Comparison of depression, anxiety and long-term quality of health in patients with a history of either primary closure or Limberg flap reconstruction for pilonidal sinus

OBJECTİVE: Pilonidal sinus is characterized by high operative morbidity mainly due to wound problems. We aimed to compare the quality of health, comfort and psychological status in patients who underwent surgery for pilonidal sinus. METHODS: A total of 205 pilonidal sinus patients operated on with either primary closure or Limberg flap reconstruction were compared in terms of depression, anxiety, and long-term quality of health by using Short Form 36, Beck Depression Inventory, and Beck Anxiety Inventory scales. RESULTS: There were 107 patients in the primary closure group with a mean follow-up of 29.6±7.7 months and 98 patients in the Limberg flap group with a mean follow-up of 34.1±7.3 months. In the SF-36 analysis, the mental health and bodily pain scores (59±6 and 56±11 in the primary closure group and 62±8 and 61±10 in the Limberg flap group) were significantly higher in the Limberg flap group (p = 0.014 and p = 0.002, respectively). The mean Beck Depression Inventory (19±6.13 vs. 16±4.90

A probable outbreak of toxoplasmosis among boarding school students in Turkey

ABSTRACTIn total, 171 students from a boarding school in Izmir, Turkey, with mild and non-specific symptoms of toxoplasmosis, were screened during September–October 2002. All 171 students were seropositive for Toxoplasma gondii IgG and IgM. Of 43 students tested, 40 (93%) had low IgG avidity. None showed evidence of ophthalmic involvement. The data suggest that T. gondii may spread rapidly in close living conditions, possibly following exposure to cat litter. This is the largest recent outbreak of toxoplamosis described in the medical literature

Combining and optimizing NIRS and EEG to study interictal epileptic discharges

We describe our ongoing application of NIRS-EEG to the study of inter-ictal discharges in adult epilepsy. We discuss optimizing NIRS-EEG data acquisition and analysis and we present preliminary NIRS-EEG results for an epileptic patient. © 2012 OSA

A Title 40 Code of Federal Regulations Part 191 Evaluation of Buried Transuranic Waste at the Nevada Test Site -8210

ABSTRACT In 1986, 21 m 3 of transuranic (TRU) waste was inadvertently buried in a shallow land burial trench at the Area 5 Radioactive Waste Management Site on the Nevada Test Site (NTS). Th

Biodiesel production from jatropha seeds: Solvent extraction and in situ transesterification in a single step

The objective of this study was to investigate solvent extraction and in situ transesterification in a single step to allow direct production of biodiesel from jatropha seeds. Experiments were conducted using milled jatropha seeds, and n-hexane as extracting solvent. The influence of methanol to seed ratio (2:1–6:1), amount of alkali (KOH) catalyst (0.05–0.1 mol/L in methanol), stirring speed (700–900 rpm), temperature (40–60 °C) and reaction time (3–5 h) was examined to define optimum biodiesel yield and biodiesel quality after water washing and drying. When stirring speed, temperature and reaction time were fixed at 700 rpm, 60 °C and 4 h respectively, highest biodiesel yield (80% with a fatty acid methyl ester purity of 99.9%) and optimum biodiesel quality were obtained with a methanol to seed ratio of 6:1 and 0.075 mol/L KOH in methanol. Subsequently, the influence of stirring speed, temperature and reaction time on biodiesel yield and biodiesel quality was studied, by applying the randomized factorial experimental design with ANOVA (F-test at p = 0.05), and using the optimum values previously found for methanol to seed ratio and KOH catalyst level. Most experimental runs conducted at 50 °C resulted to high biodiesel yields, while stirring speed and reaction time did not give significantly effect. The highest biodiesel yield (87% with a fatty acid methyl ester purity of 99.7%) was obtained with a methanol to seed ratio of 6:1, KOH catalyst of 0.075 mol/L in methanol, a stirring speed of 800 rpm, a temperature of 50 °C, and a reaction time of 5 h. The effects of stirring speed, temperature and reaction time on biodiesel quality were not significant. Most of the biodiesel quality obtained in this study conformed to the Indonesian Biodiesel Standard

A Title 40 Code of Federal Regulations Part 191 Evaluation of Buried Transuranic Waste at the Nevada Test Site

In 1986, 21 m{sup 3} of transuranic (TRU) waste was inadvertently buried in a shallow land burial trench at the Area 5 Radioactive Waste Management Site on the Nevada Test Site (NTS). The U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office is considered five options for management of the buried TRU waste. One option is to leave the waste in-place if the disposal can meet the requirements of Title 40 Code of Federal Regulations (CFR) Part 191, 'Environmental Radiation Protection Standard for Management and Disposal of Spent Nuclear Fuel, High-Level, and Transuranic Radioactive Wastes'. This paper describes analyses that assess the likelihood that TRU waste in shallow land burial can meet the 40 CFR 191 standards for a geologic repository. The simulated probability of the cumulative release exceeding 1 and 10 times the 40 CFR 191.13 containment requirements is estimated to be 0.009 and less than 0.0001, respectively. The cumulative release is most sensitive to the number of groundwater withdrawal wells drilled through the disposal trench. The mean total effective dose equivalent for a member of the public is estimated to reach a maximum of 0.014 milliSievert (mSv) at 10,000 years, or approximately 10 percent of the 0.15 mSv 40 CFR 191.15 individual protection requirement. The dose is predominantly from inhalation of short-lived Rn-222 progeny in air produced by low-level waste disposed in the same trench. The transuranic radionuclide released in greatest amounts, Pu-239, contributes only 0.4 percent of the dose. The member of public dose is most sensitive to the U-234 inventory and the radon emanation coefficient. Reasonable assurance of compliance with the Subpart C groundwater protection standard is provided by site characterization data and hydrologic processes modeling which support a conclusion of no groundwater pathway within 10,000 years. Limited quantities of transuranic waste in a shallow land burial trench at the NTS can meet the requirements of 40 CFR 191

Probabilistic Performance Assessment of a Low-Level Radioactive Waste Disposal Site on the Nevada Test Site

The Area 5 Radioactive Waste Management Site on the Nevada Test Site has been disposing of low-level, mixed low-level, and transuranic radioactive waste since 1961. In 1988, the U.S. Department of Energy implemented performance objectives for low-level radioactive waste disposal site performance and required all site operators to prepare a performance assessment. Since then, an iterative performance assessment process has been implemented that consists of repeated cycles of site characterization, conceptual model formation/revision, and performance assessment modeling. At the end of each cycle uncertainty and sensitivity analysis are used to determine the need for revision and to identify topics requiring additional research and development. The performance assessment model is implemented in the GoldSim{reg_sign} probabilistic simulation platform. The current site conceptual model, based on site characterization data and process model results, assumes that there is no groundwater pathway under current climatic conditions and that radionuclide releases are predominately upward to the land surface. Radionuclides are released to the land surface by upward liquid advection/diffusion, gas diffusion, biointrusion, and inadvertent human intrusion. The model calculates dose for four members of public exposure scenarios and two intruder scenarios. The highest mean-dose, 0.04 mSv yr{sup -1}, is expected for a low-probability exposure scenario: establishment of a rural community at the site boundary at the end of institutional control. At the end of institutional control, doses are contributed primarily by {sup 3}H in agricultural products produced onsite. After approximately 300 years, the doses are contributed equally by {sup 99}Tc and {sup 210}Pb ingested in vegetables grown at the residence. Technetium is released to the surface by the coupled processes of liquid advection/diffusion occurring deep in the cover and plant uptake/animal burrowing occurring at shallower depths. Lead-210 is deposited in shallow cover soil by the radioactive decay of {sup 222}Rn diffusing in the gas phase. The highest mean dose for the more likely exposure scenario of transient recreational use of the site is 0.002 mSv yr{sup -1}. The transient visitor's dose is contributed predominantly by external irradiation from {sup 214}Pb and {sup 214}Bi, deposited in the cover by diffusion of {sup 222}Rn

The effect of continuous diffusion of oxygen treatment on cytokines, perfusion, bacterial load, and healing in patients with diabetic foot ulcers

To evaluate continuous diffusion of oxygen therapy (CDO) on cytokines, perfusion, and bacterial load in diabetic foot ulcers we evaluated 23 patients for 3 weeks. Tissues biopsies were obtained at each visit to evaluate cytokines and quantitative bacterial cultures. Perfusion was measured with hyperspectral imaging and transcutaneous oxygen. We used paired T tests to compare continuous variables and independent T tests to compare healers and nonhealers. There was an increase from baseline to week 1 in TGF-β (P =.008), TNF-α (P =.014), VEGF (P =.008), PDGF (P =.087), and IGF-1 (P =.058); baseline to week 2 in TGF-β (P =.010), VEGF (P =.051), and IL-6 (P =.031); and baseline to week 3 with TGF-β (P =.055) and IL-6 (P =.054). There was a significant increase in transcutaneous oxygen after 1 week of treatment on both medial and lateral foot (P =.086 and.025). Fifty-three percent of the patients had at least a 50% wound area reduction (healers). At baseline, there were no differences in cytokines between healers and nonhealers. However, there was an increase in CXCL8 after 1 week of treatment (P =.080) and IL-6 after 3 weeks of treatment in nonhealers (P =.099). There were no differences in quantitative cultures in healers and nonhealers

Closure Strategy for a Waste Disposal Facility with Multiple Waste Types and Regulatory Drivers at the Nevada Test Site

The U.S. Department of Energy, National Security Administration Nevada Site Office (NNSA/NSO) is planning to close the 92-Acre Area of the Area 5 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS), which is about 65 miles northwest of Las Vegas, Nevada. Closure planning for this facility must take into account the regulatory requirements for a diversity of waste streams, disposal and storage configurations, disposal history, and site conditions. This paper provides a brief background of the Area 5 RWMS, identifies key closure issues, and presents the closure strategy. Disposals have been made in 25 shallow excavated pits and trenches and 13 Greater Confinement Disposal (GCD) boreholes at the 92-Acre Area since 1961. The pits and trenches have been used to dispose unclassified low-level waste (LLW), low-level mixed waste (LLMW), and asbestiform waste, and to store classified low-level and low-level mixed materials. The GCD boreholes are intermediate-depth disposal units about 10 feet (ft) in diameter and 120 ft deep. Classified and unclassified high-specific activity LLW, transuranic (TRU), and mixed TRU are disposed in the GCD boreholes. TRU waste was also disposed inadvertently in trench T-04C. Except for three disposal units that are active, all pits and trenches are operationally covered with 8-ft thick alluvium. The 92-Acre Area also includes a Mixed Waste Disposal Unit (MWDU) operating under Resource Conservation and Recovery Act (RCRA) Interim Status, and an asbestiform waste unit operating under a state of Nevada Solid Waste Disposal Site Permit. A single final closure cover is envisioned over the 92-Acre Area. The cover is the evapotranspirative-type cover that has been successfully employed at the NTS. Closure, post-closure care, and monitoring must meet the requirements of the following regulations: U.S. Department of Energy Order 435.1, Title 40 Code of Federal Regulations (CFR) Part 191, Title 40 CFR Part 265, Nevada Administrative Code (NAC) 444.743, RCRA requirements as incorporated into NAC 444.8632, and the Federal Facility Agreement and Consent Order (FFACO). A grouping of waste disposal units according to waste type, location, and similarity in regulatory requirements identified six closure units: LLW Unit, Corrective Action Unit (CAU) 111 under FFACO, Asbestiform LLW Unit, Pit 3 MWDU, TRU GCD Borehole Unit, and TRU Trench Unit. The closure schedule of all units is tied to the closure schedule of the Pit 3 MWDU under RCRA

Closure Strategy for a Waste Disposal Facility with Multiple Waste Types and Regulatory Drivers at the Nevada Test Site

The U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) plans to close the waste and classified material storage cells in the southeast quadrant of the Area 5 Radioactive Waste Management Site (RWMS), informally known as the '92-Acre Area', by 2011. The 25 shallow trenches and pits and the 13 Greater Confinement Disposal (GCD) borings contain various waste streams including low-level waste (LLW), low-level mixed waste (LLMW), transuranic (TRU), mixed transuranic (MTRU), and high specific activity LLW. The cells are managed under several regulatory and permit programs by the U.S. Department of Energy (DOE) and the Nevada Division of Environmental Protection (NDEP). Although the specific closure requirements for each cell vary, 37 closely spaced cells will be closed under a single integrated monolayer evapotranspirative (ET) final cover. One cell will be closed under a separate cover concurrently. The site setting and climate constrain transport pathways and are factors in the technical approach to closure and performance assessment. Successful implementation of the integrated closure plan requires excellent communication and coordination between NNSA/NSO and the regulators