Percutaneous bifurcation intervention is usually sufficient with a single-stent strategy. When the double-stent strategy is employed, higher restenosis and target lesion revascularization (TLR) rates are observed, especially at the side-branch ostium. The results may be improved, however, with refinement in techniques, for example, final kissing balloon inflation and double kissing balloon inflation.
Hollow fibre liquid-phase microextraction with in situ derivatization using dansyl chloride has been successfully developed for the high-performance liquid chromatography-ultraviolet (HPLC-UV) determination of the biogenic amines (tryptamine, putrescine, cadaverine, histamine, tyramine, spermidine) in food samples. Parameters affecting the performance of the in situ derivatization process such as type of extraction solvent, temperature, extraction time, stirring speed and salt addition were studied and optimized. Under the optimized conditions (extraction solvent, dihexyl ether; acceptor phase, 0.1M HCl; extraction time, 30 min; extraction temperature, 26 degrees C; without addition of salt), enrichment factors varying from 47 to 456 were achieved. Good linearity of the analytes was obtained over a concentration range of 0.1-5 microg mL(-1) (with correlation coefficients of 0.9901-0.9974). The limits of detection and quantification based on a signal-to-noise ratio of 3-10, ranged from 0.0075 to 0.030 microg mL(-1) and 0.03 to 0.10 microg mL(-1), respectively. The relative standard deviations based on the peak areas for six replicate analysis of water spiked with 0.5 microg mL(-1) of each biogenic amine were lower than 7.5%. The method was successfully applied to shrimp sauce and tomato ketchup samples, offering an interesting alternative to liquid-liquid extraction and solid phase extraction for the analysis of biogenic amines in food samples.
Matched MeSH terms: Chromatography, High Pressure Liquid/methods*; Chemical Fractionation/methods*
Traditional open approaches to the nasopharynx either provide limited access and risk significant morbidity. Here we describe our experience with endoscopic resection of nasopharyngeal tumours. Retrospective chart review was performed for all patients who underwent endoscopic nasopharyngeal resection from September 1993 to January 2007 at a tertiary rhinology centre. Six patients underwent endoscopic nasopharyngectomy for tumours arising from or involving the nasopharynx. The mean age was 49.8 years (range 23 - 70). The sex distribution was five males and one female. Four tumours were malignant and two were benign. The mean disease-free and overall survival for malignant tumors was 90.75 months (range 66 - 120 months). None of the benign tumors recurred. The endoscopic nasopharyngectomy technique may be successfully used for resection of tumors arising from or involving the nasopharynx with good efficacy and a decrease in morbidity when compared to open approaches.
Concern about environmental protection has aroused over the years from a global viewpoint. To date, the ever-increasing importance of biomass as the energy and material resources has lately been accounted by the rising prices for the crude petroleum oil. Rice husk ash, the most appropriate representative of the high ash biomass waste, is currently obtaining sufficient attraction, owning to its wide usefulness and potentiality in environmental conservation. Confirming the assertion, this paper presents a state of the art review of the rice milling industry, its background studies, fundamental properties and industrial applications. Moreover, the key advance on the preparation of novel adsorbents, its major challenges together with the future expectation has been highlighted and discussed. Conclusively, the expanding of rice husk ash in the field of adsorption science represents a viable and powerful tool, leading to the superior improvement of pollution control and environmental preservation.
This paper presents a comparative study between wavelet and curvelet transform for breast cancer diagnosis in digital mammogram. Using multiresolution analysis, mammogram images are decomposed into different resolution levels, which are sensitive to different frequency bands. A set of the biggest coefficients from each decomposition level is extracted. Then a supervised classifier system based on Euclidian distance is constructed. The performance of the classifier is evaluated using a 2 x 5-fold cross validation followed by a statistical analysis. The experimental results suggest that curvelet transform outperforms wavelet transform and the difference is statistically significant.
Removal of arsenic from aqueous solution was carried out using electrocoagulation. Experiments were conducted using mild steel sacrificial anode covering wide range in operating conditions to assess the removal efficiency. The maximum arsenic removal efficiency was recorded as 94% under optimum condition. The electrocoagulation mechanism of arsenic removal has been developed to understand the effect of applied charge and electrolyte pH on arsenic removal efficiency. Further the experimental data were tested with different adsorption isotherm model to describe the electrocoagulation process.
Matched MeSH terms: Electrocoagulation/methods*; Water Purification/methods
Microwave has received a widespread application in pharmaceuticals and food processing, microbial sterilization, biomedical therapy, scientific and biomedical analysis, as well as, drug synthesis. This paper reviews the basis of application of microwave to prepare pharmaceutical dosage forms such as agglomerates, gel beads, microspheres, nanomatrix, solid dispersion, tablets and film coat. The microwave could induce drying, polymeric crosslinkages as well as drug-polymer interaction, and modify the structure of drug crystallites via its effects of heating and/or electromagnetic field on the dosage forms. The use of microwave opens a new approach to control the physicochemical properties and drug delivery profiles of pharmaceutical dosage forms without the need for excessive heat, lengthy process or toxic reactants. Alternatively, the microwave can be utilized to process excipients prior to their use in the formulation of drug delivery systems. The intended release characteristics of drugs in dosage forms can be met through modifying the physicochemical properties of excipients using the microwave.
A review of 45 patients who underwent endoscopic dacryocystorhinostomy (EDCR) from 1998 to 2005 was done. Only patients who had complete notes and had Jones tube removed at least three months before the study were included. Our experience with EDCR concludes it to be an easy, efficient treatment for nasolacrimal duct obstruction with minimal complications.
A city consumes a large amount of water. Urban planning and development are becoming more compelling due to the fact of growing competition for water, which has lead to an increasing and conflicting demand. As such, investments in water supply, sanitation and water resources management is a strong potential for a solid return. A pilot project of greywater ecological treatment has been established in Kuching city since 2003. Such a treatment facility opens up an opportunity of wastewater reclamation for reuse as secondary sources of water for non-consumptive purposes. This paper aims to explore the potential of the intended purposes in the newly developed ecological treatment project. By utilizing the Wallingford Software model, InfoWorks WS (Water Supply) is employed to carry out a hydraulic modeling of a hypothetical greywater recycling system as an integrated part of the Kuching urban water supply, where the greywater is treated, recycled and reused in the domestic environment. The modeling efforts have shown water savings of about 40% from the investigated system reinstating that the system presents an alternative water source worth exploring in an urban environment.
Matched MeSH terms: Conservation of Natural Resources/methods*; Sanitary Engineering/methods*
During the last century, a great deal of research and development as well as applications has been devoted to waste. These include waste minimization and treatment, the environmental assessment of waste, minimization of environmental impact, life cycle assessment and others. The major reason for such huge efforts is that waste generation constitutes one of the major environmental problems where production industries are concerned. Until now, an increasing pressure has been put on finding methods of reusing waste, for instance through cleaner production, thus mirroring rapid changes in environmental policies. The palm oil industry is one of the leading industries in Malaysia with a yearly production of more than 13 million tons of crude palm oil and plantations covering 11% of the Malaysian land area. However, the production of such amounts of crude palm oil result in even larger amounts of palm oil mill effluent (POME), estimated at nearly three times the quantity of crude palm oil. Normally, POME is treated using end-of-pipe processes, but it is worth considering the potential value of POME prior to its treatment through introduction of a cleaner production. It is envisaged that POME can be sustainably reused as a fermentation substrate in the production of various metabolites, fertilizers and animal feeds through biotechnological advances. The present paper thus discusses various technically feasible and economically beneficial means of transforming the POME into low or preferably high value added products.
Matched MeSH terms: Biotechnology/methods*; Conservation of Natural Resources/methods*
Positron emission tomography (PET) has emerged as an important diagnostic tool in the management of lung cancers. Although PET is sensitive in detection of lung cancer, but FDG (2-deoxy-2- 18 fluro-D-glucose) is not tumor specific and may accumulate in a variety of nonmalignant conditions occasionally giving false positive result. Addition of CT to PET improves specificity foremost, but also sensitivity in tumor imaging. Thus, PET/CT fusion images are a more accurate test than either of its individual components and are probably also better than side-by-side viewing of images from both modalities. PET/CT fusion images are useful in differentiating between malignant and benign disease, fibrosis and recurrence, staging and in changing patient management to more appropriate therapy. With analysis and discussion it appears that PET/ CT fusion images have the potential to dramatically improve our ability to manage the patients with lung cancer and is contributing to our understanding of cancer cell biology and in development of new therapies.
Paraesophageal hernias have been historically associated with risk of substantial morbidity and mortality. We report a case of a 92 year old lady with acute gastric outlet obstruction due to a chronic paraesophageal hernia that was successfully treated by minimal invasive surgery. Anterior gastropexy was performed after the stomach was reduced. The hiatal opening was enlarged to reduce the risk of obstruction in the future. She was discharged well on the third day.
Matched MeSH terms: Laparoscopy/methods*; Digestive System Surgical Procedures/methods
BACKGROUND AND RATIONALE: Evidence based medicine is the present backbone of rational and objective, modern medical problem solving and is a meeting ground for quantitative and qualitative researchers alike as it culminates into applying the fruits of clinical research to the individual patient. A systematic enquiry into the evolving paradigms in EBM is a need of the hour.
AIMS AND METHODS: A qualitative enquiry examining the impact of different methodologies in EBM and their role in generating meaning interpretable at individual levels.
RESULTS: Present day outcome based research deals less with patients as individuals than as populations. Evidence based medicine struggles to apply the fruits of population based research to individuals who are often not as predictable as linear quantitative research would like them to be. The present EBM literature neglects a lot of events it doesn't believe to be statistically significant and perhaps here is an area that needs to be improved on - it assumes that because associations are demonstrated between interventions and outcomes in RCTs/meta-analysis, these associations are linear and causal in the real world. While they may be demonstrated repeatedly in highly controlled environments, in the real 'uncontrolled' world of clinical practice with real people, their validity breaks down.
CONCLUSIONS: One needs to make the EBM standard model patient-individual (a projection of collective patient event data) resemble the real human individual patient so that optimal EBM individual data that matches our query can be easily and quickly spotted from the dense jungle of information that has grown over the years. This hints at rethinking our entire research methodology and modifying it to suit the needs of the individual patient.
Tonsillectomy in children is performed on a regular basis in ENT. The indications are chronic tonsillitis, sleep apnea to deeper structures. The natural history of tonsillar hyperplasia is regression when a child is six years beyond. In children with bilateral tonsillar hyperplasia we studied the use of laser as an alternative procedure to reduce the bulk of the tonsillar mass. Children with symptoms of bilateral tonsillar hyperplasia underwent laser tonsillotomy. The tonsils were dissected using carbon dioxide (CO2) laser. The tonsillar bed was left untouched. Intraoperative and postoperative conditions were noted.
Two-stage lossless data compression methods involving predictors and encoders are well known. This paper discusses the application of context based error modeling techniques for neural network predictors used for the compression of EEG signals. Error modeling improves the performance of a compression algorithm by removing the statistical redundancy that exists among the error signals after the prediction stage. In this paper experiments are carried out by using human EEG signals recorded under various physiological conditions to evaluate the effect of context based error modeling in the EEG compression. It is found that the compression efficiency of the neural network based predictive techniques is significantly improved by using the error modeling schemes. It is shown that the bits per sample required for EEG compression with error modeling and entropy coding lie in the range of 2.92 to 6.62 which indicates a saving of 0.3 to 0.7 bits compared to the compression scheme without error modeling.
Matched MeSH terms: Electroencephalography/methods*; Data Compression/methods*
To determine the accuracy of transabdominal and transvaginal gray-scale and color Doppler in diagnosing placenta previa accreta in patients with previous cesarean sections.
Magnetic resonance angiographic evaluation of the intracranial vasculature has been predominantly carried out using conventional angiographic techniques such as time of flight and phase contrast sequences. These techniques have good spatial resolution but lack temporal resolution. Newer faster angiographic techniques have been developed to circumvent this limitation. Elliptical centric time-resolved imaging of contrast kinetics (EC-TRICKS) is one such technique which has combined the use of elliptical centric ordering of the k-space with multiphase 3D digital subtraction MR angiogram (MRA) to achieve excellent temporal resolution of the arterial and venous circulations. Its applications have been mainly in the peripheral vasculature. We report the use of this technique in a case of a high-flow, direct carotid-cavernous fistula to demonstrate its potential in intracranial MR angiography.
Matched MeSH terms: Image Enhancement/methods*; Magnetic Resonance Angiography/methods*