The Unit Price Implication of Reinforcement Usage in Tie Beam Reinforced Concrete Construction

The construction cost as one of the most important project resources should be planned and use efficiently. Cost estimation can be analysed using standard of unit price analysis according to Indonesian National Standard (SNI 7394:2008). Related to unit price analysis for tie beam reinforced concrete, the standard mentioned a specific analysis that combine all materials requirement include reinforcement (unit price analysis No. 6.29). In such analysis, reinforcement requirement is stated as much as 200 kg/m3 of concrete. Considering the diversity of dimension design of building structure caused by geographical location and building function, a further study required to response these problems. This research is aimed to provide information to what extent the unit price analysis related to tie beam reinforced concrete can be enforced in cost estimating. Research process initiated with secondary data collection to building construction located in zone 10 and 15 based on earthquake zone map (SNI 1726:2012) in Province of Aceh. The results of analysis informed that the ratio of reinforcement requirement of tie beam in zone 10 is 198.03 kg/m3 to 217.26 kg/m3 of concrete with average ratio 209.83 kg/m3. For zone 15, reinforcement requirement ratio is 203.76 kg/m3 to 233.83 kg/m3 of concrete with average ratio 215.17 kg/m3. The Potential inaccurate of cost estimation appears in the two review zones. Such inaccuracies may have an impact on the insufficient costs for the work. Thus, the use of the standard unit price analysis needs further assessment for proper application

The relationship between gestational PCB exposure, thyroid hormones and ADHD

PCB exposure has been associated with a reduction in circulating thyroid hormones via several different mechanisms. While thyroid hormones can influence many physiological endpoints in adults, precise concentrations during critical periods of gestation are crucial to normal development. Maternal consumption of PCB contaminated fish has been associated with developmental problems in animals and humans. Alterations of thyroid hormones is postulated to be one possible source of the developmental latencies associated with PCB exposure. Thus, this study investigated the influence of maternal thyroxine supplements in rodents exposed to a low dose of commercial PCBs; Pregnant Long-Evans rats were exposed to one of four doses including: Aroclor 1016 (IP); Aroclor and thyroxine (oral); thyroxine plus saline (IP), or saline. The offspring of all groups were observed for developmental landmarks and were put through a battery of behavior tests. Data were statistically analyzed using SPSS. Litters born to PCB exposed dams had significantly less males than those born to dams in all other dose groups. After receiving Aroclor, pinna unfolding, incisor eruption, and negative geotaxis were delayed and foot splay was wider than the controls. The group receiving both the Aroclor and thyroxine exhibited no statistically significant changes in these endpoints compared to controls. Overall response to startle stimuli was greater in pups after maternal exposure to Aroclor, and this group habituated significantly less than the other groups. Pups in the Aroclor group were most active in the figure 8 maze on average, and least active (and least accurate) in the 5-choice task, although these trends were not statistically significant; The supplementation of thyroxine to PCB exposed rats has provided some insight to the mechanisms underlying thyroid mediated PCB toxicity and suggests further examination into the efficacy of thyroxine to prevent or minimize developmental and behavioral effects in maternally exposed populations

Dupuytren's contracture as result of prolonged administration of phenobarbital.

Dupuytren's disease is a fibroproliferative condition involving the superficial palmar fascia, leading to a progressive and irreversible flexion of the fingers. In literature, there are different opinions regarding the phenobarbital, a common antiepileptic drug, and its effective role in the genesis and development of Dupuytren's disease. In this retrospective investigation the association between phenobarbital and Dupuytren's contracture is discussed.Three patients in treatment with phenobarbital who had no others significant risk factors for Dupuytren's contracture were included in this study. The disease occurred after one to four years of drug therapy, at dosage of 100 mg/day. After surgery, Dupuytren's disease showed different evolutions in relation to dosage and type of antiepileptic drug used. Phenobarbital causes a dose and time-dipendent profibrotic effect. A clinical regression was observed when phenobarbital was substituted by carbamazepine, maintaining the same dosage (100 mg/day). This data confirms that not all the antiepileptic drugs are implicated in palmar fibrosis, and suggests that, according to the efficacy and adverse effects, the administration of benzodiazepine reduces the risk of Dupuytren's recurrence

Giant condylomata (Buschke-Löwenstein tumours): our case load in surgical treatment and review of the current therapies.

BACKGROUND: Buschke-Löwenstein tumour (BLT) or giant condyloma is a verrucous infiltrating lesion, due to a sexually transmitted virus infection, human papilloma virus subtypes 6 and 11. Poor hygiene, promiscuity, chronic irritation and cellular immunocompromised states are often implicated in its genesis. Typical treatment of giant condyloma includes imiquimod cream, podophillin resin, cryotherapy, laser surgery, tangential shave excision with electrocautery. OBJECTIVE: The authors report their case load in the treatment of giant condyloma and the review of the modern therapies. METHODS AND MATERIALS: 27 consecutive patients (18 men, nine women) underwent surgery for giant condylomata of perianal region and externa genitalia at the Department of Plastic Surgery of the University of Palermo, from October 2006 to December 2009. All the patients had been treated before with conservative therapies without significant results. We performed the radical excision with split-thickness skin graft in all the patients. RESULTS: No significant complications have occurred in all the cases. The functional and aesthetic outcome were satisfying. No recurrence of disease were noticed in the follow-up. CONCLUSION: the radical excision with split-thickness skin graft appears to be a successful option of treatment for Buschke-Löwenstein tumours. Compared to other methods it does not necessitate several stages of treatment, moreover it has the advantage of a lower risk of recurrence, it allows a complete histologic examination, the healing process is rapid, the improvement of quality of patients's life is significant

30 Years on: How the Neurodevelopmental Hypothesis of Schizophrenia Morphed into the Developmental Risk Factor Model of Psychosis

At its re-birth 30 years ago, the neurodevelopment hypothesis of schizophrenia focussed on aberrant genes and early neural hazards, but then it grew to include ideas concerning aberrant synaptic pruning in adolescence. The hypothesis had its own stormy development and it endured some difficult teenage years when a resurgence of interest in neurodegeneration threatened its survival. In early adult life, it over-reached itself with some reductionists claiming that schizophrenia was simply a neurodevelopmental disease. However, by age 30, the hypothesis has matured sufficiently to incorporated childhood and adult adversity, urban living and migration, as well as heavy cannabis use, as important risk factors. Thus, it morphed into the developmental risk factor model of psychosis and integrated new evidence concerning dysregulated striatal dopamine as the final step on the pathway linking risk factors to psychotic symptoms

Histopathology of the muscle in rheumatic diseases.

The presence of muscular symptoms is common in rheumatological clinical practice, but often the differential diagnosis between muscular involvement in connective tissue diseases, vasculitis and drug-induced myopathy may be difficult. In addition to clinical assessment, laboratory analysis and instrumental examinations, muscle biopsy may help to clarify the diagnosis in patients with muscular involvement. The purpose of this review is to provide a critical analysis of the current medical literature on muscular histopathology, to help clinicians to identify when to perform muscular biopsy and to provide a practical guide to a better understanding of the pathology report. Moreover, we provide an overview of the muscular involvement and the most common histopathological findings in rheumatic diseases

A propeller flap for single-stage nose reconstruction in selected patients: supratrochlear artery axial propeller flap

The paramedian forehead flap is the gold standard technique for nose reconstruction. It requires two different surgical operations which prolonged the postoperative dressing and care. We present our 5-year experience with a propeller flap based on the supratrochlear artery, which allows one-stage transfer of the forehead skin to the nose without the need for pedicle division. This technique is indicated in a selected group of patients who are not suitable for multiple-stage reconstructions because they have concurrent medical conditions, reduced mobility, or live far away from specialized medical centers. We have renamed this procedure as supratrochlear artery axial propeller flap, from the acronym STAAP flap, to stress the axial, well known and constant, vascularization of the flap. In the past 5 years, we have been performing 25 STAAP flaps; full-thickness nasal reconstruction was performed in 11 cases. The patients were 16 males and 9 females, with a mean age of 79.5 years. All patients had multiple comorbidities. Complete flap survival was observed in 23 cases and healing was complete in 7 days. In two cases, there was a partial distal necrosis of the flap treated conservatively. Cosmetic results were good and the patient's satisfaction was significant. These results indicate that the STAAP flap is a reliable and useful technique in selected cases, as old or noncompliant patients who benefit from a one-stage technique of nose reconstructio

The combination of laser-assisted surgery with PRP for the treatment of BRONJ in cancer patient. A pilot study

Aim. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-known potential complication of bisphosphonates (BPs) therapy and its treatment could reckon on different approaches. Recently, encouraging results for BRONJ were showed from some clinical studies using Er, Cr: YSGG laser-assisted surgery. Platelet-Rich Plasma (PRP), a new approach to promote tissue regeneration and healing, may be a promising complementary therapy. The aim of this pilot study is to study the effectiveness, in terms of clinical healing, of a combined treatment (laserassisted surgery and topical PRP) for BRONJ in a group of cancer patients. Methods. Ten oncological patients (3 males, 7 females; aged 69-89 years, mean age 76.2±5.8) with BRONJ were consecutively recruited. BRONJ was classified (T0) according to. All patients underwent pre- and peri-operatory antibiotic prophylaxis, and preparation of autologous PRP; the following combined surgical protocol was applied: i) exposure of the surgical area, through the creation of surgical edges; ii) courettage of the necrotic bone and, if present, sequestrectomy, by using a Er, Cr: YSGG laser; iii) application of autologous PRP over the entire bone cavity; iiii) suture of surgical flaps. All patients performed a CT after 3 months from surgery (T1) in order to re-stage of the disease. Successful treatments were considered the complete healing and the radiological improvement (transition from a higher stage to a lower one). Results. At T0 6/10 patients were stage IB, 2/10 were stage IIA and 2/10 were stage IIB. At T1, 3/10 (30%) cases (2 cases IB and 1 case IIB) showed no clinical and radiological signs of BRONJ relapse; 5/10 (50%) cases (4 cases IB and 1 case IIB) showed clinical improvement, whereas 2/10 (20%) (both IIA) showed no-improvement. Conclusion. The association of laser-assisted surgery and topical PRP, firstly investigated in this study, seems useful in BRONJ healing among cancer patients. Further investigation is necessary in order to validate these preliminary result