sacral root of sciatic nerve. The iliolumbar artery provides vascular supply for lumbosacral trunk 57.3% in whereas the sacral root in 5.1%. As a result, surgeons should pay attention to these variations to decrease iatrogenic fault.

Keywords: iliolumbar, sciatic artery, internal iliac, external iliac, posterior division

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Authors: Bruno RamaëL, GwenaëL Page, Catherine Knopf-Lenoir, Olivier Baledent, Anne-Virginie Salsac

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No routine technique currently exists for clinicians to measure the mechanical properties of vascular walls non-invasively. Most of the data available in the literature come from traction or dilatation tests conducted ex vivo on native blood vessels. The objective of the study is to develop a non-invasive characterization technique based on Magnetic Resonance Imaging (MRI) measurements of the deformation of vascular walls under pulsating blood flow conditions. The goal is to determine the mechanical properties of the vessels by inverse analysis, coupling imaging measurements and numerical simulations of the fluid-structure interactions. The hyperelastic properties are identified using Solidworks and Ansys workbench (ANSYS Inc.) solving an optimization technique. The vessel of interest targeted in the study is the common carotid artery. In vivo MRI measurements of the vessel anatomy and inlet velocity profiles was acquired along the facial vascular network on a cohort of 30 healthy volunteers: - The time-evolution of the blood vessel contours and, thus, of the cross-section surface area was measured by 3D imaging angiography sequences of phase-contrast MRI. - The blood flow velocity was measured using a 2D CINE MRI phase contrast (PC-MRI) method. Reference arterial pressure waveforms were simultaneously measured in the brachial artery using a sphygmomanometer. The three-dimensional (3D) geometry of the arterial network was reconstructed by first creating an STL file from the raw MRI data using the open source imaging software ITK-SNAP. The resulting geometry was then transformed with Solidworks into volumes that are compatible with Ansys softwares. Tetrahedral meshes of the wall and fluid domains were built using the ANSYS Meshing software, with a near-wall mesh refinement method in the case of the fluid domain to improve the accuracy of the fluid flow calculations. Ansys Structural was used for the numerical simulation of the vessel deformation and Ansys CFX for the simulation of the blood flow. The fluid structure interaction simulations showed that the systolic and diastolic blood pressures of the common carotid artery could be taken as reference pressures to identify the mechanical properties of the different arteries of the network. The coefficients of the hyperelastic law were identified using Ansys Design model for the common carotid. Under large deformations, a stiffness of 800 kPa is measured, which is of the same order of magnitude as the Young modulus of collagen fibers. Areas of maximum deformations were highlighted near bifurcations. This study is a first step towards patient-specific characterization of the mechanical properties of the facial vessels. The method is currently applied on patients suffering from facial vascular malformations and on patients scheduled for facial reconstruction. Information on the blood flow velocity as well as on the vessel anatomy and deformability will be key to improve surgical planning in the case of such vascular pathologies.

Keywords: identification, mechanical properties, arterial walls, MRI measurements, numerical simulations

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Authors: Arina V. Tankanag, Gennady V. Krasnikov, Nikolai K. Chemeris

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The development of respiration-dependent oscillations in the peripheral blood flow may occur by at least two mechanisms. The first mechanism is related to the change of venous pressure due to mechanical activity of lungs. This phenomenon is known as ‘respiratory pump’ and is one of the mechanisms of venous return of blood from the peripheral vessels to the heart. The second mechanism is related to the vasomotor reflexes controlled by the respiratory modulation of the activity of centers of the vegetative nervous system. Early high phase synchronization of respiration-dependent blood flow oscillations of left and right forearm skin in healthy volunteers at rest was shown. The aim of the work was to study the effect of deep controlled breathing on the phase synchronization of skin blood flow oscillations. 29 normotensive non-smoking young women (18-25 years old) of the normal constitution without diagnosed pathologies of skin, cardiovascular and respiratory systems participated in the study. For each of the participants six recording sessions were carried out: first, at the spontaneous breathing rate; and the next five, in the regimes of controlled breathing with fixed breathing depth and different rates of enforced breathing regime. The following rates of controlled breathing regime were used: 0.25, 0.16, 0.10, 0.07 and 0.05 Hz. The breathing depth amounted to 40% of the maximal chest excursion. Blood perfusion was registered by laser flowmeter LAKK-02 (LAZMA, Russia) with two identical channels (wavelength 0.63 µm; emission power, 0.5 mW). The first probe was fastened to the palmar surface of the distal phalanx of left forefinger; the second probe was attached to the external surface of the left forearm near the wrist joint. These skin zones were chosen as zones with different dominant mechanisms of vascular tonus regulation. The degree of phase synchronization of the registered signals was estimated from the value of the wavelet phase coherence. The duration of all recording was 5 min. The sampling frequency of the signals was 16 Hz. The increasing of synchronization of the respiratory-dependent skin blood flow oscillations for all controlled breathing regimes was obtained. Since the formation of respiration-dependent oscillations in the peripheral blood flow is mainly caused by the respiratory modulation of system blood pressure, the observed effects are most likely dependent on the breathing depth. It should be noted that with spontaneous breathing depth does not exceed 15% of the maximal chest excursion, while in the present study the breathing depth was 40%. Therefore it has been suggested that the observed significant increase of the phase synchronization of blood flow oscillations in our conditions is primarily due to an increase of breathing depth. This is due to the enhancement of both potential mechanisms of respiratory oscillation generation: venous pressure and sympathetic modulation of vascular tone.

Keywords: deep controlled breathing, peripheral blood flow oscillations, phase synchronization, wavelet phase coherence

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Authors: Mohamed A. Ghandourah, Walied M. Alarif, Nahed O. Bawakid

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Halogenated cyclic enynes and terpenoids are commonly identified among secondary metabolites of the genus Laurencia. Laurencian acetogenins are entirly C15 non-terpenoid haloethers with different carbocyclic nuclei; a specimen of the Red Sea red alga L. obtusa was investigated for its acetogenin content. The dichloromethane extract of the air-dried red algal material was fractionated on aluminum oxide column preparative thin-layer chromatography. Three new rare C12 acetogenin derivatives (1-3) were isolated from the organic extract obtained from Laurencia obtusa, collected from the territorial Red Sea water of Saudi Arabia. The structures of the isolated metabolites were established by means of spectroscopical data analyses. Examining the isolated compounds in activated human peripheral blood mononuclear cells (PBMC) revealed potent Anti-inflammatory activity as evidenced by inhibition of NFκB and release of other inflammatory mediators like TNF-α, IL-1β and IL-6.

Keywords: Red Sea, red algae, fatty acids, spectroscopy, anti-inflammatory

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Authors: Pablo Cid Galache, Laura Zamorano Bonilla

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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.

Keywords: Mauriac, diabetes, complication, developing countries

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Authors: Sara Mahmood, Omar Ahmed, Youssef Aladham, Moustafa Abdelnaby

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The varied complications of COVID-19 present an ongoing challenge to healthcare professionals. A rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient, was reported. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Intra-operatively, the sphenopalatine artery was found to be thrombosed. This case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through a multidisciplinary team.

Keywords: COVID-19, sinusitis, sphenopalatine artery, thrombosis

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Authors: S. Nqayi, B. Sondezi

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A rare-earth-based Sm₂MnRuO₆₊δ (SMRO) double perovskite was prepared using a high-temperature solid-state reaction. The structural, morphological, chemical, thermodynamic, and magnetic properties were measured with X-ray diffraction (XRD), energy dispersive spectroscopy (EDS), X-ray photoemission spectroscopy (XPS), and vibrating sample magnetometer (VSM), respectively. The XRD revealed a tetragonal structure belonging to the I4/mmm space group, number 139, with linear Mn−O−Ru bonds. Replacing the well-studied alkaline earth metal with a rare-earth element increased the Mn-O bond length difference between the shorter equatorial (Mn-Oab) and the axial (Mn-Oc) bonds by approximately 6.3%. The elemental composition showed an O-rich double perovskite with a Ru deficit, which encourages the formation of a Ru⁶⁺ (d²) state. XPS spectra of Sm-3d, Ru-3d, and Mn-2p revealed the coexistence of a double oxidation state for each cation; Sm²⁺, Sm³⁺, Ru³⁺, Ru⁶⁺, Mn²⁺ , and Mn³⁺, in varying proportions. Entropy studies showed drastic ordering of spins at low temperatures (up to 12.4 K), whilst increasing temperatures above this point resulted in a drastic increase of disorder of the spins (up to 43.26 K), beyond which a constant slope of entropy is observed. Magnetic measurements revealed two magnetic ground states at TN = 12.4 K and TC = 43.3 K ordering antiferromagnetically (AFM) and ferromagnetically (FM), respectively. Kneller fit further showed that the materials become completely paramagnetic at TB = 88.1 K, (the blocking temperature). The existence of ferromagnetic (FM) super-exchange coupling in this work originating from Mn³⁺ (t³₂𝓰e¹𝓰)−O−Ru³⁺ (t⁵₂𝓰e⁰𝓰) and Mn²⁺ (t³₂𝓰e²𝓰−O−Ru⁶⁺ (t²₂𝓰e⁰𝓰) which plays an important role in suppressing the Mn/Ru−O−Mn/Ru antiferromagnetic (AFM) interactions.

Keywords: solid-state reaction, super-exchange coupling, ferromagnetic, Kneller’s law, entropy

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Authors: Shumaila Shakoor

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C. tubulosa is a rare parasitic plant. It is found to be endangered and it acquires nutrition by penetrating roots deep in host roots. It has momentous potential to fulfill local and national health needs. This specie became endangered due to its parasitic mode of life and lack of awareness. Investigation of distribution and habitat conditions of C. tubulosa from District Pakpattan is the objective of this study. To explore its habitat conditions and community ecology phytosociological survey of C. tubulosa in different habitats i.e roadsides and graveyards was carried out. It was found that C. tubulosa occurs successfully in different habitats like graveyards and roadsides with specific neighboring species. Soil analysis was carried out by taking soil samples from seven sites. Soil was analyzed for pH, EC, soil texture, OM, N %age, Ca, Mg, P and K, which shows that soil of C. tubulosa is rich in all these nutrients.

Keywords: organic matter, potassium, phosphorus, magnesium

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Authors: Sarah Bouayyad, Ajay Nigam, Meera Beena

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Acquired benign tracheoesophageal fistula is a rare medical condition that usually results from trauma, foreign bodies, or granulomatous infections. This is an unusual presentation of a male patient with a history of laryngectomy who had had over a period of several years inappropriately and vigorously used valve cleaning brushes to clean tracheal secretions, which had led to the formation of a tracheoesophageal fistula. Due to the patient’s obsessive habit, we couldn’t manage him using conventional surgical methods. Instead, we opted for the placement of a salivary bypass tube, which yielded good results and recovery. To the best of our knowledge, no other case of similar etiology has been published. We would like to highlight the importance of appropriate patient selection and education prior to performing a tracheoesophageal puncture to avoid developing life-threatening complications as demonstrated in our case report.

Keywords: tracheoesophageal fistula, speech valve, endoscopic insertion of salivary bypass tube, head and neck malignancies

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Authors: Hatem A. El-Mezayen, Hossam Darwesh

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Background/Aim: Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between vascular endothelial growth factor (VEGF) and HCC progression, we aimed to develop a novel score based on combination of VEGF and routine laboratory tests for early prediction of HCC. Methods: VEGF was assayed for HCC group (123), liver cirrhosis group (210) and control group (50) by Enzyme Linked Immunosorbent Assay (ELISA). Data from all groups were retrospectively analyzed including α feto protein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under ROC curve were used to develop the score. Results: A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-VEGF score)=1.26 (numerical constant) + 0.05 ×AFP (U L-1)+0.038 × VEGF(ng ml-1)+0.004× INR –1.02 × Albumin (g l-1)–0.002 × Platelet count × 109 l-1 was developed. HCC-VEGF score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91% and specificity of 82% at cut-off 4.4 (ie less than 4.4 considered cirrhosis and greater than 4.4 considered HCC). Conclusion: Hepatocellular carcinoma-VEGF score could replace AFP in HCC screening and follow up of cirrhotic patients.

Keywords: Hepatocellular carcinoma, cirrhosis, HCV, diagnosis, tumor markers

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Authors: Christy M. Moen, Richard B. Townsley

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Introduction: Metastasis to the frontal bone in thyroid cancer is extremely rare. A literature review found only six cases of thyroid cancer that metastasised to the frontal bone, with two of those involving further bone sites. Case Report: The patient was originally referred to the Oral and Maxillofacial Surgery team with an isolated mass on her forehead. Biopsies were performed, which showed this was likely a metastatic deposit from thyroid cancer. CT-PET scan showed this was an isolated lesion. The patient had a total thyroidectomy, and the forehead lesion was managed with radiotherapy. On interval scanning, the patient’s bony lesion had increased in size and had new lung nodules, which likely represented further metastasis. Conclusion: Isolated bony metastases to the frontal bone are rare. An important clinical principle to remember is that a bony metastasis from an unknown primary is more likely than primary bone cancer.

Keywords: cancer, thyroid, head and neck, surgery

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Authors: Muhammad Nouman Qureshi, Muhammad Hanif

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Adaptive cluster sampling (ACS) is specifically developed for the estimation of highly clumped populations and applied to a wide range of situations like animals of rare and endangered species, uneven minerals, HIV patients and drug users. In this paper, we proposed a generalized semi-exponential estimator with two auxiliary variables under the framework of ACS design. The expressions of approximate bias and mean square error (MSE) of the proposed estimator are derived. Theoretical comparisons of the proposed estimator have been made with existing estimators. A numerical study is conducted on real and artificial populations to demonstrate and compare the efficiencies of the proposed estimator. The results indicate that the proposed generalized semi-exponential estimator performed considerably better than all the adaptive and non-adaptive estimators considered in this paper.

Keywords: auxiliary information, adaptive cluster sampling, clustered populations, Hansen-Hurwitz estimation

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Authors: Naresh Kumar, Radhika Sharma, A. K. Singh

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Acid plutonic rocks from the Khanak and Devsar areas of southwestern Haryana were investigated to understand their geochemical and petrogenetic characteristics and tectonic environments. Three dominant rock types (grey, grayish green and pink granites) are the principal geochemical features of Khanak and Devsar areas which reflect the dependencies of their composition on varied geological environment during the anorogenic magmatism. These rocks are enriched in SiO₂, Na₂O+K₂O, Fe/Mg, Rb, Zr, Y, Th, U, REE (Rare Earth Elements) enriched and depleted in MgO, CaO, Sr, P, Ti, Ni, Cr, V and Eu and exhibit a clear affinity to the within-plate granites that were emplaced in an extensional tectonic environment. Chondrite-normalized REE patterns show enriched LREE (Light Rare Earth Elements), moderate to strong negative Eu anomalies and flat heavy REE and grey and grayish green is different from pink granite which is enriched by Rb, Ga, Nb, Th, U, Y and HREE (Heavy Rare Earth Elements) concentrations. The composition of parental magma of both areas corresponds to mafic source contaminated with crustal materials. Petrogenetic modelling suggest that the acid plutonic rocks might have been generated from a basaltic source by partial melting (15-25%) leaving a residue with 35% plagioclase, 25% alkali feldspar, 25% quartz, 7% orthopyroxene, 5% biotite and 3% hornblende. Granites from both areas might be formed from different sources with different degree of melting for grey, grayish green and pink granites.

Keywords: A-type granite, anorogenic, Malani igneous suite, Khanak and Devsar

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Authors: Djehich Mohamed Yousri

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Nowadays, migration has become a phenomenon that attracts the attention of researchers, countries, agencies, and national and international bodies. Wars and climate change, demographics, poverty, natural disasters, and epidemics are all threats that are contributing daily to forcing more people to migrate. There are those who resort to emigration because of the deteriorating political conditions in their country, others resort to emigration to improve their financial situation, and others emigrate from their country for fear of some penalties and judgments issued against them. In the field of migration, becoming a member of the United Nations as a "relevant organization" gives the United Nations a clear mandate on migration. Its primary goal is to facilitate the management of international migration in an orderly and humane manner. In order to achieve this goal, the organization adopts an international policy to meet the challenges posed in the field of migration. This paper attempts to study the structure of this international organization and its strategy in dealing with the phenomenon of international migration.

Keywords: international organization for migration, immigrants, immigrant rights, resettlement, migration organization strategy

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Authors: V. G. Cappellesso, D. M. G. da Silva, J. A. Arndt, N. dos Santos Petry, A. B. Masuero, D. C. C. Dal Molin

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Concrete elements are subject to cracking, which can be an access point for deleterious agents that can trigger pathological manifestations reducing the service life of these structures. Finding ways to minimize or eliminate the effects of this aggressive agents’ penetration, such as the sealing of these cracks, is a manner of contributing to the durability of these structures. The cementitious self-healing phenomenon can be classified in two different processes. The autogenous self-healing that can be defined as a natural process in which the sealing of this cracks occurs without the stimulation of external agents, meaning, without different materials being added to the mixture, while on the other hand, the autonomous seal-healing phenomenon depends on the insertion of a specific engineered material added to the cement matrix in order to promote its recovery. This work aims to evaluate the autogenous self-healing of concretes produced with different water/cement ratios and exposed to wet/dry cycles, considering two ages of crack openings, 3 days and 28 days. The self-healing phenomenon was evaluated using two techniques: crack healing measurement using ultrasonic waves and image analysis performed with an optical microscope. It is possible to observe that by both methods, it possible to observe the self-healing phenomenon of the cracks. For young ages of crack openings and lower water/cement ratios, the self-healing capacity is higher when compared to advanced ages of crack openings and higher water/cement ratios. Regardless of the crack opening age, these concretes were found to stabilize the self-healing processes after 80 days or 90 days.

Keywords: sealf-healing, autogenous, water/cement ratio, curing cycles, test methods

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Authors: Angelis P. Barlampas

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Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.

Keywords: phycosis, intraventricular masses, CT, brain calcifications

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Authors: Ali Abbas

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Industrial Engineering is a broad multidisciplinary field with intersections and applications in numerous areas. In out current environment, the path from a phenomenon to value involves numerous people with expertise in various areas including domain knowledge of a field and the ability to make decisions within an operating environment that lead to value creation. We propose some skills that industrial engineering programs should focus on, and argue that an industrial engineer is a decision maker instead of a problem solver.

Keywords: decision analysis, problem-solving, value creation, industrial engineering

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Authors: P. Christodoulou, M. Gerasimou, S. Mantzoukis, N. Varsamis, G. Kolliopoulou, N. Zotos

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Abstract— Purpose: The Intensive Care Unit (ICU) environment is conducive to the growth of microorganisms. A variety of microorganisms gain access to the intravascular area and are transported throughout the circulatory system. Therefore, examination of the catheters used in ICU patients is of paramount importance. Material and Method: The culture medium is a catheter tip, which is enriched with Tryptic soy broth (TSB). After one day of incubation, the broth is passaged in the following selective media: Blood, Mac conkey No. 2, chocolate, Mueller Hinton, Chapman, and Saboureaud agar. The above selective media is incubated for 2 days. After this period, if any number of microbial colonies is detected, gram staining is performed and then the microorganisms are identified by biochemical techniques in the automated Microscan (Siemens) system followed by a sensitivity test in the same system using the minimum inhibitory concentration (MIC) technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017, the Microbiology Laboratory received 84 catheters from the ICU. 42 were found positive. Of these, S. epidermidis was identified at 8, A. baumannii in 10, K. pneumoniae in 6, P. aeruginosa in 6, P. mirabilis in 3, S. simulans in 1, S. haemolyticus in 4, S. aureus in 3 and S. hominis in 1. Conclusions: The results show that the placement and maintenance of the catheters in ICU patients are relatively successful, despite the unfavorable environment of the unit.

Keywords: culture, intensive care unit, microorganisms, vascular catheters

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Authors: Christine Li, Amanda Robertson

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Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

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Authors: Christopher Leung, Assad Zahid

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Mesenteric vasculitis can often mimic abdominal sepsis in a postoperative setting leading to a predicament where steroids could improve mesenteric vasculitis whilst worsening abdominal sepsis. Here this study presents a unique and rare case of perforated sigmoid diverticulitis secondary to systemic vasculitis. A 68-year-old gentleman presented with perforated sigmoid diverticulitis requiring an emergency Hartmann’s procedure. Early in his postoperative course, he had painful and asymmetrical neuropathy that, after a careful history and examination, revealed a patient with mono neuritis multiplex on a background history of longstanding rheumatoid arthritis. On day seven of his postoperative course, he had rising inflammatory markers and a CT abdomen and pelvis showing fluid around the mesentery. Whilst contamination from sigmoid perforation was somewhat congruent with these signs, a diagnosis of polyarteritis nodosa, a common cause of mononeuritis multiplex, is also possible, although involvement of the large bowel in polyarteritis nodosa is extremely rare. The histopathology from the initial Hartmann’s procedure was re-examined, showing medium vessel disease vasculitis. Given his lack of fevers, absence of abdominal pain, and worsening neurology, he was given a provisional diagnosis of polyarteritis nodosa and was treated successfully, not on IV antibiotics but on steroids. Large bowel involvement of polyarteritis nodosa is extremely rare and this is the first case of polyarteritis nodosa causing perforated diverticulitis. The learning point here is to obtain a good clinical picture of a patient to identify mesenteric vasculitis as compared to abdominal sepsis as the treatment of one worsens the other.

Keywords: abdominal sepsis, diverticulitis, mesenteric vasculitis, polyarteritis nodosa

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Authors: Jake Hindmarch, Edward Farley, Norman Eizenberg, Mark Midwinter

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There is a need to bring the anatomical knowledge of medical students up to the standards required by surgical specialties. Contention exists amongst anatomists, clinicians, and surgeons about the standard of anatomical knowledge medical students need. The aim of this study was to explore the standards which the Royal Australasian College of Surgeons are applying knowledge of anatomy. Furthermore, to align medical school teaching to what the surgical profession requires from graduates.: The 2018 volume of the ANZ Journal of Surgery was narrowed down to 254 articles by applying the search term “Anatomy”. The main topic was then extracted from each paper. The content of the paper was assessed for ‘novel description’ or ‘application’ of anatomical knowledge’ and classified accordingly. The majority of papers with an anatomical focus was from the general surgery specialty, which focused on surgical techniques, outcomes and management. Vascular surgery had the highest percentage of papers with a novel description and application of anatomy. Cardiothoracic and paediatric surgery had no papers with a novel description of anatomy. Finally, a novel application of anatomy was the main focus of each speciality. Firstly, a high proportion of novel applications and descriptions of anatomy are in general surgery. Secondly, vascular surgery had the largest proportion of novel application and description of anatomy, namely due to the rise of therapeutic imaging and endovascular techniques. Finally, all disciplines demonstrated a trend towards having a higher proportion of novel application of anatomical knowledge

Keywords: anatomical knowledge, anatomy, surgery, novel anatomy

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Authors: Concetta Papapicco

Abstract:

The spreading of new Coronavirus (COVID-19) in addition to becoming a global phenomenon, following the declaration of a pandemic state, has generated excessive access to information, sometimes not thoroughly screened, which makes it difficult to navigate a given topic because of the difficulty of finding reliable sources. As a result, there is a high level of contagion, understood as the spread of the virus, but also as the spread of information in a viral and harmful way, which prompted the World Health Organization to coin the term Infodemia to give 'a name' the phenomenon of excessive information. With neologism 'Infodemia', the World Health Organization (OMS) wanted, in these days when fear of the coronavirus is raging, point out that perhaps the greatest danger of global society in the age of social media. This phenomenon is the distortion of reality in the rumble of echoes and comments of the global community on real or often invented facts. The general purpose of the exploratory study is to investigate how the coronavirus situation is described from journalistic communication. Starting from La Repubblica online, as a reference journalistic magazine, as a specific objective, the research aims to understand the way in which journalistic communication describes the phenomenon of the COVID-19 virus spread, the spread of contagion and restrictive measures of social distancing in the Italian context. The study starts from the hypothesis that if the circulation of information helps to create a social representation of the phenomenon, the excessive accessibility to sources of information (Infodemia) can be modulated by the 'how' the phenomenon is described by the journalists. The methodology proposed, in fact, in the exploratory study is a quanti-qualitative (mixed) method. A Content Analysis with the SketchEngine software is carried out first. In support of the Content Analysis, a Diatextual Analysis was carried out. The Diatextual Analysis is a qualitative analysis useful to detect in the analyzed texts, that is the online articles of La Repubblica on the topic of coronavirus, Subjectivity, Argomentativity, and Mode. The research focuses mainly on 'Mode' or 'How' are the events related to coronavirus in the online articles of La Repubblica about COVID-19 phenomenon. The results show the presence of the contrast vision about COVID-19 situation in Italy.

Keywords: coronavirus, Italian infodemia, La Republica online, mix method

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Authors: Diwei Lin, Amanda Jh. Tan

Abstract:

We present a very rare case of de novo large cell neuroendocrine carcinoma of the prostate (LCNEC) in an 84-year-old male on a background of high-grade, muscle-invasive transitional cell carcinoma of the bladder. While NE tumours account for 1% to 5% of all cases of prostate cancer and scattered NE cells can be found in 10% to 100% of prostate adenocarcinomas, pure LCNEC of the prostate is extremely rare. Most LCNEC of the prostate is thought to originate by clonal progression under the selection pressure of therapy and refractory to long-term hormonal treatment for adenocarcinoma of the prostate. De novo LCNEC is only described in case reports and is thought to develop via direct malignant transformation. Limited data in the English literature makes it difficult to accurately predict the prognosis of LCNEC of the prostate. However, current evidence suggesting that increasing NE differentiation in prostate adenocarcinoma is associated with a higher stage, high-grade disease, and a worse prognosis.

Keywords: large cell neuroendocrine cancer, prostate cancer, refractory cancer, medical and health sciences

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Authors: Norsuhana Omar, Amilia Aminuddina Zaiton Zakaria, Raifana Rosa Mohamad Sattar, Kalaivani Chellappan, Mohd Alauddin Mohd Ali, Norizam Salamt, Zanariyah Asmawi, Norliza Saari, Aini Farzana Zulkefli, Nor Anita Megat Mohd. Nordin

Abstract:

Inflammation plays an important role in the pathogenesis of vascular dysfunction leading to arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AS), as tools for the assessment of vascular damages are widely used and have been shown to predict cardiovascular disease (CVD). C-reactive protein (CRP) is a marker of inflammation. Several studies noted that regular exercise is associated with reduced arterial stiffness. The lack of exercise among Malaysians and the increasing CVD morbidity and mortality among young men are of concern. In Malaysia data on the workplace exercise intervention is scarce. A programme was designed to enable subjects to increase their level of walking as part of their daily work routine and self-monitored by using pedometers. The aim of this study to evaluate the reducing of inflammation by measuring CRP and improvement arterial stiffness measured by carotid femoral PWV (PWVCF) and AI. A total of 70 young men (20 - 40 years) who were sedentary, achieving less than 5,000 steps/day in casual walking with 2 or more cardiovascular risk factors were recruited in Institute of Vocational Skills for Youth (IKBN Hulu Langat). Subjects were randomly assigned to a control (CG) (n=34; no change in walking) and pedometer group (PG) (n=36; minimum target: 8,000 steps/day). The CRP was measured by using immunological method while PWVCF and AI were measured using Vicorder. All parameters were measured at baseline and after 12 weeks. Data for analysis was conducted using Statistical Package of Social Sciences Version 22 (SPSS Inc., Chicago, IL, USA). At post intervention, the CG step counts were similar (4983 ± 366vs 5697 ± 407steps/day). The PG increased step count from 4996 ± 805 to 10,128 ±511 steps/day (P<0.001). The PG showed significant improvement in anthropometric variables and lipid (time and group effect p<0.001). For vascular assessment, the PG showed significantly decreased for time and effect (p<0.001) for PWV (7.21± 0.83 to 6.42 ± 0.89) m/s; AI (11.88± 6.25 to 8.83 ± 3.7) % and CRP (pre= 2.28 ± 3.09, post=1.08± 1.37mg/L). However, no changes were seen in CG. As a conclusion, a pedometer-based walking programme may be an effective strategy for promoting increased daily physical activity which reduces cardiovascular risk markers and thus improve cardiovascular health in terms of inflammation and arterial stiffness. The community intervention for health maintenance has potential to adopt walking as an exercise and adopting vascular fitness index as the performance measuring tools.

Keywords: arterial stiffness, exercise, inflammation, pedometer

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Authors: Shafiq Alam, Yen Ning Lee

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Conventional hydrometallurgical processing of metals involves the use of large quantities of toxic chemicals. Realizing a need to develop sustainable technologies, extensive research studies are being carried out to recover and recycle base, precious and rare earth metals from their pregnant leach solutions (PLS) using green chemicals/biomaterials prepared from biomass wastes derived from agriculture, marine and forest resources. Our innovative research showed that bio-adsorbents prepared from such biomass wastes can effectively adsorb precious metals, especially gold after conversion of their functional groups in a very simple process. The highly effective ‘Adsorption-coupled-Reduction’ phenomenon witnessed appears promising for the potential use of this gold biosorption process in the mining industry. Proper management and effective use of biomass wastes as value added green chemicals will not only reduce the volume of wastes being generated every day in our society, but will also have a high-end value to the mining and mineral processing industries as those biomaterials would be cheap, but very selective for gold recovery/recycling from low grade ore, leach residue or e-wastes.

Keywords: biosorption, hydrometallurgy, gold, adsorption, reduction, biomass, sustainability

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Authors: Kherafa Abdennasser

Abstract:

A literature review was conducted to gather as much information. Concerns the phenomenon of swelling clays, as well as a presentation of some bibliographic findings on factors affecting the swelling potential. Citing the various techniques of stabilization of clays as well as a presentation of some literature results on the stabilization of swelling. Then a characterization of the materials was carried out at basic bibliographic study. These are standard mechanical geotechnical testing. Simple practical, economical and efficient to minimize the phenomenon swelling.

Keywords: stabilization, expansive soils, cement, lime, oedometer

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Authors: Ninel Kokanyan, Edvard Kokanyan, Anush Movsesyan, Marc D. Fontana

Abstract:

Lithium Niobate (LN) is one of the widely used ferroelectrics having a wide number of applications such as phase-conjugation, holographic storage, frequency doubling, SAW sensors. Furthermore, the possibility of doping with rare-earth ions leads to new laser applications. Ho and Tm dopants seem interesting due to laser emission obtained at around 2 µm. Raman spectroscopy is a powerful spectroscopic technique providing a possibility to obtain a number of information about physicochemical and also optical properties of a given material. Polarized Raman measurements were carried out on Ho and Tm doped LN crystals with excitation wavelengths of 532nm and 785nm. In obtained Raman anti-Stokes spectra, we detect expected modes according to Raman selection rules. In contrast, Raman Stokes spectra are significantly different compared to what is expected by selection rules. Additional forbidden lines are detected. These lines have quite high intensity and are well defined. Moreover, the intensity of mentioned additional lines increases with an increase of Ho or Tm concentrations in the crystal. These additional lines are attributed to emission lines reflecting the photoluminescence spectra of these crystals. It means that in our case we were able to detect, within a very good resolution, in the same Stokes spectrum, the transitions between the electronic states, and the vibrational states as well. The analysis of these data is reported as a function of Ho and Tm content, for different polarizations and wavelengths, of the incident laser beam. Results also highlight additional information about π and σ polarizations of crystals under study.

Keywords: lithium niobate, Raman spectroscopy, luminescence, rare-earth ions doped lithium niobate

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Authors: W. G. Kim, J. M. Chang, W. S. Kim

Abstract:

Immunologically non-treated and acellularized porcine xenografts were implanted as an arterial graft in goats and comparatively analyzed for the explanted grafts with gross observation, as well as light microscopy and immunohistochemistry, following the predetermined periods. For immunologically non-treated xenografts, bilateral porcine carotid arteries were harvested, and after short-term freezing at -70°C, were implanted into goats. The preparation of acellularized xenograft vessels has been performed with Nacl-SDS solution and stored at the freezer until use. The goats were randomly assigned for three periods of observation (3, 6, and 12 months after implantation), four animals were observed at each of these times. Periodic ultrasonographic examinations were performed during observation period. Following the predetermined periods, the explanted grafts were analyzed. Among 12 animals, one goat died prematurely, and a total of 22 grafts were evaluated. Gross observations revealed non-thrombotic patent smooth lumens. Microscopic examinations of the explanted grafts showed satisfactory cellular reconstruction up to the 12-month observation period. The proportions of CD3 positive T lymphocytes among inflammatory cells infiltrations were very low. In conclusion, these findings, as a whole, suggest that porcine vessel xenografts can be clinically acceptably implanted in the goats as a form of small-diameter vascular graft, regardless of the acellularized xenograft or immunologically non-treated xenograft.

Keywords: xenograft, arterial graft, long-term survival animals, immunology

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