Indoor air quality in a metropolitan area metro using fuzzy logic assessment system.

According to past experience, the concentration of air pollutants indoor varies significantly in different environmental conditions. The present study focuses on the investigation of the indoor air quality (IAQ) of the underground trains in Athens, Greece. The investigation was performed in both major lines of the ATTIKO METRO. Monitoring was performed in order to determine the concentration of pollutants and particulate matter, specifically TVOCs, PM10, ΡΜ2.5, ΡΜ1 as well as temperature and relative humidity in the coaches of the trains. In the present study, a methodology based on fuzzy inference systems to assess air quality is proposed. A fuzzy logic assessment system (FLAS) is developed incorporating rules stem collected from real data, human experience and intuition. The results demonstrate the applicability and effectiveness of the FLAS.

The academic environment: the students' perspective.

Dental education is regarded as a complex, demanding and often stressful pedagogical procedure. Undergraduates, while enrolled in programmes of 4-6 years duration, are required to attain a unique and diverse collection of competences. Despite the major differences in educational systems, philosophies, methods and resources available worldwide, dental students' views regarding their education appear to be relatively convergent. This paper summarizes dental students' standpoint of their studies, showcases their experiences in different educational settings and discusses the characteristics of a positive academic environment. It is a consensus opinion that the 'students' perspective' should be taken into consideration in all discussions and decisions regarding dental education. Moreover, it is suggested that the set of recommendations proposed can improve students' quality of life and well-being, enhance their total educational experience and positively influence their future careers as oral health physicians. The 'ideal' academic environment may be defined as one that best prepares students for their future professional life and contributes towards their personal development, psychosomatic and social well-being. A number of diverse factors significantly influence the way students perceive and experience their education. These range from 'class size', 'leisure time' and 'assessment procedures' to 'relations with peers and faculty', 'ethical climate' and 'extra-curricular opportunities'. Research has revealed that stress symptoms, including psychological and psychosomatic manifestations, are prevalent among dental students. Apparently some stressors are inherent in dental studies. Nevertheless, suggested strategies and preventive interventions can reduce or eliminate many sources of stress and appropriate support services should be readily available. A key point for the Working Group has been the discrimination between 'teaching' and 'learning'. It is suggested that the educational content should be made available to students through a variety of methods, because individual learning styles and preferences vary considerably. Regardless of the educational philosophy adopted, students should be placed at the centre of the process. Moreover, it is critical that they are encouraged to take responsibility for their own learning. Other improvements suggested include increased formative assessment and self-assessment opportunities, reflective portfolios, collaborative learning, familiarization with and increased implementation of information and communication technology applications, early clinical exposure, greater emphasis on qualitative criteria in clinical education, community placements, and other extracurricular experiences such as international exchanges and awareness of minority and global health issues. The establishment of a global network in dental education is firmly supported but to be effective it will need active student representation and involvement.

Clinically occult Leydig cell tumor in a cryptorchid man. Report of a case presenting with unilateral gynecomastia and impotence.

Left painful breast enlargement and impotence were the main complaints of a right cryptorchid young man. On ultrasonography a hypoechoic mass was found in the right testis. Postoperatively the increased level of estrogens and the decreased levels of testosterone were normalized 6 months following the orchiectomy, gynecomastia subsided considerably and the impotence improved quite satisfactorily.

Tamoxifen treatment in male infertility. I. Effect on spermatozoa.

OBJECTIVE: To evaluate the effects of tamoxifen treatment on sperm density, motility, vitality, and morphology. DESIGN: Placebo-controlled, randomized study. SETTING: Outpatient department. INTERVENTIONS: Patients were assigned to two comparable groups: group A (n = 122) was treated with 10 mg tamoxifen twice daily for a period of 3 months and group B (n = 117) was given placebo for the same period of time, following a previously randomized design. MAIN OUTCOME MEASURES: In every patient sperm density, motility, viability, and morphology were evaluated 3 months after cessation of treatment. RESULTS: Mean sperm density in group A improved significantly with a more pronounced improvement in severe oligozoospermic men. Sperm density was found significantly improved compared with group B. Dead spermatozoa in group A significantly decreased after tamoxifen treatment and were also found significantly decreased compared with group B. CONCLUSION: It is concluded that tamoxifen exerts a beneficial effect on sperm density and number of live spermatozoa but it has no substantial effect in sperm motility and morphology.

Recurrence of papilloma of renal pelvis on ureteral stump thirty years after nephrectomy.

Papillomas of the upper urinary tract may be multiple, developing either simultaneously or at various times. Recurrence may occur many years after surgical treatment, even after thirty years, as in the case we report.

Urinary problems in decompression sickness.

The records of 25 patients with type II decompression sickness and urinary problems have been reviewed. Seventeen patients were professionals and 8 were above the age of 40. The disease appeared within the 1st hour of emergence from the water in 70% of the cases and within the first 4 hours in the remaining 30%. Nine patients were diagnosed as paraplegic and two as tetraplegic. All patients had urinary disturbances and 14 were on Foley-catheter drainage during the decompression while 11 were on intermittent catheterisation. Fifteen patients had improved urinary function after recompression, 8 had some difficulty, 2 underwent a sphincterotomy and one a transurethral prostatectomy. The low percentage of complete recovery was due to the delayed arrival at the decompression chamber.

Primary localized amyloidosis of the urethra.

Amyloidosis of the urethra is a rare condition. A case of primary localized amyloidosis of the male external urethral meatus and navicular fossa is reported.

Cecocystoplasty for bladder augmentation.

Augmentation of the bladder by cecocystoplasty has been studied in 37 patients during a 15-year period. The indications for an operation were a small contracted bladder secondary to tuberculosis in 31 cases, interstitial cystitis in 5 and carcinoma of the bladder in 1. Results were studied by the assessment of symptomatic improvement, the effect on renal function, urinary tract infection and the postoperative complications. Urodynamic studies also were done on 23 patients with tuberculosis of the renal tract and the results are discussed. Azotemia was not a contraindication to an operation but patients with enuresis or those who have evidence of psychiatric disturbance should be assessed carefully.

Bladder augmentation--a long-term review.

Fifty-nine patients who had undergone augmentation cystoplasty were studied over a period of 18 years. The indications for the operation were a tuberculous contracted bladder in 51, interstitial cystitis in 7 and carcinoma in 1. The ileum was used in one patient, the colon in 16 and the caecum in 42. The results did not seem to be influenced by the segment of bowel and the long-term results of using the colon as bladder substitute were similar to those achieved by using the caecum. An excellent result has been achieved in 78% of the 49 surviving patients. Operative mortality was 5.1% (3 patients). Contraindications include progressive severe renal failure, enuresis and a history of previous psychiatric disturbance.

The early results of treatment of stricture of the male urethra using the Sachse optical urethrotome.

Thirty-nine male patients with urethral stricture have undergone urethrotomy using the Sachse optical urethrotome. Post-operatively a urethral catheter was used for 24 to 72 h. The technique is simple, the stay in hospital is short and complications are uncommon. Eighty-two per cent of the patients are now symptom-free and further 13% are sufficiently improved to be able to void satisfactorily at follow-up varying from 4 months to 2 1/2 years (mean 12 months). The 2 patients in whom unsatisfactory results were obtained had long strictures. We feel that direct vision urethrotomy should be considered as a treatment for urethral stricture.

Balanitis xerotica obliterans.

Twenty patients with histologically proven balantis xerotica obliterans have undergone different forms of treatment; their progress has been reviewed and discussed. Balanitis xerotica obliterans involving only the foreskin was best treated by circumcision. The patients in whom meatal stenosis was present responded well to regular meatal dilatation, meatotomy followed by regular dilatation and, in advanced cases, to meatoplasty. At present there is no evidence to indicate that associated urethral strictures, proximal to the fossa navicularis, are due to balanitis xerotica obliterans.

Primary malignant melanoma of the penis. Two cases and a review of the literature.

Two cases of primary malignant melanoma of the penis are reported and 35 cases from the world literature are reviewed. The tumour most commonly started in the glans penis and less frequently from the prepuce. The microscopic appearances were identical with those of tumours arising elsewhere in the skin. A comparison is made between the incidence of melanoma of the penis and melanoma occurring elsewhere on the body surface. Evaluation of the best treatment was difficult because the total number of cases was small and the methods of treatment and results so variable. It would seem that the prognosis of malignant melanoma of the penis is generally poor, although there are sufficient examples of long-term survival after total amputation in Stage I disease to suggest that this radical treatment is justified.

The management of vesicoureteric reflux in children.

One hundred and seventy children with vesicoureteric reflux have been reviewed. Conservative therapy was the treatment of choice in Grade I reflux. Children with Grade II and Grade II reflux treated conservatively developed progressive upper tract dilation and scarring. Unilateral reflux sometimes became bilateral. In addition, the grade of reflux could worsen in the absence of symptoms or overt infection. Cystourethroscopy was an important investigation as an aid to management: the findings of abnormal ureteric orifices in the presence of Grade II and Grade III reflux indicated early surgical treatment. Surgery was also indicated in the presence of ureteric dilatation on excretion urography aand/or micturating cystourography. Vesicouretic reimplantation gave excellent results with few complications.

The late symptomatic and functional results of enterocystoplasty.

A symptomatic and, where possible, urodynamic assessment has been made in 19 patients undergoing enterocystoplasty over a 16-year period. It is suggested that this operation should be considered in those cases of interstitial cystitis and irritable bladder syndrome in which all recognised medical and surgical treatment has failed.

Ureteric reimplantation for vesico-ureteric reflux in the adult.

A retrospective study of 32 adult patients undergoing ureteric reimplantation for reflux has been carried out. Reflux and reimplantation in relation to urolithiasis, pregnancy, renal failure, hypertension and bladder neck obstruction have been discussed. Eighty-four per cent of patients with primary reflux had pyelonephritic scarring compared with only 34% of patients where reflux was secondary. Reimplantation has been technically successful in preventing reflux in every patient in this series, with 18 patients (65%) becoming symptom free. Pyelonephritis, hypertension and renal failure were not significantly improved but no progressive changes were observed in the follow-up period after reimplantation.