Search results for: overstitch endoscopic suturing system

Authors: Hao Cheng, Zhiwu Wang, Guozheng Yan, Pingping Jiang, Shijia Qin, Shuai Kuang

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Autofluorescence Imaging (AFI) is a technology for detecting early carcinogenesis of the gastrointestinal tract in recent years. Compared with traditional white light endoscopy (WLE), this technology greatly improves the detection accuracy of early carcinogenesis, because the colors of normal tissues are different from cancerous tissues. Thus, edge detection can distinguish them in grayscale images. In this paper, based on the traditional Sobel edge detection method, optimization has been performed on this method which considers the environment of the gastrointestinal, including adaptive threshold and morphological processing. All of the processes are implemented on our self-designed system based on the image sensor OV6930 and Field Programmable Gate Array (FPGA), The system can capture the gastrointestinal image taken by the lens in real time and detect edges. The final experiments verified the feasibility of our system and the effectiveness and accuracy of the edge detection algorithm.

Keywords: AFI, edge detection, adaptive threshold, morphological processing, OV6930, FPGA

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Authors: N. A. D. P. Niwunhella, W. G. R. C. K. Sirisena

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Appendicitis is one of the most encountered abdominal emergencies worldwide. Proper clinical diagnosis and appendicectomy with minimal post operative complications are therefore priorities. Aim of this study was to ascertain the overall management of acute appendicitis in Sri Lanka in special preference to delayed primary suturing of the surgical site, comparing other local and international treatment outcomes. Data were collected prospectively from 155 patients who underwent appendicectomy following clinical and radiological diagnosis with ultrasonography. Histological assessment was done for all the specimens. All perforated appendices were managed with delayed primary closure. Patients were followed up for 28 days to assess complications. Mean age of patient presentation was 27 years; mean pre-operative waiting time following admission was 24 hours; average hospital stay was 72 hours; accuracy of clinical diagnosis of appendicitis as confirmed by histology was 87.1%; post operative wound infection rate was 8.3%, and among them 5% had perforated appendices; 4 patients had post operative complications managed without re-opening. There was no fistula formation or mortality reported. Current study was compared with previously published data: a comparison on management of acute appendicitis in Sri Lanka vs. United Kingdom (UK). The diagnosis of current study was equally accurate, but post operative complications were significantly reduced - (current study-9.6%, compared Sri Lankan study-16.4%; compared UK study-14.1%). During the recent years, there has been an exponential rise in the use of Computerised Tomography (CT) imaging in the assessment of patients with acute appendicitis. Even though, the diagnostic accuracy without using CT, and treatment outcome of acute appendicitis in this study match other local studies as well as with data compared to UK. Therefore CT usage has not increased the diagnostic accuracy of acute appendicitis significantly. Especially, delayed primary closure may have reduced post operative wound infection rate for ruptured appendices, therefore suggest this approach for further evaluation as a safer and an effective practice in other hospitals worldwide as well.

Keywords: acute appendicitis, computerised tomography, diagnostic accuracy, delayed primary closure

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Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

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Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

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Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Lubna M. Al-Otaibi

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Mucocele is a common benign neoplasm of the oral cavity and the most common after fibroma. The lesion develops as a result of retention or extravasation of mucous material from minor salivary glands. Extravasation type of mucocele results from trauma and mostly occurs in the lower lip of young patients. The various treatment options available for the treatment of mucocele are associated with a relatively high incidence of recurrence making surgical intervention necessary for a permanent cure. The conventional surgical procedure, however, arouses apprehension in the patient and is associated with bleeding and postoperative pain. Recently, treatment of mucocele with lasers has become a viable treatment option. Various types of lasers are being used and are preferable over the conventional surgical procedure as they provide good hemostasis, reduced postoperative swelling and pain, reduced bacterial population, lesser need for suturing, faster healing and low recurrence rates. Er,Cr:YSGG is a solid-state laser with great affinity to water molecule. Its hydrokinetic cutting action allows it to work effectively on hydrated tissues without any thermal damage. However, up to date, only a few studies have reported its use in the removal of lip mucocele, especially in children. In this case, a 6 year old female patient with history of trauma to the lower lip presented with a soft, sessile, whitish-bluish 4 mm papule. The lesion was present for approximately four months and was fluctuant in size. The child developed a habit of biting the lesion causing injury, bleeding and discomfort. Surgical excision under local anaesthesia was performed using 2780 nm Er,Cr:YSGG Laser (WaterLase iPlus, Irvine, CA) with a Gold handpiece and MZ6 tip (3.5w, 50 Hz, 20% H2O, 20% Air, S mode). The tip was first applied in contact mode with focused beam using the Circumferential Incision Technique (CIT) to excise the tissue followed by the removal of the underlying causative minor salivary gland. Bleeding was stopped using Laser Dry Bandage setting (0.5w, 50 Hz, 1% H2O, 20% Air, S mode) and no suturing was needed. Safety goggles were worn and high-speed suction was used for smoke evacuation. Mucocele excision using 2780 nm Er,Cr:YSGG laser was rapid, easy to perform with excellent precision and allowed for histopathological examination of the excised tissue. The patient was comfortable and there were minimum bleeding and no sutures, postoperative pain, scarring or recurrence. Laser assisted mucocele excision appears to have efficient and reliable benefits in young patients and should be considered as an alternative to conventional surgical and non-surgical techniques.

Keywords: Erbium, excision, laser, lip, mucocele

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Authors: T. N. Goh, M. Hashmi, O. Hussain

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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Dina Muharib

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Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested.

Keywords: SCI, energy, protein, nutrition assessment, eneral feeding, nitrogen balance

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Jiri Kysucan, Dusan Klos, Katherine Vomackova, Pavel Koranda, Martin Lovecek, Cestmir Neoral, Roman Havlik

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Aim: The prognosis of patients with pancreatic cancer is poor. The median of survival after establishing diagnosis is 3-11 months without surgical treatment, 13-20 months with surgical treatment depending on the disease stage, 5-year survival is less than 5%. Radical surgical resection remains the only hope of curing the disease. Early diagnosis with valid establishment of tumor resectability is, therefore, the most important aim for patients with pancreatic cancer. The aim of the work is to evaluate the contribution and define the role of 18F-FDG PET/CT in preoperative staging. Material and Methods: In 195 patients (103 males, 92 females, median age 66,7 years, 32-88 years) with a suspect pancreatic lesion, as part of the standard preoperative staging, in addition to standard examination methods (ultrasonography, contrast spiral CT, endoscopic ultrasonography, endoscopic ultrasonographic biopsy), a hybrid 18F-FDG PET/CT was performed. All PET/CT findings were subsequently compared with standard staging (CT, EUS, EUS FNA), with peroperative findings and definitive histology in the operated patients as reference standards. Interpretation defined the extent of the tumor according to TNM classification. Limitations of resectability were local advancement (T4) and presence of distant metastases (M1). Results: PET/CT was performed in a total of 195 patients with a suspect pancreatic lesion. In 153 patients, pancreatic carcinoma was confirmed and of these patients, 72 were not indicated for radical surgical procedure due to local inoperability or generalization of the disease. The sensitivity of PET/CT in detecting the primary lesion was 92.2%, specificity was 90.5%. A false negative finding in 12 patients, a false positive finding was seen in 4 cases, positive predictive value (PPV) 97.2%, negative predictive value (NPV) 76,0%. In evaluating regional lymph nodes, sensitivity was 51.9%, specificity 58.3%, PPV 58,3%, NPV 51.9%. In detecting distant metastases, PET/CT reached a sensitivity of 82.8%, specificity was 97.8%, PPV 96.9%, NPV 87.0%. PET/CT found distant metastases in 12 patients, which were not detected by standard methods. In 15 patients (15.6%) with potentially radically resectable findings, the procedure was contraindicated based on PET/CT findings and the treatment strategy was changed. Conclusion: PET/CT is a highly sensitive and specific method useful in preoperative staging of pancreatic cancer. It improves the selection of patients for radical surgical procedures, who can benefit from it and decreases the number of incorrectly indicated operations.

Keywords: cancer, PET/CT, staging, surgery

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Khalil Ibrahim, Ahmed Ramadan, Mohamed Fanni, Yo Kobayashi, Ahmed Abo-Ismail, Masakatus G. Fujie

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This paper deals with the design process and the dynamic control simulation of a new type of 4-DOFs parallel mechanism that can be used as an endoscopic surgical manipulator. The proposed mechanism, 2-PUU_2-PUS, is designed based on the screw theory and the parallel virtual chain type synthesis method. Based on the structure analysis of the 4-DOF parallel mechanism, the inverse position equation is studied using the inverse analysis theory of kinematics. The design and the stress analysis of the mechanism are investigated using SolidWorks software. The virtual prototype of the parallel mechanism is constructed, and the dynamic simulation is performed using ADAMS TM software. The system model utilizing PID and PI controllers has been built using MATLAB software. A more realistic simulation in accordance with a given bending angle and point to point control is implemented by the use of both ADAMS/MATLAB software. The simulation results showed that this control method has solved the coordinate control for the 4-DOF parallel manipulator so that each output is feedback to the four driving rods. From the results, the tracking performance is achieved. Other control techniques, such as intelligent ones, are recommended to improve the tracking performance and reduce the numerical truncation error.

Keywords: parallel mechanisms, medical robotics, tracjectory control, virtual chain type synthesis method

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Authors: Mekha Mathew, Varun P Gopi

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Wireless Capsule Endoscopy (WCE) has become a great device in Gastrointestinal (GI) tract diagnosis, which can examine the entire GI tract, especially the small intestine without invasiveness and sedation. Bleeding in the digestive tract is a symptom of a disease rather than a disease itself. Hence the detection of bleeding is important in diagnosing many diseases. In this paper we proposes a novel method for distinguishing bleeding regions from normal regions based on Contourlet transform and Local Binary Pattern (LBP). Experiments show that this method provides a high accuracy rate of 96.38% in CIE XYZ colour space for k-Nearest Neighbour (k-NN) classifier.

Keywords: Wireless Capsule Endoscopy, local binary pattern, k-NN classifier, contourlet transform

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Authors: Ahmad Abdul-Razzak Aboudi Al-Issa

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Thermal is the main important aspect in any hydraulic system since it is affected on the hydraulic system performance. Therefore must be simulated the hydraulic system -that was designed- in this aspect before constructing it. In this study, an existed expert system was using to simulate the thermal aspect of a designed hydraulic system that will be used in an industrial field. The expert system which is used in this study is (Hydraulic System Calculations), and its symbol (HSC). HSC had been designed and coded in an interactive program userfriendly named (Microsoft Visual Basic 2010).

Keywords: fluid power, hydraulic system, thermal and hydrodynamic, expert system

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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: Salem Ben Said

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In recent times the decimal number system to which we are accustomed has received serious competition from the binary number system. In this note, an approach is suggested to teaching and learning the binary number system using examples from the real world. More precisely, we will demonstrate the utility of the binary system in describing the optimal strategy to win the Chinese Nim game, and in telegraphy by decoding the hidden message on Perseverance’s Mars parachute written in the language of binary system. Finally, we will answer the question, “why do modern computers prefer the ternary number system instead of the binary system?”. All materials are provided in a format that is conductive to classroom presentation and discussion.

Keywords: binary number system, Nim game, telegraphy, computers prefer the ternary system

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Authors: Ying Zhu, Ning Wu, Hai-Dong Huang, Yu-Chao Dong, Qin-Ying Sun, Wei Zhang, Qin Wang, Qiang Li

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Background and study aims: Tracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China. Patients and Methods: Retrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination. Results: 22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45 ±10.91 years old. The most frequent symptoms at presentation were chronic cough (n=14) and increased sputum production (n=10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n=2), Stage II (n=6) and Stage III(n=14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible. Conclusions: TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Keywords: airway obstruction, bronchoscopy, etiology, Tracheobronchopathia osteochondroplastica (TO), treatment

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Authors: Shiyun Liu

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Radiant heating systems work fundamentally differently from air systems by taking advantage of both radiant and convective heat transfer to remove space heating load. There are rare studies on differences of heating systems between all-air system and radiant floor system. This paper uses the method of simulation based on state-space to calculate the indoor temperature and wall temperature of each system and shows how the dynamic heat transfer in rooms conditioned by a radiant system is different from an air system. Then this paper analyses the changes of indoor temperature of these two systems, finding out the differences between all-air heating system and radiant floor heating system to help the designer choose a more suitable heating system.

Keywords: radiant floor, all-air system, thermal comfort, simulation, heating system

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Authors: Ahmad Abdul-Razzak Aboudi Al-Issa

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Thermal and Hydrodynamic are basic aspects in any hydraulic system and therefore, they must be assessed with regard to this aspect before constructing the system. This assessment needs a good expertise in this aspect to obtain an efficient hydraulic system. Therefore, this study aims to build an expert system called Hydraulic System Calculations (HSC) to ensure a smooth operation for the hydraulic system. The expert system (HSC) had been designed and coded in an user-friendly interactive program called Microsoft Visual Basic 2010. The suggested code provides the designer with a number of choices to resolve the problem of hydraulic oil overheating which may arise during the continuous operation of the hydraulic unit. As a result, the HSC can minimize the human errors, effort, time and cost of hydraulic machine design.

Keywords: fluid power, hydraulic system, thermal and hydrodynamic, expert system

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Authors: Jaemyoung Lee

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We present a method to set up system functions through a near filed communication (NFC) of a smartphone. The short communication distance of the NFC which is usually less than 4 cm could prevent any interferences from other devices and establish a secure communication channel between a system and the smartphone. The proposed set-up method for system function values is demonstrated for a blacbox system in a car. In demonstration, system functions of a blackbox which is manipulated through NFC of a smartphone are controls of image quality, sound level, shock sensing level to store images, etc. The proposed set-up method for system function values can be used for any devices with NFC.

Keywords: system set-up, near field communication, smartphone, android

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Authors: Zakir Husain, Neem Sagar, Neeraj Gupta

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Due to the increased penetration of renewable energy resources in the distribution system, the system is no longer passive in nature. In this paper, a steady state analysis of the distribution system has been done with the inclusion of wind generation. The modeling of wind turbine generator system and wind generator has been made to obtain the average active and the reactive power injection into the system. The study has been conducted on a IEEE-33 bus system with two wind generators. The present research work is useful not only to utilities but also to customers.

Keywords: distributed generation, distribution network, radial network, wind turbine generating system

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Authors: Suraj Kumar Mukti

Abstract:

Enterprise Resource Planning (ERP) system is a management tool to integrate all departments in an organization. It integrates business processes, manages resources efficiently and provides an appropriate decision support system to management. ERP system implementation is a typical and time taking process as well as money consuming process. Articles related to key success factors of ERP system implementation are available in the literature, but rare authors have focused on roadmap of successful ERP system implementation. Postponement is better if the organization is not ready to implement ERP system in better way; hence checking of organization’s preparation to adopt new system is an important prerequisite to ensure the success of ERP system implementation in an organization. Then comes what will be called as success of ERP system implementation. Benefits achieved by ERP system may be categorized into two categories; viz. tangible and intangible benefits. This research article presents a roadmap to ensure the success of ERP system implementation and benefits achieved through the new system as in success indicator. A case study is presented to evaluate the success and benefit achieved through the new system. The article gives a comprehensive approach to academicians and a roadmap to the organizations seeking to implement the ERP system.

Keywords: ERP system, decision support system, tangible, intangible

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Authors: Kushakov Kholmurodjon, Muhammadjonov Akbarshox

Abstract:

This present paper is devoted to a system of second-order nonlinear differential equations with a special right-hand side, exactly, the linear part and a third-order polynomial of a special form. It is shown that for some relations between the parameters, there is a second-order curve in which trajectories leaving the points of this curve remain in the same place. Thus, the curve is invariant with respect to the given system. Moreover, this system is invariant under a non-degenerate linear transformation of variables. The form of this curve, depending on the relations between the parameters and the eigenvalues of the matrix, is proved. All solutions of this system of differential equations are shown analytically.

Keywords: dynamic system, ellipse, hyperbola, Hess system, polar coordinate system

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Authors: Farhad Ghasemi

Abstract:

Along with transforming the international system into a complex and chaotic system, the fundamental question arises: how can deterrence be reconstructed conceptually and theoretically in this system model? The deterrence system is much more complex today than it was seven decades ago. This article suggests that the perception of deterrence as a linear system is a fundamental mistake because it does not consider the new dynamics of the international system, including network power dynamics. The author aims to improve this point by focusing on complexity and chaos theories, especially their nonlinearity and cascading failure principles. This article proposes that the perception of deterrence as a linear system is a fundamental mistake, as the new dynamics of the surrounding international system do not take into account. The author recognizes deterrence as a nonlinear system and introduces it as a concept in strategic studies.

Keywords: complexity, international system, deterrence, linear deterrence, nonlinear deterrence

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Authors: Nora Arbaoui, Rachid Tadili

Abstract:

This study focuses on a solar system designed to heat an agricultural greenhouse. This solar system is based on the heating of a transfer fluid that circulates inside the greenhouse through a solar copper coil integrated into the roof of the greenhouse. The thermal energy stored during the day will be released during the night to improve the microclimate of the greenhouse. This system was tested in a small agricultural greenhouse in order to ameliorate the different operational parameters. The climatic and agronomic results obtained with this system are significant in comparison with a greenhouse with no heating system.

Keywords: solar system, agricultural greenhouse, heating, storage, drying

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Authors: Amal M. Alrayes

Abstract:

Data and system quality play a central role in organizational success, and the quality of any existing information system has a major influence on the effectiveness of overall system performance.Given the importance of system and data quality to an organization, it is relevant to highlight their importance on organizational performance in the Kingdom of Bahrain. This research aims to discover whether system quality and data quality are related, and to study the impact of system and data quality on organizational success. A theoretical model based on previous research is used to show the relationship between data and system quality, and organizational impact. We hypothesize, first, that system quality is positively associated with organizational impact, secondly that system quality is positively associated with data quality, and finally that data quality is positively associated with organizational impact. A questionnaire was conducted among public and private organizations in the Kingdom of Bahrain. The results show that there is a strong association between data and system quality, that affects organizational success.

Keywords: data quality, performance, system quality, Kingdom of Bahrain

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Authors: Anuphan Suttimarn, Natcha Wattanaprapa, Suwaree Yordchim

Abstract:

The aim of this study is to develop the online journal system using a web application to manage the journal service of Suan Sunandha Rajabhat University in order to improve the journal management of the university. The main structures of the system process consist of 1. journal content management system 2. membership system of the journal and 3. online submission or review process. The investigators developed the system based on a web application using open source OJS software and phpMyAdmin to manage a research database. The system test showed that this online system 'Online Journal System (OJS)' could shorten the time in the period of submission article to journal and helped in managing a journal procedure efficiently and accurately. The quality evaluation of Suan Sunandha Rajabhat online journal system (SSRUOJS) undertaken by experts and researchers in 5 aspects; design, usability, security, reducing time, and accuracy showed the highest average value (X=4.30) on the aspect of reducing time. Meanwhile, the system efficiency evaluation was on an excellent level (X=4.13).

Keywords: online journal system, Journal management, Information system development, OJS

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Authors: Xuezhang Hou

Abstract:

In the present paper, a hybrid hyperbolic dynamic system formulated by partial differential equations with initial and boundary conditions is considered. First, the system is transformed to an abstract evolution system in an appropriate Hilbert space, and spectral analysis and semigroup generation of the system operator is discussed. Subsequently, a sliding model control problem is proposed and investigated, and an equivalent control method is introduced and applied to the system. Finally, a significant result that the state of the system can be approximated by an ideal sliding mode under control in any accuracy is derived and examined.

Keywords: hyperbolic dynamic system, sliding model control, semigroup of linear operators, partial differential equations

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Authors: Stephen A. Akinlabi, Esther T. Akinlabi

Abstract:

The drip irrigation system is one of the important areas that affect the livelihood of farmers directly. The use of drip irrigation system has been the most efficient system compared to the other types of irrigations systems because the drip irrigation helps to save water and increase the productivity of crops. But like any other system, it can be considered inefficient when the filters and the emitters get clogged while in operation. The efficiency of the entire system is reduced when the emitters are clogged and blocked. This consequently impact and affect the farm operations which may result in scarcity of farm products and increase the demand. This design work focuses on how to overcome some of the challenges affecting drip irrigation system through the design of an efficient filtration and flushing system.

Keywords: drip irrigation system, filters, soil texture, mechanical engineering design, analysis

Procedia PDF Downloads 344