Efficiency and feasibility of product disassembly: A case-based study

The productivity associated with commonly available disassembly methods today seldomly makes disassembly the preferred end-of-life solution for massive take back product streams. Systematic reuse of parts or components, or recycling of pure material fractions are often not achievable in an economically sustainable way. In this paper a case-based review of current disassembly practices is used to analyse the factors influencing disassembly feasibility. Data mining techniques were used to identify major factors influencing the profitability of disassembly operations. Case characteristics such as involvement of the product manufacturer in the end-of-life treatment and continuous ownership are some of the important dimensions. Economic models demonstrate that the efficiency of disassembly operations should be increased an order of magnitude to assure the competitiveness of ecologically preferred, disassembly oriented end-of-life scenarios for large waste of electric and electronic equipment (WEEE) streams. Technological means available to increase the productivity of the disassembly operations are summarized. Automated disassembly techniques can contribute to the robustness of the process, but do not allow to overcome the efficiency gap if not combined with appropriate product design measures. Innovative, reversible joints, collectively activated by external trigger signals, form a promising approach to low cost, mass disassembly in this context. A short overview of the state-of-the-art in the development of such self-disassembling joints is included.     

Establishment of a reference library for evaluating computer ECG measurement programs

As a result of an international cooperative project entitled "Common Standards for Quantitative Electrocardiography" (CSE), an ECG reference data base has been established with the aim of standardizing computer-derived ECG measurements. The objective of the project is to reduce the wide variation in wave measurements currently obtained by ECG analysis programs. A library of 250 ECGs with selective ECG abnormalities was established and a comprehensive reviewing scheme was devised for the visual determination of the onsets and offsets of P, QRS, and T. This task was performed by a board of cardiologists on highly amplified, selected complexes from the library. A subset was examined in order to study beat-to-beat and intraobserver variability. By using a modified Delphi approach, individual outlying point estimates were eliminated in four successive rounds. In this way final referee estimates were obtained which proved to be highly reproducible and precise. A reference library has thereby been developed which allows testing of the performance of ECG measurement programs and is a useful instrument in establishing recommendations for more precise measurement rules and definitions.     

Quality control of an unreliable random FMS: with Bernoulli and CSP sampling

It is widely recognized that disassembly-based product End-of-Life strategies, such as component reuse or simple fraction material recycling, are environmentally beneficial. However, current disassembly costs hinder a widespread application of these strategies. This paper quantifies the disassembly time reductions required to achieve economic feasibility of systematic product disassembly. A modelling framework, based on linear programming, is used to investigate the effect of reducing the expected disassembly time and cost on the selection of the optimal End-of-Life strategy. The problem is optimized from an End-of-Life treatment facility point of view. All findings are based on the Belgian cost and price information captured in spring 2004. The linear programming model shows that for small products from the Waste of Electric and Electrical Equipment (WEEE) category disassembly-based End-of-Life strategies will hardly become optimal, while for medium- and large-sized products, this scenario can be made optimal if a substantial disassembly time reduction is achieved. Possible strategies to realize such reduction are briefly sketched.     

Clinically significant hearing loss in renal allograft recipients treated with intravenous erythromycin

BACKGROUND: Hearing loss is generally regarded as a rare side effect of erythromycin therapy. However, our own clinical experiences in erythromycin-treated patients led us to suspect that this complication may be more common among renal allograft recipients. The purpose of this study was to evaluate the incidence, predisposing factors, clinical characteristics, and outcomes of erythromycin-induced hearing loss among renal allograft recipients. METHODS: We reviewed medical records of renal transplant patients treated for pneumonia with intravenous erythromycin lactobionate. Patients were evaluated for the occurrence of clinically significant hearing loss (including onset, duration, and reversibility), other signs and symptoms of ototoxicity (vertigo and tinnitus), daily erythromycin dose and duration of treatment, concurrent ototoxic drug therapy, renal and hepatic function, and history of previous otic disease. RESULTS: Eleven (32%) of 34 courses of intravenous erythromycin therapy resulted in hearing loss. The incidence of hearing loss was 53% (eight of 15 courses) in patients treated with 4 g of erythromycin daily compared with 16% (three of 19 courses) among those receiving 2 g/d (P = .05). In addition, courses of erythromycin were longer in those suffering auditory toxicity (9.6 +/- 4.7 days) than in nontoxic patients (5.7 +/- 3.6 days) (P < .05). Hepatic and renal function did not differ between toxic and nontoxic patients. All episodes of erythromycin-induced hearing loss were reversible. CONCLUSIONS: We conclude that clinically significant hearing loss occurs in more than 30% of renal allograft recipients treated for pneumonia with intravenous erythromycin lactobionate. Patients who require prolonged courses of erythromycin and those treated with 4 g/d are at particular risk for the development of auditory toxicity. With prompt recognition and modification of therapy, erythromycin-induced hearing loss appears to be completely reversible.     

Povidone iodine and skin disinfection before initiation of epidural anesthesia

OBJECTIVE: The clinical, mammographic and low grade cytologic features of mucinous carcinoma can make it difficult to diagnose by fine needle aspiration (FNA). Fine needle aspirates of mucinous carcinoma were reviewed with the mammographic findings to improve the diagnostic criteria and specificity for FNA. STUDY DESIGN: All aspirates were reviewed for cytologic criteria and cellularity, atypia and single epithelial cells (SEC). A nuclear grade was assigned to each aspirate. The mammographic findings were correlated with the FNA diagnoses. RESULTS: Forty-five patients with an aspirate and confirmed diagnosis of mucinous carcinoma were identified. The clinical impressions were: benign tissue (5), fibroadenoma (6) and cancer (32). The initial cytologic diagnoses were: adenocarcinoma (32), atypical/suspicious for cancer (11), insufficient (1) and negative (1). The cytologic findings showed smears with increased cellularity (35/45 cases) and minimal atypia. SEC with eccentrically located nuclei and eosinophilic cytoplasm were numerous. The assigned nuclear grade was as follows: grade 1, 16 cases; grade 2, 20 cases; and grade 3, 6 cases. Abundant mucin was present in Papanicolaou-stained slides in 23 cases; focal mucin was observed in 14 cases. The mammograms showed a smoothly outlined to lobulated mass with only slight irregularities identified. CONCLUSION: Mucinous carcinoma has a cytologic pattern that includes increased cellularity, with numerous single cells and abundant mucin. Although the mammographic findings may mimic a benign lesion, in the most patients a specific diagnosis of mucinous carcinoma can be made by FNA.     

Revascularization of calvarial, mandibular, tibial, and iliac bone grafts in rats

The development of approaches to screening of hospital patients for harmful drinking frequently encounters resistance from both patients and hospital staff. A contributing factor could be the discomfort both feel about talking specifically about drinking. One approach to reducing this discomfort has been to mask concern about alcohol consumption into a general focus on other health and lifestyle issues. One-hundred and eighty-two patients admitted to an emergency department were presented randomly with either a straight alcohol screening questionnaire or a general health and lifestyle questionnaire with alcohol questions embedded amongst items on smoking exercise and diet. The number of returns was equal for both questionnaires which suggests the masked questionnaire does not improve the acceptability of alcohol screening in hospital environments.     

K-ras gene mutations: an unfavorable prognostic marker in stage I lung adenocarcinoma

Activation of K-ras gene by point mutations, a common finding in lung adenocarcinomas, has been suggested to decrease patient survival. We investigated 109 lung adenocarcinomas, mostly small, peripheral, stage I tumours (81/109) for presence of K-ras gene mutations at codons 12 and 13. Mutations were detected by denaturing gradient gel electrophoresis analysis of specific sequences amplified by polymerase chain reaction from DNA extracted from archival pathological material. Thirty-three of 109 (30.3%) tumours showed mutations at codon 12 (28/33, 84.8%) or 13 (5/33, 15.2%) of the gene. Mutations and type of nucleotide substitutions were differently distributed among cytological subtypes, being more prevalent among less differentiated (G2 and G3) tumours and among bronchial than bronchiolo-alveolar type adenocarcinomas. Survival analysis showed an adverse effect of K-ras mutation on survival, restricted to stage I tumours. Median survival for 81 stage I patients was 30 months for non-mutated tumours versus 20 months for mutated tumours (p = 0.016). Multivariate analysis showed that age of patient (p = 0.001) and K-ras mutation status (p = 0.04) were the only independent factors influencing survival significantly. These data strengthen the hypothesis that K-ras gene mutations may be useful in identifying a subgroup of patients with poor outcome.     

White matter lesion detection in multiple sclerosis: improved interobserver concordance with multispectral MRI display

The histopathology specimens from 256 consecutive prostatectomies were retrospectively analysed and classified into three categories namely BPH alone, BPH and an inflammatory lesion and adenocarcinoma. Mode of presentation (acute urine retention versus prostatism) as well as short term post-operative complications, namely, haemorrhage and genitourinary infection were compared in the three histological categories to study the impact of histology on clinical presentation and complications. There were no significant differences between the three categories neither in presentation nor in complications. We conclude that prostate gland histology neither correlates with the onset of acute urine retention nor with the surgical complications studied in this report.     

p-aminohippurate uptake by syncytial microvillous membrane vesicles of human term placenta

The mechanism of uptake of p-aminohippurate (PAH) by syncytial microvillous membrane vesicles of human term placenta was investigated. Initial PAH uptake and efflux were increased in the presence of a pH-gradient and a Cl(-)-gradient, respectively. Forced negative and positive membrane potentials did not influence the uptake, which indicated that the transport is not electrogenic. The pH-dependent increase is probably the result of a higher rate of diffusion due to a lower degree of dissociation of PAH. Because several organic anions failed to transstimulate PAH uptake and FCCP did not decrease the uptake in the presence of an inwardly directed H(+)-gradient, ruling out a PAH/OH- antiport, an anion exchange system does not appear to be present in these membranes. Since electrogenicity and anion exchange seem not to be involved in the Cl(-)-dependent increase, an allosteric effect of Cl- on the transporter might be possible. Various organic anions were able to inhibit pH-stimulated PAH uptake significantly. Kinetic analysis of the probenecid sensitive part of uptake provided further evidence for mediated transport of PAH (Km = 7.4 +/- 2.6 mM and Vmax = 2.0 +/- 0.4 nmol/mg/15 s). Non-inhibitable diffusion accounted for the main part of total transport. Concentration dependent inhibition of PAH transport by probenecid showed a Ki of 2.5 +/- 0.9 mM. It is concluded that human placental syncytial microvillous membrane vesicles possess a low affinity transport mechanism for PAH with low specificity. The importance of this system, for placental excretion of anionic drugs, will depend on the intrasyncytial concentration of these drugs, caused by the transport across the basal membrane.