Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications
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Improving the ability of asphalt pavement to survive the heavily repeated axle loads and weathering challenges in Iraq has been the subject of research for many years. The critical need for such data in the design and construction of more durable flexible pavement in bridge deck material is paramount. One of new possible steps is the epoxy asphalt concrete, which is classified as a superior asphalt concrete in roads and greatly imparts the level of design and construction. This paper describes a study on 40-50 penetration graded asphalt cement mixed with epoxy to produce asphalt concrete mixtures. The tests carried out are the Marshall properties, permanent deformation, flexural fatigue cracking and moisture damage. Epoxy asphalt mixes perf
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Passive optical network (PON) is a point to multipoint, bidirectional, high rate optical network for data communication. Different standards of PONs are being implemented, first of all PON was ATM PON (APON) which evolved in Broadband PON (BPON). The two major types are Ethernet PON (EPON) and Gigabit passive optical network (GPON). PON with these different standards is called xPON. To have an efficient performance for the last two standards of PON, some important issues will considered. In our work we will integrate a network with different queuing models such M/M/1 and M/M/m model. After analyzing IPACT as a DBA scheme for this integrated network, we modulate cycle time, traffic load, throughput, utilization and overall delay
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Protein arginine methyltransferases (PRMTs) play important roles in transcription, splicing, DNA damage repair, RNA biology, and cellular metabolism. Thus, PRMTs have been attractive targets for various diseases. In this study, we reported the design and synthesis of a potent pan-inhibitor for PRMTs that tethers a thioadenosine and various substituted guanidino groups through a propyl linker. Compound II757 exhibits a half-maximal inhibition concentration (IC50) value of 5 to 555 nM for eight tested PRMTs, with the highest inhibition for PRMT4 (IC50 = 5 nM). The kinetic study demonstrated that II757 competitively binds at the SAM binding site of PRMT1. Notably, II757 is selective for PRMTs over a panel of other methyltransferases, w
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There are many images you need to large Khoznah space With the continued evolution of storage technology for computers, there is a need nailed required to reduce Alkhoznip space for pictures and image compression in a good way, the conversion method Alamueja