Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.
Modern Agricultural production wants to efficiently produce plant products and benefits to meet people's needs. However, because of better plant species and varieties, overuse of fertilizer and overdose of pesticide alters the plant resources relationship, resulting in soil degradation, vegetation decline, and crop failure or waste of resources, which influence the quality of fruit and benefit and are unfavorable for the sustainable utilization of nature resources and crops high-quality development. After a couple of years of study, the results showed that Agricultural development went into agricultural high-quality development in 2017, which is to use effective measures or methods to maximize yield and benefits and meet the need of people's need for better Agricultural produce and a better life. The theory foundation of the sustainable utilization of natural resources and Agriculture high-quality production is the resources use limit by plants, vegetation carrying capacity, and critical period of plant resources relationship regulation. The methods of Agriculture high-quality development are to select excellent plant species or varieties based on site conditions and market needs before planting crop young plants and sowing seeds, adopt appropriate initial planting density when planting crop young plants and sowing seeds, and regulate the relationship between plant growth and resources need in the process of crop production in a timely and appropriate amount, especially the chemical fertilizer and pesticide to obtain the maximum yield and benefits and realize the sustainable utilization of natural resources and achieve agricultural high-quality development.
Compacted bentonite or sand-bentonite mixtures are considered buffer/backfill materials in the engineering barriers of deep geological repositories for high-level nuclear waste (HLW) disposal in many countries. The design and long-term functionality of nuclear repositories have critical importance for environmental safety and public health. The initially unsaturated buffer material could become re-saturated long after following the sealing of the repository. Although the saturation degree of the buffer might decrease due to high temperatures and evaporation, it tends to increase with groundwater intrusion. Therefore, the soil water characteristic curves (SWCCs) for these unsaturated soils are a key factor in geotechnical engineering. Yet, the determination of SWCCs can be time-consuming and prone to inaccuracies. The HYPROP (Hydraulic Property Analyzer) evaporation technique is a preferred method for accurately determining water retention curves of soils. This reliable method was applied to estimate the water retention curves for sand-bentonite mixtures in the presence of boron minerals. Known for their minimal thermal expansion and commonly used in various industries, boron minerals may improve the thermal stability of sand-bentonite mixtures. The findings revealed that the boron addition increased the water retention capacity of the 10% bentonite mixtures but had a negligible impact on the 20% bentonite mixtures.
Introduction
In actual pharmacological therapy we can see that some drugs can be added to other medical instruments to improve their activity: in example we can see medicated stent for some coronary disease, or hormonal medical devices used in pregnancy prevention, but other example are known today. In example Carmustine wafer is delivered by delivery systems in some brain cancer and radioactive seed implants in prostatic cancer. Ocular intra vitreal implants for some macular degenerations (MABS or cortisones) other implants delivery systems drugs, naltrexone implant for opiate dependence. Other strategies imply carrier use to deliver the drugs in the site of action: In example MABS linked to radioactive isotopes in some relapse of severe Hodgkin disease but many other example we can see in therapy used today. So we can think that other chronic conditions can be treated using a combination of drugs with other instrument to improve the clinical outcomes. This to make possible that the ERLICH MUGIC BULLETS can act in the right site reducing the side effect. In example today we can see various medical interventional radiological strategy to treat in coronary and hearth disease with medicate stents positioning or to local use of contrast agents or other valvle surgery procedures with global good clinical results.
Introduction: Laparoscopic approach is emerging as a standard of care approach for management of masses amenable to partial nephrectomy. Laparoscopic partial nephrectomy is a challenging surgery and its successful performance depends on various factors. We aim to evaluate the influence of tumor characterestics on the operative performance for laparoscopic partial nephrectomy.
Methods: Patients undergoing laparoscopic partial nephrectomy in our institution were recruited for this study. The tumor profile was evaluated by a senior radiologist from cross sectional imaging (computed tomography or magnetic resonance imaging). Tumor characerestics was defined by assessing tumor size, tumor location and RENAL score. The operative performance was evaluated in terms of warm ischemia time, blood loss, operation duration and any significant operative complications. Statistical inference was drawn.
Results: 37 patients who underwent laparoscopic partial nephrectomy between January 2010 and June 2012 were included in this study. The mean tumor dimension was 3.81 cms. 21 tumors involved left kidney and 16 involved right kidney. 12 were located in upper pole, 8 were located in midpole and 17 were located in lower pole. The average RENAL score was 6.56. The mean warm ischemia time, blood loss and operation duration was 26.29 minutes (min), 256.76 millilitres (ml) and 208.11 min respectively. Statistically significant correlation was appreciated between tumor location (polar location, side, anterior/ posterior location) and RENAL score and operative parameters (warm ischemia time and operation duration). Tumor size did not have any correlation with the operative parameters.
Conclusion: The operative performance of laparoscopic partial nephrectomy is significantly influenced by the tumor location and RENAL score.
Broad-spectrum sunscreens are now widely used worldwide as an adjunct to help prevent sunburn, skin cancers and premature skin aging. In the United States, all persons older than 6 months are recommended to apply sunscreen to all sun-exposed skin from toes to head except eyes and mouth even on cloudy days. Such a recommendation is apparently based on concepts that exposure to sunlight damages the skin, the damage is cumulative and hence any sun exposure should be minimized or prevented. This communication raises several questions suggesting that the above recommendation may need to be reconsidered. For example, numerous previous studies have indicated many potential health benefits from non-burning sun exposure including protection against sunburn, melanoma, colorectal cancer, breast cancer and prostate cancer, increasing vitamin D synthesis, helping sleep, reducing blood pressure, heart attack and stroke. Recent studies suggested that regular lifetime non-burning sun exposure may not result in premature skin aging and the skin aging is mainly caused by the intrinsic factor. Skin aging or whole-body aging has been recently postulated to be mainly attributed to a gradual reduction in cardiac output/index with age and a new anti-aging or age-reversing nutritional theory has been proposed. An apparent lack of long-term cumulative sunray damage was also supported by reported age independence in incidences of sunburn and skin cancers. It is of interest that the current US policy is different from that of World Health Organization and Australia recommending the need of sun protection only when UV Index is 3 or greater. In view of the above, some general guidelines regarding when to best apply sunscreen are proposed.
Background: After the closure of patent processus vaginalis (PPV) in boys with indirect inguinal hernia (IIH) or hydrocele, large scrotal hydroceles can occur on rare occasions despite the complete occlusion of internal inguinal ring (IIR). We present some cases that may help to explain the cause of this rare occurrence.
Materials: During last 14 years, six boys exhibited non-communicating large scrotal hydroceles (2 right, 1 left, 3 bilateral) among 352 children who underwent laparoscopic repair for hydroceles. Ages ranged from 7 months to 15 years with a median of 12 years. Five of them had a history of repair for hydrocele or IIH prior to the definitive surgery and one boy underwent an initial operation.
Results: In all the patients, laparoscopic inspection at the definitive surgery revealed completely closed IIRs. One infant with primary hydroceles was found to have large hydroceles bulging into the peritoneal cavity. All the patients were treated with subtotal removal of the sac without any recurrence. Marked thickness of the sack walls with abundant lymph vessels was characteristic histopathological findings.
Conclusions: The complete occlusion of the PPV does not always prevent the recurrence of hydrocele through alternative pathogenesis. The pathological findings of resected specimens suggested a disturbance in lymph flow in the testicular system. The subtotal removal of the sac is the treatment of choice. Diagnostic laparoscopy prior to a direct cut-down approach to the neck of the seminal cord is advisable to identify non-communicating hydroceles to avoid further impairment of lymph drainage around the IIR.
Tuva has been a cattle-breeding region since ancient times, extremely continental climate of this region is little suitable for agriculture. However, the steppes of intermountain depressions in Tuva were heavily plowed by the early 1980s. In the 1990s most of the arable lands were abandoned; the process of restoration (demutation) of natural vegetation on fallow lands began. By now, 30 years later, the old fallows are expected to achieve the stage of the secondary steppe.The purpose of this work is to estimate the differences between virgin steppes and corresponding secondary steppes in Tuva. Tussock, hummock, and desert virgin steppes have been compared with corresponding to three types of 30-year-old fallow communities. For this study, 330 geobotanical releves have been used. The criteria for comparison have been chosen as follows: the similarity of species composition, the spectrum of dominant species, species richness, grass cover, and grass height. The statistical validity of their differences has been verified. According to these criteria, virgin steppes and their 30-year-old fallow derivatives are shown to differ significantly.
Background: Clinical education is an important component of physiotherapy education programs. It provides insights to the students in the fields of physiotherapy practice, develops leadership, and enhances their clinical skills in patient assessment, examination, diagnosis, treatment, planning, and intervention selection. The dimension of physiotherapy education is in the developing phase in Nepal. For further growth, the experience and the perception of the students are very important. Through this, the facilitators and barriers in physiotherapy clinical education need to be recognized. Therefore, this study aimed to explore the facilitators and barriers in physiotherapy clinical education in Nepal from a student’s perspective.Objectives: The main objective of this study was to identify the perception of physiotherapy undergraduate students about their clinical education and to find out the facilitators and barriers in clinical education.Methods: A qualitative research using focused group discussion was conducted. Ethical considerations were taken from respective departments and IRC approval was taken. BPT 3rd year, 4th year, and intern students of KUSMS were called to participate in the study. After the consent from the participants, focus groups of 6 participants (2 participants from each 3rd year, 4th year, and intern) were formed. In five FGDs, data saturation was observed and no further FGDs were conducted. FGDs were collected with audio tape recordings. The data were transcribed verbatim and translated into the English language. Then data coding was done and themes and sub-themes were generated from the codes.Results: Through the transcribed and translated data, seven themes were generated which were clinical education, student expectation, student attitude and behavior, roles and responsibilities of clinical educators, exposure, resources, and miscellaneous. These headings explained the perception of facilitators and barriers.Conclusion: The facilitators and barriers to physiotherapy clinical education were identified through student’s perspectives. These findings should be considered while preparing the guiding document for clinical education to enhance the quality of education.
Cluster headache (CH) is a primary headache belonging to the group of trigeminal-autonomic cephalalgias, characterized by short attacks of very severe headache, always involving the same side of the head, more frequently localized to the periorbital and temporal area, associated with homolateral tearing, red eye, nose obstruction or rhinorrhea, ptosis, miosis, and restlessness. These attacks generally last 15-180 minutes and can occur from once every day to 8 times a day.
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