Search results for: organ transplant.

Authors: I. McCulloh, A. Placona, D. Stewart, D. Gause, K. Kiernan, M. Stuart, C. Zinner, L. Cartwright

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We find in our data that an alarming number of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. We observe as many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient-specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision-makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.

Keywords: Decision science, KDPI, optimism bias, organ transplant.

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Authors: Min-Chuan Huang, I-Ping Chen, Shu-Ying Chung

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Taking the medical staff in an emergency ward of a medical center in Central Taiwan as the research object, the questionnaire data were collected by anonymous and voluntary reporting methods with structured questionnaires to explore organ donation’s actual situation, willingness, and attitude. Only 80 valid questionnaires were gathered. Of the 8 questions, the correct mean rate was 5.9 and the correct rate was 73.13%. According to the statistics of organ donation survey, only 8.7% have signed the consent for organ donation, 21.3% are willing but have not yet signed the consent for organ donation, 62.5% have not yet decided, and 7.5% are unwilling. The average total score (standard deviation) of attitude towards organ donation was 36.2. There is no significant difference between the demographic variables and the awareness and willingness of organ donation, but there is a significant correlation between marital status and the attitude toward organ donation.

Keywords: clinical psychology, organ donation, factors affecting psychological disorders, commitment

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Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

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Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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Authors: A. Khourgami, M. Rafiee, H. Jafari, Z. Bitarafan

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To study the effect of suitable methods for propagation of True Potato Seed (TPS) progenies, transplant and selection of the best progenies, a factorial experiment base on a randomized complete block design was carried out in the research field of Sahneh region, Kermanshah, Iran during 2009-2010. Five selective progenies from CIP (International Potato Center) including CIP.994013, CIP.994002, CIP.994014, CIP.888006, and CIP.994001 and two transplant preparation methods (Paper pot preparation for mechanical cultivation and preparation in transplant trays for manual cultivation) were studied in three replications. Results showed that different progenies had no significant effect on plant height (cm) and tuber yield (t ha-1), whereas had a significant effect on number of tubers per unit area (m2). There was significant difference between transplant preparation methods for plant height and tuber yield. The interaction effect of progenies and transplant preparation method was not significant for these traits. CIP.888006 progeny and paper pot preparation method produced the highest tuber yields. Also CIP.994002 and CIP.994014 progenies considered as the best progenies under paper pot preparation method due to high yields.

Keywords: Potato, Solanum tuberosum, TPS progenies, Transplant preparation method

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Authors: Petru Manescu, Joseph Azencot, Michael Beuve, Hamid Ladjal, Jacques Saade, Jean-Michel Morreau, Philippe Giraud, Behzad Shariat

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Organ motion, especially respiratory motion, is a technical challenge to radiation therapy planning and dosimetry. This motion induces displacements and deformation of the organ tissues within the irradiated region which need to be taken into account when simulating dose distribution during treatment. Finite element modeling (FEM) can provide a great insight into the mechanical behavior of the organs, since they are based on the biomechanical material properties, complex geometry of organs, and anatomical boundary conditions. In this paper we present an original approach that offers the possibility to combine image-based biomechanical models with particle transport simulations. We propose a new method to map material density information issued from CT images to deformable tetrahedral meshes. Based on the principle of mass conservation our method can correlate density variation of organ tissues with geometrical deformations during the different phases of the respiratory cycle. The first results are particularly encouraging, as local error quantification of density mapping on organ geometry and density variation with organ motion are performed to evaluate and validate our approach.

Keywords: Biomechanical simulation, dose distribution, image guided radiation therapy, organ motion, tetrahedral mesh, 4D-CT.

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Authors: Ariyanti Mustapha

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The development of Islamic jurisprudence since the first century of the hijra has fascinated many orientalists to explore the historiography of Islamic legislation. The practice of usul fiqh began during the lifetime of the Prophet Muhammad and was continued by the companions as the legal reasoning due to the absence of the legal injunction in the Qur’an and Sunnah. The orientalists propagated that the Roman and Jewish legislation were transplanted into Islamic jurisprudence and it was the primary reason for its progression. We used qualitative and comparative methods to analyze the orientalists’ views. Results showed that many erroneous facts were propagated by Goldziher and Schacht by claiming the parallels between the principles, methodologies, and fundamental concepts in Islamic jurisprudence and Roman Provincial law. The orientalists claimed that Islamic jurisprudence was derived from the corpus of Jewish Mishnah and Ha-kol. These judgments are used by the orientalists to prove the inferiority of Islamic jurisprudence. Nevertheless, many evidences have proven that Islamic legislation is capable of developing independently without any foreign transplant.

Keywords: Foreign transplant, ijtihad, orientalist, usul fiqh.

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Authors: Irfan Z. Qureshi, Fareeha A., Wajid A. Khan

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Human amniotic membrane (HAM) is a useful biological material for the reconstruction of damaged ocular surface. The processing and preservation of HAM is critical to prevent the patients undergoing amniotic membrane transplant (AMT) from cross infections. For HAM preparation human placenta is obtained after an elective cesarean delivery. Before collection, the donor is screened for seronegativity of HCV, Hbs Ag, HIV and Syphilis. After collection, placenta is washed in balanced salt solution (BSS) in sterile environment. Amniotic membrane is then separated from the placenta as well as chorion while keeping the preparation in BSS. Scrapping of HAM is then carried out manually until all the debris is removed and clear transparent membrane is acquired. Nitrocellulose membrane filters are then placed on the stromal side of HAM, cut around the edges with little membrane folded towards other side making it easy to separate during surgery. HAM is finally stored in solution of glycerine and Dulbecco-s Modified Eagle Medium (DMEM) in 1:1 ratio containing antibiotics. The capped borosil vials containing HAM are kept at -80°C until use. This vial is thawed to room temperature and opened under sterile operation theatre conditions at the time of surgery.

Keywords: HAM, AMT, ocular transplant

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Authors: M Nazrul-Hakim, A Yaacob, Y Adam, A Zuraini

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This study examined the toxicological effects and safety of polypeptide k isolated from the seeds of Momordica charantia in laboratory rats. 30 male Sprague Dawley rats (12 weeks old, bodyweight 180-200 g) were randomly divided into 3 groups (1000 mg/kg, 500 mg and 0 mg/kg). Rats were acclimatized to laboratory conditions for 7 days and at day 8 rats were dosed orally with polypeptide k (in 2% DMSO/normal saline) and the controls received the dosed vehicle only. Rats were then observed for 72 hours before sacrificed. Rats were anaesthetized by pentobarbital (50 mg/kg ip) and 2-3.0 mL of blood was taken by cardiac puncture and rats were scarified by anaesthetic overdose. Immediately, organs (heart, lungs, liver, kidneys) were weigh and taken for histology. Organ sections were then evaluated by a histopathologist. Serum samples were assayed for liver functions (ALT and γ-GT) and kidney functions (BUN and creatinine). All rats showed normal behavior after the dosing and no statistical changes were observed in all blood parameters and organ weight. Histological examinations revealed normal organ structures. In conclusion, dosing of rats up to 1000 mg/kg did not have any effects on the rat behavior, liver or kidney functions nor histology of the selected organs.

Keywords: Polypeptide k, safety, histology, toxicology, Momordica charantia

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Authors: Sharan Badiger, Prema T. Akkasaligar, Sandeep HM, Biradar MS

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Essential hypertension (HTN) usually clusters with other cardiovascular risk factors such as age, overweight, diabetes, insulin resistance and dyslipidemia. The target organ damage (TOD) such as left ventricular hypertrophy, microalbuminuria (MA), acute coronary syndrome (ACS), stroke and cognitive dysfunction takes place early in course of hypertension. Though the prevalence of hypertension is high in India, the relationship between microalbuminuria and target organ damage in hypertension is not well studied. This study aim at detecting MA in essential hypertension and its relation to severity of HTN, duration of HTN, body mass index (BMI), age and TOD such as HTN retinopathy and acute coronary syndrome The present study was done in 100 patients of essential hypertension non diabetics admitted to B.L.D.E.University-s Sri B.M.Patil Medical College, Bijapur, from October 2008 to April 2011. The patients underwent detailed history and clinical examination. Early morning 5 ml of urine sample was collected & MA was estimated by immunoturbidometry method. The relationship of MA with the duration & severity of HTN, BMI, age, sex and TOD's like hypertensive retinopathy, ACS was assessed by univariate analysis. The prevalence of MA in this study was found to be 63 %. In that 42% were male & 21% were female. In this study a significant association between MA and the duration of hypertension (p = 0.036) & (OR =0.438). Longer the duration of hypertension, more possibility of microalbumin in urine. Also there was a significant association between severity of hypertension and MA (p=0.045) and (OR=0.093). MA was positive in 50 (79.4%) patients out of 63, whose blood pressure was >160/100 mm Hg. In this study a significant association between MA and the grades of hypertensive retinopathy (p =0.011) and acute coronary syndrome (p = 0.041) (OR =2.805). Gender and BMI did not pose high risk for MA in this study.The prevalence of MA in essential hypertension is high in this part of the community and MA will increase the risk of developing target organ damage.Early screening of patients with essential hypertension for MA and aggressive management of positive cases might reduce the burden of chronic kidney diseases and cardiovascular diseases in the community.

Keywords: Acute coronary syndrome, Essential hypertension, Microalbuminuria, Target organ damage

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Authors: M. A. Askari, M. A. Nazari, P. Perrier, Y. Payan

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Growth and remodeling of biological structures have gained lots of attention over the past decades. Determining the response of living tissues to mechanical loads is necessary for a wide range of developing fields such as prosthetics design or computerassisted surgical interventions. It is a well-known fact that biological structures are never stress-free, even when externally unloaded. The exact origin of these residual stresses is not clear, but theoretically, growth is one of the main sources. Extracting body organ’s shapes from medical imaging does not produce any information regarding the existing residual stresses in that organ. The simplest cause of such stresses is gravity since an organ grows under its influence from birth. Ignoring such residual stresses might cause erroneous results in numerical simulations. Accounting for residual stresses due to tissue growth can improve the accuracy of mechanical analysis results. This paper presents an original computational framework based on gradual growth to determine the residual stresses due to growth. To illustrate the method, we apply it to a finite element model of a healthy human face reconstructed from medical images. The distribution of residual stress in facial tissues is computed, which can overcome the effect of gravity and maintain tissues firmness. Our assumption is that tissue wrinkles caused by aging could be a consequence of decreasing residual stress and thus not counteracting gravity. Taking into account these stresses seems therefore extremely important in maxillofacial surgery. It would indeed help surgeons to estimate tissues changes after surgery.

Keywords: Finite element method, growth, residual stress, soft tissue.

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Authors: Sutisa Khempaka, Supattra Okrathok, Laddawan Hokking, Buntita Thukhanon, Wittawat Molee

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This study was conducted to investigate the optimum levels of glutamine (Gln) supplementation in broiler diets. A total of 32 one-day-old male chicks with initial body weight 41.5 g were segregated into 4 groups (8 chicks per group) and subsequently distributed to individual cages. Feed and water were provided ad libitum for 21 days. Four dietary treatments were as follows: control and supplemented Gln at 1, 2 and 3%, respectively. The results found that the addition Gln had no negative effects on dry matter, organic matter, ash digestibility or nitrogen retention. Birds fed with 1% Gln had significantly higher villi wide and villi height : crypt depth ratio in duodenum than the control chicks and 2 and 3% Gln chicks. It is suggested that the addition of Gln at 1% indicated a beneficial effect on improving small intestinal morphology, in addition Gln may stimulate immune organ development of broiler chickens.

Keywords: broiler chicken, digestibility, gastrointestinal tract glutamine, glutamine

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Authors: Lubis A., Widayanti R., Hikmah Z., Endaryanto A., Harsono A., Harianto A., Etika R., Handayani D. K., Sampurna M.

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: Neonatus lupus erythematous, maternal autoantibody, clinical characteristic.

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Authors: Sh. Edrisi, A. Farahbakhsh

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An experiment was conducted under controlled conditions to study the effect of water extract of leaves, shoots and roots of either Sisymbrium irio L. =SISIR and or Descurainia sophia (L.) Schur =DESSO on the germination and primary growth of barley. A split-split plot experiment in CRD with three replications was used. The main plots were the type of weed: i.e. SISIR and DESSO and the sub-plots were type of organ: i.e. leaf, stem and root and, the sub-sub plots were concentration of the water extract of each organ of the weeds: i.e. 0, 2, 4 and 8 % w/v. The results showed that the SISIR water extracts had a greater inhibitory effects on the germination and primary growth of barley than those of DESSO water extracts. The water extracts of the leaves of both weeds had the greatest inhibitory effects on the germination and primary growth of barley, compared to those of stems and roots. Increasing the concentration of water extracts of leaves, stems and roots of both weeds up to 8 % caused the greatest inhibitory effects to barley and reduced the germination rate and primary growth of it linearly.

Keywords: Allelopathy, barley, DESSO, SISIR

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Authors: Dursun Aydin

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This paper study about using of nonparametric models for Gross National Product data in Turkey and Stanford heart transplant data. It is discussed two nonparametric techniques called smoothing spline and kernel regression. The main goal is to compare the techniques used for prediction of the nonparametric regression models. According to the results of numerical studies, it is concluded that smoothing spline regression estimators are better than those of the kernel regression.

Keywords: Kernel regression, Nonparametric models, Prediction, Smoothing spline.

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Authors: Jiakai Li, Gursel Serpen, Steven Selman, Matt Franchetti, Mike Riesen, Cynthia Schneider

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This paper presents the development of a Bayesian belief network classifier for prediction of graft status and survival period in renal transplantation using the patient profile information prior to the transplantation. The objective was to explore feasibility of developing a decision making tool for identifying the most suitable recipient among the candidate pool members. The dataset was compiled from the University of Toledo Medical Center Hospital patients as reported to the United Network Organ Sharing, and had 1228 patient records for the period covering 1987 through 2009. The Bayes net classifiers were developed using the Weka machine learning software workbench. Two separate classifiers were induced from the data set, one to predict the status of the graft as either failed or living, and a second classifier to predict the graft survival period. The classifier for graft status prediction performed very well with a prediction accuracy of 97.8% and true positive values of 0.967 and 0.988 for the living and failed classes, respectively. The second classifier to predict the graft survival period yielded a prediction accuracy of 68.2% and a true positive rate of 0.85 for the class representing those instances with kidneys failing during the first year following transplantation. Simulation results indicated that it is feasible to develop a successful Bayesian belief network classifier for prediction of graft status, but not the graft survival period, using the information in UNOS database.

Keywords: Bayesian network classifier, renal transplantation, graft survival period, United Network for Organ Sharing

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Authors: Sh. Edrisi, A. Farahbakhsh

Abstract:

An experiment was conducted under controlled conditions to study the effect of water extract of leaves, shoots and roots of either Sisymbrium irio L. =SISIR and/or Descurainia sophia (L.) Schur =DESSO on the germination and primary growth of wheat. A split-split plot experiment in CRD with three replications was used. The main plots were the type of weed: i.e. SISIR and DESSO and the sub-plots were type of organ: i.e. leaf, stem and root and, the sub-sub plots were concentration of the water extract of each organ of the weeds: i.e. 0, 2, 4 and 8 % w/v. The plant materials were cut in 2-3 cm pieces and then were ground in a blender. The crushed materials were weighed according to experimental protocol and the final volume was reached to 100 ml in distilled water in dark bottles. All bottles were put on a shaker for 24 hours. The solutions were filtered by muslin cloth. Whatman paper, 9 cm in diameter, were put in petri dishes and twenty seeds of wheat were put on it and 5 ml distilled water or water extract of weeds were added to each petri dish. All petri dishes were put in constant temperature of 15 0C incubator. The results showed that the SISIR water extract had a greater inhibitory effects on germination and primary growth of wheat than those of DESSO water extract. The water extracts of the leaves of both weeds had the greatest inhibitory effects on germination and primary growth of wheat, compared to those of stems and roots. Increasing the concentration of water extract of leaves, stems and roots of both weeds up to 8 % caused the greatest inhibitory effects to wheat and reduced the germination rate and primary growth of it linearly.

Keywords: Allelopathy, DESSO, SISIR, wheat

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

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Bile spillage occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visit, with subsequent readmission and additional procedures. Thus, this study sought to examine whether bile spillage is indeed associated with increased risk of postoperative wound infections after laparoscopic cholecystectomy. We hypothesize that patients who experience bile spillage (BS) during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per Center for disease control and prevention (CDC) defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and absent in the rest i.e., 92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in non-bile spillage cases SSI was found in 8 cases (8.7%). However, it was statistically not significant (p value > 0.05). 11 (92%) cases were superficial SSI and one was organ-space infection. No mortality or 30-day readmission was found in our study period. Spillage of gallbladder content does not lead to an increase in SSIs. However, as the rate of SSI is still higher, surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage, thorough peritoneal irrigation with normal saline should be done.

Keywords: Biliary spillage, organ space infection, Laparoscopic cholecystectomy, surgical site infection.

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Authors: Houman Tamaddon, Mehrdad Behnia, Masud Behnia

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An accurate study of blood flow is associated with an accurate vascular pattern and geometrical properties of the organ of interest. Due to the complexity of vascular networks and poor accessibility in vivo, it is challenging to reconstruct the entire vasculature of any organ experimentally. The objective of this study is to introduce an innovative approach for the reconstruction of a full vascular tree from available morphometric data. Our method consists of implementing morphometric data on those parts of the vascular tree that are smaller than the resolution of medical imaging methods. This technique reconstructs the entire arterial tree down to the capillaries. Vessels greater than 2 mm are obtained from direct volume and surface analysis using contrast enhanced computed tomography (CT). Vessels smaller than 2mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray’s Laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray’s Laws to every vessel bifurcation simultaneously, lead to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the first capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-defined Strahler system, are assigned. During the simulation, we used the averaged flow rate for each order to predict the pressure drop and once the pressure drop is predicted, the flow rate is corrected to match the computed pressure drop for each vessel. The final results for 3 cardiac cycles is presented and compared to the clinical data.

Keywords: Blood flow, Morphometric data, Vascular tree, Strahler ordering system.

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Authors: M. Umar Farooq, T. Ahmad Afridi, M. Zia-Ul-Islam Arsalan, U. Hussain Haider, S. Ullah

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Cancer, a leading fatal disease worldwide, can be treated with various techniques including radiation therapy. It involves the use of ionizing radiation to target cancer cells. On basis of source placement, radiation therapy is of two types i.e., Brachytherapy and External Beam Radiotherapy (EBRT). EBRT has evolved from 2-D conventional therapy to 3-D Conformal radiotherapy (3D-CRT) and then Intensity-Modulated Radiotherapy (IMRT). IMRT improves dose conformity and sparing of organs at risk. Volumetric Modulated Arc Therapy (VMAT) is a modern technique that uses treatment delivery in arcs with rotation of the gantry. In this report, a dosimetry comparison was performed between IMRT and VMAT. This study was conducted in the Radiotherapy Department of the Institute of Nuclear Medicine and Oncology Lahore (INMOL). Ten patients with Prostate Carcinoma were selected for this study to compare the methods. Simulation of these patients was done with help of a CT Simulator. All target volumes and organs were delineated by the oncologists. Then suitable fields/arcs were applied which cover volumes effectively. This was followed by the optimization of plans for both techniques for every patient. Finally, a comparison of evaluating parameters e.g., Conformity Index (CI), Volume Coverage, Homogeneity Index (HI), Organ Doses, and MUs (Monitor Units) was performed. We obtained better results of target conformity indices from VMAT (CI = 1.16) than IMRT (CI = 1.24). VMAT was better in organ sparing too. Also, VMAT shows fewer MUs (733 MUs) as compared to IMRT (2149 MUs). From this study, it is concluded that VMAT is a better treatment technique than IMRT. This technique will enhance treatment efficiency as it takes less time in obtaining the required results. Also, a very less scatter dose will be delivered to the patient.

Keywords: 2-D Conventional Radiotherapy, 3-D Conformal Radiotherapy, Intensity Modulated Radiotherapy, Prostate Carcinoma, Radiotherapy, Volumetric Modulated Arc Therapy.

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Authors: Khlopova N.S., Glazko V.I., Glazko T.T.

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Using DNA microarrays the comparative analysis of a gene expression profiles is carried out in a liver and kidneys of pigs. The hypothesis of a cross hybridization of one probe with different cDNA sites of the same gene or different genes is checked up, and it is shown, that cross hybridization can be a source of essential errors at revealing of a key genes in organ-specific transcriptome. It is reveald that distinctions in profiles of a gene expression are well coordinated with function, morphology, biochemistry and histology of these organs.

Keywords: Microarray, gene expression profiles, key genes.

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Authors: R. Amooaghaie

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Principally, plants grown in soilless culture may be attacked by the same pests and diseases as cultivated traditionally in soil. The most destructive phytopathogens are fungi, such as Phythium, Phytophthora and Fusarium, followed by viruses, bacteria and nematodes. We investigated effect of carbon nanotube filters on disease management of soilless culture. Tomato seedlings transplant in plastic pots filled with a soilless media of vermiculite. The crop irrigated and fertilized using a hydroponic nutrient solution. We used carbon nanotube filters for nutrient solution disinfection. Our results show that carbon nanotube filtration significantly reduces pathogens on tomato plants. Fungal elimination (Fusarium oxysporum and Pythium spp.) was usually successful at about 96 to 99.9% all over the cultural season. It is seem that in tomato soilless culture, nanofiltration constitutes a reliable method that allows control of the development of diseases caused by pathogenic fungi

Keywords: Fusarium oxysporum, Nanofilteration, Pythium spp., Soilless culture, Tomato

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Authors: Vladimir V. Iakovlev, Erin T. Carey, John Steege

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The use of polypropylene mesh devices for Pelvic Organ Prolapse (POP) spread rapidly during the last decade, yet our knowledge of the mesh-tissue interaction is far from complete. We aimed to perform a thorough pathological examination of explanted POP meshes and describe findings that may explain mechanisms of complications resulting in product excision. We report a spectrum of important findings, including nerve ingrowth, mesh deformation, involvement of detrusor muscle with neural ganglia, and polypropylene degradation. Analysis of these findings may improve and guide future treatment strategies.

Keywords: Transvaginal, mesh, nerves, polypropylene degradation.

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Authors: Sharan Badiger, Prema T. Akkasaligar, Patil LS, Manish Patel, Biradar MS

Abstract:

Human immunodeficiency virus infection and acquired immunodeficiency syndrome is a global pandemic with cases reporting from virtually every country and continues to be a common infection in developing country like India. Microalbuminuria is a manifestation of human immunodeficiency virus associated nephropathy. Therefore, microalbuminuria may be an early marker of human immunodeficiency virus associated nephropathy, and screening for its presence may be beneficial. A strikingly high prevalence of microalbuminuria among human immunodeficiency virus infected patients has been described in various studies. Risk factors for clinically significant proteinuria include African - American race, higher human immunodeficiency virus ribonucleic acid level and lower CD4 lymphocyte count. The cardiovascular risk factors of increased systolic blood pressure and increase fasting blood sugar level are strongly associated with microalbuminuria in human immunodeficiency virus patient. These results suggest that microalbuminuria may be a sign of current endothelial dysfunction and micro-vascular disease and there is substantial risk of future cardiovascular disease events. Positive contributing factors include early kidney disease such as human immunodeficiency virus associated nephropathy, a marker of end organ damage related to co morbidities of diabetes or hypertension, or more diffuse endothelial cells dysfunction. Nevertheless after adjustment for non human immunodeficiency virus factors, human immunodeficiency virus itself is a major risk factor. The presence of human immunodeficiency virus infection is independent risk to develop microalbuminuria in human immunodeficiency virus patient. Cardiovascular risk factors appeared to be stronger predictors of microalbuminuria than markers of human immunodeficiency virus severity person with human immunodeficiency virus infection and microalbuminuria therefore appear to potentially bear the burden of two separate damage related to known vascular end organ damage related to know vascular risk factors, and human immunodeficiency virus specific processes such as the direct viral infection of kidney cells.The higher prevalence of microalbuminuria among the human immunodeficiency virus infected could be harbinger of future increased risks of both kidney and cardiovascular disease. Further study defining the prognostic significance of microalbuminuria among human immunodeficiency virus infected persons will be essential. Microalbuminuria seems to be a predictor of cardiovascular disease in diabetic and non diabetic subjects, hence it can also be used for early detection of micro vascular disease in human immunodeficiency virus positive patients, thus can help to diagnose the disease at the earliest.

Keywords: Acquired immunodeficiency syndrome, Human immunodeficiency virus, Microalbuminuria.

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Authors: Gurung S., Yadav B. N., Budhathoki SS.

Abstract:

Problem based learning is one of the highly acclaimed learning methods in medical education since its first introduction at Mc-Master University in Canada in the 1960s. It has now been adopted as a teaching learning method in many medical colleges of Nepal. B.P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university is the second institute in Nepal to establish problem-based learning academic program and need-based teaching approach hence minimizing teaching through lectures since its inception. During the first two years of MBBS course, the curriculum is divided into various organ-systems incorporated with problem-based learning exercise each of one week duration.

Keywords: PBL, medical education.

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Authors: I-En Lin, Feng-Jung Yang

Abstract:

In addition to kidney transplant, renal replacement therapy involves hemodialysis and peritoneal dialysis (PD). PD possesses advantages such as maintaining stable physiological blood status and blood pressure, alleviating anemia, and improving mobility, which make it an ideal method for at-home dialysis treatment. However, potential danger still exists despite the numerous advantages of PD, particularly when patients require dialysis exchange four to five times a day, during which improper operation can easily lead to peritonitis. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. Connecting the transfer set requires sterile technique. Transfer set may require a new cap each time that it disconnects from the bag after an exchange. There are many chances to get infection due to unsafe behavior (ex: hand tremor, poor eyesight and weakness, cap fall-down). The proposed semi-automatic connection mechanism used in the PD can greatly reduce infection chances. This light-weight connection device is portable. The device also does not require using throughout the entire process. It is capable of significantly improving quality of life. Therefore, it is very promising to adopt in home care application.

Keywords: Automatic connection, catheter, glomerulonephritis, peritoneal dialysis.

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Authors: Ayodeji Fasuyi

Abstract:

Telfairia occidentalis is a leafy vegetable commonly grown in the tropics for nutritional benefits. The use of enzymes and probiotics is becoming prominent due to the ban on antibiotics as growth promoters in many parts of the world. It is conceived that with enzymes and probiotics additives, fibrous leafy vegetables can be incorporated into poultry feeds as protein source. However, certain antinutrients were also found in the leaves of Telfairia occidentalis. Four broiler starter and finisher diets were formulated for the two phases of the broiler experiments. A mixture of fiber degrading enzymes, Roxazyme G2 (combination of cellulase, glucanase and xylanase) and probiotics (Turbotox), a growth promoter, were used in broiler diets at 1:1. The Roxazyme G2/Turbotox mixtures were used in diets containing four varying levels of Telfairia occidentalis leaf meal (TOLM) at 0, 10, 20 and 30%. Diets 1 were standard broiler diets without TOLM and Roxazyme G2 and Turbotox additives. Diets 2, 3 and 4 had enzymes and probiotics additives. Certain mineral elements such as Ca, P, K, Na, Mg, Fe, Mn, Cu and Zn were found in notable quantities viz. 2.6 g/100 g, 1.2 g/100 g, 6.2 g/100 g, 5.1 g/100 g, 4.7 g/100 g, 5875 ppm, 182 ppm, 136 ppm and 1036 ppm, respectively. Phytin, phytin-P, oxalate, tannin and HCN were also found in ample quantities viz. 189.2 mg/100 g, 120.1 mg/100 g, 80.7 mg/100 g, 43.1 mg/100 g and 61.2 mg/100 g, respectively. The average weight gain was highest at 46.3 g/bird/day for birds on 10% TOLM diet but similar (P > 0.05) to 46.2 g/bird/day for birds on 20% TOLM. The feed conversion ratio (FCR) of 2.27 was the lowest and optimum for birds on 10% TOLM although similar (P > 0.05) to 2.29 obtained for birds on 20% TOLM. FCR of 2.61 was the highest at 2.61 for birds on 30% TOLM diet. The lowest FCR of 2.27 was obtained for birds on 10% TOLM diet although similar (P > 0.05) to 2.29 for birds on 20% TOLM diet. Most carcass characteristics and organ weights were similar (P > 0.05) for the experimental birds on the different diets except for kidney, gizzard and intestinal length. The values for kidney, gizzard and intestinal length were significantly higher (P < 0.05) for birds on the TOLM diets. The nitrogen retention had the highest value of 72.37 ± 0.10% for birds on 10% TOLM diet although similar (P > 0.05) to 71.54 ± 1.89 obtained for birds on the control diet without TOLM and enzymes/probiotics mixture. There was evidence of a better utilization of TOLM as a plant protein source. The carcass characteristics and organ weights all showed evidence of uniform tissue buildup and muscles development particularly in diets containing 10% of TOLM level. There was also better nitrogen utilization in birds on the 10% TOLM diet. Considering the cheap cost of TOLM, it is envisaged that its introduction into poultry feeds as a plant protein source will ultimately reduce the cost of poultry feeds.

Keywords: Telfairia occidentalis leaf meal, enzymes, probiotics, additives.

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Authors: S. Buloyan, V. Mamikonyan, H. Hakobyan, H. Harutyunyan, H. Gasparyan

Abstract:

The liver is the strongest regenerating organ of the organism, and even with 2/3 surgically removed, it can regenerate completely. Hence liver cirrhosis may only develop when the regenerating system is off. We present the results of a comparative study of structural and functional characteristics of rat liver tissue under the conditions of toxic liver cirrhosis development, induced by carbon tetrachloride, and its prevention/treatment by natural compounds with antioxidant and immune stimulating action. Studies were made on Wister rats, weighing 120~140 g. Grape seeds extracts, separately and in combination with well-known anticirrhotic drug ursodeoxycholic acid (Urdoxa), have demonstrated effectiveness in prevention of liver cirrhosis development and its treatment.

Keywords: Carbon tetrachloride, GSE, liver cirrhosis, prevention, treatment.

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Authors: Sharan Badiger, Prema T. Akkasaligar, Deepak Kadeli

Abstract:

Human Immunodeficiency Virus is known to affect almost all organ systems in the body. In addition to central nervous system it also affects the autonomic nervous system. Autonomic nervous dysfunction has been known to severely affect the quality of life in human immunodeficiency virus positive patients. It is known to have caused fatal consequences in late stages of the disease in patients who go in for invasive diagnostic or therapeutic procedures. The aim of this review is to determine the incidence, clinical significance and frequency of cardiac autonomic neuropathy in patients human immunodeficiency virus infection.

Keywords: Autonomic nervous system, autonomic nervous dysfunction, cardiac autonomic dysfunction, human immunodeficiency virus.

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Authors: Nazrina Aziz, Dong Q. Wang

Abstract:

There have been various methods created based on the regression ideas to resolve the problem of data set containing censored observations, i.e. the Buckley-James method, Miller-s method, Cox method, and Koul-Susarla-Van Ryzin estimators. Even though comparison studies show the Buckley-James method performs better than some other methods, it is still rarely used by researchers mainly because of the limited diagnostics analysis developed for the Buckley-James method thus far. Therefore, a diagnostic tool for the Buckley-James method is proposed in this paper. It is called the renovated Cook-s Distance, (RD* i ) and has been developed based on the Cook-s idea. The renovated Cook-s Distance (RD* i ) has advantages (depending on the analyst demand) over (i) the change in the fitted value for a single case, DFIT* i as it measures the influence of case i on all n fitted values Yˆ∗ (not just the fitted value for case i as DFIT* i) (ii) the change in the estimate of the coefficient when the ith case is deleted, DBETA* i since DBETA* i corresponds to the number of variables p so it is usually easier to look at a diagnostic measure such as RD* i since information from p variables can be considered simultaneously. Finally, an example using Stanford Heart Transplant data is provided to illustrate the proposed diagnostic tool.

Keywords: Buckley-James estimators, censored regression, censored data, diagnostic analysis, product-limit estimator, renovated Cook's Distance.

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Authors: B. Selma, S. Chouraqui

Abstract:

The pancreas is an elongated organ that extends across the abdomen, below the stomach. In addition, it secretes certain enzymes that aid in food digestion. The pancreas also manufactures hormones responsible for regulating blood glucose levels. In the present paper, we propose a mathematical model to study the homeostasis of glucose and insulin in healthy human, and a simulation of this model, which depicts the physiological events after a meal, will be represented in ordinary humans. The aim of this paper is to design an algorithm which regulates the level of glucose in the blood. The algorithm applied the concept of expert system for performing an algorithm control in the form of an "active" used to prescribe the rate of insulin infusion. By decomposing the system into subsystems, we have developed parametric models of each subsystem by using a forcing function strategy. The results showed a performance of the control system.

Keywords: Modeling, algorithm, regulation, glucose-insulin, blood, control system.

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