Size of cervical lesion in locally advanced carcinoma cervix and response to neoadjuvant chemotherapy

Background: Recently neoadjuvant chemotherapy has started being considered for advanced stage of carcinoma cervix. Drug delivery to pelvic tumour is optimal with neoadjuvant chemotherapy since tumour vascular supply has not been damaged by any previous pelvic interference. Tumor size and parametrial involvement have been reported to be important predictor of NACT response. Objective of this study was to find out association between size of cervical lesion in locally advanced carcinoma cervix and response to neoadjuvant chemotherapy.Methods: The present prospective cohort study was carried out in the Department of Obstetrics and Gynaecology with the collaboration of Department of Radiotherapy, Chhatrapati Shahuji Maharaj Medical University Lucknow for a period of 1-year august 2010 to august 2011. 26 patients with histologically proven locally advanced carcinoma cervix were studied. In all cases Cisplatin 75 mg/m2 and paclitaxel 135 mg/m2 on day one was given at 14 days interval up to maximum of three courses. Evaluation of operability status was done two weeks after second course of chemotherapy. Those found operable were taken up for radical hysterectomy and rest were given 3rd course of chemotherapy. After two weeks of 3rd course again operability assessment was done and patient was taken up either for surgery or radiotherapy.Results: It was observed that out of 14 patients who had tumour size <4 cm, 9 (64.2%) responded completely (CR), 2 (14.2%) responded partially and 3 (21.4%) responded as SD while in 12 patients with tumour size >4 cm, 4 (33.3%) responded completely (CR) and rest 8 (66.6%) response was partial (PR).Conclusions: Response to chemotherapy was modified by pre-treatment volume of the tumour.

Optimization of ethanol reflux extraction process of red ginseng using a design space approach based on hazard and operability analysis / 中国中药杂志

Quality by design principle was used as a guideline in this study to optimize ethanol reflux extraction of red ginseng. Firstly, hazard and operability analysis(HAZOP) was used as a risk assessment tool to evaluate the hazard degree of process parameters.Ethanol concentration, the ratio of alcohol and herbal material (A/M ratio), and extraction time were identified as the critical process parameters(CPPs) according to HAZOP method.Secondly, Box-Behnken experimental design was applied to establish theregression models between CPPs and the process indices. Finally, the design space was calculated. The recommended operation space of parametersis as follows：alcohol concentration of 90.3%-90.7%, A/M ratio of 2.5-3.1 mL•g ⁻¹ and extraction time of 124-130 min. The study shows that the design space approach combined with the risk assessment using HAZOP has the potential to reduce the risk of red ginseng extraction process, which might ultimately improve the process control..

Critical decision of operability in congenital heart disease patient with severe pulmonary hypertension.

Repair of congenital heart disease in the presence of high pulmonary pressure has always been a contentious issue. Pulmonary vascular resistance (PVR) is considered important for establishing operability in these patients. However, PVR estimation is not always accurate and cannot solely be relied upon to make critical decision of operability. Clinical examination, chest X‑ray, and echocardiography are also important indicators of pulmonary vascular disease. Knowledge of pits and falls of each investigation is important for appropriate management in these patients. We present a case report of successfully operated, 6‑year‑old child with anomalous origin of the right pulmonary artery from aorta, deemed inoperable on the basis of PVR estimation.

Evaluation of Interhandle Distance During Pushing and Pulling of a Four-Caster Cart for Upper Limb Exertion

BACKGROUND: This study examined the relationship between interhandle distances and upper limb exertion during simply pushing and pulling of a cart with four swivel wheels, defined by a roll box pallet (RBP) in a Japanese industrial standard. METHODS: Six healthy young male participants were asked to push and pull an RBP at a distance of 5.2 m under six conditions corresponding to different interhandle distances (40 cm, 60 cm, and 80 cm) and weights (130 kg and 250 kg). The upper limb exertion was studied by shoulder abduction and flexion, and elbow flexion, as well as surface electromyogram (EMG) in shoulder extensor, and elbow flexor and extensor. Participants were required to provide subjective evaluations on operability after each trial. RESULTS: Subjective operability indicated that a narrower interhandle distance had a better operability for pushing. Interhandle distance was also related to upper limb exertion especially for pushing. A narrow interhandle distance caused smaller shoulder adduction but larger elbow flexion. The normalized EMG data revealed that muscular activity became smaller with a narrow interhandle distance in shoulder extensor. During the pulling task, elbow flexion was smaller at a narrow interhandle distance, although subjective operability and normalized EMG were not significantly varied. CONCLUSION: A wider interhandle distance, such as 80 cm, was not suitable in the forwardbackward movement of the RBP. Therefore, this study concluded that an interhandle distance of 40 cm would be suitable for pushing and pulling an RBP to protect the workers' hands against the risk of injury by installing inner handles.

Analyzing framework for inter-organizational network of medical and health organizations / 中华医学图书情报杂志

After the important role of interoperability in health information construction , organizational interopera-bility and inter-organizational network studies were analyzed , the analyzing framework for inter-organizational net-work of medical and health organizations and its relevant study directions were proposed from the aspects of its nodes, dyads and overall structure.

Grupos operativos: sobre la operatividad / Operating groups: on operability

Este trabajo lo realizo a partir del desarrollo de un concepto, es decir, tratando de rastrear elementos para su construcción. Como el concepto elegido es «operatividad¼, esto hace que también se presente un eje de trabajo que tal vez enfatice mucho en la técnica, lo cual no quiere decir que sea el único eje a partir del cual se pueda investigar la propuesta de los grupos operativos. (Otros ejes podrían ser por ejemplo el concepto de salud, de sujeto, etc. en los que se soportan los grupos operativos).

I carry out this work based on the development of a concept, that is, trying to trace elements for its construction. As the concept chosen is "operability", this also makes it possible to present a work axis that may emphasize a lot in the technique, which does not mean that it is the only axis from which the group's proposal can be investigated operational (Other axes could be for example the concept of health, of subject, etc. in which the operative groups are supported).