Laparoscopic Closure of Acutely Perforated Duodenal-Ulcer - An Early Experience

Laparoscopic closure of an acutely perforated duodenal ulcer is an alternative procedure to open surgery. With proper training and experience this procedure might overtake laparotomy and simple closure thereby reducing the post operative morbidity in terms of reduced wound pain, short hospital stay, likely reduced wound sepsis and hernia occurrence and post operative chest complications. This article describes four patients with acute perforation of duodenal ulcer who were submitted to an emergency laparoscopic repair

Normalized Affymetrix expression data are biased by G-quadruplex formation

Probes with runs of four or more guanines (G-stacks) in their sequences can exhibit a level of hybridization that is unrelated to the expression levels of the mRNA that they are intended to measure. This is most likely caused by the formation of G-quadruplexes, where inter-probe guanines form Hoogsteen hydrogen bonds, which probes with G-stacks are capable of forming. We demonstrate that for a specific microarray data set using the Human HG-U133A Affymetrix GeneChip and RMA normalization there is significant bias in the expression levels, the fold change and the correlations between expression levels. These effects grow more pronounced as the number of G-stack probes in a probe set increases. Approximately 14 of the probe sets are directly affected. The analysis was repeated for a number of other normalization pipelines and two, FARMS and PLIER, minimized the bias to some extent. We estimate that ∼15 of the data sets deposited in the GEO database are susceptible to the effect. The inclusion of G-stack probes in the affected data sets can bias key parameters used in the selection and clustering of genes. The elimination of these probes from any analysis in such affected data sets outweighs the increase of noise in the signal. © 2011 The Author(s)

Taking Synchrony Seriously: A Perceptual-Level Model of Infant Synchrony Detection

Synchrony detection between different sensory and/or motor channels appears critically important for young infant learning and cognitive development. For example, empirical studies demonstrate that audio-visual synchrony aids in language acquisition. In this paper we compare these infant studies with a model of synchrony detection based on the Hershey and Movellan (2000) algorithm augmented with methods for quantitative synchrony estimation. Four infant-model comparisons are presented, using audio-visual stimuli of increasing complexity. While infants and the model showed learning or discrimination with each type of stimuli used, the model was most successful with stimuli comprised of one audio and one visual source, and also with two audio sources and a dynamic-face visual motion source. More difficult for the model were stimuli conditions with two motion sources, and more abstract visual dynamics—an oscilloscope instead of a face. Future research should model the developmental pathway of synchrony detection. Normal audio-visual synchrony detection in infants may be experience-dependent (e.g., Bergeson, et al., 2004)

Motif effects in Affymetrix GeneChips seriously affect probe intensities

An Affymetrix GeneChip consists of an array of hundreds of thousands of probes (each a sequence of 25 bases) with the probe values being used to infer the extent to which genes are expressed in the biological material under investigation. In this article, we demonstrate that these probe values are also strongly influenced by their precise base sequence. We use data from >28 000 CEL files relating to 10 different Affymetrix GeneChip platforms and involving nearly 1000 experiments. Our results confirm known effects (those due to the T7-primer and the formation of G-quadruplexes) but reveal other effects. We show that there can be huge variations from one experiment to another, and that there may also be sizeable disparities between batches within an experiment and between CEL files within a batch. © 2012 The Author(s)

RELAPSE OF GUILLAIN-BARRE SYNDROME AFTER SPINAL ANESTHESIA: A CASE REPORT

Guillain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with or without sensory or autonomic symptoms. It is most commonly caused by an autoimmune response of the body to an infectious agent like Campylobacter jejuni. It is less common during pregnancy but it may relapse during postpartum period. Cases of GBS have been reported after Spinal, epidural and general anesthesia. Here we report a case of 28year old female patient who had relapse of GBS after undergoing emergency laparotomy for ruptured ectopic pregnancy. In this case report, we are presenting an unusual case of GBS relapsing 4 years after initial episode following spinal anesthesia.KEYWORDS: Guillain-Barre Syndrome; Campylobacter jejuni; Postpartum period

RELAPSE OF GUILLAIN-BARRE SYNDROME AFTER SPINAL ANESTHESIA: A CASE REPORT

Guillain-Barre Syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis and hyporeflexia with or without sensory or autonomic symptoms. It is most commonly caused by an autoimmune response of the body to an infectious agent like Campylobacter jejuni. It is less common during pregnancy but it may relapse during postpartum period. Cases of GBS have been reported after Spinal, epidural and general anesthesia. Here we report a case of 28year old female patient who had relapse of GBS after undergoing emergency laparotomy for ruptured ectopic pregnancy. In this case report, we are presenting an unusual case of GBS relapsing 4 years after initial episode following spinal anesthesia.KEYWORDS: Guillain-Barre Syndrome; Campylobacter jejuni; Postpartum period

Improving Detection of Events at Water Treatment Works: A UK Case Study

This is the author accepted manuscriptThis study presents improvements to the event detection capabilities of the existing, thresholdbased detection system used by United Utilities in one of their Water Treatment Works. These improvements were achieved by using new threshold and persistence values identified by performing a sensitivity type analysis. The findings from this study show that, although an overall increase in the true detection rate and decrease in the number of false alarms were achieved, the high number of false alarms remains an issue

Frequency of Peri-operative Hypertension in a tertiary care hospital in Karachi, Pakistan

This study aims to determine the frequency of perioperative hypertension and its types (pre, intra and post-operative) hypertension in patients admitted for surgical procedures. This was a cross-sectional study conducted between the years 2012-2013 at the Aga Khan University Hospital, Karachi. Patients admitted for any surgical procedure during this time were included. Perioperative hypertension has been defined as systolic blood pressure of \u3e140 mm Hg or a diastolic blood pressure of \u3e90 mm Hg or whose blood pressure increased by 20% during surgery. A total of 428 surgical procedures were reviewed for the study. Overall perioperative hypertension was present in 231 (54%) of the patients. In the sample, 91 (21.7%) had pre-operative hypertension, 126(29.4%) reported pre-surgery hypertension, 24(5.6%) had intra-operative hypertension and 63(14.7%) had post-operative hypertension. Mean pain score was 1.43(1.4) v 1.25(1.2) in those with postoperative hypertension v no post-operative hypertension

Energy and Exergy Analyses on Seasonal Comparative Evaluation of Water Flow Cooling for Improving the Performance of Monocrystalline PV Module in Hot-Arid Climate

Solar irradiation in hot-arid climatic countries results in increased temperatures, which is one of the major factors affecting the power generation efficiency of monocrystalline photovoltaic (PV) systems, posing performance and degradation challenges. In this paper, the efficiency of a water-flow cooling system to increase the output of a monocrystalline PV module with a rated capacity of 80 W is studied from both energy and exergy perspectives. The energy and exergy tests are performed for each season of the year, with and without cooling. The energy and exergy efficiencies, as well as the commodity exergy values, are used to compare the photovoltaic device with and without cooling. The findings are based on the experimental data that were collected in Tehran, Iran as an investigated case study in a country with a hot-arid climate. The findings show that when water-flow cooling is used, the values of the three efficiency metrics change significantly. In various seasons, improvements in regular average energy efficiency vary from 7.3% to 12.4%. Furthermore, the achieved increase in exergy efficiency is in the 13.0% to 19.6% range. Using water flow cooling also results in a 12.1% to 18.4% rise in product exergy