Catalytic hydrocracking of jatropha oil over natural clay for bio-jet fuel production.

Currently, the conversion of biomass to produce high-valued biofuels such as biodiesel and bio-jet fuel has attached booming interests, when used for partial replacement of petroleum fuels in different ratios is a promising solution due to the problem of depleting petroleum reserves and environmental purposes. Non-edible Jatropha oil can be transformed to biofuel when subjected to were hydrocracking at hydrogen pressure using an activated natural clay as a catalyst in a high pressure batch reactor. The type of product and its quality and quantity depend on the process conditions such as reaction time, temperature, and catalyst type, form, and amount. The present work aims to study the hydrocracking process of Jatropha oil at different operating conditions. The catalyst is characterized using SEM, FTIR, XRF, and XRD. The effect of process conditions variation have been studied and discussed. The results showed the highest yield of 40% bio-jet fuel was achieved at a temperature of 350 °C, H2 pressure of 4 bar, and reaction time of 18 min. the bio-jet fuel products were tested and their specifications were conformed to ASTM D1655 specifications, viz the freezing point (-56 °C), the flash point (53 °C), and existent gum content (5.9 mg/100 ml).

Endovascular Embolization of Post-tonsillectomy Pseudoaneurysm: A Single-Center Case Series.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of endovascular embolization of post-tonsillectomy pseudoaneurysm with the usage of monomeric n-butyl-2-cyanoacrylate (NBCA) glue as a first intention. METHODS: We retrospectively analyzed the technical details and clinical outcome of ten consecutive children presented with delayed post-tonsillectomy bleeding, caused by lingual or facial artery pseudoaneurysm, which was treated by endovascular embolization. RESULTS: Seven patients had lingual artery pseudoaneurysm, and three patients had injury of a common linguo-facial trunk. Eight patients were treated by endovascular embolization using NBCA glue, and two patients had to be embolized using microcoils. All patients were successfully embolized with no clinical complications. One patient suffered from bleeding during the interventional procedure that was controlled by NBCA which infiltrated normal branches with no clinical sequelae. CONCLUSION: NBCA glue can be used as an effective appropriate embolizing material in endovascular embolization of post-tonsillectomy pseudoaneurysm. However, certain precautions are mandatory to avoid distal infiltration of normal arteries or proximal reflux that may endanger the internal carotid artery. LEVEL OF EVIDENCE: Level 4, case series.

Disequilibria in the distribution of rpoB alleles in rifampicin-resistant M. tuberculosis isolates from Germany and Sierra Leone.

The effectiveness of culture-independent resistance predictions by molecular techniques is dependent on the number and the frequency of accessible resistance-associated genomic mutations. We have characterized an rpoB gene region involved in rifampicin resistance in 49 Mycobacterium tuberculosis isolates resistant to rifampicin from Germany and Sierra Leone. The determined frequencies of mutations differed between both countries of origins as well as with respect to previously reported distributions of resistance mutations. It is concluded that at least for some isolates the acquisition of mutations leading to rifampicin resistance in clinical samples of M. tuberculosis is a non-random process which may lead to a geographical and temporal dependence of the sensitivities of molecular typing techniques for rifampicin resistance predictions.

Usefulness of Mycobacterium tuberculosis genomic mutations in the genes katG and inhA for the prediction of isoniazid resistance.

SETTING: Mutations in two genes of Mycobacterium tuberculosis, inhA and katG, are known to correlate with resistance to isoniazid (INH). OBJECTIVE: To determine which mutation or mutations are the most predictive for INH resistance and the most frequent ones in such isolates. Further, to propose a simple and generally applicable method for their detection. DESIGN: Codons 94 and 95 in the inhA gene and codons 315 and 463 in the katG gene were characterized in 50 INH-resistant and 12 INH-sensitive isolates from Germany and Sierra Leone. RESULTS: Mutations in codon 315 of the katG gene were detected in 27 of the INH-resistant and none of the INH-sensitive isolates. All mutations in this codon altered an AciI restriction enzyme site. No mutations were found in the investigated codons of the inhA gene. CONCLUSION: We propose that most INH resistances can be rapidly predicted by a simple AciI restriction enzyme digest of a polymerase chain reaction (PCR)-amplified katG fragment.

Pharyngeal repair after laryngopharyngectomy: 4-year experience.

The most common forms of surgical intervention carried out at the National Cancer Institute of Cairo for patients initially seen with hypopharyngeal carcinoma are (1) laryngopharyngectomy and pharyngeal repair using the pectoralis major myocutaneous flap (PMMF) and (2) extrapleural total pharyngolaryngoesophagectomy with gastric transposition (GT) and pharyngogastrostomy. The advantages and disadvantages with both techniques will be discussed on the basis of results of 69 patients with different tumor distributions over a 4-year period.

Epidemiology of accidental home poisoning in Riyadh (Saudi Arabia).

In a prospective study on 178 cases of accidental home poisoning admitted to the main children's hospital in Riyadh poisoning was found to account for 5.6% of the total annual admissions--greater than any other developing country and approaching Western proportions. The commonest ages were between 1 and 5 years. Drugs accounted for 52% of cases and household products for 46%. This picture also differs from the pattern of poisoning in developing countries and is more akin to that of industrialised countries. The most important factors in aetiology, besides the age of the patient and the underprivileged social class, were the abundance of drugs and household chemicals in the Saudi home, none of them in child proof containers; inappropriate storage; and lack of supervision of children. Cultural factors also contributed. The frequency of poisoning in childhood may be decreased in the long run by improved housing, socioeconomic status, and education. The place and methods of health education, also a long term objective, is discussed. For immediate primary prevention two important legislative measures are proposed: (1) provision of childproof containers of drugs and other chemicals used in the home and (2) banning of over the counter sales of drugs. For more accurate epidemiological data collection, and thereby better preventative planning, a national register of accidental poisoning and other accidents is recommended. Poison information centres are also deemed necessary.

Use of Halifax interlaminar clamps for posterior C1-C2 arthrodesis.

Eight patients with atlantoaxial instability secondary to trauma or rheumatoid arthritis were treated with posterior C1-C2 arthrodesis using the Halifax interlaminar clamp and autogenous bone graft or methylmethacrylate. Thus far, with an average follow-up of 6 months, satisfactory stability has been achieved with no instrument failure.

Culture-independent prediction of isoniazid resistance in Mycobacterium tuberculosis by katG gene analysis directly from sputum samples.

BACKGROUND: The molecular prediction of isoniazid (INH) resistance in Mycobacterium tuberculosis is hampered by the need for specialized equipment, expertise, high costs, a limited range of detectable mutations, or several of these factors. The rationale for the study was to find a practical alternative and to demonstrate generally valid problems. METHODS AND RESULTS: DNA extracted from decontaminated sputum pellets was used to amplify a 0.26 kb target sequence within the katG gene. Mutations of codon 315, frequently found in isoniazid-resistant isolates, could be discriminated in a simple agarose minigel format following an AciI digest of the nested polymerase chain reaction (PCR) product. Within a panel of 22 sputum samples, INH resistance could be predicted in 5 of 10 samples containing isoniazid-resistant M. tuberculosis. The protocol is robust, requires little expertise and no specialized equipment, and provides the test results within 2 days. CONCLUSION: The results show the feasibility to rapidly and easily detect mutations highly predictive of isoniazid resistance. Nevertheless, this, like any other molecular resistance prediction test, is affected by often neglected factors, including mutation prevalences, the phenomenon of heteroresistance, and a possible bias toward one's own method.

Nontraumatic brain hemorrhage in children: etiology and presentation.

The clinical and radiographic findings of 68 children and adolescents with nontraumatic intraparenchymal brain hemorrhage were analyzed retrospectively. There were 43 boys and 25 girls, and the average age was 7.1 years (range, 3 months to 18 years). The most common presenting symptom was a combination of headache or vomiting (40 cases, or 58.8%). Hemiparesis was the major presenting sign in 11 (16.2%) of the children, seizures occurred in 25 (36.8%) patients, and 6 (8.8%) children were irritable. Only 2 (2.9%) children were comatose at presentation. One or more risk factors for hemorrhage were found in 61 (89.7%) of 68 children. A third (23 cases, or 33.8%) had an arteriovenous malformation or fistula; altogether 29 (42.6%) children had some type of congenital vascular anomaly. Hematologic or coagulation disorders were present in 22 (32.4%) patients, and 9 (13.2%) patients had brain tumors. Hemorrhage could not be attributed to systemic hypertension in any child. The likelihood of establishing the cause of bleeding was greater when evaluation included cerebral angiography (97.3% versus 80.4% without angiography). Half (34 cases, or 50.0%) of the patients regained normal neurologic function. Six (8.8%) patients died, either directly or partly as a consequence of the hemorrhage. The remaining patients had various neurologic sequelae, including 17 (25.0%) with hemiparesis, 5 (7.4%) with aphasia, 7 (10.3%) with epileptic seizures, and 3 (4.4%) with hydrocephalus. More detailed follow-up studies are needed to obtain more information about the frequency of cognitive sequelae.

An unusual case of penetrating head injury with excellent recovery.

We report the remarkable case of the passage of a heavy metal rod through the head of a 42-year-old man. The patient had an excellent outcome because of prompt and efficient rescue efforts combined with transport to a major neurosurgical trauma center. Reference is made to a somewhat similar case publicized over 130 years ago.

Subdural hematomas. I. Acute subdural hematoma: progress in definition, clinical pathology, and therapy.

A series of 206 patients with clotted subdural hematomas operated within 3 days of closed head injury is presented. Sixty-two percent (128) were operated within 24 hours of trauma (acute subdural hematoma) carrying a high incidence of sterotypic motor posturing, impaired oculomotor reflexes, and unilateral dilated fixed pupil. A functional recovery occurred in 27% and a vegetative state or death resulted in 62%. The remaining 38% were operated after 24 but within 72 hours from injury (early subacute subdural hematoma) and generally had less severe neurologic dysfunction. A functional recovery occurred in 54% and vegetative state or death in 34%. The 128 acute cases are presented in detail to establish a logical basis for time differential. The cases requiring operation within 12 hours of injury were the most challenging. Improved outcome is felt to result from prompt referral and large craniotomy in the earliest hours after injury, combined with careful postoperative monitoring. Clinical, operative and autopsy findings are presented and discussed in relation to pathogenesis.

Laryngotracheal resection for post scleromatous laryngeal stenosis.

Scleroma is an endemic disease in Egypt, which frequently results in subglottic laryngeal stenosis. Six patients suffering from laryngoscleroma are represented. They all underwent laryngotracheal resection of the stenosed segment, followed by direct anastomosis. The results were satisfactory in four of the patients. Surgery was abandoned in one patient who was believed to suffer from perichondritis following previous surgery. Restenosis occurred in a 14-year-old girl two weeks after surgery. This was attributed to recurrence, possibly due to residual activity of the disease which was missed before surgery.

Visual dysfunction: abnormal sign of benign sphenoethmoidal lesions.

Isolated visual dysfunction with or without proptosis is rarely described as a sign of benign sphenoethmoidal lesions. Five patients with benign swelling of the sino-orbital region and related visual defects are reported. Cases include one patient with fibrous dysplasia, two patients with mucocoeles and two patients suffering from aspergillosis of the sinuses. A review of the literature and discussion of the cases is presented.

Direct extension of laryngeal carcinoma to the skin of the neck.

Invasion of the skin of the neck by laryngeal carcinoma is relatively uncommon. Twelve cases of cancer of the larynx fungating through the cervical skin are presented. They mostly followed initial treatment by deep X-ray therapy or partial laryngectomy. A high tracheostomy was also considered to be a contributing cause for the occurrence of such a mishap. The management and follow-up of these patients is described.

Arytenoidectomy and posterior cordectomy for bilateral abductor paralysis.

Twelve patients with bilateral fixed vocal cords seeking decannulation of their tracheostomies were subjected to endoscopic correction of the compromised airway. They all had arytenoidectomy associated with posterior cordectomy whether as a primary or secondary stage procedure. Decannulation was achieved in all patients using the technique described.

[Retroperitoneal marsupialization of renal cysts]. / Retroperitoneoskopska marsupijalizacija bubrezne ciste.

The use of minimal invasive surgery in urology continue to increase. Retroperitoneoscopic approach in performing minimal invasive surgery of retroperitoneum shortens the duration of operation in comparison with transabdominal approach, with minimal risk of intraabdominal complications. We described the use of the retroperitoneoscopic approach to the upper pole of a kidney for marsupialization of a symptomatic renal cyst. The procedure was minimally traumatic, morbidity was negligible and the patient was discharged from the hospital the third day after the operation. We believe that retroperitoneoscopic management of giant symptomatic renal cysts will be applicable, together with other existing methods.

[Study of sodium metabolism in the bodies of patients with essential hypertension by the profile scanning technic using 22Na]. / Izuchenie obmena natriia v organizme bol'nykh gipertonicheskoi bolezn'iu metodom profil'nogo skennirovaniia s nuklidom 22Na.

Profile scanning with sodium-22 nuclide was performed in 37 patients with essential hypertension to determine the time-course of the isotope distribution in different parts of the body and the rate of its elimination. The rate of sodium-22 infiltration into the tissues of the pelvis and lower extremities was higher in women than in men, and that of elimination lower than in men with a stable course of arterial hypertension. This index showed no correlation with changes of the central hemodynamics and glomerular filtration. The labile and stable courses of arterial hypertension were characterized by different rates of sodium-22 uptake by the renal tissue.

[Changes in water-sodium balance in patients with hypertension subjected to different types of hypotensive therapy]. / Kharakter vodno-natrievykh izmenenii v organizme bol'nykh gipertonicheskoi bolezn'iu pod vliianiem razlichnykh vidov gipotenzivnoi terapii.

The parameters of water-electrolyte metabolism and central hemodynamics were studied in 44 patients with essential hypertension (stage II-III) after 3-week treatment with sympatholytics and diuretics. Patients with hyperkinetic type of hemocirculation had a sodium lack at the stage of stable hypertension, therefore the diuretic treatment is not indicated for such patients. The treatment with the diuretic oxodolin was accompanied by the decrease in the peripheral resistance of blood vessels, in sodium metabolism and its extracellular fraction, and by the increase of the deposit sodium fraction. The elevation of the renin-angiotensin system activity due to the diuretic therapy did not influence the blood pressure level and the central hemodynamics parameters.

[Contribution of closed mitral commissurotomy in the surgery of rheumatic mitral stenosis]. / Apport de la commissurotomie à cœur fermé dans la chirurgie de la sténose mitrale rhumatismale.

UNLABELLED: The objective of this work was to study the indications, techniques and results of closed heart mitral commissurotomy in patients with rheumatic mitral stenosis in Morocco. METHODS: All patients who had undergone closed heart mitral commissurotomy for rheumatic mitral stenosis, operated between 1999 and 2008 were collected in this study. Mitral stenosis was diagnosed and evaluated using Doppler echocardiography. Patients with commissural calcification, severe mitral regurgitation, and surgical tricuspid or aortic valvular disease were excluded from this study. RESULTS: Six hundred and twenty-five patients have been collected. 62.2% were young with an age between 18 and 35 years and 491 (78.8%) were female. Seventy-nine percent of patients had stage III or IV NYHA and were in sinus regular rhythm. The closed heart mitral commissurotomy was performed for all patients through a left thoracotomy using either digital or dual dilatation. The mitral area was significantly increased postoperatively to 2.11 ± 0.32 with 100% opening of the anterior commissure, while the posterior commissure was opened only for 93.7% of patients. There were nine perioperative deaths (4.9%) and all patients who died had severe mitral stenosis (<0.8 cm(2)) with an elevated systolic pulmonary artery pressure (>60 mmHg). CONCLUSION: The closed heart mitral commissurotomy provides excellent results in young patients with rheumatic mitral stenosis.