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Satisfactory
Kinds of Satisfactory Terms modified by Satisfactory Selected AbstractsA CRITICAL LOOK AT PAP ADEQUECY: ARE OUR CRITERIA SATISFACTORY?CYTOPATHOLOGY, Issue 2006D.R. Bolick Liquid based Pap (LBP) specimen adequacy is a highly documented, yet poorly understood cornerstone of our GYN cytology practice. Each day, as cytology professionals, we make adequacy assessments and seldom wonder how the criteria we use were established. Are the criteria appropriate? Are they safe? What is the scientific data that support them? Were they clinically and statistically tested or refined to achieve optimal patient care? In this presentation, we will take a fresh look at what we know about Pap specimen adequacy and challenge some of the core assumptions of our daily practice. LBP tests have a consistent, well-defined surface area for screening, facilitating the quantitative estimates of slide cellularity. This provides an unprecedented opportunity to establish reproducible adequacy standards that can be subjected to scientific scrutiny and rigorous statistical analysis. Capitalizing on this opportunity, the TBS2001 took the landmark step to define specimen adequacy quantitatively, and set the threshold for a satisfactory LBP at greater than 5,000 well visualized squamous epithelial cells. To date, few published studies have attempted to evaluate the validity or receiver operator characteristics for this threshold, define an optimal threshold for clinical utility or assess risks of detection failure in ,satisfactory' but relatively hypocellular Pap specimens. Five years of cumulative adequacy and cellularity data of prospectively collected Pap samples from the author's laboratory will be presented, which will serve as a foundation for a discussion on ,Pap failure'. A relationship between cellularity and detection of HSIL will be presented. Risk levels for Pap failure will be presented for Pap samples of different cellularities. The effect of different cellularity criterion on unsatisfactory Pap rates and Pap failure rates will be demonstrated. Results from this data set raise serious questions as to the safety of current TBS2001 adequacy guidelines and suggest that the risk of Pap failure in specimens with 5,000 to 20 000 squamous cells on the slide is significantly higher than those assumed by the current criteria. TBS2001 designated all LBP to have the same adequacy criterion. Up to this point, it has been assumed that ThinPrep, SurePath, or any other LBP would be sufficiently similar that they should have the same adequacy criteria. Data for squamous cellularity and other performance characteristics of ThinPrep and SurePath from the author's laboratory will be compared. Intriguing data involving the recently approved MonoPrep Pap Test will be reviewed. MonoPrep clinical trial data show the unexpected finding of a strong correlation between abundance of endocervical component and the detection of high-grade lesions, provoking an inquiry of a potential new role for a quantitative assessment of the transition zone component. The current science of LBP adequacy criteria is underdeveloped and does not appear to be founded on statistically valid methods. This condition calls us forward as a body of practitioners and scientists to rigorously explore, clarify and define the fundamental nature of cytology adequacy. As we forge this emerging science, we will improve diagnostic performance, guide the development of future technologies, and better serve the patients who give us their trust. Reference:, Birdsong GG: Pap smear adequacy: Is our understanding satisfactory? Diagn Cytopathol. 2001 Feb; 24(2): 79,81. [source] Microfluidic chip-capillary electrophoresis for two orders extension of adjustable upper working range for profiling of inorganic and organic anions in urineELECTROPHORESIS, Issue 18 2010Wen Peng Guo Abstract To meet the need for onsite monitoring of urine anions, a microfluidic chip-capillary electrophoresis device was designed, fabricated and tested to extend the upper CE working range for an enhancement up to 500 fold (100 fold for sample dilution and 5 folds for CE injection) in order to analyze highly variable anionic metabolites in urine samples. Capillaries were embedded between two PMMA plates with laser-fabricated microchannel patterns to produce the microfluidic chip-capillary electrophoresis to perform standard/sample dilution and CE injection with adjustable dilution ratios. A circular ferrofluid valve was incorporated on-chip to perform cleanup and conditioning, mixing and dilution, injection and CE separation. Under optimized conditions, a complete assay for four samples can be achieved within an hour for 15 anions commonly found in urines. Satisfactory working ranges (0.005,500,mM) and low detection limits (0.5,6.5,,M based on S/N =2) are obtained with satisfactory repeatability (RSD, n=5) 0.52,0.87% and 4.1,6.5% for migration time and peak area, respectively. The working ranges with two orders adjustable upper extension are adequate to cover all analytes concentrations commonly found in human urine samples. The device fabricated shows sufficiently large experimentally verifiable enhancement factor to meet the application requirements. Its reliability was established by more than 94% recoveries of spiked standards and agreeable results from parallel method comparison with conventional ion chromatography method. The extension of the upper CE working range enables flexible onsite dilution on demand, a quick turn-around of results, and a low-cost device suitable for bedside monitoring of patients under critical conditions for metabolic disorders. [source] Management Strategies and Improvement of Performance of Sewer NetworksCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 7 2007Denys Breysse Even when they are conscious about the needs of maintenance to keep the system in a good condition, they lack efficient methods and tools that may help them in taking appropriate decisions. One can say that no really satisfactory and efficient tool exists, enabling the optimization of Inspection, Maintenance, or Rehabilitation (IMR) strategies on such systems. Sewer managers and researchers have been involved for many years in the French National Research Project for Renewal of Non Man Entry Sewer System (RERAU,Réhabilitation des Réseaux d'Assainissement Urbains, in French) to improve their knowledge of these systems and the management policies. During the RERAU project, a specific action has been dedicated to the modeling of asset ageing and maintenance. A special attention has been dedicated to the description of defects and dysfunctions, to the evaluation of performances and its modeling, accounting for its various dimensions (from the point of view of the manager, of the user, of the environment,). After having defined an Index of Technical Performance (ITp), we will introduce the Index of Technical and Economic Performance (ITEp) that is a combined measure of performance (including social costs) and technical costs. This index provides an objective standard tool for managers to compare different alternatives. It is used in the article to compare some simple IMR strategies. It sets the basis of a new method for no-man entry sewer system management, enabling us to analyze the profitableness of investment in terms of both technical and economic performance. [source] A CRITICAL LOOK AT PAP ADEQUECY: ARE OUR CRITERIA SATISFACTORY?CYTOPATHOLOGY, Issue 2006D.R. Bolick Liquid based Pap (LBP) specimen adequacy is a highly documented, yet poorly understood cornerstone of our GYN cytology practice. Each day, as cytology professionals, we make adequacy assessments and seldom wonder how the criteria we use were established. Are the criteria appropriate? Are they safe? What is the scientific data that support them? Were they clinically and statistically tested or refined to achieve optimal patient care? In this presentation, we will take a fresh look at what we know about Pap specimen adequacy and challenge some of the core assumptions of our daily practice. LBP tests have a consistent, well-defined surface area for screening, facilitating the quantitative estimates of slide cellularity. This provides an unprecedented opportunity to establish reproducible adequacy standards that can be subjected to scientific scrutiny and rigorous statistical analysis. Capitalizing on this opportunity, the TBS2001 took the landmark step to define specimen adequacy quantitatively, and set the threshold for a satisfactory LBP at greater than 5,000 well visualized squamous epithelial cells. To date, few published studies have attempted to evaluate the validity or receiver operator characteristics for this threshold, define an optimal threshold for clinical utility or assess risks of detection failure in ,satisfactory' but relatively hypocellular Pap specimens. Five years of cumulative adequacy and cellularity data of prospectively collected Pap samples from the author's laboratory will be presented, which will serve as a foundation for a discussion on ,Pap failure'. A relationship between cellularity and detection of HSIL will be presented. Risk levels for Pap failure will be presented for Pap samples of different cellularities. The effect of different cellularity criterion on unsatisfactory Pap rates and Pap failure rates will be demonstrated. Results from this data set raise serious questions as to the safety of current TBS2001 adequacy guidelines and suggest that the risk of Pap failure in specimens with 5,000 to 20 000 squamous cells on the slide is significantly higher than those assumed by the current criteria. TBS2001 designated all LBP to have the same adequacy criterion. Up to this point, it has been assumed that ThinPrep, SurePath, or any other LBP would be sufficiently similar that they should have the same adequacy criteria. Data for squamous cellularity and other performance characteristics of ThinPrep and SurePath from the author's laboratory will be compared. Intriguing data involving the recently approved MonoPrep Pap Test will be reviewed. MonoPrep clinical trial data show the unexpected finding of a strong correlation between abundance of endocervical component and the detection of high-grade lesions, provoking an inquiry of a potential new role for a quantitative assessment of the transition zone component. The current science of LBP adequacy criteria is underdeveloped and does not appear to be founded on statistically valid methods. This condition calls us forward as a body of practitioners and scientists to rigorously explore, clarify and define the fundamental nature of cytology adequacy. As we forge this emerging science, we will improve diagnostic performance, guide the development of future technologies, and better serve the patients who give us their trust. Reference:, Birdsong GG: Pap smear adequacy: Is our understanding satisfactory? Diagn Cytopathol. 2001 Feb; 24(2): 79,81. [source] Segmental osteotomy to reposition multiple osseointegrated dental implants in the anterior maxilla in a trauma patientDENTAL TRAUMATOLOGY, Issue 1 2007Shou-Yen Kao Abstract,,, A 16-year-old young man had severe loss of alveolar bone and lost four teeth in the anterior maxilla because of traumatic injury in a traffic accident. To overcome the surgically compromised condition for implant rehabilitation, the deficient ridge was augmented by autogenous bone graft from the mandibular symphysis. The augmented ridge had much improvement in width but less in vertical height. Four implants were placed to gain initial osseointegration. Segmental osteotomy was performed to occlusally reposition the implants and bone for 5-mm in the anterior maxilla. After 2 years of clinical follow-up, the rehabilitation outcome is satisfactory and stable. [source] Cross-cultural evaluation of the Panic Disorder Severity Scale in JapanDEPRESSION AND ANXIETY, Issue 1 2004Ikuyo Yamamoto M.D. Abstract The Panic Disorder Severity Scale (PDSS) [Shear et al., 1997] is rapidly gaining world-wide acceptance as a standard global severity measure of panic disorder, however, its cross-cultural validity and reliability have not been reported yet. We developed the Japanese version of the PDSS and examined its factor structure, internal consistency and inter-rater reliability and concurrent validity among Japanese patients with panic disorder with or without agoraphobia. We also established rules of thumb for interpreting PDSS total scores, taking the Clinical Global Impression severity scale as the anchoring criterion. The identical one-factor structure of the PDSS was confirmed among the Japanese patients as among the United States patients. Both internal and inter-rater reliability was excellent (Cronbach's alpha was 0.86, and ANOVA ICCs were all above 0.90). Concurrent validity of the PDSS items with self-report questionnaires tapping similar or overlapping domains was satisfactory (Pearson correlation coefficients were mostly above 0.5). Using the anchor-based approach, the following interpretative guides are suggested: among those with established panic disorder diagnosis, PDSS total scores up to 10 correspond with "mild," those between 11 and 15 with "moderate," and those at or above 16 correspond with "severe" panic disorder. The present findings support the cross-cultural generalizability of panic disorder symptomatology and of the PDSS, in particular. Depression and Anxiety 20:17,22, 2004. © 2004 Wiley-Liss, Inc. [source] In Vivo Follicular Unit Multiplication: Is It Possible to Harvest an Unlimited Donor Supply?DERMATOLOGIC SURGERY, Issue 11 2006ERGIN ER MD BACKGROUND Follicular unit extraction is a process of removing one follicular unit at a time from the donor region. The most important limitation of this surgical procedure is a high transection rate. OBJECTIVE In this clinical study, we have transplanted different parts of transected hair follicle by harvesting with the follicular unit extraction technique (FUE) in five male patients. MATERIALS AND METHODS In each patient, three boxes of 1 cm2 are marked at both donor and recipient sites. The proximal one-third, one-half, and two-thirds of 15 hair follicles are extracted from each defined box and transplanted in recipient boxes. The density is determined at 12 months after the procedure. RESULTS A mean of 3 (range, 2,4) of the proximal one-third, 4.4 (range, 2,6) of the proximal one-half, and 6.2 (range, 5,8) of the proximal two-thirds of the transplanted follicles were observed as fully grown after 1 year. At the donor site, the regrowth rate was a mean of 12.6 (range, 10,14) of the proximal one-third, 10.2 (range, 8,13) of the proximal one-half, and 8 (range, 7,12) of the proximal two-thirds, respectively. CONCLUSION The survival rate of the transected hair follicles is directly related to the level of transection. Even the transected parts, however, can survive at the recipient site; the growth rate is not satisfactory and they are thinner than the original follicles. We therefore recommend that the surgeon not transplant the sectioned parts and be careful with the patients whose transection rate is high during FUE procedures. [source] A Percutaneous Approach to Eyebrow Lift: The Salvadorean OptionDERMATOLOGIC SURGERY, Issue 8 2003Enrique Hernandez-Perez MD Background Surgical eyebrow lift can result in a number of complications. A nonsurgical simple method of lifting the brow is presented. Objective To raise the eyebrows using a simple, quick, and noninvasive approach. Methods Twenty-nine patients, 27 women and 2 men, whose ages varied from 24 to 56 years (mean of 32 years) were included in the study. Preoperative and postoperative photographs were taken. In two patients, brow suspension was performed at the time of blepharoplasty. Informed consent was signed by all of the patients. For measuring the degree of satisfaction of the patients, we gave to them a sheet grading it from one to three (with one being the least satisfactory). Local anesthesia (1% lidocaine, 1:400,000 epinephrine), a conveniently sized Keith needle, and prolene 3/0 sutures were used. Results Satisfying results were obtained in all cases. The only problem encountered in two patients was temporary edema, and it settled in a few days. Conclusion This is a very simple, quick, and noncomplicated method of raising the eyebrows. It can be repeated, revised easily, or combined with other modalities, such as peels, topical tretinoin, oral isotretinoin, fat injection, Goretex, and Botox as part of a facial rejuvenation program. [source] Oral Isotretinoin as Part of the Treatment of Cutaneous AgingDERMATOLOGIC SURGERY, Issue 7 2000Enrique Hernandez-Perez MD Background. A number of drugs have been used to prevent aging changes. However, studies of oral isotretinoin, the commonly used acne drug, as an antiaging drug are lacking. Objective. To determine improvement in cutaneous aging utilizing oral isotretinoin combined with different procedures of facial rejuvenation. Methods. Sixty patients ranging in age from 35 to 65 years, in whom additional modalities of rejuvenation were also used, were randomly assigned to receive treatment with oral isotretinoin (10,20 mg three times a week for 2 months, group A). Their results were compared with 60 patients who had undergone the same surgical procedures but with no oral isotretinoin (group B). Results. All patients treated with oral isotretinoin noted improvement in wrinkles, thickness and color of the skin, size of pores, skin elasticity, tone, and reduction in pigmented lesions and mottled hyperpigmentation. A statistically significant difference was found in the improvement of group A (Wilcoxon test <0.01). Using minimal amounts of this drug, the side effects were practically negligible. Conclusion. Utilizing various procedures with oral isotretinoin allowed us to improve the effects of cutaneous aging. Our results using isotretinoin in these cases have been satisfactory. We believe that this is one of the first reports of the use of oral isotretinoin in intrinsic and photoaged skin. [source] Beliefs about medications: measurement and relationship to adherence in patients with severe mental disordersACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009H. Jónsdóttir Objective:, To determine if the Beliefs about Medicines Questionnaire (BMQ) has satisfactory psychometric properties in patients with severe mental disorders and if their scores differ from those of patients with severe medical disorders. To investigate if the scores are related to medication adherence. Method:, Two hundred and eighty psychiatric patients completed the BMQ and reported how much of their medication they had taken the past week. Serum concentrations of medications were analyzed. BMQ scores were compared with those of patients with chronic medical disorders. Results:, Cronbach's alpha was satisfactory for all subscales. The psychiatric group scored lower on the necessity of taking medication than the medical group. Non-adherent patients felt medication to be less necessary and were more concerned about it than adherent patients. The necessity subscale predicted adherence fairly well. Conclusion:, The BMQ has satisfactory psychometric properties for use in patients with severe mental disorders. The constructs measured by the BMQ are related to adherence in these patients. [source] Results of treatment when orthopaedic surgeons follow gait-analysis recommendations in children with CPDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2008Bjørn Lofterød MD The aim of the present study was to assess the outcome of orthopaedic surgery in ambulant children with cerebral palsy, when the orthopaedic surgeons followed the recommendations from preoperative three-dimensional gait analysis. 55 children, mean age 10y 11mo, were clinically evaluated by orthopaedic surgeons who proposed a surgical treatment plan. After gait analysis and subsequent surgery, three groups were defined. In group A, there was agreement between clinical proposals, gait-analysis recommendations, and subsequent surgery in 128 specific surgical procedures. In group B, 54 procedures were performed based on gait analysis, although these procedures had not been proposed at the clinical examination. In group C, 55 surgical procedures that had been proposed after clinical evaluation were not performed because of the gait-analysis recommendations. The children underwent follow-up gait analysis 1 to 2 years after the initial analysis. The kinematic results were satisfactory, with improvement in most of the gait parameters in children who had undergone surgery and no significant deterioration in those who were not operated. In group A, there were significant improvements in maximum hip extension in stance, minimum knee flexion in stance, timing of maximum knee flexion in swing and knee range of motion, maximum ankle dorsiflexion in stance, and mean femur rotation in stance. In group B, there were significant improvements in maximum hip extension in stance, minimum knee flexion in stance, and knee range of motion. We conclude that gait analysis was useful in confirming clinical indications for surgery, in defining indications for surgery that had not been clinically proposed, and for excluding or delaying surgery that was clinically proposed. [source] The Brøset violence checklist (BVC)ACTA PSYCHIATRICA SCANDINAVICA, Issue 2002Phil Woods Objective:, The Brøset violence checklist (BVC) is a short-term violence prediction instrument assessing confusion, irritability, boisterousness, verbal threats, physical threats and attacks on objects as either present or absent. The aim of this paper is to describe the evolution and usefulness of the BVC. Method:, This paper reviews studies on the BVC and discusses implications for further research. Results:, Empirical research has shown that it has moderate sensitivity and high specificity with an adequate inter-rater reliability. Conclusion:, The BVC is a useful instrument for predicting inpatient violence within the next 24-h period. The psychometric properties of the instrument are satisfactory. Results from ongoing studies will give important information on cultural differences, the validity of the BVC in less well staffed wards, the clinical use of the checklist and its ability to predict violence throughout all the hospital stay. [source] Preservation of sight in diabetes: developing a national risk reduction programmeDIABETIC MEDICINE, Issue 9 2000L. Garvican SUMMARY Background Early treatment for diabetic retinopathy is effective at saving sight, but dependent on pre-symptomatic detection. Although 60% of people with diabetes have their eyes examined annually, few UK health authorities have systematic programmes that meet the British Diabetic Association's standards for sensitivity (> 80%) and specificity (> 95%). Screening is generally performed by general practitioners and optometrists, with some camera-based schemes, operated by dedicated staff. The National Screening Committee commissioned a group to develop a model and cost estimates for a comprehensive national risk-reduction programme. Ophthalmoscopy Evidence indicates that direct ophthalmoscopy using a hand-held ophthalmoscope does not give adequate specificity and sensitivity, and should be abandoned as a systematic screening technique. Indirect ophthalmoscopy using a slit lamp is sensitive and specific enough to be viable, and widespread availability in high street optometrists is an advantage, but the method requires considerable skill. Photographic schemes The principal advantage of camera-based screening is the capturing of an image, for patient education, review of disease progression, and quality assurance. Digital cameras are becoming cheaper, and are now the preferred option. The image is satisfactory for screening and may be transmitted electronically. With appropriate training and equipment, different professional groups might participate in programme delivery, based on local decisions. Cost issues Considerable resources are already invested in ad hoc screening, with inevitable high referral rates incurring heavy outpatient costs. Treatment for advanced disease is expensive, but less likely to be effective. The costs of a new systematic screening and treatment programme appear similar to current expenditure, as a result of savings in treatment of late-presenting advanced retinopathy. Conclusion A systematic national programme based on digital photography is proposed. [source] Cytohistologic correlations in schwannomas (neurilemmomas), including "ancient," cellular, and epithelioid variantsDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2006Jerzy Klijanienko M.D. Abstract Schwannoma accounts for one of the most common benign mesenchymal neoplasms of soft tissues. Although it is well defined in the cytology literature, particular histologic subtypes such as "ancient," cellular and epitheliod variants could be a source of diagnostic difficulties. We have reviewed cytology aspirates and corresponding histologic sections from 34 schwannomas diagnosed at Institut Curie. Histologically, 24 cases were classic, 5 were "ancient," 4 were cellular, and 1 was epithelioid schwannomas. No example of melanotic schwannoma was recorded. Original cytologic diagnosis was schwannoma in 13 (38.2%) cases, benign soft tissue tumor in 11 (32.4%), pleomorphic adenoma in 2 (6%) cases, angioma in 1 (2.9%) case, nodular fasciitis in 1 (2.9%) case, suspicious in 3 (8.8%) cases, and not satisfactory in 3 (8.8%) cases. There were no major differences between classical, "ancient," cellular, and epithelioid variants on cytology smears. Myxoid stroma, mast cells, and intranuclear inclusions were limited to classical subtype. Similarly, cyto-nuclear atypia was more frequent in classical subtype than in other subtypes. Schwannoma should be differentiated from well-differentiated malignant peripheral nerve sheath tumor, neurofibroma, and pleomorphic adenoma, in the last instance particularly for head and neck lesions. Diagn. Cytopathol. 2006;34:517,522. © 2006 Wiley-Liss, Inc. [source] Assessment of specimen adequacy reproducibility: An Italian experienceDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2003Gioia Montanari M.D. Abstract Interobserver disagreement on smear adequacy may influence the evaluation of the performance of samplers as well as Pap test sensitivity and follow-up. In 1998, the Italian Group for Cervical Cancer Screening (GISCi) promoted a study on the reproducibility of adequacy criteria using a modified version of the Bethesda system. A set of 200 smears was circulated among six Italian laboratories situated in different parts of the country. For each smear, participants were requested to provide a summary judgment on its adequacy and on the cause(s) of inadequacy, if any. Agreement was measured using kappa-type statistics. The agreement among laboratories was generally good. In comparisons, among five laboratories, kappa values ranged from 0.47 to 0.66. At the consensus meeting on 42 slides, on which at least 2 laboratories dissented from the majority, agreement was reached unanimously for 31 reviewed slides and among 5,6 centers for 11. In this article, some guidance is given in order to attribute to one of the two categories satisfactory/unsatisfactory those smears that have been traditionally considered as candidates for the category of "satisfactory but limited by ," (SBLB). New Italian guidelines on adequacy proposed the GISCi are presented and the recommendation is made to eliminate the SBLB category. Diagn. Cytopathol. 2003;28:224,226. © 2003 Wiley-Liss, Inc. [source] Utility of fine-needle aspiration cytology in the classification of leprosyDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2001I. Satish Rao M.D. Abstract The role of fine-needle aspiration cytology (FNAC) in the diagnosis of benign skin lesions has been restricted primarily to the evaluation of bacteriologic and morphologic indices in leprosy. This study was undertaken to evaluate the efficacy of FNAC in the diagnosis and classification of lepromatous lesions. Aspirates of 94 newly diagnosed cases of leprosy were studied, and the bacterial load was determined by modified Ziehl-Neelsen (ZN) stain. A skin biopsy was taken from the same site at the same sitting. Frozen and paraffin sections stained with hematoxylin-eosin (H&E) and ZN stains were examined from the biopsy specimen. In 61 of 94 cases (64.9%), the aspirates were satisfactory. Both diagnosis and classification of leprosy were possible in 40 of these 61 cases; the rest of the aspirates showed nonspecific chronic inflammation. The 39 cases of leprosy where a biopsy was available from the same site were classified on FNAC into tuberculoid (TT and BT), lepromatous (LL and BL), and midborderline (BB) subtypes. Taking the histologic diagnosis and Ridley-Jopling classification to be the gold standard, a strong concordance in tuberculoid leprosy cases (18 of 20 cases, 90%) and in lepromatous cases (15 of 16 cases, 93.7%) was observed. Midborderline cases of leprosy posed a problem, and a correct cytohistological correlation was observed in only one of the three cases. Diagn. Cytopathol. 24:317,321, 2001. © 2001 Wiley-Liss, Inc. [source] CLINICAL USE OF THE NEWLY DEVELOPED ELECTRONIC RADIAL ULTRASOUND ENDOSCOPEDIGESTIVE ENDOSCOPY, Issue 1 2006Masami Ogawa Background:, Endoscopic ultrasonography (EUS) is widely accepted as a diagnostic tool for bilio-pancreatic and gastrointestinal tract diseases. Recently, an ultrasound endoscope with an electronic radial scan transducer has been developed. To evaluate the clinical usefulness of this system, its image quality, advantages and disadvantages were evaluated. Materials and methods:, Ultrasound endoscope with electronic radial scan transducer and its monitor unit were used. The direction of the imaging plane was similar to that of the mechanical radial models. Color Doppler function and tissue harmonic imaging were feasible by this system. To evaluate this endoscope, we investigated the image quality and distance resolution by in-vitro study using thin papers, and 50 patients were examined by this system. Results:, Comparison with the mechanical radial endoscope GF-UM2000 revealed that the image quality was almost equivalent. However, the ultrasound penetration of the electronic radial scanner was better and more satisfactory with less echoic reduction. In addition, the blood-flow signal could be obtained by using the color Doppler function. In contrast, the diameter of the new endoscope was bigger than the advanced mechanical radial models, the monitor unit was bigger than that of the mechanical radial system, and the operation of this unit was complicated. Conclusion:, A prototype of the ultrasound endoscope with electronic radial scan showed satisfactory results regarding the image quality, ultrasound penetration, and clinical diagnosis. The blood flow could be investigated by using the color Doppler function, which is useful to diagnose lesions and detect involvement of the blood vessels in cancers. [source] Thoracoscopic enucleation of esophageal leiomyoma: a retrospective study on 40 casesDISEASES OF THE ESOPHAGUS, Issue 3 2009G. Jiang SUMMARY Esophageal leiomyoma is the most common benign esophageal tumor. Thoracoscopic enucleation is currently a preferred approach to most of these lesions. We present our experiences of enucleation of these tumors using thoracoscopic approach. A retrospective review of 40 patients who underwent enucleation of esophageal leiomyoma from 1997 to 2007 in our institute was conducted. Presenting symptoms, operative approach, tumor size, tumor shape, outcomes, and indication for this approach were analyzed. Forty patients were identified. Postoperative histopathology confirmed the leiomyoma in all patients. The thoracoscopic enucleation was completed in 34 cases, and the operation was converted to open procedure in six cases. Reasons for conversion included too small tumors to be visualized in two cases, thoracic cavity adhesion in one case, and the too large tumors in three cases. The median operating time was 70 min (50 to 210 min). Mean tumor size was 3.7 cm (0.5,10 cm). There were no major postoperative complications. Symptoms especially dysphasia were relieved postoperatively. Short- and long-term follow-up was satisfactory with none of the patients having tumor recurrences or other problems. Thoracoscopic enucleation of esophageal leiomyoma is technically safe and effective. It is currently the best choice for management of esophageal leiomyoma 1 to 5 cm in diameter. It can also be tried on a tumor larger than 5 cm, although the possibility of conversion to thoracotomy increases along with tumor growing and surrounding the esophagus. [source] Sustained ophthalmic in situ gel of ketorolac tromethamine: rheology and in vivo studiesDRUG DEVELOPMENT RESEARCH, Issue 6 2009A.S. Manjappa Abstract Most ocular diseases are treated with topical eye drops. The poor bioavailability and therapeutic response exhibited by these conventional eye drops due to rapid precorneal elimination of the drug may be overcome by the use of in situ gelling systems that are instilled as drops into the eye and undergo a sol-to-gel transition in the cul-de-sac. The present work describes the formulation and evaluation of an ophthalmic delivery system of the nonsteroidal anti-inflammatory drug (NSAID), ketorolac tromethamine, based on the concept of pH-triggered in situ gelation. Polyacrylic acid (Carbopol® 934) was used as the gelling agent in combination with hydroxypropylmethylcellulose (Methocel E15LV), which acted as a viscosity enhancer. The prepared formulations were characterized for clarity, pH, drug content, rheology, and in vivo drug release. Clarity, pH, and drug content of the developed formulations were found to be satisfactory. The developed formulation showed pseudo-plastic rheology. The formulation with benzalkonium chloride and edetate disodium improved the rate of corneal absorption but not the extent. The developed formulation is a viable alternative to conventional eye drops by virtue of its ability to enhance bioavailability through its longer precorneal residence time and ability to sustain drug release. Also importantly is the ease of instillation afforded and decreased frequency of instillation resulting in better patient acceptance. Drug Dev Res, 2009. © 2009 Wiley-Liss, Inc. [source] DWEPP: a dynamic soil erosion model based on WEPP source termsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 7 2007N. S. Bulygina Abstract A new rangeland overland-flow erosion model was developed based on Water Erosion Prediction Project (WEPP) sediment source and sink terms. Total sediment yield was estimated for rainfall simulation plots from the WEPP field experiments as well as for a small watershed without a well developed channel network. Both WEPP and DWEPP gave a similar level of prediction accuracy for total event soil losses measured from both rainfall simulation and small watershed experiments. Predictions for plot and hillslope scale erosion simulations were in the range of expected natural variability. Sediment yield dynamics were plotted and compared with experimental results for plots and hillslope, and the results were satisfactory. Effects of cover and canopy on the predicted sediment yields were well represented by the model. DWEPP provides a new tool for assessing erosion rates and dynamics, has physically based erosion mechanics descriptions, is sensitive to treatment differences on the experimental plots and has a well developed parameter database inherited from WEPP. Copyright © 2006 John Wiley & Sons, Ltd. [source] Restoring landscapes: the authenticity problemEARTH SURFACE PROCESSES AND LANDFORMS, Issue 13 2006Isis Brook Abstract Philosophical concerns about restoring landscapes often revolve around two, connected, issues. First is the idea that a restored landscape, even if it is a perfect replica, has lost some of its value. The claim might appeal to a break in the continuity of the landscape and that continuity is part of what is valuable. Alternatively, often in the case of natural landscapes, the appeal is that any human manipulation is inauthentic; here the analogy is sometimes made with the art world and the restoration is deemed a fake. The second problem highlighted in philosophical debates is that the greater the success of restoration projects, the more threatened natural landscapes become: any claim that something must be preserved in its pristine or historically layered state is undermined by the claim that it could be put back again. Initially I discuss two opposing potential responses to these claims: (1) that humans are part of nature and thus cannot be an alien dominating force outside of nature; and (2) that nature is itself a social construct. Neither of these positions is entirely satisfactory, but what they jointly reveal is the reality of our fluid and multifaceted relationship with the world. I then show that Elliot's claim of the additional value of pristine nature is actually not based on an inherent value, but is dependent on the human valuation of it. I propose an alternative that places the source of value in the thing itself and thus arrive at a positive role for restoration as the setting in train and guiding of positive relationships above and beyond their social or public amenity value to us. Copyright © 2006 John Wiley & Sons, Ltd. [source] Testing bedload transport formulae using morphologic transport estimates and field data: lower Fraser River, British ColumbiaEARTH SURFACE PROCESSES AND LANDFORMS, Issue 10 2005Yvonne Martin Abstract Morphologic transport estimates available for a 65-km stretch of Fraser River over the period 1952,1999 provide a unique opportunity to evaluate the performance of bedload transport formulae for a large river over decadal time scales. Formulae tested in this paper include the original and rational versions of the Bagnold formula, the Meyer-Peter and Muller formula and a stream power correlation. The generalized approach adopted herein does not account for spatial variability in flow, bed structure and channel morphology. However, river managers and engineers, as well as those studying rivers within the context of long-term landscape change, may find this approach satisfactory as it has minimal data requirements and provides a level of process specification that may be commensurable with longer time scales. Hydraulic geometry equations for width and depth are defined using morphologic maps based on aerial photography and bathymetric survey data. Comparison of transport predictions with bedload transport measurements completed at Mission indicates that the original Bagnold formula most closely approximates the main trends in the field data. Sensitivity analyses are conducted to evaluate the impact of inaccuracies in input variables width, depth, slope and grain size on transport predictions. The formulae differ in their sensitivity to input variables and between reaches. Average annual bedload transport predictions for the four formulae show that they vary between each other as well as from the morphologic transport estimates. The original Bagnold and Meyer-Peter and Muller formulae provide the best transport predictions, although the former underestimates while the latter overestimates transport rates. Based on our findings, an error margin of up to an order of magnitude can be expected when adopting generalized approaches for the prediction of bedload transport. Copyright © 2005 John Wiley & Sons, Ltd. [source] A model of equilibrium bed topography for meander bends with erodible banksEARTH SURFACE PROCESSES AND LANDFORMS, Issue 10 2002Stephen E. Darby Abstract Channel curvature produces secondary currents and a transverse sloping channel bed, along which the depth increases towards the outer bank. As a result deep pools tend to form adjacent to the outer bank, promoting bank collapse. The interaction of sediment grains with the primary and secondary flow and the transverse sloping bed also causes meanders to move different grain sizes in different proportions and directions, resulting in a consistent sorting pattern. Several models have been developed to describe this process, but they all have the potential to over-predict pool depth because they cannot account for the influence of erodible banks. In reality, bank collapse might lead to the development of a wider, shallower cross-section and any resulting flow depth discrepancy can bias associated predictions of flow, sediment transport, and grain-size sorting. While bed topography, sediment transport and grain sorting in bends will partly be controlled by the sedimentary characteristics of the bank materials, the magnitude of this effect has not previously been explored. This paper reports the development of a model of flow, sediment transport, grain-size sorting, and bed topography for river bends with erodible banks. The model is tested via intercomparison of predicted and observed bed topography in one low-energy (5·3 W m,2 specific stream power) and one high-energy (43·4 W m,2) study reach, namely the River South Esk in Scotland and Goodwin Creek in Mississippi, respectively. Model predictions of bed topography are found to be satisfactory, at least close to the apices of bends. Finally, the model is used in sensitivity analyses that provide insight into the influence of bank erodibility on equilibrium meander morphology and associated patterns of grain-size sorting. The sensitivity of meander response to bank cohesion is found to increase as a function of the available stream power within the two study bends. Copyright © 2002 John Wiley & Sons, Ltd. [source] Evaluation of site-dependent constant-damage design spectra for reinforced concrete structuresEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 12 2004Phaiboon Panyakapo Abstract An investigation on the validity of the conventional design approach known as constant displacement ductility is carried out. The hysteretic behaviour described by the Modified Takeda model is taken to represent the characteristics of reinforced concrete structural systems. The results presented in the form of seismic damage spectra indicate that the conventional design approach may not be valid because cumulative damage is excessively high. The inelastic design spectra based on the constant-damage concept are proposed in terms of simplified expressions. The expressions are derived from constant-damage design spectra computed by non-linear response analysis for SDOF systems subjected to ground motions recorded on rock sites, alluvium deposits, and soft-soil sites. The proposed expressions, which are dependent on the local soil conditions, are functions of target seismic damage, displacement ductility ratio and period of vibration. The seismic damage of structures that have been designed based on this new design approach is also checked by a design-and-evaluation approach. The results are found to be satisfactory. Copyright © 2004 John Wiley & Sons, Ltd. [source] Approximate modal decomposition of inelastic dynamic responses of wall buildingsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 9 2004C. Sangarayakul Abstract Two approximate methods for decomposing complicated inelastic dynamic responses of wall buildings into simple modal responses are presented. Both methods are based on the equivalent linear concept, where a non-linear structure is represented by a set of equivalent linear models. One linear model is used for representing only one vibration mode of the non-linear structure, and its equivalent linear parameters are identified from the inelastic response time histories by using a numerical optimizer. Several theoretical relations essential for the modal decomposition are derived under the framework of complex modal analysis. Various numerical examinations have been carried out to check the validity of the proposed modal decomposition methods, and the results are quite satisfactory in all cases. Fluctuating bending moment and shear at any location along the wall height contributed by each individual vibration mode can be obtained. Modal contributions to shear and flexural strength demands, as well as the corresponding modal properties, under various seismic loading conditions can also be identified and examined in detail. Furthermore, the effects of higher vibration modes on seismic demands of wall buildings are investigated by using the modal decomposition methods. Several new insights into the complicated inelastic dynamics of multi-story wall buildings are presented. Copyright © 2004 John Wiley & Sons, Ltd. [source] Hybrid platform for vibration control of high-tech equipment in buildings subject to ground motion.EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 8 2003Part 2: analysis Abstract The experimental results of using a hybrid platform to mitigate vibration of a batch of high-tech equipment installed in a building subject to nearby traffic-induced ground motion have been presented and discussed in the companion paper. Based on the identified dynamic properties of both the building and the platform, this paper first establishes an analytical model for hybrid control of the building-platform system subject to ground motion in terms of the absolute co-ordinate to facilitate the absolute velocity feedback control strategy used in the experiment. The traffic-induced ground motion used in the experiment is then employed as input to the analytical model to compute the dynamic response of the building-platform system. The computed results are compared with the measured results, and the comparison is found to be satisfactory. Based on the verified analytical model, coupling effects between the building and platform are then investigated. A parametric study is finally conducted to further assess the performance of both passive and hybrid platforms at microvibration level. The analytical study shows that the dynamic interaction between the building and platform should be taken into consideration. The hybrid control is effective in reducing both velocity response and drift of the platform/high-tech equipment at microvibration level with reasonable control force. Copyright © 2003 John Wiley & Sons, Ltd. [source] Dynamic analysis method of a combined energy dissipation system and its experimental verificationEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 6 2002Xilin Lu Abstract A combined energy dissipation system is developed in this paper. In this system lead rubber dampers and their parallel connection with oil dampers are used in the braces of a structural frame. A dynamic analysis method of the system, including the modelling of the lead rubber damper and the oil damper, is proposed. In the analysis method, the restoring force characterestics of the lead rubber damper is simulated by the Bouc,Wen hysteretic model, and the behaviour of the oil damper is simulated by a velocity and displacement-related model in which the contributions of the oil damper to the damping force and stiffness of the system are considered. A series of shaking table tests of a three-storey steel frame with the combined energy dissipation system are carried out to evaluate the performance of the system and to verify the analysis method. The test and analysis show that the performance of the combined energy dissipation system is quite satisfactory and there is a good agreement between the analysis and test results, which indicates that the analysis method proposed in this paper is valid and suitable for the dynamic analysis of the combined energy dissipation system. Copyright © 2002 John Wiley & Sons, Ltd. [source] Noninvasive Estimation of Pulmonary Vascular Resistance in Pulmonary HypertensionECHOCARDIOGRAPHY, Issue 5 2009Navin Rajagopalan M.D. Background: Determination of pulmonary vascular resistance (PVR) in patients with suspected or known pulmonary hypertension (PH) requires right heart catheterization. Our purpose was to use Doppler echocardiography to estimate PVR in patients with PH. Methods: Patient population consisted of 52 patients (53 ± 12 years; 35 females) who underwent Doppler echocardiography and right heart catheterization within 24 hours of each other. The ratio of peak tricuspid regurgitation velocity (TRV) and right ventricular outflow time-velocity integral (VTIRVOT) was measured via transthoracic echocardiography and correlated to invasively determined PVR. A linear regression equation was generated to determine PVR by echocardiography based upon the TRV/VTIRVOT ratio. PVR by echocardiography was compared to invasive PVR using Bland-Altman analysis. Results: Significant correlation was demonstrated between TRV/VTIRVOT and PVR by catheterization (r = 0.73; P < 0.001). However, Bland-Altman analysis showed that agreement between PVR determined by echocardiography and invasive PVR was poor (bias = 0; standard deviation = 4.3 Wood units). In a subset of patients with invasive PVR < 8 Wood units (26 patients), correlation between TRV/VTIRVOT and invasive PVR was strong (r = 0.94; P < 0.001). In these patients, agreement between PVR by echocardiography and invasive PVR was satisfactory (bias = 0; standard deviation = 0.5 Wood units). There was no correlation between TRV/VTIRVOT and invasive PVR in patients with PVR > 8 Wood units (n = 26; r = 0.17). Conclusion: While TRV/VTIRVOT correlates significantly with PVR, using it to estimate PVR in a PH patient population cannot be recommended. [source] Measurements in the Addictions for Triage and Evaluation (MATE): an instrument based on the World Health Organization family of international classificationsADDICTION, Issue 5 2010Gerard M. Schippers ABSTRACT Aims To present and evaluate a measurement tool for assessing characteristics of people with drug and/or alcohol problems for triage and evaluation in treatment. Measurements in the Addictions for Triage and Evaluation (MATE) is composed of 10 modules, selected on the basis of a detailed set of specifications. Conceptually, the MATE was constructed according to the ICD and International Classification of Functioning (ICF) in the World Health Organization (WHO) classification system. Two of the ICF-related modules were newly designed. Design Monitoring feasibility and field-testing in a treatment-seeking population with researcher and clinician-administered test,retest interviews, construct validation with related instruments and evaluation of the dimensional structure of the ICF-related modules. Setting The research was conducted in a large, regional substance abuse treatment centre in the Netherlands and at the Municipal Health Service of Amsterdam. Participants A total of 945 treatment-seeking patients were recruited during routine intakes, 159 of whom were interviewed twice; 32 problem drug users were also recruited from the Amsterdam cohort studies among problem drug users. Findings Completion time was reasonably short, and there were relatively few missing data. The factor structure of the ICF-related modules revealed a three-factor model with an acceptable fit. Inter-rater reliability ranged between 0.75 and 0.92 and was satisfactory, but interviewer reliability ranged between 0.34 and 0.73, indicating that some of subscales need to be improved. Concurrent validity was indicated by significant correlations (>0.50) between the ICF-related modules and the WHO Disability Assessment Schedule II (WHODAS II) and WHO Quality of Life brief version (WHOQOL-BREF). Conclusions The MATE can be used to allocate patients to substance abuse treatment. Because it is a comprehensive but flexible measurement tool that is also practical to use, the MATE is well suited for use in a heterogeneous population. [source] A Biomimetic Potentiometric Sensor Using Molecularly Imprinted Polymer for the Cetirizine Assay in Tablets and Biological FluidsELECTROANALYSIS, Issue 18 2008Mehran Javanbakht Abstract Despite the increasing number of applications of molecularly imprinted polymers (MIPs) in analytical chemistry, the construction of a biomimetic potentiometric sensor remains still challenging. In this work, a biomimetic potentiometric sensor, based on a non-covalent imprinted polymer was fabricated for the recognition and determination of cetirizine. The MIP was synthesized by precipitation polymerization, using cetirizine dihydrochloride as a template molecule, methacrylic acid (MAA) as a functional monomer and ethylene glycol dimethacrylate (EGDMA) as a cross linking agent. The sensor showed high selectivity and a sensitive response to the template in aqueous system. The MIP-modified electrode exhibited Nernstian response (28.0±0.9 mV/decade) in a wide concentration range of 1.0×10,6 to 1.0×10,2 M with a lower detection limit of 7.0×10,7 M. The electrode has response time of ca. 20,s, high performance, high sensitivity, and good long term stability (more than 5,months). The method was satisfactory and used to the cetirizine assay in tablets and biological fluids. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||