Retained Intraabdominal Gossypiboma, Five Years after Bilateral Orchiopexy

Introduction. Gossypiboma or textiloma is used to describe a retained surgical swab in the body after an operation. Intraabdominal surgical sponge is an uncommon surgical error. The incidence of gossypiboma has been reported as high as 1 in 1000 to 15,000 intraabdominal operations. Gossypiboma may cause serious morbidity and may lead to mortality. Case presentation. Herein, we report a 24 years-old man who was admitted due to the intraabdominal mass after evaluation of primary infertility. He had a surgical history of bilateral abdominal orchiopexy 5 years previously, performed at another hospital. Hydatid cyst was suspected by abdominal computed tomography. After laparotomy excision, the cyst wall opened incidentally, and draining of a large amount of thick pus with retained surgical gauze within the cyst was found, with final diagnosis of gossypiboma. Conclusion. The policy that prevention is far more important than cure is highly appreciated. Accurate sponge and instrument counts, along with radiologic evaluation when a discrepancy is found, can be helpful. Although human errors cannot be completely avoided, continuous medical training and strict adherence to rules of the operation room should reduce the incidence of gossypiboma to a minimum. Surgical sponges should be counted once at the start and twice at the end of all surgical operations

A Clinical Decision Tree for Preserving versus Extracting a Compromised Tooth with Extensive Subgingival Caries or Crown Fractures

One of the most challenging issues in the field of dentistry is to decide whether to preserve or extract a compromised tooth with subgingival caries/crown fractures. Several patient-related factors (i.e. biological, behavioral, or financial factors), tooth-related factors (i.e. periodontal, endodontic, or restorative factors), and the role of the tooth in the overall treatment plan should be considered to make the most accurate decision. This article has focused on the decision-making process related to the management of compromised teeth with subgingival caries/crown fractures. Based on the current scientific evidence and clinical experience of the authors, an algorithm has been suggested to simplify this process of decision. In the first step, compromised teeth were classified as single-root or multi-root groups. “Crown-to-root ratio” (C/R ratio), and “apical extension of caries to the crestal bone” were considered the main clinical parameters in the decision-making process for single-root and multi-root teeth, respectively. We do not recommend restoring the compromised teeth if the C/R ratio is more than 1 (for single-root teeth) or if the extension of caries has reached the alveolar bone crest (for multi-root teeth). For maintainable single-root teeth, there are three treatment options to provide space for the re-establishment of supracrestal soft tissue attachment (previously named as biologic width) between the future restorative margin and underlying crestal bone. These approaches include: surgical crown lengthening (SCL), orthodontic forced eruption (OFE), and deep marginal elevation (DME). For multi-root teeth, SCL and DME are usually the procedures of choice. Multi-root teeth are not amenable to OFE due to the heavy orthodontic forces needed for extrusion. We also discussed the indications and limitations related to each treatment option. Further studies should be conducted to evaluate the external validity of this decision tree. Keywords: Decision trees; Decision making; Tooth fractures; Dental caries; Tooth extraction

Experimental Study of Fatigue Durability in Bending Effect on Welded Joints in Steel Profiles

Ships are always prone to fatigue through high periodic loads, usually caused by waves and changing load conditions. So, fatigue is an important factor in design. One of the reasons for fatigue in welding parts is variable bending loads. In this paper, a specimen of low-carbon steel T-Bar profiles is used, along with plates of the same type of steel that have been welded by the manual electrode welding process. To determine the distribution of static and dynamic forces created by welding, the specimens were subjected to bending (three-point loading) and tensile tests, and finally fatigue tests. The T-Bar Steel profile has more tolerance for fatigue loads than welded. The load T-Bar profile has not failed until the two million cycles, while the welding specimen has failed in about 3×105 cycles. Finally, strong penetrating welds should be used if a stronger welding joint is required

Controls of Fish Mercury Concentrations in Subarctic Lakes of Canada

Mercury (Hg) is a global pollutant that in its organic and more toxic form, methyl Hg (MeHg), can cause detrimental health effects on fish, wildlife, and humans. In lake ecosystems, concentrations of Hg ([Hg]) in fish reflect a complex outcome of interactions among variables that act at different ecological and spatial scales. From catchment and lake characteristics to fish and food web ecology, numerous processes interact to influence Hg uptake, methylation, bioaccumulation, and biomagnification, and ultimately, [Hg] in fish. As a result, fish [Hg] often vary among lakes and species, and among individuals of the same population. While factors that affect fish [Hg] in lakes are well studied and generally well understood, the relative importance and influence of these factors can vary among populations, species, ecosystems, and geographical regions, making it difficult to generalize and predict variability in fish [Hg]. Generally, little is known about controls of fish [Hg] in northern regions, where ecosystems and biota can be profoundly influenced by environmental perturbations, and where fish provide a critically important subsistence food source. In the subarctic Dehcho Region, Northwest Territories, Canada, fish [Hg] vary widely among lakes due to largely unknown mechanisms, and have, on occasion, triggered both general and site-specific consumption notices (sometimes referred to as consumption advisories or contaminant advisories). These advisories, and the lack of understanding about sources of among-lake variation in fish [Hg], are of concern for First Nation communities that rely on wild-caught fish as a subsistence food source. This thesis is aimed to address knowledge gaps regarding causes of among-lake variation in fish [Hg] in the Dehcho Region, and to improve the current understanding of what variables and processes control fish [Hg] in remote and understudied subarctic lakes. In Chapter 1, I provide a detailed overview of freshwater fish and fisheries, Hg cycling in the environment, and controls of [Hg] in fish, with a focus on lakes, especially in the Canadian subarctic. I then describe my study area, the Dehcho Region, and elaborate on the importance of wild-caught freshwater fish for local communities and Hg-related fish safety concerns, which frames my specific objectives for each data chapter (i.e., Chapters 2, 3, and 4). My data chapters, and associated analyses and findings, use comprehensive geospatial, environmental, and biological data that were collected from eleven lakes in the Dehcho Region over the period of seven years, from 2013 to 2019. In Chapter 2, I conducted an ecosystem-scale study to investigate causes of among-lake variability in fish [Hg] in the study area. I investigated how interacting processes at scales ranging from whole catchments to individual organisms influence [Hg] in Northern Pike (Esox lucius), a predatory fish of widespread subsistence and commercial importance. Findings indicated that more than four-fifths of the among-lake variability in [Hg] in Northern Pike was explained by fish growth rates (negative) and concentrations of methyl Hg ([MeHg]) in benthic invertebrates (positive). Fish growth rates and [MeHg] in benthic invertebrates were, in turn, influenced by concentrations of dissolved organic carbon and MeHg in water, and total Hg in sediment. These in lake variables were ultimately driven by catchment characteristics. Lower-elevation lakes in relatively larger catchments with proportionally more temperate/subpolar needleleaf and mixed forests had Northern Pike with higher [Hg]. In Chapter 3, my goal was to understand causes of among-lake variability in fish growth rates in the study area. I investigated how fish trophic ecology (i.e., trophic level and foraging area) and lake-catchment interactions influence growth rates in Northern Pike. Growth was slower in lakes that were subject to greater inferred catchment influence, which were lakes located at lower elevation and in relatively larger catchments with proportionally greater forest cover. Northern Pike in lakes subject to greater inferred catchment influence also had more depleted carbon stable isotope ratios. As carbon stable isotope ratios in benthic invertebrates were also more depleted in lakes that were subject to greater inferred catchment influence, slower Northern Pike growth in lakes with greater catchment influence may reflect the fact that terrestrially derived organic matter has lower nutritional value and less bioaccessibility relative to internally derived organic matter. In Chapter 4, I investigated biomagnification of Hg through lake food webs in the study area. I examined how estimates of Hg biomagnification rates can be affected by the species of mercury (total Hg vs methyl Hg) that is measured in fish and used in biomagnification models. I also investigated relationships between rates of Hg biomagnification and [Hg] in resident fish, and how rates of Hg biomagnification are related to ecosystem characteristics, including in-lake and in-catchment variables. Results showed that uncertainty around estimates of Hg biomagnification rate was lower when estimated using measured concentrations of MeHg, the biomagnifying form of Hg. Rates of Hg biomagnification were positively but not significantly related to [Hg] in resident fish used for subsistence. Rates of Hg biomagnification were on average higher than previously reported for lakes at lower latitudes, and were higher in lakes surrounded by catchments with proportionally greater forest cover. In Chapter 5, I synthesized findings that were discussed in Chapters 2 through 4. Together, results from this thesis show that mercury levels in resident fish are influenced by biological processes (growth rates in fish, Hg concentrations in primary consumers, and biomagnification of Hg through food webs), that are, in turn, influenced by lake-catchment interactions (higher concentrations of DOC and both total and methyl Hg in lakes located in lower-elevation catchments with relatively larger size and proportionally more forest cover). Given that catchment physical attributes (elevation, relative size, and proportional forest cover) appeared to result in changes in abiotic and biotic ecosystem compartments in downstream lakes and ultimately influenced fish [Hg], findings provide invaluable direction for prioritizing lakes for monitoring and management, especially because physical characteristics of lakes and catchments can be sensed remotely. Ongoing monitoring and assessment of fish [Hg] are necessary in northern lakes due to profound effects of climate warming on northern latitudes and the heavy reliance of northern communities on wild-caught freshwater fish. This thesis reveals insights that address knowledge gaps regarding causes of among-lake variability in fish [Hg] in the Dehcho Region and improve the current and general understanding of fish [Hg] controls in subarctic lakes

Torsion of Testis in an Infant with Unilateral UDT

Torsion of an undescended testis is uncommon. Torsion of a cryptorchid testicle presents a nonspecific symptomatology. Clinical suspicion indicates emergent surgical exploration, irrespective of Doppler ultrasound with its inherent false negative results. Management of the contralateral testis is controversial. We emphasize the need of a complete physical examination of the child who goes to the emergency room with nonspecific symptoms of abdominal pain and ipsilateral empty hemiscrotum to rule out torsion of a cryptorchid testicle. Herein, we report a one-year-old infant with missed torsion of undescended left testis

Genitourinary system trauma after 2003 Bam earthquake in Kerman, Iran

Mohammad Hasan Dehghani Firoozabadi1, Mehdi Abedinzadeh2, Mohammad Kazem Moslemi31Department of Urology, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran; 2Department of Urology, Moradi Hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 3Department of Urology, Kamkar Hospital, School of Medicine, Qom University of Medical Sciences, Qom, IranBackground: Natural disasters, especially earthquakes, result in many health problems all over the world, of which urological injuries should not be underestimated. Car accidents and falling from a height are the most common causes of genitourinary system injury. The lack of specific data in the literature regarding the outcome of earthquake-related genitourinary system trauma prompted us to undertake this study.Methods: We retrospectively evaluated the genitourinary system injury in patients who had survived the Bam earthquake. In this study, all patients admitted to two main back-up hospitals of Kerman were included. Of 256 patients who had been referred to Kerman hospitals, 28 cases were found to have urologic damage on physical examination, intravenous pyelography, abdominopelvic X-ray, and ultrasonography.Results: Of 28 patients with urologic damage, 22 (78.5%) were male and six (21.5%) were female. Their age ranged from 18 to 65 years. The injures included urethral disruption in 21 cases (75.5%), vesicovaginal fistula in four cases (14%), kidney rupture in two cases (7%) and bladder neck disruption accompanied with total right ureteral disruption and vesicovaginal fistula in a female patient (3.5%).Conclusion: We have evaluated the incidence of genitourinary injuries after an earthquake disaster for the first time. The most and least common urologic injury in our patients was urethral disruption and ureteral injury, respectively.Keywords: earthquake, urethral injury, trauma, genitourinary system, renal injury, emergency department&nbsp

Optimization of DNA extraction and amplified fragment length polymorphism (AFLP) analysis of pomegranate (Punica granatum L.)

Pomegranate (Punica granatum L.) is a plant rich in polysaccharides, polyphenols and secondary metabolites, which makes it difficult to obtain high quality DNA. The present study reports a quick, simple and inexpensive method to isolate genomic DNA suitable for amplified fragment length polymorphism (AFLP) analysis and other PCR-based applications. This method is a modification of a protocol described by Doyle and Doyle (1990). It is a cetyl trimethyl ammonium bromide (CTAB)-based protocol modified by the use of potassium acetate (KoAc) and  polyvinylpyrrolidone (PVP) to remove polyphenols and polysaccharides and a high concentration of β-mercaptoethanol to reduce oxidation. Moreover, the final optimized protocol was then compared with three different methods, which are routinely used for many plant species. The results show that our modified CTAB protocol produced a high yield (>500 ng/μl) of good-quality DNA (A<sub>260</sub>/A<sub>280</sub> >1.8) compared to the other three methods. The DNA purity was further confirmed by complete digestion with EcoRI and MseI enzymes. The modified CTAB protocol used in this study could be a useful protocol for extraction of high quality DNA not only for pomegranate but also for other plants rich in polysaccharides, polyphenolices and secondary metabolites. Using this method, DNA was extracted from 67 accessions of pomegranate. The DNA was then used for AFLP analysis. To optimize the AFLP protocol, the effects of MgCl2 concentration during selective amplification, the dilution level of pre-amplified DNA and the cycle number used in the preamplification were studied. After optimization of the reaction conditions, AFLP was used to study genetic diversity among Iranian pomegranate accessions.Keywords: Pomegranate, DNA extraction, amplified fragment length polymorphism (AFLP), secondary metabolites.African Journal of Biotechnology Vol. 12(34), pp. 5252-525

Temperature Effect on Moving Water Droplets at the Channel of ‎PEMFC by Multi-component Multiphase Lattice Boltzmann Method

In this paper, a multi-component multiphase pseudopotential Lattice Boltzmann method with multi relaxation time (MRT) collision operator is presented to examine the dynamic behavior of liquid droplets movement and coalescence process in the gas channel of PEMFC. In the numerical method, the forcing term is improved to achieve a high-density ratio and thermodynamic consistency. First, the density ratio, Laplace law, and contact angle are validated with previous studies. Then, different parameters, such as operating temperature, pressure difference, surface contact angle, the radius of droplets, and distance between two droplets on the droplet movement and coalescence process are studied. The results revealed by rising temperature from 30 to 80 degrees, the speed of drop increases around 6 percent. The simulation results indicated that the rising of pressure gradient increases the gas flow velocity on the channel and leads to increasing the shear force and eventually faster movement of the droplet on the gas channel. Also, investigation of various contact angles shows that a hydrophilic surface causes a resistance force between the droplet and the wall and delays the removal of droplets. Moreover, droplet coalescence is useful for droplet movement because of increasing the velocity gradient on top of the droplet; consequently, the shear force on the droplet is raised during coalescence

Theoretical extension of elastic-perfectly plastic deformation length in roll forming of a channel section

In this paper, the Young’s modulus and the yield strength of the strip are considered in order to modify the deformation length analysis proposed by Bhattacharyya et al. New analytical equations are developed assuming an elastic-perfectly plastic material behaviour and the deformation length analysed for the simple case of roll forming a U-channel; the analytical results are verified by comparison with experimental data found in the literature. The proposed elastic-plastic deformation length is shorter than Bhattacharyya’s which is rigid-perfectly plastic. It is observed that the influence of elastic properties on the deformation length is not as significant as the plastic properties; however, the authors believe that the elastic effects become more important under conditions where a major area of the strip is under elastic deformation such as when the flange length is long

Flange Wrinkling in Flexible Roll Forming Process

AbstractFlexible roll forming is an advanced sheet metal forming process for producing variable cross section profiles. Flange wrinkling at the transition zone where the cross section changes is a major defect in the flexible roll forming process. In this paper, the flange wrinkling at the transition zone is studied using finite element analysis. The results showed that the strip deformation at the transition zone can be considered as a combination of two strip deformations observed in the conventional roll forming process and the flanging process. According to finite element analysis results, when the flange wrinkling occurs, compressive longitudinal strain is smaller than the necessary compressive longitudinal strain calculated by mathematical modeling to obtain the intended profile geometry in the compression zone. Therefore, comparison of compressive longitudinal strain obtained from the finite element analysis and the necessary compressive longitudinal strain is a good criterion to predict the flange wrinkling occurrence. A flexible roll forming setup was developed. Longitudinal strain history is obtained from the finite element simulation and is compared with the experimental data from the flexible roll forming setup. Results show a good agreement and confirm the finite element analysis