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[Four cases of pulmonary infection due to Mycobacterium szulgai with a review of previous case reports in Japan].  


We report 4 cases of pulmonary infection due to Mycobacterium szulgai with review of 23 cases previously reported in Japan. All 4 patients were male and two of them in their 20's were found to have abnormal chest X-ray findings recognized on a health checkup without any symptoms. One case had no previous history of illness and had never smoked. Radiographic study showed thick-walled cavities in 3 cases and multiple small nodules in 2, indicating the difficulty of distinguishing M. szulgai infection from pulmonary tuberculosis or M. kansasii infection. Three cases were treated as pulmonary tuberculosis at first, and later we changed the medication referring to the drug susceptibility. In most cases, rifampicin, ethionamide and ethanbutol were used and the medication regimen was successfully completed in all cases. Considering that the detected M. szulgai could be regarded as pathogen in almost all cases, it is important to evaluate the risk factor of patients and not to delay diagnosis and treatment with adhering to usual diagnostic criteria. PMID:19068760

Sekine, Akimasa; Hagiwara, Eri; Ogura, Takashi; Sato, Tomohide; Shinohara, Takeshi; Baba, Tomohisa; Endo, Takahiro; Sogo, Yoko; Nishihira, Ryuichi; Komatsu, Shigeru; Matsumoto, Yutaka; Takahashi, Hiroshi



Hallux saltans due to flexor hallucis longus entrapment at a previously unreported site in an unskilled manual laborer: a case report.  


Triggering of the big toe, or hallux saltans, is commonly due to stenosing tenosynovitis of the flexor hallucis longus at the fibro-osseous tunnel below the sustentaculum tali. It is a rare condition described mainly in female ballet dancers. This is hypothesized to be due to the en pointe position used in ballet, which puts enormous supraphysiologic loads on the flexor hallucis longus, predisposing it to injury. Trigger hallux is extremely uncommon in the general population. We are reporting a case of hallux saltans in an unskilled manual laborer, with the site of tendon entrapment just proximal to the medial malleolus in the distal leg, a hitherto unreported location of stenosis. PMID:22459424

Purushothaman, Rajesh; Karuppal, Raju; Inassi, Jojo; Valsalan, Rejith



Pleuritis due to Brevundimonas diminuta in a previously healthy man.  


Brevundimonas diminuta is rarely associated with invasive infections. We report the case of a previously healthy young man with pleural effusion, in which B. diminuta was recovered but incorrectly identified as Kingella kingae when it was freshly isolated. Consequently, the misidentification resulted in initial treatment failure. The correct identification was achieved through further incubation, sequencing of the 16S rRNA gene and MS. PMID:23180480

Lu, Binghuai; Shi, Yanli; Zhu, Fengxia; Xu, Xiaolin



Appearance of Uterine Scar Due to Previous Cesarean Section on Hysterosalpingography: Various Shapes, Locations and Sizes  

PubMed Central

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes that is used predominantly in the assessment of infertility and evaluation of abnormalities of the uterus and fallopian tubes. Some of the abnormalities that can be detected by HSG include congenital anomalies, polyps, leiomyomas, synechiae and adenomyosis. HSG is also used to evaluate any scarring on the uterus and fallopian tubes. Cesarean section is the most commonly performed surgical procedure involving the uterus in fertile women. Cesarean section involves an incision made in the lower uterine segment or isthmus. Various changes in the site of the cesarean incision may be seen due to wall weakness and fibrosis. The scar may have various shapes; unilateral or bilateral, single or multiple, wedge-shaped or linear. Awareness of the appearance and locations of uterine defects due to previous cesarean section is necessary in order to differentiate them from normal variations and other pathologies mimicking it. In this study, we demonstrate the appearance of anatomic defects of the uterine cavity on HSG after cesarian section. We define different shapes such as thin linear defect, focal saccular outpouching, unilateral or bilateral diverticula (dog-ear like) and fistula and different locations such as the uterine body, lower uterine segment, uterine isthmus and the upper endocervical canal.

Ahmadi, Firoozeh; Torbati, Leila; Akhbari, Farnaz; Shahrzad, Gholam



17 CFR 46.11 - Reporting of errors and omissions in previously reported data.  

Code of Federal Regulations, 2013 CFR

...errors and omissions in previously reported data. 46.11 Section 46.11 Commodity...COMMODITY FUTURES TRADING COMMISSION SWAP DATA RECORDKEEPING AND REPORTING REQUIREMENTS...errors and omissions in previously reported data. (a) Each swap counterparty...



17 CFR 45.14 - Reporting of errors and omissions in previously reported data.  

Code of Federal Regulations, 2013 CFR

...errors and omissions in previously reported data. 45.14 Section 45.14 Commodity...COMMODITY FUTURES TRADING COMMISSION SWAP DATA RECORDKEEPING AND REPORTING REQUIREMENTS...errors and omissions in previously reported data. (a) Each registered entity and...



Prolonged asthma after smoke inhalation: A report of three cases and a review of previous reports  

SciTech Connect

The development of prolonged obstructive airways disease after smoke inhalation is of concern to fire victims and fire fighters. Three cases of asthma that developed following the inhalation of pyrolysis products are presented along with a review of previous reports of airway injury from smoke inhalation. Polyvinyl chloride pyrolysis products seem to pose a high risk, but other toxic inhalants are also implicated. There is substantial evidence that prolonged airway hyper-responsiveness and asthma may follow numerous inflammatory insults including smoke inhalation. Studies to identify specific individual risk factors and asthmagenic pyrolysis products are needed. Early, postexposure anti-inflammatory treatment may modify the outcome. 42 refs.

Moisan, T.C. (Department of Preventive Medicine, Loyola University-Stritch School of Medicine, Maywood, IL (USA))



Cladophialophora bantiana (Previously Cladosporium trichoides): First Report of a Case in Brazil.  


Cladophialophora bantiana (Cladosporium trichoides) is a black fungus recorded rarely as a cause of brain abscess. Only 21 cases have been reported in the literature world-wide. We describe the first case seen in Brazil. A 30 year old, previously healthy female, HIV negative, came to the hospital with a clinical diagnosis of brain tumor. After biopsy and culture of the lesion, it was found that she had an abscess due to Cladosporium trichoides. During the following five months, the patient underwent three more surgical brain interventions to totally remove the area of compromised tissue. In addition to surgery, amphotericin B, both intravenously and intrathecally, was used followed by itraconazole orally, without success. Six months after the first surgical intervention, the patient died. The worldwide experience with diagnosis and treatment of patients with this diseases is reviewed. PMID:11105153

Freitas; Pedral-Sampaio; Espinheira Nogueira L; Daltro; Sampaio; Athanásio; Lacaz; Badaró



Hypoxic respiratory failure due to phrenic nerve palsy from an interscalene brachial plexus block and previously asymptomatic pulmonary embolism  

Microsoft Academic Search

Interscalene brachial plexus block is a common regional anesthesia method for upper extremity surgery. A rare complication\\u000a of this procedure is dyspnea secondary to phrenic nerve palsy and hemidiaphragm paralysis. In our case, this rare complication\\u000a diagnosed using ultrasound led to the diagnosis of a previously asymptomatic pulmonary embolism. The use of ultrasonography\\u000a was key in the diagnosis of the

Danielle M. Minett; Jason T. Nomura



Lobular Breast Cancer in a Male Patient with a Previous History of Irradiation Due to Hodgkin's Disease  

PubMed Central

Background Male breast cancer is rare and represents less than 1% of all breast cancers. Considering the fact that the male breast most often does not consist of lobules and acini, lobular carcinoma of the male breast is exceptionally rare. Case Report In this paper we present a unique case of alveolar variant of lobular male breast cancer in a 56-year-old patient. Conclusion According to our knowledge this is the first presentation of an alveolar variant of lobular male breast cancer that appeared 14 years after chemo- and radiotherapy for the treatment of Hodgkin's disease.

Ninkovic, Srdjan; Azanjac, Goran; Knezevic, Milan; Radovanovic, Dragce; Canovic, Dragan; Nedovic, Jasmina; Mitrovic, Slobodanka



Anesthetic experience in patient for single lung transplantation with previous contralateral pneumonectomy -A case report-  

PubMed Central

A 48-year-old woman with cystic fibrosis and a previous left pneumonectomy had surgery planned for single lung transplantation under general anesthesia. Due to progressive dyspnea and recurrent respiratory infection, she could not maintain her normal daily life without lung transplantation. The anesthetic management and surgical procedure was expected to be difficult because of the left mediastinal shift and an asymmetric thorax after the left pneumonectomy, but the single lung transplantation was successfully done under cardiopulmonary bypass.

Chung, Ji-Hyun; Cha, Seung-Cheol; Hwang, Jin-Hwan



Cervico-isthmic pregnancy developing within the scar of a previous cesarean section: a case report  

Microsoft Academic Search

The cervico-isthmic pregnancy is a rare event occurring during pregnancy. In this current report, we describe a case of a\\u000a woman with pregnancy developed within a previous cesarean section scar and successfully treated with conservative management.

Achille Tolino; Lucia Battista; Gaetano Chiacchio; Erika Rania; Caterina Materazzo; Stefano Palomba



Residual silicone detection using mri following previous breast implant removal: Case reports  

Microsoft Academic Search

The current controversy surrounding the safety of silicone gel breast implants has resulted in an increasing number being removed. Although previous reports have suggested that remnants of the implant capsule are reabsorbed after explantation surgery, the persistence of the capsule in fact may be associated with implant fragments and silicone gel leakage. In this study we have used magnetic resonance

Christina Y. Ahn; William W. Shaw; Krishna Narayanan; David P Gorczyca; Nanette D. DeBruhl; Lawrence W. Bassett



New Results from Previously Reported NBS (National Bureau of Standards) Fundamental Constant Determinations.  

National Technical Information Service (NTIS)

A new treatment of previously reported results of three electric-unit-dependent fundamental constant experiments carried out at NBS over the last decade or so yields accurate, indirect values in SI units for a number of important quantities. These include...

B. N. Taylor



Heat Losses Due to Windows. Project Report.  

National Technical Information Service (NTIS)

An evaluation of heat losses due to various window constructions is given. Traditional window systems are compared to modern ones, like gas insulated glass etc. Insolation and building design are estimated on basis of a standard house, K-value of various ...

B. Lund Nielsen



IMAGe syndrome: Case report with a previously unreported feature and review of published literature.  


IMAGe syndrome is a rare condition, first reported by Vilain et al., in 1999, characterized by intrauterine growth restriction, metaphyseal dysplasia, congenital adrenal hypoplasia, and genital anomalies. Patients with this condition may present shortly after birth with severe adrenal insufficiency, which can be life-threatening if not recognized early and commenced on steroid replacement therapy. Other reported features in this condition include, hypercalciuria and/or hypercalcemia, craniosynostosis, cleft palate, and scoliosis. We report on a 7-year-old boy with IMAGe syndrome, who in addition to the features in the acronym also has bilateral sensorineural hearing loss which has not been reported in previously published cases of IMAGe syndrome. We discuss the clinical presentation in our patient and review the literature in this rare multisystem disorder. PMID:21108398

Balasubramanian, Meena; Sprigg, Alan; Johnson, Diana S



Aortic valve replacement after previous coronary artery bypass grafting: a case report.  


We experienced a case of aortic valve replacement after previous coronary artery bypass grafting with patent bypass grafts. Based on the retrosternal anatomy assessed by preoperative angiography and thoracic computed tomography, aortic valve replacement was performed through a median resternotomy. After careful dissection of the right side of the heart and the ascending aorta, cardiopulmonary bypass was established with cannulation of the ascending aorta and bicaval venous cannulation. The patent bypass grafts were dissected only as required for clamping and were clamped during cardiac arrest. After aortic valve replacement, the patient was uneventfully weaned from cardiopulmonary bypass and had a good postoperative recovery. It is important that surgeons have a meticulous strategy for reducing the risks associated with operating on patients with patent bypass grafts. We report on the surgical management of patients undergoing aortic valve replacement after previous coronary artery bypass grafting, including careful planning during the first operation. PMID:23877203

Suzuki, Shigemitsu; Nakamura, Katsuhiko; Takagi, Kazumi; Kashikie, Hideyuki; Akaiwa, Keiichi



Reduced processing speed in rugby union players reporting three or more previous concussions.  


The issue pertaining to the effect of multiple self-reported sports-related concussions on cognitive function is controversial. Although this topic has received increased attention in the literature recently, the issue remains unresolved. Evidence supporting a detrimental cognitive effect has been reported at a sub-concussive level and following one, two, and three or more previous concussions. However, numerous studies have been unable to replicate these findings. Additionally, discrepancies between neuropsychological testing formats have been identified, where studies utilizing traditional tests tend to support the notion of detrimental cognitive effects whereas studies with computerized tests have tended to demonstrate no effect. The present study sought to examine possible detrimental cognitive effects in a sample of adult male rugby union players who reported a history of three or more concussions (n = 34) compared with those who reported no previous concussions (n = 39). A computerized neuropsychological battery and a traditional neuropsychological measure of processing speed were administered for this purpose. Findings revealed that there were differences between groups on two processing speed measures from both traditional and computerized tests. Athletes with a history of multiple concussions performed significantly lower on these measures than those with no history of concussion. These results provide further evidence to suggest that a history of three or more self-reported concussions in active athletes may have a detrimental effect on cognitive function. Future research may focus on identifying moderating factors in an attempt to resolve some of the conflicting findings and identify potential athletes at risk for sustaining cognitive deficits. PMID:20202986

Gardner, Andrew; Shores, E Arthur; Batchelor, Jennifer



Disseminated Infection Caused by Eggerthella lenta in a Previously Healthy Young Man: A Case Report  

PubMed Central

Anaerobic bacteria are the predominant normal flora of the mucous membranes which may cause life-threatening disseminated infections and are often difficult to culture from infected sites. Eggerthella (previously known as Eubacteria species) is an anaerobic, nonsporulating, nonmotile, Gram-positive rod that is found in the human colon and feces and has been isolated from various other clinical specimens. We report a case of complicated disseminated anaerobic bacterial infection with Eggerthella lenta in a healthy immunocompetent man causing multiple brain abscesses, liver abscesses, necrotizing pneumonia, and osteomyelitis of the left radial bone. He was successfully treated with empiric penicillin G and metronidazole.

Klotz, Stephen A.; Zangeneh, Tirdad T.



The use of buflomedil in reduction mammaplasty for a previously irradiated breast: a case report.  


In recent years, lumpectomy combined with breast irradiation and chemotherapy, as a part of conservation therapy for breast cancer, has well-established results. Little has been published on reduction mammoplasty for breast-irradiated patients. These patients have increased risks of nipple necrosis, wound complications, and delayed healing. Breast reduction techniques that rely on minimum skin undermining combined with the use of buflomedil may prevent major postoperative complications in breast-irradiated patients. Buflomedil was administered intraoperatively and for 14 days after the procedure. The use of buflomedil in reduction mammaplasty for a previously irradiated breast patient has not been heretofore described. The case of a 58-year-old woman who underwent bilateral breast reduction after breast conservation therapy is reported. PMID:18058164

Sterodimas, A; Vargas, A; Radwanski, H N; Pitanguy, I



Previously undescribed pulpal and periodontal ligament calcifications in systemic sclerosis: a case report.  


Systemic sclerosis (SSc), a multisystem autoimmune disease characterized by widespread fibrosis, vascular alterations, autoimmunity, and inflammation, has effects on the hard and soft tissues of the orofacial region. The most common oral radiographic features correspond to widening of the periodontal ligament space and to mandibular resorption. In this report, cone-beam computerized tomography (CBCT) confirmed not only the well described periodontal features associated with SSc but also revealed previously undescribed calcifications within the periodontal ligament space of most maxillary teeth. Moreover, CBCT showed pulp calcifications in some incisors and premolars with these calcifications leading to root canal obliterations. Such manifestations (which could be linked to different major pathogenic features of SSc such as calcinosis, vasculopathy, and fibrosis) contribute to the phenotypic spectrum of the disease. PMID:23332508

Jung, Sophie; Minoux, Maryline; Manière, Marie-Cécile; Martin, Thierry; Schmittbuhl, Matthieu



Unusual spectral energy distribution of a galaxy previously reported to be at redshift 6.68.  


Observations of distant galaxies are important both for understanding how galaxies form and for probing the physical conditions of the Universe at early times. It is, however, very difficult to identify galaxies at redshifts z > 5, because they are so faint and have few spectral characteristics. We previously reported the probable identification of a galaxy at z = 6.68, based on one line and an apparent break in the spectrum just shortwards of that, which we interpreted as Lyman alpha emission and the Lyman alpha break, where photons with shorter wavelengths are absorbed by the intervening neutral hydrogen gas. Here we present optical photometry that shows moderate detections of light in the B- and V-band images, which are inconsistent with the expected absence of flux shortwards of the Lyman alpha break for alpha galaxy at z > 5, and inconsistent with the previous flux measurement. Moreover, the spectral energy distribution for this object cannot readily be fitted by any known galaxy spectral template at any redshift, so the redshift is undetermined. PMID:11117738

Chen, H W; Lanzetta, K M; Pascarelle, S; Yahata, N



Adenylosuccinate lyase (ADSL) and infantile autism: absence of previously reported point mutation.  


Autism is a heterogeneous neuropsychiatric syndrome of unknown etiology. There is evidence that a deficiency in the enzyme adenylosuccinate lyase (ADSL), essential for de novo purine biosynthesis, could be involved in the pathogenesis of certain cases. A point mutation in the ADSL gene, resulting in a predicted serine-to-proline substitution and conferring structural instability to the mutant enzyme, has been reported previously in 3 affected siblings. In order to determine the prevalence of the mutation, we PCR-amplified the exon spanning the site of this mutation from the genomic DNA of patients fulfilling DSM-III-R criteria for autistic disorder. None of the 119 patients tested were found to have this mutation. Furthermore, on preliminary screening using singlestrand conformation polymorphism (SSCP), no novel mutations were detected in the coding sequence of four ADSL exons, spanning approximately 50% of the cDNA. In light of these findings, it appears that mutations in the ADSL gene represent a distinctly uncommon cause of autism. PMID:8825895

Fon, E A; Sarrazin, J; Meunier, C; Alarcia, J; Shevell, M I; Philippe, A; Leboyer, M; Rouleau, G A



45 CFR 265.4 - When are quarterly reports due?  

Code of Federal Regulations, 2011 CFR

45 Public Welfare 2 2011-10-01 2011-10-01 false When...quarterly reports due? 265.4 Section 265.4 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS),...



Placenta Percreta Invading Broad Ligament and Parametrium in a Woman with Two Previous Cesarean Sections: A Case Report  

PubMed Central

Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate.

Vahdat, Mansoureh; Mehdizadeh, Abolfazl; Sariri, Elaheh; Chaichian, Shahla; Najmi, Zahra; Kadivar, Maryam



The Social and Behavioral Effects of Broadcast Television on Previously Untouched Audiences. Final Report.  

ERIC Educational Resources Information Center

|This study, conducted prior to the installation of daily prime-time television programming in areas of rural Alaska previously without commercial television service, was designed to provide a foundation of pre-television baseline data against which to measure the social and behavioral effects of television on this multicultural population.…

Orvik, James M.; And Others


Life History Reports of Young Adults Previously Referred for Mental Health Services  

Microsoft Academic Search

In this article, we report factors associated with good versus poor outcomes for 173 young adults who were referred for mental health services as children or adolescents. Life history reports were compared for participants showing relatively good (n = III) versus poor (n = 62) outcomes, as determined by deviance on ? 2 of 3 measures of psychopathology. Participants with

Stephanie H. Mcconaughy; Martha E. Wadsworth



Plasmablastic Lymphoma in a Previously Undiagnosed Aids Patient: A Case Report  

Microsoft Academic Search

Background Plasmablastic lymphoma (PBL) is an unusual non-Hodgkin lymphoma (NHL) most commonly found in the head and neck region. The\\u000a majority of cases are seen in adult HIV-positive patients, although PBL has been reported in HIV-negative patients. The diagnosis\\u000a of PBL serves as an AIDS-defining illness. Methods We report a case of PBL localized to the oral cavity in a

Francisco O. Vieira; Omar El Gandour; Francis K. Buadi; Glenn B. Williams; Courtney B. Shires; Nadeem Zafar




SciTech Connect

The radial velocity-discovered exoplanet HD 97658b was recently announced to transit, with a derived planetary radius of 2.93 {+-} 0.28 R{sub Circled-Plus }. As a transiting super-Earth orbiting a bright star, this planet would make an attractive candidate for additional observations, including studies of its atmospheric properties. We present and analyze follow-up photometric observations of the HD 97658 system acquired with the Microvariability and Oscillations of STars space telescope. Our results show no transit with the depth and ephemeris reported in the announcement paper. For the same ephemeris, we rule out transits for a planet with radius larger than 2.09 R{sub Circled-Plus }, corresponding to the reported 3{sigma} lower limit. We also report new radial velocity measurements which continue to support the existence of an exoplanet with a period of 9.5 days, and obtain improved orbital parameters.

Dragomir, Diana; Matthews, Jaymie M.; Antoci, Victoria [Department of Physics and Astronomy, University of British Columbia, Vancouver, BC V6T1Z1 (Canada); Howard, Andrew W.; Marcy, Geoffrey W. [Department of Astronomy, University of California, Berkeley, CA 94720-3411 (United States); Henry, Gregory W. [Center of Excellence in Information Systems, Tennessee State University, 3500 John A. Merritt Blvd., Box 9501, Nashville, TN 37209 (United States); Guenther, David B. [Department of Astronomy and Physics, St. Marys University Halifax, NS B3H 3C3 (Canada); Johnson, John A. [Department of Astronomy, California Institute of Technology, 1200 East California Boulevard, MC 249-17, Pasadena, CA 91125 (United States); Kuschnig, Rainer; Weiss, Werner W. [Universitaet Wien, Institut fuer Astronomie, Tuerkenschanzstrasse 17, A1180 Wien (Austria); Moffat, Anthony F. J. [Dept de physique, Univ de Montreal C.P. 6128, Succ. Centre-Ville, Montreal, QC H3C 3J7, and Obs. du mont Megantic (Canada); Rowe, Jason F. [NASA Ames Research Center, Moffett Field, CA 94035 (United States); Rucinski, Slavek M. [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada); Sasselov, Dimitar, E-mail: [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)



Severe infective endocarditis due to Neisseria sicca: case report and review of literature.  


We report a case of infective endocarditis (IE) caused by an unusual micro-organism in a previously healthy young man. Our patient presented with meningo-encephalitis and embolic signs due to IE caused by Neisseria sicca. Risk factors for IE due to Neisseria sicca, such as intravenous drug use and pre-existing heart disease were absent. The patient recovered well after mitral valve surgery and antimicrobial therapy. IE due to Neisseria spp. is associated with embolic manifestations and valve destruction. However, no deaths have been reported in patients who are treated with appropriate antimicrobial and surgical therapy. PMID:17240741

Jeurissen, A; Stroy, J P; Wielenga, R P; Andriesse, G I


Appendectomy due to lead poisoning: a case-report  

Microsoft Academic Search

BACKGROUND: Lead poisoning is a common occupational health hazard in developing countries and many misdiagnoses and malpractices may occur due to unawareness of lead poisoning symptoms. CASE PRESENTATION: We report a case of occupational lead poisoning in an adult battery worker with abdominal colic who initially underwent appendectomy with removal of normal appendix. Later on he was diagnosed with lead

S Mohammadi; AH Mehrparvar; M Aghilinejad



Bacteremia due to Rhodococcus equi--a case report.  


Rhodococcus equi (R. equi) primarily causes zoonotic infections affecting grazing animals and is an unusual cause of infection in immunocompetent human beings. We report a case of bacteremia due to R. equi a rare isolate in a child suffering from protein energy malnutrition PMID:16295396

Sarangi, Gitanjali; Chayani, Nirupama; Mahapatra, Ashoka; Mahapatra, Dharitri; Paty, Bimoch Prajna; Parida, Banojini



Adenylosuccinate lyase (ADSL) and infantile autism: Absence of previously reported point mutation  

Microsoft Academic Search

Autism is a heterogeneous neuropsychiatric syndrome of unknown etiology. There is evidence that a deficiency in the enzyme adenylosuccinate lyase (ADSL), essential for de novo purine biosynthesis, could be involved in the pathogenesis of certain cases. A point mutation in the ADSL gene, resulting in a predicted serine-to-proline substitution and conferring structural instability to the mutant enzyme, has been reported

Edward A. Fon; Julie Sarrazin; G. A. Rouleau; Julio Alarcia; Michael I. Shevell; Anne Philippe; Marion Leboyer



Sudden onset methaemoglobinaemia in a previously well Ugandan child: a case report and literature review  

PubMed Central

Methaemoglobinaemia is a rare condition of unknown prevalence. Diagnostic tests in resource limited settings are very rare but clinical signs can be a good guide. We set out to describe a case of Methaemoglobinaemia, raise awareness among practitioners in resource limited settings and to share experiences in its diagnosis and management. A previously well three and a half year old girl was admitted with central cyanosis of sudden onset. She underwent clinical, laboratory and radiological evaluation. Having been in a resource limited setting, the process of making a diagnosis was slow and difficult. After the diagnosis, the treatment was not available in the country but we managed to get it all the way from Nairobi, Kenya. A diagnosis of Methaemoglobinaemia was made using Spectrophotometry and she was successfully treated using 2 doses of intravenous Methylene blue. The cause of Methaemoglobinaemia was established to have been nitrites from food preservatives.

Nabukeera-Barungi, Nicolette; Mworozi, Edison



Reduced dose maintenance eculizumab in atypical hemolytic uremic syndrome (aHUS): an update on a previous case report  

PubMed Central

Objective To describe how maintenance eculizumab sustains improved renal function in severe atypical hemolytic uremic syndrome (aHUS). Case report A previously described 50-year-old woman with aHUS had a remarkable recovery with eculizumab, which safely reversed profound neurologic damage and eliminated the need for dialysis. Her recovery has been sustained on long-term eculizumab treatment. She initially received eculizumab 900 mg weekly for four doses. On week 5 she commenced maintenance therapy starting at 1200 mg every 2 weeks. Due to nausea and vomiting at that dose, the maintenance dosing was reduced to 600 mg weekly, beginning on dose seven. After receiving 600 mg weekly for nine doses, eculizumab was then reduced to 600 mg every 2 weeks, with continued improvement in renal function. This dosing is lower than the usual 1200 mg every 2 weeks described in the adult literature and used in current clinical trials of aHUS. Conclusion Six months after the initial diagnosis, our patient continues to have improved renal function on maintenance doses of eculizumab as low as 600 mg every 2 weeks.

Ohanian, Maro; Cable, Christian; Halka, Kathleen



Non-detection of Previously Reported Transits of HD 97658b with MOST Photometry  

NASA Astrophysics Data System (ADS)

The radial velocity-discovered exoplanet HD 97658b was recently announced to transit, with a derived planetary radius of 2.93 ± 0.28 R ?. As a transiting super-Earth orbiting a bright star, this planet would make an attractive candidate for additional observations, including studies of its atmospheric properties. We present and analyze follow-up photometric observations of the HD 97658 system acquired with the Microvariability and Oscillations of STars space telescope. Our results show no transit with the depth and ephemeris reported in the announcement paper. For the same ephemeris, we rule out transits for a planet with radius larger than 2.09 R ?, corresponding to the reported 3? lower limit. We also report new radial velocity measurements which continue to support the existence of an exoplanet with a period of 9.5 days, and obtain improved orbital parameters. Based on data from the MOST satellite, a Canadian Space Agency mission operated by Microsatellite Systems Canada Inc. (MSCI; former Dynacon Inc.) and the Universities of Toronto and British Columbia, with the assistance of the University of Vienna.

Dragomir, Diana; Matthews, Jaymie M.; Howard, Andrew W.; Antoci, Victoria; Henry, Gregory W.; Guenther, David B.; Johnson, John A.; Kuschnig, Rainer; Marcy, Geoffrey W.; Moffat, Anthony F. J.; Rowe, Jason F.; Rucinski, Slavek M.; Sasselov, Dimitar; Weiss, Werner W.



Recurrent sebaceous gland carcinoma of eyelid previously diagnosed as basal cell carcinoma: case report.  


Sebaceous gland carcinoma (SGC) of the eyelid is a highly malignant neoplasm that arises from the meibomian glands, glands of Zeis, and sebaceous glands of the skin. The characteristics of this disease are high recurrence rate, significant metastatic potential, and notable mortality rate, which are quite different from basal cell carcinoma (BCC). We report the case of a 37-year-old woman with the history of left lower eyelid BCC (diagnosed 9 years ago), who had left parotid lymph nodes metastases and local recurrence twice. The chief complaint during visit was a left upper eyelid swelling mass noted for 3 months. She received salvage ablation surgery later. The final pathologic report is SGC. The diagnosis corresponds to the clinical presentation of this patient at last. The delay between initial examination and final diagnosis in this patient is about 9 years, but operation and concurrent chemotherapy and radiotherapy were performed after left parotid lymph nodes metastasis was noted. Although there was still local recurrence after concurrent chemotherapy and radiotherapy, the patient is still alive without distant metastasis. In this article, we would discuss the differences of the pathologic characters, treatment, and prognosis between SGC and BCC. PMID:21168242

Kan, Li-Wei; Leu, Yi-Shing; Tzen, Chi-Yuan; Wu, Chien-Hsiu



Erythroderma due to thalidomide: report of two cases.  


Cutaneous reactions to thalidomide therapy are reported infrequently. We report two new cases. Both patients suffered from chronic renal insufficiency and were on thalidomide therapy because of prurigo nodularis. The cutaneous reaction consisted of a severe erythematous rash progressing to erythroderma, associated with peripheral eosinophilia. In both cases rapid resolution occurred after withdrawal of thalidomide. We emphasize the possibility of a severe cutaneous hypersensitivity reaction due to thalidomide and speculate about the role played by the renal insufficiency present in both cases. PMID:8075450

Bielsa, I; Teixidó, J; Ribera, M; Ferrándiz, C



[Neonatal cholestasis due to congenital toxoplasmosis. Case report].  


Neonatal cholestasis is the manifestation of many different diseases. Its early etiological diagnosis is crucial, since treatment before 60 days of life changes the prognosis in children with biliary atresia. Congenital toxoplasmosis can be asymptomatic in the newborn, or have mainly neurological, ophthalmological or gastrointestinal symptoms (hepatomegaly, cholestatic jaundice). Neonatal cholestasis secondary to congenital toxoplasmosis is not a situation frequently reported. We report the case of an infant with neonatal cholestasis due to a congenital toxoplasmosis, in order to discuss the difficulties in establishing the etiological diagnostic and to review the indications of invasive studies such as liver biopsy in these situations. PMID:23912297

Robino, Luciana; Machado, Karina; Montano, Alicia


Corneal Transplant Infection due to Alternaria alternata: A Case Report.  


Purpose. To report a case of Alternaria alternata keratitis in a patient with a corneal transplant in her right eye due to bullous pseudophakic keratopathy. Methods. A 66-year-old female underwent a full-thickness keratoplasty in her right eye due to bullous pseudophakic keratopathy. Three weeks after keratoplasty, epithelial edema and a stromal opacity with an infiltrate and development of peripheral corneal opacities appeared. The diagnosis of Alternaria alternata keratitis was made. Results. The patient underwent a second keratoplasty, due to the corneal melting as a result of the fungal infection. She was also given combined antifungal treatment locally and systematically. Conclusion. Corneal transplantation alone would not have been sufficient to keep the fungus in the anterior portion of the eye. Combined antifungal treatment, locally and systematically, was important in attempting to prevent the further spread of the fungus to the interior of the eye. To our knowledge, the case presented here is only the second one in the literature concerning a keratomycosis due to Alternaria alternata corneal transplant infection. PMID:23573439

Konidaris, Vasileios; Mersinoglou, Andreana; Vyzantiadis, Timoleon-Achilleas; Papadopoulou, Domniki; Boboridis, Kostas G; Ekonomidis, Panagiotis



Corneal Transplant Infection due to Alternaria alternata: A Case Report  

PubMed Central

Purpose. To report a case of Alternaria alternata keratitis in a patient with a corneal transplant in her right eye due to bullous pseudophakic keratopathy. Methods. A 66-year-old female underwent a full-thickness keratoplasty in her right eye due to bullous pseudophakic keratopathy. Three weeks after keratoplasty, epithelial edema and a stromal opacity with an infiltrate and development of peripheral corneal opacities appeared. The diagnosis of Alternaria alternata keratitis was made. Results. The patient underwent a second keratoplasty, due to the corneal melting as a result of the fungal infection. She was also given combined antifungal treatment locally and systematically. Conclusion. Corneal transplantation alone would not have been sufficient to keep the fungus in the anterior portion of the eye. Combined antifungal treatment, locally and systematically, was important in attempting to prevent the further spread of the fungus to the interior of the eye. To our knowledge, the case presented here is only the second one in the literature concerning a keratomycosis due to Alternaria alternata corneal transplant infection.

Konidaris, Vasileios; Mersinoglou, Andreana; Vyzantiadis, Timoleon-Achilleas; Papadopoulou, Domniki; Boboridis, Kostas G.; Ekonomidis, Panagiotis



Non-surgical management of recurrent perforation of a jejunal diverticulum following previous segmental bowel resection: a case report  

PubMed Central

Introduction Perforations of jejunal diverticula are uncommon and repeated symptomatic perforations have been reported only twice before in the literature. This is the first case report of recurrent perforation of a jejunal diverticulum to be successfully managed non-operatively. Case presentation We report a recurrent perforation of a jejunal diverticulum in an 87-year-old Caucasian man who presented with a 1-week history of epigastric pain. The diagnosis of a perforated jejunal diverticulum was made from the appearances of the abdominal computed tomography scan together with the presence of jejunal diverticula noted at the time of a previous laparotomy for the first perforation of a jejunal diverticulum. Conclusion Whilst this case report by itself does not add to the knowledge we already have of jejunal diverticula, it is one report of a rare condition and more reports are required in the future to establish the recurrence rate of jejunal diverticula perforation and how perforated jejunal diverticula are best managed.



Multisegmental spondylitis due to Tropheryma whipplei: Case report  

PubMed Central

We report a patient who presented with inflammatory back pain due to multisegmental spondylitis. Following a vertebral biopsy which failed to detect an infectious organism, the patient was treated with etanercept, a tumor necrosis factor (TNF)-? inhibitor, for suspected undifferentiated spondyloarthritis. The back pain worsened and the spondylitic lesions increased. Only in a vertebral rebiopsy with polymerase chain reaction (PCR) amplification of Tropheryma whipplei, the causative agent of Whipple's disease was identified. Tropheryma whipplei should be considered as a cause of spondylitis even with multisegmental involvement and in the absence of gastrointestinal symptoms. In this clinical setting, routine PCR for Tropheryma whipplei from vertebral biopsies is recommended.

Spoerl, David; Bar, Diego; Cooper, Julian; Vogt, Thomas; Tyndall, Alan; Walker, Ulrich A



Multisegmental spondylitis due to Tropheryma whipplei: case report.  


We report a patient who presented with inflammatory back pain due to multisegmental spondylitis. Following a vertebral biopsy which failed to detect an infectious organism, the patient was treated with etanercept, a tumor necrosis factor (TNF)-alpha inhibitor, for suspected undifferentiated spondyloarthritis. The back pain worsened and the spondylitic lesions increased. Only in a vertebral rebiopsy with polymerase chain reaction (PCR) amplification of Tropheryma whipplei, the causative agent of Whipple's disease was identified. Tropheryma whipplei should be considered as a cause of spondylitis even with multisegmental involvement and in the absence of gastrointestinal symptoms. In this clinical setting, routine PCR for Tropheryma whipplei from vertebral biopsies is recommended. PMID:19493331

Spoerl, David; Bär, Diego; Cooper, Julian; Vogt, Thomas; Tyndall, Alan; Walker, Ulrich A



[Intestinal obstruction due to perforated cecal volvulus. Case report].  


Cecal volvulus is an uncommon cause of large-bowel obstruction. Its developement is due to an abnormal mobility of the ileocecal loop because of lacking attachement of ascending colon. Clinical features are frequently aspecific and should be differentiated from sigmoid volvulus and neoplastic obstruction. Therapy depends on visceral circulatory conditions at the moment of diagnosis. Possible options include endoscopic decompression, cecopexy with or without cecostomy, right colectomy with immediate or delayed anastomosis. The present paper reports the case of cecal volvulus in a 44 year old woman, successfully treated with right colectomy and primary anastomosis. PMID:15558982

Pomata, M; Dazzi, C; Crobu, F; Martinasco, L; Pisano, G; Licheri, S


Should Authors Submit Previous Peer-Review Reports When Submitting Research Papers? Views of General Medical Journal Editors  

PubMed Central

Publishing research can be time consuming, as papers are often submitted and reviewed by multiple journals before final acceptance. We hypothesized that attaching previous peer-review reports to the next submission of the paper to a different journal (possibly with point-to-point responses and amendments) could decrease the workload for both reviewers and editors and could shorten the time from final draft to actual publication. We therefore performed an online survey to assess the views of the editors-in-chief of all 100 general medical journals from the citation impact factor report category “internal & general medicine” (ISI Web of Knowledge). Of contacted editors, 61% responded. One of 4 journals do currently receive peer-review reports on occasion. Editors recognized potential advantages but also concerns on using previous peer-review reports across 3 themes: scientific community, quality of papers, and the publication process. The use of previous peer-review reports has the potential to facilitate authors, reviewers, and editors in optimizing peer review in general medical science.

Cals, Jochen W. L.; Mallen, Christian D.; Glynn, Liam G.; Kotz, Daniel



S-deficiency responsive accumulation of amino acids is mainly due to hydrolysis of the previously synthesized proteins - not to de novo synthesis in Brassica napus.  


To characterize the mechanisms of amino acid accumulation under sulphur (S)-deficiency and its physiological significance in Brassica napus, stable isotopes (15) N and (34) S were employed. The plants were exposed for 9 days to S-deficient conditions (0.05 mM vs 1.5 mM sulphate). After 9 days of S-deficiency, leaf-osmotic potential and total chlorophyll content significantly decreased. S uptake decreased by 94%, whereas N uptake and biomass were not significantly changed. Using (15) N and (34) S labelling, de novo synthesis of amino acids and proteins derived from newly absorbed NO(3) (-) and SO(4) (2) (-) and the content of N and S in the previously synthesized amino acids and proteins were quantified. At the whole plant level, S-deficiency increased the pool of amino acids but resulted in strong decrease of incorporation of newly absorbed NO(3) (-) and SO(4) (2) (-) into amino acids by 22.2 and 76.6%, respectively, compared to the controls. Total amount of N and S incorporated into proteins also decreased by 28.8 and 62.1%, respectively. The levels of (14) N- and (32) S-proteins (previously synthesized proteins) strongly decreased, mainly in mature leaves. The data thus indicate that amino acid accumulation under short-term S-deficiency results from the degradation of previously synthesized proteins rather than from de novo synthesis. PMID:22725131

Lee, Bok-Rye; Muneer, Sowbiya; Kim, Kil-Yong; Avice, Jean-Christophe; Ourry, Alain; Kim, Tae-Hwan



Sacroiliitis due to Salmonella Typhi: A case report  

PubMed Central

Context: Pyogenic infections of the sacroiliac joint are observed quite rarely. The most frequent causative microorganisms are Staphylococcus aureus, Streptococcus species, and Pseudomonas aeruginosa that are commonly found in patients under intravenous medication. In this paper, a rare sacroiliitis case that developed due to Salmonella Typhi is discussed. Case Report: A woman at the age of twenty applied to our clinic with complaints of fever, headache and diarrhea with which she had been suffering for five days. On physical examination, she had a slight fever, with a body temperature of 38.6°C. She was hospitalized, and Salmonella Typhi was isolated from her blood culture. Later on, the patient described pain during left hip movement. Diffusion-weighted magnetic resonance imaging and scintigraphic examinations revealed left sacroiliitis. Conclusion: Although sacroiliitis arising from Salmonella Typhi infection is a rare entity, it should not be ignored in patients who have a clinical history for sacroiliitis.

Avcu, Serhat; Mentes, Osman; Bulut, Mehmet Deniz; Sunnetcioglu, Mahmut; Karahocagil, Mustafa Kas?m



Neonatal Meningoventriculitis Due to Proteus Mirabilis - A Case Report  

PubMed Central

A five day old full term born baby was admitted to our Neonatal Intensive Care Unit with seizures, opisthotonous posture and was icteric upto thigh. Baby had a three day history of poor feeding, lethargy and abnormal body movements. Mother was a 29 years old primigravida and had a normal vaginal delivery at home. Sepsis profile of the patient was requested, lumbar puncture and ventricular tap was performed. Patient was put on third generation cephalosporins, aminoglycosides and phenobarbitone. Culture and sensitivity report of blood, Cerebro spinal fluid and ventricular fluid showed Proteus mirabilis. Computerized Tomography scan showed a large parenchymal lesion in the right frontal lobe and diffuse ependymal enhancement along both the lateral ventricles suggestive of meningoventriculitis. We hereby present a fatal case of neonatal meningoventriculitis due to Proteus mirabilis.

Juyal, Deepak; Rathaur, Vyas Kumar; Sharma, Neelam




Microsoft Academic Search

Recent spree-killings and a controversial 2 Amendment Supreme Court ruling have re-directed criminological research toward the critical question of how best to prevent gun related fatalities. However, a recent National Academy of Science report raises methodological concerns about many of the most commonly cited and reviewed gun policy research designs, which re-introduces scientifically the question of whether any existing gun-intervention

James M. La Valle



Scrape cytology of myositis ossificans: report of a case and analysis of the cytologic findings described previously.  


Myositis ossificans is a reactive, ossifying process within soft tissues, which by its clinical and histological features is considered a pseudosarcomatous lesion. There are few reports that describe the cytologic findings in myositis ossificans, and each of these mentions different cellular composition. We describe the cytology of a case of myositis ossificans in a 14-year-old boy with clinical diagnosis of soft tissue sarcoma, and analyze the most common cytologic findings reported previously of this entity. We conclude that the different cellular composition reported, reflects the different histologic components of this lesion according to the area (zonation phenomenon), and that clinico-radiologic correlation is essential for the cytological diagnosis. PMID:18064693

Estrada-Villaseñor, E; Cedillo, E Delgado; Martínez, G Rico



Glandular odontogenic cyst (sialo-odontogenic cyst): report of two cases and literature review of 45 previously reported cases.  


The clinical, radiological, histopathological and immunohistochemical (cytokeratin) features of two cases of glandular odontogenic cyst (GOC) are presented and discussed in a review of 45 cases of GOC hitherto reported. Of cases with available information, 34 occurred in the mandible and 6 in the maxilla; the male:female ratio was 19:28, and the mean age was 46.7 years in males and 50.0 years in females. Six cysts recurred once after 2-8 years (mean 2 years 8 months) and 2 (5.3%) recurred twice after 2 and 5 years and after 3 and 5 years, respectively, giving a rate of recurrence of 21%. The identification of osteodentin in one of the present cases and the co-expression of cytokeratins (CK) 13, 19 and 8 strongly support the concept of odontogenic differentiation in the GOC. Careful surgical removal of the lesion succeeded by a 5-year follow-up period is recommended. PMID:9790100

Koppang, H S; Johannessen, S; Haugen, L K; Haanaes, H R; Solheim, T; Donath, K



Gastric outlet obstruction due to duodenal bezoar: A case report?  

PubMed Central

INTRODUCTION Gastric outlet obstruction (GOO) is a clinical syndrome characterized by abdominal pain and postprandial vomiting. Causes of GOO include both benign and malignant disease. Bezoars, concretions of undigested or partially digested material in the gastrointestinal tract, are a rare entity and GOO due to duodenal bezoar is an uncommon presentation. PRESENTATION OF CASE We report the case of a 56-year-old woman who presented to the emergency department acutely with a 3-day history of epigastric pain, weakness and postprandial nonbilious vomiting. Initially, an upper gastrointestinal endoscopy (UGE) was performed to evaluate the cause of the GOO. A solid impacted bezoar was detected in the first portion of the duodenum with complete obstruction of the pyloric canal. In spite of multiple attempts for fragmentation using different devices, the extraction attempts failed. We administered acetylcysteine and cola per os. Abdominal computerized tomography was obtained and showed a solid mass in the duodenum. UGE was performed once more however, the mass was not suitable for fragmentation and removal. Thus, surgical treatment was decided. The bezoar was extracted via gastrotomy. The postoperative period was uneventful. DISCUSSION Even if a duodenal bezoar is small, because of its location it may cause GOO with abruptly clinical features. The diagnostic approach is similar to the other causes of the GOO. However, therapeutic options differ for each patient. CONCLUSION We should remember all the therapeutic and diagnostic options for a patient with upper gastrointestinal bezoars who present at the hospital whether or not there is a predisposing risk factor.

Guner, Ali; Kahraman, Izzettin; Aktas, Adem; Kece, Can; Reis, Erhan



Anton's syndrome due to cerebrovascular disease: a case report  

PubMed Central

Introduction Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted. Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome. Conclusions A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation.



Chemical cystitis due to crystal violet dye: a case report  

PubMed Central

Introduction Crystal violet was commonly used for the treatment of oral and vaginal candidiasis or for sterilization during operations up to the 1960s. Because crystal violet is potentially toxic to mucosal membranes, it has been replaced with other disinfectants, and crystal violet is rarely used. We report a case of chemical cystitis due to intravesical instillation of crystal violet dye. Case presentation Crystal violet dye was instilled into the bladder of a 47-year-old Japanese woman to confirm the presence of a vesicovaginal fistula. Our patient developed symptoms of gross hematuria, frequent urination and lower abdominal pain. Computed tomography showed thickening of her whole bladder wall with spotted high-density lesions. Cystoscopy demonstrated desquamated epithelial cells and a hemorrhagic bladder wall. We treated our patient conservatively with nonsteroidal anti-inflammatory drugs and glucocorticoids. During follow-up, magnetic resonance images showed that the detrusor muscle of her bladder was normal. Our patient’s symptoms gradually improved and she completely recovered within six months. Conclusion Considering the severe side effect of crystal violet, it would be better not to use this dye to examine conditions such as a vesicovaginal fistula. Magnetic resonance imaging may help to evaluate the level of damage in the bladder wall of patients with chemical cystitis.



Fetal Adrenal Suppression Due to Maternal Corticosteroid Use: Case Report  

PubMed Central

During pregnancy, steroids are usually used in maternal diseases such as adrenal failure or other autoimmune diseases, e.g. idiopathic thrombocytopenic purpura (ITP), Crohn’s disease, systemic lupus erythematosus, dermatomyositis, scleroderma, Addison’s disease and hyperemesis gravidarum, HELLP syndrome. Endogenous or exogenous maternal steroids are metabolized by the placental enzyme 11 beta-hydroxy steroid dehydrogenase type 2. Prednisolone and methylprednisolone are highly sensitive to this enzyme, while dexamethasone and betamethasone are less well metabolized. Steroids which can cross the placental barrier are administered in cases like fetal lupus, congenital adrenal hyperplasia and for enhancement of fetal lung maturation, whereas steroids used in maternal diseases are usually the ones with low affinity to the placenta; however, in case of long-term use or in high doses, placental enzyme saturation occurs and thus, resulting in fetal adrenal suppression. Antenatal steroids can lead to low birth weight, as observed in our patient. Here, we report a case with fetal adrenal suppression due to maternal methylprednisolone use presenting with early hypoglycaemia and late hyponatremia in neonatal period and requiring three-month replacement therapy. Conflict of interest:None declared.

Kurtoglu, Selim; Sar?c?, Dilek; Ak?n, Mustafa Ali; Daar, Ghaniya; Memur, Seyma



Power line frequency electromagnetic fields do not increase the rate of protein synthesis in human skin fibroblasts as previously reported.  


Rodemann et al. [Rodemann et al. (1987): Biochem Biophys Res Commun 145:1-9] reported that human skin fibroblasts increase their rate of protein synthesis by as much as over ninefold in response to long term exposure to 20 Hz, 8.4 mT (84 G) magnetic fields. Here we report studies of protein synthesis using an identical cell type, exposure conditions, and the same means of measuring protein synthetic rates. Our initial goal was to determine if the earlier results could be replicated, but we found an inconsistency in the earlier protocol. It exposed cells to [(3)H]leucine for 6 h prior to measuring incorporation into protein. We found, however, that 24 h is required for [(3)H]leucine to reach a steady state distribution across the cells' plasma membranes. In addition, we typically measured 100-200 cpm/thousand cells. This is four- to eightfold higher than the 19-28 cpm/1000 cells previously reported. Using these conditions, we could find no significant difference in protein synthesis rates between control cells and cells exposed for up to three weeks in an identical electromagnetic field. In addition, we investigated the effects of a 60 Hz field since that is the frequency used for electric power distribution in the United States. Again, we could find no significant effect of this field on rates of protein synthesis, even after 21 days of exposure. PMID:12955751

Shi, Biao; Isseroff, R Rivkah; Nuccitelli, Richard



Description of Thermococcus kodakaraensis sp. nov., a well studied hyperthermophilic archaeon previously reported as Pyrococcus sp. KOD1  

PubMed Central

A hyperthermophilic archaeal strain, KOD1, isolated from a solfatara on Kodakara Island, Japan, has previously been reported as Pyrococcus sp. KOD1. However, a detailed phylogenetic tree, made possible by the recent accumulation of 16S rRNA sequences of various species in the order Thermococcales, indicated that strain KOD1 is a member of the genus Thermococcus. We performed DNA–DNA hybridization tests against species that displayed high similarity in terms of 16S ribosomal DNA sequences, including Thermococcus peptonophilus and Thermococcus stetteri. Hybridization results and differences in growth characteristics and substrate utilization differentiated strain KOD1 from T. peptonophilus and T. stetteri at the species level. Our results indicate that strain KOD1 represents a new species of Thermococcus, which we designate as Thermococcus kodakaraensis KOD1 sp. nov.

Atomi, Haruyuki; Fukui, Toshiaki; Kanai, Tamotsu; Morikawa, Masaaki; Imanaka, Tadayuki



The spectrum of inherited mutations causing HPRT deficiency: 75 new cases and a review of 196 previously reported cases.  


In humans, mutations in the gene encoding the purine salvage enzyme hypoxanthine-guanine phosphoribosyltransferase (HPRT) are associated with a spectrum of disease that ranges from hyperuricemia alone to hyperuricemia with profound neurological and behavioral dysfunction. Previous attempts to correlate different types or locations of mutations with different elements of the disease phenotype have been limited by the relatively small numbers of available cases. The current article describes the molecular genetic basis for 75 new cases of HPRT deficiency, reviews 196 previously reported cases, and summarizes four main conclusions that may be derived from the entire database of 271 mutations. First, the mutations associated with human disease appear dispersed throughout the hprt gene, with some sites appearing to represent relative mutational hot spots. Second, genotype-phenotype correlations provide no indication that specific disease features associate with specific mutation locations. Third, cases with less severe clinical manifestations typically have mutations that are predicted to permit some degree of residual enzyme function. Fourth, the nature of the mutation provides only a rough guide for predicting phenotypic severity. Though mutation analysis does not provide precise information for predicting disease severity, it continues to provide a valuable tool for genetic counseling in terms of confirmation of diagnoses, for identifying potential carriers, and for prenatal diagnosis. PMID:11018746

Jinnah, H A; De Gregorio, L; Harris, J C; Nyhan, W L; O'Neill, J P



50 CFR 86.81 - When are the reports due?  

Code of Federal Regulations, 2010 CFR

...SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for the States § 86.81...d) The State must report certified percentage of completion data and other significant developments in accordance with the...



50 CFR 86.81 - When are the reports due?  

Code of Federal Regulations, 2010 CFR

...SPORT FISH RESTORATION PROGRAM BOATING INFRASTRUCTURE GRANT (BIG) PROGRAM Reporting Requirements for the States § 86.81...d) The State must report certified percentage of completion data and other significant developments in accordance with the...



Ileocolic intussusception due to Burkitt lymphoma: a case report  

PubMed Central

Burkitt lymphoma has many forms of clinical presentations and, in children, it is usually discovered due to the presence of an abdominal mass. This rapidly growing tumor is highly malignant, aggressive, and may cause either indirect symptoms, due to pressure phenomena or direct involvement of the bowel lumen, leading to either intestinal obstruction or intussusception. We describe the case of a 4-year-old girl who exhibited an unusual presentation of ileocolic intussusception on a Burkitt lymphoma lesion of the ileum.

Balanescu, NR; Topor, L; Malureanu, D; Stoica, I



The magnetic properties of transition metals on triangular lattices and the crystallography of new and previously reported sulfates  

NASA Astrophysics Data System (ADS)

The study of magnetism on a triangular lattice has intrigued physicists for some years, as this special arrangement allows the probing of new electronic phenomena by frustrating the dominant nearest-neighbor couplings. Every project presented here bears importance to geometric frustration. Three chapters present research on compounds in previously known crystal structure families that exhibit signs of geometric frustration: pyrochlores (ch. 2), anhydrous alums (ch. 3) and yavapaiites (ch. 4). The last two chapters (5 and 6) present the discovery of two previously unknown crystal structures, both possessing triangles within their structures, and which may lead to future discoveries within the field of geometric frustration. In addition to the magnetic properties of triangular lattice materials, each project presents important progress in the crystallography of these materials. It was shown that the pyrochlores could soak up oxygen into the normally vacant 8a site forming a metastable material with excess oxygen. The anhydrous alums were shown to exhibit an inherent disorder along one crystallographic axis. The discovery of this feature led to the reassignment of the crystal structure of anhydrous alum itself, KAl(SO4)2. A comparison of the known anhydrous alums and the related yavapaiite structures has shown a non-systematic correlation of cation radius and electron count to specific crystallographic features such as unit cell size and bond angles. The discovery of two crystal structures in the Pb-Mn-SO4 phase diagram revealed novel crystallographic features. The first, PbMn5(SO4) 6, has unique Mn2+2O9 dimers of face sharing octahedra and two complementary triangular layers of magnetic cations that resemble regular polygon tilings. The second material, PbMn(SO 4)2, forms a rare chiral structure in which the Pb and Mn atoms spiral around each other along one axis to form a double helix. Overall, the work provides insight into the interplay of magnetism, magnetic interactions and crystal structure by probing materials that were previously reported, and by expanding horizons through the discovery of novel crystal structures. It is of particular importance that the new crystal structures are made with readily available materials under relatively simple conditions. This implies that many chemically simple systems may remain to be found. In addition, it highlights the wonderful complexity of solid state chemistry that prevents the researcher from knowing a priori what crystal structures will form with a particular stoichiometry.

West, D. Vincent


Septic Arthritis Due to Scedosporium apiospermum: Case Report and Review  

Microsoft Academic Search

Septic arthritis is a relatively common disease, but reports of septic arthritis caused by fungi are still rare and it is often associated with predisposing factors that reduce cellular immunity (alcoholism, cancer, endogenous or exogenous hypercortisolism, intravenous drug abuse). Articular conditions caused by Scedosporium apiospermum are uncommon. Here we report the case of a 32-year-old immunocompetent male with septic arthritis

R. Tirado-Miranda; J. Solera-Santos; J. C. Brasero; M. Haro-Estarriol; P. Cascales-Sánchez; J. B. Igualada



Cardiac arrest due to lymphocytic colitis: a case report  

PubMed Central

Introduction We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis. Case presentation A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L) and pH 6.86 (reference range: pH 7.37 to 7.45). As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest. Conclusion Diarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.



Neck emergency due to parathyroid adenoma bleeding: a case report  

PubMed Central

Introduction The spontaneous rupture of a parathyroid adenoma accompanied by extracapsular hemorrhage is a rare, potentially fatal, condition and is a cervicomediastinal surgical emergency. Case presentation This report describes an atypical two-step spontaneous rupture of an asymptomatic parathyroid adenoma in a 56-year-old Caucasian woman who presented with a painful mass in the right side of her neck. Conclusion Based on this case report and similar cases reported in the medical literature, a diagnosis of extracapsular parathyroid hemorrhage should be considered when a non-traumatic sudden neck swelling coexists with hypercalcemia and regional ecchymosis.



Dermatitis due to Olindias sambaquiensis: a case report.  


Olindias sambaquiensis, Muller 1861 (Hydrozoa: Limnomedusae: Olindiidae) is a neritic jellyfish endemic in the Blanca Bay area (South of Buenos Aires, Argentina). In this paper we describe the first report of a dermatitis caused by this jellyfish in a thirty-four-year-old marine biologist who presented with an erythematous vesicular eruption after contact with Olindias sambaquiensis. Some preliminary ultramicroscopic observations on the nematocysts of this jellyfish are also reported. PMID:8099877

Kokelj, F; Mianzan, H; Avian, M; Burnett, J W



Factitious Biochemical Reports which are Caused Due to Paraproteinaemia in Multiple Myeloma - A Case Report.  


Factitious biochemical reports result in the misguiding of clinicians, unnecessary retesting, wrong diagnoses and incorrect treatments. A vigilant biochemist identifies these factitious biochemical reports and alerts the clinician regarding the proper interpretation of the biochemical reports, thus preventing a misdiagnosis and an incorrect treatment. We are presenting a case report of a multiple myeloma patient who presented with factitious biochemical reports which were caused due to paraproteinaemia. In the present case, the patient presented with an underestimation of urea and creatinine, an underestimation of sodium, low albumin levels and high phosphate levels. On repeating the same tests after dilutions and deproteinizing, the effects of the paraproteins on the above mentioned tests were reduced. Thus, from the observations of our study, we suggest that the interference by paraproteinaemia can be reduced by analyzing the biochemical parameters after dilution and deproteinization. PMID:23542790

Nanda, Sunil Kumar; Sarangi, Rajlaxmi; Ray, Lopamudra; Kumar, Anil; Padhi, Somanath



Factitious Biochemical Reports which are Caused Due to Paraproteinaemia in Multiple Myeloma - A Case Report  

PubMed Central

Factitious biochemical reports result in the misguiding of clinicians, unnecessary retesting, wrong diagnoses and incorrect treatments. A vigilant biochemist identifies these factitious biochemical reports and alerts the clinician regarding the proper interpretation of the biochemical reports, thus preventing a misdiagnosis and an incorrect treatment. We are presenting a case report of a multiple myeloma patient who presented with factitious biochemical reports which were caused due to paraproteinaemia. In the present case, the patient presented with an underestimation of urea and creatinine, an underestimation of sodium, low albumin levels and high phosphate levels. On repeating the same tests after dilutions and deproteinizing, the effects of the paraproteins on the above mentioned tests were reduced. Thus, from the observations of our study, we suggest that the interference by paraproteinaemia can be reduced by analyzing the biochemical parameters after dilution and deproteinization.

Nanda, Sunil Kumar; Sarangi, Rajlaxmi; Ray, Lopamudra; Kumar, Anil; Padhi, Somanath




Microsoft Academic Search

Dear Sir, Carbamazepine is commonly used as an antiepileptic, although it is structurally related to tricyclic antidepressants. Its most frequent unwanted effects involve the central nervous system (vertigo, drowsiness, ataxia, diplopia, migraine) but the most serious are blood dyscrasias (leucopenia, agranulocytosis, eosinophilia and thrombocytopenia). The gastrointestinal and urinary systems, liver and skin may also be affected. We report a case

JJ Ortiz de Urbina; JM González; A Sanchéz; A Carvajal


Keratomycosis due to Exserohilum rostratum - a case report.  


We report here a case of keratomycosis by Exserohilum rostratum. An 18-year old female patient presented with pain and watery discharge from the left eye since 10 days. Clinically the case was diagnosed as keratomycosis. Gram stain and KOH preparation of corneal scrapings revealed fungal elements. Fungal isolate was identified as Exserohilum rostratum by standard techniques. PMID:17642711

Peerapur, B V; Rao, S D; Patil, S; Mantur, B G


Pure cerebellitis due to scrub typhus: a unique case report.  


We report the case of a 24-year old Indian man who presented with: high fever; drowsiness; an eschar and gross cerebellar dysfunction with horizontal gaze nystagmus; ataxic speech; and truncal ataxia. Scrub typhus was diagnosed by serological tests. This is the first case of a pure cerebellar involvement as the only manifestation of scrub typhus in the published literature. PMID:23550204

Karanth, Suman S; Gupta, Anurag; Prabhu, Mukhyaprana



A robust, sensitive assay for genomic uracil determination by LC/MS/MS reveals lower levels than previously reported.  


Considerable progress has been made in understanding the origins of genomic uracil and its role in genome stability and host defense; however, the main question concerning the basal level of uracil in DNA remains disputed. Results from assays designed to quantify genomic uracil vary by almost three orders of magnitude. To address the issues leading to this inconsistency, we explored possible shortcomings with existing methods and developed a sensitive LC/MS/MS-based method for the absolute quantification of genomic 2'-deoxyuridine (dUrd). To this end, DNA was enzymatically hydrolyzed to 2'-deoxyribonucleosides and dUrd was purified in a preparative HPLC step and analyzed by LC/MS/MS. The standard curve was linear over four orders of magnitude with a quantification limit of 5 fmol dUrd. Control samples demonstrated high inter-experimental accuracy (94.3%) and precision (CV 9.7%). An alternative method that employed UNG2 to excise uracil from DNA for LC/MS/MS analysis gave similar results, but the intra-assay variability was significantly greater. We quantified genomic dUrd in Ung(+/+) and Ung(-/-) mouse embryonic fibroblasts and human lymphoblastoid cell lines carrying UNG mutations. DNA-dUrd is 5-fold higher in Ung(-/-) than in Ung(+/+) fibroblasts and 11-fold higher in UNG2 dysfunctional than in UNG2 functional lymphoblastoid cells. We report approximately 400-600 dUrd per human or murine genome in repair-proficient cells, which is lower than results using other methods and suggests that genomic uracil levels may have previously been overestimated. PMID:23742752

Galashevskaya, Anastasia; Sarno, Antonio; Vågbø, Cathrine B; Aas, Per A; Hagen, Lars; Slupphaug, Geir; Krokan, Hans E



Bilateral Multifocal Chorioretinitis and Optic Neuritis due to Epstein-Barr Virus: A Case Report  

PubMed Central

Epstein-Barr virus (EBV) is a DNA virus that mainly causes infectious mononucleosis. Ocular manifestations are rare and typically mild. Only a few cases of EBV involving the retina or the optic nerve have been reported. Herein, we report the case of a 67-year-old man with bilateral chorioretinitis and optic neuritis due to EBV. The patient had no previous ocular history and presented with decreased vision in both eyes. His past medical history included EBV encephalopathy, which was confirmed serologically, a few months before. Ophthalmological examination revealed bilateral chorioretinitis and optic neuritis, confirmed by fluorescein angiography as well as electrophysiological tests (visual evoked potentials and electroretinogram). It is very important to include EBV in the differential diagnosis of chorioretinal atrophic lesions. Clinicians should be aware of ocular manifestations of EBV, in order to suggest ophthalmological examination and start treatment promptly before irreversible damage to the optic nerve or retina occurs.

Peponis, Vasileios G.; Chatziralli, Irini P.; Parikakis, Efstratios A.; Chaira, Niki; Katzakis, Michail C.; Mitropoulos, Panagiotis G.



Acute ITP due to insect bite: report of 2 cases.  


Immune thrombocytopenic purpura (ITP) of childhood is a common hematologic disorder. Immune thrombocytopenic purpura is characterized by increased destruction of antibody-coated platelets in the reticuloendothelial system. In the majority of children with acute ITP, thrombocytopenia occurs within 1 to 3 weeks after an infectious disease. Immune thrombocytopenic purpura may also occur after rubella, rubeola, chickenpox, or live virus vaccination. Here we report 2 cases with acute ITP that were developed after honeybee and insect bite. PMID:20460348

Akbayram, Sinan; Akgun, Cihangir; Dogan, Murat; Caksen, Hüseyin; Oner, Ahmet Faik



Infections due to Phialemonium species: case report and review.  


Abstract Infections caused by rarely encountered fungal pathogens have increased in recent decades. The present study describes a disseminated infection caused by Phialemonium curvatum, and reviews the literature in an effort to summarize prior experiences with this unusual pathogen. The clinical and microbiological characteristics of a new case due to Phialemonium are presented. The case is analysed with 19 other which have appeared in the literature since 1986. Ten cases were sporadic infections, while the others were associated with three small outbreaks. In all but our patient the skin's natural barrier was compromised (15/20 [75%]) and immunosuppression was a factor in the majority of cases (14/20 [70%]). Dissemination was noted in 83% (5/6) of the immunocompetent patients and in 57% (8/14) of immunocompromised patients. Endocarditis was the most frequent form of infection (8/20 [40%]). Blood cultures were positive in 92% (12/13) of those with disseminated disease. The mortality rate was 54% (7/13) among those with disseminated infections, but fatal outcomes were not observed in patients receiving treatment with itraconazole, voriconazole or posaconazole. The in vitro susceptibility of Phialemonium indicated a more consistent level of activity for voriconazole and posaconazole. Although infections usually occur when there is a breakdown in the skin the skin barrier or host defences are weakened, our case points out that infections due to Phialemonium species may occur in patients without these risk factors. The most frequent form of Phialemonium infections is endovascular, often with endocarditis and positive blood cultures, associated with high mortality rates. Treatment with the new triazoles is associated with improved survival. PMID:19888810

Rivero, María; Hidalgo, Angel; Alastruey-Izquierdo, Ana; Cía, Maite; Torroba, Luis; Rodríguez-Tudela, Juan Luis



Tinea capitis due to Microsporum vanbreuseghemii: report of two cases.  


Two cases of dermatophytosis caused by Microsporum vanbreuseghemii are reported. A 7-year-old boy and his brother were examined for tinea capitis. Hair samples and skin scrapings were collected from each patient to microscopy and culture. Direct microscopic examination of the hairs using lactophenol revealed an ectothrix invasion. Cultures inoculated with portions of clinical material yielded M. vanbreuseghemii after 2 weeks. The identification of the fungi were based on colony morphology on mycobiotic agar, microscopic characteristic on slide cultures, biochemical reactions and hair perforation tests. PMID:22240855

Naseri, Ali; Fata, Abdolmajid; Khosravi, Ali Reza



Intestinal subocclusion due to colonic lipoma: a case report.  


Colonic lipomas are rare benign tumors infrequently met in clinical practice. Most of them are asymptomatic making frequent their fortuitous discovery. The therapeutic approach to the fortuitous discovery of a lipoma is even less clear. The treatment depends essentially on the clinical picture, on the size of the lipoma and on its location. We report the case of a 31-year old woman, which sub-occlusive accidents events revealed a lipoma of the descending colon. The diagnosis was suspected on colonoscopy and segmental colectomy was performed. The diagnosis was confirmed by histological examination. We review the literature and discuss the clinical features, diagnosis and treatment of this uncommon disease. PMID:22187604

Bentama, Kamal; Chourak, Miloud; Chemlal, Ilias; Benabbou, Mohamed; Raiss, Mohamed; Hrora, Abdelmalek; Sabbah, Farid; Benamer, Abdesslam; Ahellat, Mohamed



Intestinal subocclusion due to colonic lipoma: a case report  

PubMed Central

Colonic lipomas are rare benign tumors infrequently met in clinical practice. Most of them are asymptomatic making frequent their fortuitous discovery. The therapeutic approach to the fortuitous discovery of a lipoma is even less clear. The treatment depends essentially on the clinical picture, on the size of the lipoma and on its location. We report the case of a 31-year old woman, which sub-occlusive accidents events revealed a lipoma of the descending colon. The diagnosis was suspected on colonoscopy and segmental colectomy was performed. The diagnosis was confirmed by histological examination. We review the literature and discuss the clinical features, diagnosis and treatment of this uncommon disease.

Bentama, Kamal; Chourak, Miloud; Chemlal, Ilias; Benabbou, Mohamed; Raiss, Mohamed; Hrora, Abdelmalek; Sabbah, Farid; Benamer, Abdesslam; Ahellat, Mohamed



Sudden death due to black esophagus: a case report.  


Black esophagus, also known as acute esophageal necrosis syndrome, is a rare but often fatal pathology. It can be identified during autopsy examination and should be diagnosed by the forensic examiner via simple macroscopic examination. We report the case of an elderly man who was found dead, presenting with this pathology. A microscopic examination was carried out that confirmed the diagnosis. We consider that all forensic examiners should be made aware of this pathology to make the diagnosis quickly, in turn allowing the deceased to be returned promptly to their loved ones. PMID:23099544

Venara, Aurélien; Pavageau, Aude Helene; Maillart, Clotilde Rouge; Jousset, Nathalie



Fatality due to amisulpride toxicity: a case report.  


Amisulpride is an atypical antipsychotic agent effective in the treatment of schizophrenia. There are few cases in the literature relating to the toxicity of this agent and reported fatalities are rare. Drug induced prolongation of the QT interval of the electrocardiograph (ECG) is increasingly recognised with various classes of drugs and in particular with antipsychotics. Cardiotoxicity can manifest as ventricular tachyarrhythmia, including torsades de pointes (TdP), complicating QT prolongation. We report a case of fatal amisulpride toxicity where the post-mortem blood concentration was 48 mg/L. Hitherto under-recognised toxic effects of novel chemotherapeutic agents can pose challenges for the forensic pathologist charged with performing medico-legal autopsies in cases of sudden unexpected death in young adults and particularly in those with schizophrenia. A knowledge of the ability of antipsychotic agents to induce fatal cardiac arrhythmias should inform the approach to the autopsy (including determination of the cause and mechanism of death) in such cases, as should an appreciation of the dangers inherent in the interpretation of post-mortem toxicology. PMID:18533580

Lynch, Matthew J; Woods, Jessica; George, Natalia; Gerostamoulos, Dimitri



SDRIFE (Baboon Syndrome) Due to Paracetamol: Case Report.  


The term "baboon syndrome" (BS) (recently known as symmetrical drug related intertriginous and flexural exanthema, SDRIFE) was introduced in 1984 to describe a specific skin eruption (resembling the red gluteal area of baboons) that occurred after systemic exposure to contact allergens. The crucial characteristics include a sharply defined symmetric erythema in the gluteal area and in the flexural or intertriginous folds without any systemic symptoms or signs. Because the term BS does not reflect the complete range of symptoms and is ethically problematic, it was replaced with a new term of SDRIFE. This term specifically refers to the distinctive clinical pattern of drug eruption induced by exposure to a systemically administered drug, presented as sharply demarcated symmetric erythematous areas of the gluteal/perianal area and/or V-shaped erythema of the inguinal/perigenital area (at least one other intertriginous/flexural localization) and absence of systemic symptoms and signs. We present a case of a 33-year-old man with SDRIFE due to Panadol® tablets (paracematol). On admission, there was a densely disseminated, symmetric, livid to erythematous maculopapular exanthema present in both axillae, the sides of the trunk, inguinally spreading towards the thighs, in cubital and popliteal fossae, on the back sides of the upper legs, and in the gluteal regions. Awareness of SDRIFE (BS) as an unusual drug reaction is especially important since the connection between skin eruption and drug exposure may easily be overlooked or misdiagnosed. PMID:24001419

Lugovi?-Mihi?, Liborija; Duvan?i?, Tomislav; Vu?i?, Majda; Situm, Mirna; Koli?, Maja; Mihi?, Josip



Instructional Workbook for Preparing the 'Report on Receivables Due From the Public'.  

National Technical Information Service (NTIS)

This document presents the form and instructions for the preparation and submission of the Report on Receivables Due from the Public (Receivables Report), as revised effective August 2000. This report is the Department of the Treasury's only comprehensive...



Contact blepharoconjunctivitis due to black henna--a case report.  


Para-phenylenediamine (PPD) can induce immediate or - more often - delayed hypersensitivity. We report the case of 48-year old female admitted to the out-patient allergy clinic a day after her visit in a beauty parlour, where she had her eyelashes and eyebrows dyed with henna. Physical examination revealed prominent edema of the upper part of the face including forehead, cheeks and eyes causing severe narrowing of the palpebral chink. Skin prick tests (SPT) with common allergens were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and moulds, while the SPT with PPD was negative. Patch test to PPD was positive. Further investigations revealed eosinophilia in the tear fluid. To our knowledge, this is the first case of PPD-induced contact blepharoconjunctivitis (CB) with concomitant increased eosinophilia in the tear fluid. PMID:22492286

Pas-Wyro?lak, Alicja; Wiszniewska, Marta; Kr?cisz, Beata; Swierczy?ska-Machura, Dominika; Pa?czy?ski, Cezary; Walusiak-Skorupa, Jolanta



Nonobstructive hydronephrosis due to social polydipsia: a case report  

PubMed Central

Introduction Excessive fluid intake can lead to water intoxication, electrolyte abnormalities, exacerbation of heart failure and anatomical changes in the urinary tract that may present diagnostic and therapeutic challenges for patients and physicians. Although the development of nonobstructive hydronephrosis is recognized in patients with central and nephrogenic diabetes insipidus, pregnancy or psychiatric polydipsia, it is rarely a diagnostic consideration in healthy individuals with excessive fluid ingestion. We now present what we believe to be the first report of nonobstructive hydronephrosis associated with social polydipsia. Case presentation A 53-year-old African-American woman with moderate back pain was found to have bilateral moderate hydronephrosis and hydroureter by abdominal computed tomography. She underwent ureteral stent placement followed by exploratory laparoscopy with lysis of adhesions and a right oophorectomy, without resolution of the nonobstructive hydronephrosis. A careful assessment revealed a social habit of consuming approximately 5.5L of fluid daily in an effort to remain hydrated in accordance with public health service announcements. It was recommended that the patient reduce her fluid intake. A repeat ultrasound after six weeks revealed complete resolution of the bilateral hydronephrosis and hydroureter. Conclusion Recognition of the nonobstructive nature of hydronephrosis caused by polydipsia in healthy individuals is important to prevent unnecessary interventions.



Osmotic shock tolerance and membrane fluidity of cold-adapted Cryptococcus flavescens OH 182.9, previously reported as Cr. nodaensis, a biocontrol agent of Fusarium head blight  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cryptococcus nodaensis (previously reported as Cr. nodaensis), a biological control agent of Fusarium head blight, has been previously shown to have improved desiccation tolerance after cold adaptation. The goal of the current study was to determine the effect of cold adaptation on the physicochemi...


41 CFR 102-84.55 - When are the Annual Real Property Inventory reports due?  

Code of Federal Regulations, 2013 CFR

...Annual Real Property Inventory reports due? ...Contracts and Property Management Federal Property Management Regulations System...Continued) FEDERAL MANAGEMENT REGULATION REAL...84-ANNUAL REAL PROPERTY INVENTORIES §...



Leptotrichia endocarditis: report of two cases from the International Collaboration on Endocarditis (ICE) database and review of previous cases.  


Leptotrichia species typically colonize the oral cavity and genitourinary tract. We report the first two cases of endocarditis secondary to L. goodfellowii sp. nov. Both cases were identified using 16S rRNA gene sequencing. Review of the English literature revealed only two other cases of Leptotrichia sp. endocarditis. PMID:17960435

Caram, L B; Linefsky, J P; Read, K M; Murdoch, D R; Lalani, T; Woods, C W; Reller, L B; Kanj, S S; Premru, M M; Ryan, S; Al-Hegelan, M; Donnio, P Y; Orezzi, C; Paiva, M G; Tribouilloy, C; Watkin, R; Harris, O; Eisen, D P; Corey, G R; Cabell, C H; Petti, C A



Central posterior capsule pigmentation in a patient with pigment dispersion and previous ocular trauma: A case report  

PubMed Central

We report a 55-year-old man with unusually dense, unilateral central posterior capsule pigmentation associated with the characteristic clinical features of pigment dispersion syndrome, including a Krukenberg's spindle and dense trabecular pigmentation in both eyes. A history of an old blunt ocular trauma probably caused separation of the anterior hyaloid from the back of the lens, thereby creating an avenue by which pigment could reach the potential space of Berger's from the posterior chamber.

Al-Mezaine, Hani S



Novel clinical manifestations in Pallister-Killian syndrome: comprehensive evaluation of 59 affected individuals and review of previously reported cases.  


Pallister-Killian syndrome is a rare, multi-system developmental diagnosis typically caused by tetrasomy of chromosome 12p that exhibits tissue-limited mosaicism. The spectrum of clinical manifestations in Pallister-Killian syndrome is wide and includes craniofacial anomalies, clefts, ophthalmologic, audiologic, cardiac, musculoskeletal, diaphragmatic, gastrointestinal, genitourinary, and cutaneous anomalies in association with intellectual disability and seizures. Growth parameters are often normal to elevated at birth with deceleration of growth postnatally. No formal estimate of the prevalence of Pallister-Killian syndrome has been made. Here, we report the clinical findings in 59 individuals with Pallister-Killian syndrome who were ascertained at Pallister-Killian syndrome Foundation family meetings held in the summers of 2006, 2008, 2009, and 2010. In addition, the clinical findings of 152 cases reported in the medical literature were reviewed and compared to the cohort examined here. Several novel clinical characteristics were identified through detailed dysmorphology examinations of this cohort and reassertion of a mild developmental variant is described. This report expands the clinical manifestations of Pallister-Killian syndrome and highlights the variable expressivity of this diagnosis with important implications for diagnosis and counseling. PMID:23169767

Wilkens, Alisha; Liu, Hongbin; Park, Kristen; Campbell, Lindsey B; Jackson, Marie; Kostanecka, Anna; Pipan, Mary; Izumi, Kosuke; Pallister, Phillip; Krantz, Ian D



Outcome of unicompartmental knee arthroplasty in octogenarians with tricompartmental osteoarthritis: A longer followup of previously published report  

PubMed Central

Background: Unicompartmental knee arthroplasty (UKA) has specific indications, producing excellent results. It, however, has a limited lifespan and needs eventual conversion to total knee arthroplasty (TKA). It is, therefore, a temporizing procedure in select active young patients with advanced unicompartmental osteoarthritis (UCOA). Being a less morbid procedure it is suggested as an alternative in the very elderly patients with tricompartmental osteoarthritis (TCOA). We performed UKA in a series of 45 octogenarians with TCOA predominant medial compartment osteoarthritis (MCOA) and analyzed the results. Materials and Methods: Forty five octogenarian patients with TCOA predominant MCOA underwent UKA (19 bilateral) from January 2002 to January 2012. All had similar preoperative work-up, surgical approach, procedure, implants and postoperative protocol. Clinicoradiological assessment was done at 3-monthly intervals for the first year, then yearly till the last followup (average 72 months, range 8-128 months). Results were evaluated using the knee society scores (KSS), satisfaction index [using the visual analogue scale (VAS)] and orthogonal radiographs (for loosening, subsidence, lysis or implant wear). Resurgery for any cause was considered failure. Results: Four patients (six knees) died due to medical conditions, two patients (three knees) were lost to followup, and these were excluded from the final analysis. Barring two failures, all the remaining patients were pain-free and performing well at the final followup. Indications for resurgery were: medial femoral condyle fracture needing fixation subsequent conversion to TKA at 2 years (n=1) and progression of arthritis and pain leading to revision TKA at 6 years (n=1). Conclusion: UKA has shown successful outcomes with regards to pain relief and function with 96.4% implant survival and 94.9% good or excellent outcomes. Due to lower demands, early rehabilitation, less morbidity, and relative short life expectancy, UKA can successfully manage TCOA in the octogenarians.

Marya, Sanjiv KS; Thukral, Rajiv



Cerebral ischaemia in pituitary disorders-more common than previously thought: two case reports and literature review.  


Vasospasm and consequent cerebral ischaemia in aneurysmal subarachnoid haemorrhage are well-described. The development of cerebral ischaemia following pituitary tumour surgery is under-appreciated, and can be attributed to mainly cerebral vasospasm or internal carotid artery compression. We report on two patients with pituitary tumours who developed delayed cerebral ischaemia after transsphenoidal and transcranial pituitary macroadenoma decompression. The patients had vasospasm of intracranial vessels demonstrable on magnetic resonance angiogram. One recovered neurologically following nimodipine and hypertensive-hypervolaemia therapy while the other developed fulminant cerebral infarction. We discuss the complex multi-factorial mechanisms of cerebral ischaemia in pituitary disorders, as well as the management strategies and their limitations. PMID:23612931

Chong, Margaret Yanfong; Quak, Su Min; Chong, Chin Ted



Tenosynovitis due to Mycobacterium avium intracellulare and Mycobacterium chelonei: report of two cases with review of the literature.  


Atypical mycobacteria can induce soft tissue infections such as tenosynovitis. We observed one case of finger flexor tendon tenosynovitis infected with Mycobacterium avium intracellulare and one case of knee and ankle arthritis with lateral peroneal tendon tenosynovitis due to M. chelonei. In the first patient, a tenosynovectomy only was performed leading to resolution of the infection. The second patient was immunocompromised as a result of corticosteroid therapy and the mycobacterial infection was treated with tenosynovectomy and multidrug chemotherapy. This patient died from infectious pneumonitis. Previously reported cases of infectious tenosynovitis due to these atypical mycobacteria are reviewed. PMID:9641515

Toussirot, E; Chevrolet, A; Wendling, D



Previous Psychotherapy among Hypnotherapy Applicants  

Microsoft Academic Search

Presenting problem and reported previous psychotherapy were analyzed in a sample of 413 applicants for hypnotherapy clinic treatment. A significant relationship (p < .001) was found between type of problem and report of previous psychotherapy. Applicants stating problems usually associated with analytic psychotherapy (anxiety, depression) tended to have higher rates of previous psychotherapy than applicants presenting problems more often associated

Peter B. Field; Milton V. Kline



Providing Internet access to Los Alamos National Laboratory technical reports: A case history in providing public access to previously restricted documents  

SciTech Connect

The Los Alamos National Laboratory (LANL) Research Library recently fulfilled a strategic goal of providing worldwide desktop access via the Internet to full-image files of the complete unclassified holdings of Los Alamos technical reports in its Report Collection. This effort began in late 1994 with the scanning of paper and microfiche format reports. Concurrently, the Research Library helped to initiate shifting the model for publishing new technical reports from paper to electronic; the files could then be directly mounted on the Research Library`s Web server. Providing desktop access to these reports was instrumental in expediting the development of internal policies that would better define what documents, previously restricted to the general public, could be publicly released. Undoubtedly, the most significant category of such reports were previously classified reports that had been declassified, but had not gone through a further review for public release. Collaboration with LANL`s Classification Group led to approval for public release of 97% of these reports. The LANL Research Library`s Web site now offers unique and unprecedented access to the world of a huge body of technical reports never available before anywhere in any form. This paper discusses the issues and steps involved in this achievement.

Collins, K.A.



Preliminary Report: Missense mutations in the APOL gene family are associated with end stage kidney disease risk previously attributed to the MYH9 gene  

Microsoft Academic Search

MYH9 has been proposed as a major genetic risk locus for a spectrum of non-diabetic end stage kidney disease (ESKD). We use recently released sequences from the 1000 Genomes Project to identify two western African specific missense mutations (S342G and I384M) in the neighbouring APOL1 gene, and demonstrate that these are more strongly associated with ESKD than previously reported MYH9

Shay Tzur; Saharon Rosset; Revital Shemer; Guennady Yudkovsky; Sara Selig; Ayele Tarekegn; Endashaw Bekele; Neil Bradman; Walter G Wasser; Doron M Behar; Karl Skorecki



A concise follow-up of a previous report: posterior reduction and anterior lumbar interbody fusion in symptomatic low-grade adult isthmic spondylolisthesis  

Microsoft Academic Search

We report the updated results for a previously evaluated surgical treatment for adult low-grade isthmic spondylolisthesis. In 12 patients a decompressive laminectomy was performed followed by a circumferential fusion using posterior pedicle screw instrumented reduction and staged anterior cage-assisted interbody fusion. Average time to follow-up was 5.6 (range 4.9–6.6) years. The average Oswestry Disability Index at last follow-up was 14

M. Spruit; J. P. W. van Jonbergen; M. de Kleuver



Emergency surgery due to go-kart injuries: report of two consecutive cases.  


Injury due to go-karting accidents is a new kind of surgical emergency in Turkey and may show variations between patients. There are special details as relate to the design of the vehicles and patient characteristics. We report two seriously injured patients as a result of two different go-kart accidents. Severe intraabdominal hemorrhage due to liver laceration was seen in one patient and mesenteric intestinal avulsion in the other. Both patients were treated surgically and discharged uneventfully. PMID:23188612

Y?lmaz, Kerim Bora; Ak?nc?, Melih; Kaya, Oskay; Kulaço?lu, Hakan



Follicular mucinosis and mycosis-fungoides-like drug eruption due to leuprolide acetate: a case report and review.  


Leuprolide acetate represents a gonadotropin-releasing hormone agonist, used as part of the treatment of prostate cancer. We report an unusual case of disseminated urticarial rash following leuprolide injection in a 67-year-old man that histopathologically and immunohistochemically resembled mycosis-fungoides, including the presence of follicular mucinosis and eosinophils in the follicles. This histopathologic pattern has not been previously described as a drug reaction pattern due to leuprolide, and it underscores the importance of correlation with the clinical impression to arrive at a correct diagnosis. PMID:22882386

Shalin, Sara C; Brantley, Julie; Diwan, A Hafeez



Due Process in Intercollegiate Athletic Association Policies and Procedures. Report and Recommendations. Report 5.  

ERIC Educational Resources Information Center

|The study reviewed the legal relationship between the National Collegiate Athletic Association (NCAA) and its member institutions and the national reform movement in intercollegiate athletics, and proposed legislation that would mandate due process guarantees in all association proceedings with its member institutions. Legal research confirmed…

Florida State Postsecondary Education Planning Commission, Tallahassee.


Post-operative sinus formation due to Mycobacterium abscessus: a case report.  


Summary: Mycobacterium abscessus is ubiquitously found rapidly growing mycobacteria. Although it is an uncommon pathogen, it has been known to cause cutaneous infection following inoculation, minor trauma or surgery. This communication reports an immuno-competent patient developing multiple sinuses due to Mycobacterium abscessus in the post- operative period. PMID:24000496

Haider, Mehvash; Banerjee, Priyanka; Jaggi, Tavleen; Husain, Jasmin; Mishra, Bibhabati; Thakur, Archana; Dogra, Vineeta; Loomba, Poonam



Case report. Rhodotorula rubra fungaemia due to use of indwelling venous catheters.  


Rhodotorula has been an infrequent cause of infection in humans but there have been some case reports about this systemic yeast infection. In this article, a Rhodotorula rubra fungaemia due to an indwelling catheter in a 23-year-old woman who had been diagnosed with non-Hodgkin's lymphoma grade IV B is described. PMID:10948821

Kiraz, N; Gülbas, Z; Akgün, Y



Adrenal Failure due to Adrenal Metastasis of Lung Cancer: A Case Report  

PubMed Central

We report a case of a patient with adrenal failure due to bilateral adrenal metastasis of lung cancer. This is a rare presentation of lung cancer. We review the differential diagnosis of weight loss and how to make diagnosis of adrenal insufficiency.

Faulhaber, Gustavo Adolpho Moreira; Borges, Flavia Kessler; Ascoli, Aline Maria; Seligman, Renato; Furlanetto, Tania Weber



Inoperable HTS Pressure Sensor Due to NaK Leak. Final Unusual Occurrence Report.  

National Technical Information Service (NTIS)

The report describes an inoperable pressure sensor in the primary heat transport system, due to a NaK leak between the transducer and bellows seal assembly. The pressure transducer capillary tube and seal assembly was replaced during a planned Heat Transp...

D. B. Beagles



Severe Mitral Regurgitation due to Traumatic Anterolateral Papillary Muscle Rupture: A Case Report  

PubMed Central

A 29-year-old man was admitted for abrupt dyspnea and hemoptysis. An echocardiogram revealed severe mitral regurgitation due to papillary muscle rupture for which an emergency mitral valve replacement operation was performed 4 days after admission. Herein, we report our experience with this case along with a review of the literature.

Lee, Chul Ho; Lee, Sub; Jang, Jae Seok



First report worldwide of an infant botulism case due to Clostridium botulinum type E.  


Clostridium botulinum type E has been associated with botulism in adults but never in infants. Infant botulism type E cases have been associated with neurotoxigenic strains of C. butyricum. We report the first infant botulism case due to C. botulinum type E worldwide. PMID:19906896

Lúquez, Carolina; Dykes, Janet K; Yu, Patricia A; Raphael, Brian H; Maslanka, Susan E



Sepsis due to Clostridium perfringens after Pregnancy Termination with Feticide by Cordocentesis: A Case Report  

Microsoft Academic Search

We report a case of sepsis due to Clostridium perfringens after termination of pregnancy at 22 weeks with feticide by cordocentesis. Three weeks earlier, the 41-year-old patient had undergone an amniocentesis and a full trisomy 13 karyotype had been discovered. Feticide was performed by injection of thiopental and potassium chloride after percutaneous umbilical foetal blood sampling through the same needle.

S. V. Li Kim Mui; Y. Chitrit; M. C. Boulanger; L. Maisonneuve; L. Choudat; P. de Bièvre



Ulnar-sided wrist pain after four-corner fusion in a previously-asymptomatic ulnar positive wrist: a case report.  


Scaphoid excision and four-corner fusion is one of the treatment choices for patients who have stage II or III SLAC (scapholunate advanced collapse)/SNAC (scaphoid non-union advanced collapse) wrist arthritis. We report a case of ulnar-sided wrist pain which occurred after four-corner fusion for stage II SNAC wrist with a previously-asymptomatic ulnar positive variance, and was successfully treated by ulnar shortening osteotomy. This case highlights a possible coincidental pathology of the ulnocarpal joint in the setting of post-traumatic radiocarpal arthrosis. PMID:19598323

Gong, Hyun Sik; Jeon, Su Ha; Baek, Goo Hyun



Wear comparison between conventional and highly cross-linked polyethylene against a zirconia head: a concise follow-up, at an average 10 years, of a previous report.  


We previously reported the results of wear comparison at a minimum of 5years between highly cross-linked polyethylene (HXLPE) and conventional polyethylene (PE) against a zirconia femoral head. We now report the mean wear at 10years for 52 patients (56 hips) of the original cohort of 61 patients (65 hips) who had undergone primary total hip arthroplasty at our hospital between November 1999 and August 2000. The mean steady-state linear wear rate of HXLPE was 0.045mm/y, compared with 0.080mm/y for conventional PE (P=.0003). The incidence of osteolysis was 25% in the conventional PE group compared with 0% in the HXLPE group. Our study demonstrated that the steady-state wear rate for HXLPE remains significantly lower than that for conventional PE against a zirconia femoral head at a mean of 10years after implantation. PMID:23523499

Fukui, Kiyokazu; Kaneuji, Ayumi; Sugimori, Tanzo; Ichiseki, Toru; Matsumoto, Tadami



Inappropriate implantable cardioverter-defibrillator shock due to external alternating current leak: report of two cases.  


Two cases are reported of inappropriate implantable cardioverter-defibrillator shocks due to external alternating current leak. Electromagnetic interference (EMI) can mimic cardiac signals and cause inappropriate implantable cardioverter-defibrillator (ICD) shocks. EMI can arise from the normal functioning of electrical appliances or from alternating current leak. The two cases had inappropriate ICD shocks due to alternating current leak from a power drill in one and a washing machine in the other. The need for detailed advice on handling electrical equipment is emphasized. PMID:15763537

Chan, Ngai Yin; Wai-Ling Ho, Lillian



Chronic obstructive uropathy due to uretero-inguinal hernia: A case report  

PubMed Central

INTRODUCTION Inguinal hernia in men is common but uretero-inguinal hernia is very rare. PRESENTATION OF CASE A 85-year-old obese man presented with chronic obstructive uropathy with previous renal ultrasound showing bilateral enlarged kidneys and hydronephrosis. The medical history revealed a 3-year history of a noticeable bilateral partial reducible inguinoscrotal herniae associated with urinary symptoms. Progress CT scan showed very large inguinal herniae, which were predominantly fat-containing with the ureters herniated, and both kidneys were displaced inferiorly. DISCUSSION Uretero-inguinal hernia in patients with native kidneys is rare, but cases of renal failure secondary to uretero-inguinal hernia have also been reported previously in the literature with two anatomical variations have been reported – paraperitoneal and extraperitoneal types. Endourological and surgical procedures are rarely straight-forward because of tortuosity of the herniated ureter. CONCLUSION Although uretero-inguinal hernia is rare, it can be the cause of chronic renal impairment.

Won, Andy Chuk Moon; Testa, Gerard



First Reported Case of Catheter-Related Fungemia Due to Candida mengyuniae ?  

PubMed Central

We report a case of intravenous catheter-associated fungemia caused by the recently described species Candida mengyuniae, a yeast not previously associated with human disease. The infection occurred in an 89-year-old woman with pancreatic adenocarcinoma. Yeast isolates recovered from a catheter and blood were identified as C. mengyuniae by sequencing of the 18S, 5.8S internal transcribed spacer, and D1/D2 26S ribosomal DNA domains.

Alcoba-Florez, J.; Laich, F.; Perez-Roth, E.; Ode-Febles, J.; Mendez-Alvarez, S.



Stroke due to a fusiform aneurysm of the cervical vertebral artery: case report  

Microsoft Academic Search

Aneurysms of the cervical vertebral artery (VA) are uncommon; they are often caused by trauma or spontaneous dissection.\\u000a A fusiform aneurysm without evidence of atherosclerosis or dissection has not been reported previously. A 46-year-old man\\u000a presented with a pontine infarct. Imaging revealed a fusiform aneurysm of the left VA at the C5–6 level, with occlusion of\\u000a the basilar artery. Associated

S. Suzuki; T. Inoue; S. Haga; S. Nishio; S. Kono; A. Mizushima; M. Fukui



Large bowel obstruction due to sesame seed bezoar: a case report  

PubMed Central

We report a case of a 79 year old man with a known benign anastomotic stricture presenting with large bowel obstruction. At laparotomy the obstruction was found to be caused by a large sesame seed bezoar. Seed bezoars are well known to cause impaction in the rectum but have never been previously reported to cause large bowel obstruction. We recommend that patients with known large bowel strictures should be advised not to eat seeds as this could ultimately lead to obstruction, ischaemia or perforation.

Shaw, Aidan G; Peacock, Oliver; Lund, Jonathan N; Tierney, Gillian M; Larvin, Mike; Speake, William



The effects of measurement error on previously reported mathematical relationships between indicator organism density and swimming-associated illness: a quantitative estimate of the resulting bias.  


Several recent epidemiological studies seeking associations between swimming in recreational waters contaminated with domestic sewage and increased illness among such swimmers have reported mathematical relationships relating indicator organism densities to illness among swimmers. Common to the design of all of these studies is the failure to adequately control for large amounts of measurement error contained in estimates of exposure, i.e. estimated indicator organism densities. The limited precision of current methods of indicator organism enumeration, coupled with temporal and spacial variation in indicator organism densities at the locations studied, are responsible for a substantial portion of this measurement error. The failure to control adequately for these sources of measurement error has resulted in a significant amount of bias being present in the mathematical relationships reported by these previously published epidemiological studies. In order to explore the magnitude and direction of this bias, computer simulations were conducted using data in which estimation of indicator organism density was obtained by the two most widely used techniques of enumeration: the Multiple Tube Fermentation Technique and the Membrane Filtration Technique. The results of the computer simulations show that the bias caused by this measurement error is non-differential causing the mathematical relationships between indicator organism density and swimming-associated illness reported in previous epidemiological studies to underestimate true risk by a minimum of approximately 14%, and that this underestimate could range as high as approximately 30 to 57%. This study also demonstrates that substantial reduction of this bias can be easily accomplished by incorporating a formal water quality sampling strategy, based on statistical principles of experimental design and analysis, into the design of future epidemiological studies seeking mathematical relationships between indicator organism density and swimming-associated illness. PMID:2083996

Fleisher, J M



Successful surgical intervention for the management of endocarditis due to multidrug resistant Candida parapsilosis: case report and literature review.  


Candida parapsilosis is an uncommon cause of invasive endocarditis. This pathogen induces severe complications and carries a high mortality rate. We describe a case of C. parapsilosis endocarditis in a 54-year-old man with a history of HIV and Hepatitis C infection who previously underwent prosthetic valve replacement due to bacterial endocarditis. The patient presented with prolonged febrile episodes and fungemia with repeat blood cultures positive for C. parapsilosis. The patient failed multiple regimens of antifungal therapy and the C. parapsilosis isolate progressively acquired resistance to a number of drugs. Due to the multidrug resistant nature of the isolate, replacement of the infected valve was required to resolve his fungemia, and the patient remained asymptomatic for two years. This case is unusual due to the multidrug resistant nature of the isolate requiring both combined medical and surgical intervention. A review of published reports indicates that endocarditis due to C. parapsilosis responds well to a combination of medical and surgical interventions; the latter is particularly suitable for immunocompromised hosts. PMID:21537953

Kumar, Jessica; Fish, Douglas; Burger, Harold; Weiser, Barbara; Ross, Jeffrey S; Jones, David; Robstad, Karl; Li, Xiaojiang; Chaturvedi, Vishnu



Human infections due to Salmonella Blockley, a rare serotype in South Africa: a case report  

PubMed Central

Background Infections due to nontyphoidal Salmonella have increased worldwide over the last couple of decades. Salmonella enterica serotype Blockley (Salmonella Blockley) infections is associated with chickens and is a rarely isolated serotype in human infections in most countries. Case presentation We report a case of human infections due to Salmonella Blockley in KwaZulu-Natal, South Africa in 2011. Three African males (aged 4, 14 and 16) presented to a clinic with diarrhoea, stomach cramps and headache. They started experiencing signs of illness a day after they consumed a common meal, consisting of meat, rice and potatoes. Stool specimens from the patients cultured Salmonella Blockley. The strains showed an indistinguishable pulsed-field gel electrophoresis pattern. Conclusion This is the first recorded case of human infections due to Salmonella Blockley in South Africa.



Three-year mortality in previously hospitalized older patients from rural areas - the importance of co-morbidity and self-reported poor health  

PubMed Central

Background The risk factors for mortality after hospitalization in older persons are not fully understood. The aim of the present study was to examine the three-year (1,096 days) mortality in previously hospitalized older patients from rural areas, and to explore how objectively and self-reported health indicators at baseline were associated with mortality. Methods The study included 484 (241 men) medical inpatients with age range 65–101 (mean 80.7, SD 7.4) years. Baseline information included the following health measures: the Charlson Index, the Mini-Mental-State Examination, Lawton and Brody’s scales for physical self-maintenance and the instrumental activities of daily living, the Hospital Anxiety and Depression scale, self-reported health (one item), and perceived social functioning (one item) and assistance in living at discharge. Results In all, 172 (35.5%) of those patients included had died within the three years of the follow-up period. Three-year mortality was associated with a high score at baseline on the Charlson Index (HR 1.73, 95%CI 1.09-2.74) and poor self-reported health (HR 1.52, 95%CI 1.03-2.25) in a Cox regression analysis adjusted for age, gender, other objectively measured health indicators, and perceived impaired social functioning. Conclusion In a study of older adults admitted to a general hospital for a wide variety of disorders, we found co-morbidity (as measured with the Charlson Index) and poor self-reported health associated with three-year mortality in analysis adjusting for age, gender, and other health-related indicators. The results suggest that self-reported health is a measure that should be included in future studies.



Dislocation after Hemiarthroplasty due to Insufficiency Fracture of the Superior Acetabulum: A Case Report  

PubMed Central

Insufficiency fracture of the superior part of the acetabulum after hemiarthroplasty has not been reported before. Here we report a case of dislocation after hemiarthroplaty due to insufficiency fracture of the acetabulum. In our patient, insufficiency fracture of the ilium immediately above the acetabulum produced obvious evidence of compression and collapse that led to dislocation of the outer head of the femoral component. This patient had subsequently been treated with a cementless socket inserted into the fractured acetabulum. We should remember the possibility of insufficiency fracture of the superior acetabulum after hemiarthroplasty, particularly in elderly patients suffering from chronic postoperative pain and disability.

Nozawa, Masahiko; Nishiura, Takashi; Maezawa, Katsuhiko; Matsuda, Keiji; Morio, Hidenori



Complete transection of the pancreas due to a single stamping injury: a case report  

Microsoft Academic Search

Complete transection of the pancreas due to a single stamping injury is reported. A 47-year-old female was stamped on in\\u000a the epigastric region by her common-law husband when lying on her back. Immediately after the stamping, she complained of\\u000a severe abdominal pain. In an emergency hospital, the abdominal CT (computed tomography) scan showed a large haematoma around\\u000a the pancreas head.

K. Higashitani; T. Kondo; Y. Sato; T. Takayasu; R. Mori; T. Ohshima



Successful Management of Pregnancy with Nephrotic Syndrome due to Preexisting Membranous Glomerulonephritis: A Case Report  

Microsoft Academic Search

The influence of membranous glomerulonephritis (MGN) on maternal and fetal outcome is controversial, as is the effect of pregnancy on the course of preexisting nephrotic syndrome. We report a case of successful management of a pregnancy with preexisting severe nephrotic syndrome due to biopsy-proven primary MGN. Our patient became pregnant in a non-compliance period, discontinued the nephrological follow-up program and

Andras Sebestyen; Szabolcs Varbiro; Levente Sara; Gyorgy Deak; Lorant Kerkovits; Istvan Szabo; Istvan Kiss; Ferenc Paulin



Toxic megacolon due to Salmonella : a case report and review of the literature  

Microsoft Academic Search

Background and aims: Salmonella colitis is an unusual cause of toxic megacolon. We provide an overview of this condition and report a single case. Patients and methods: A 62-year-old man underwent subtotal colectomy with ileostomy formation for toxic megacolon due to Salmonella enteritidis phage type 4 colitis, followed by reversal with an ileorectal anastomosis. Results: Twenty-seven cases have been described

A. Chaudhuri; B. A. Bekdash



Deep sternal wound infection due to Pasteurella multocida : the first case report and review of literature  

Microsoft Academic Search

Pasteurella multocida is a Gram-negative bacterium recovered from a wide variety of wild and domestic animals and has mostly been associated with\\u000a infection following animal bites. We present the first reported case of a patient who developed a postoperative sternal wound\\u000a infection due to P. multocida complicated by bloodstream infection. The outcome was favorable following surgical debridement and antimicrobial therapy.

R. Baillot; P. Voisine; L. M. E. G. Côté; Y. Longtin


Majewski osteodysplastic primordial dwarfism type II (MOPD II) syndrome previously diagnosed as Seckel syndrome: report of a novel mutation of the PCNT gene.  


We report on a 3-year-old boy with prenatal onset of proportionate dwarfism, postnatal severe microcephaly, high forehead with receded hairline, sparse scalp hair, beaked nose, mild retrognathia and hypotonia diagnosed at birth as Seckel syndrome. At age 3 years, he became paralyzed due to a cerebrovascular malformation. Based on the clinical and radiological features showing evidence of skeletal dysplasia, the diagnosis was revised to Majewski osteodysplastic primordial dwarfism type II (MOPD II) syndrome. Western blot analysis of the patient's lymphoblastoid cell line lysate showed the absence of the protein pericentrin. Subsequent molecular analysis identified a novel homozygous single base insertion (c.1527_1528insA) in exon 10 of the PCNT gene, which leads to a frameshift (Treo510fs) and to premature protein truncation. PCNT mutations must be considered diagnostic of MOPD II syndrome. A possible role of pericentrin in the development of cerebral vessels is suggested. PMID:19839044

Piane, Maria; Della Monica, Matteo; Piatelli, Gianluca; Lulli, Patrizia; Lonardo, Fortunato; Chessa, Luciana; Scarano, Gioacchino



Mutational analysis of TSC1 and TSC2 in Japanese patients with tuberous sclerosis complex revealed higher incidence of TSC1 patients than previously reported.  


Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by multiple hamartias and hamartomas involving throughout the body. To date, many TSC1 and TSC2 mutations have been reported all over the world, however, few TSC mutation studies have been performed in the Japanese population, and genetic characteristics of Japanese TSC patients are not yet clear. In this study, we analyzed TSC1 and TSC2 in 57 Japanese patients with TSC (8 familial and 49 sporadic; 46 definite and 11 suspect TSC) and identified 31 mutations including 11 TSC1 mutations (two familial and nine sporadic; all definite TSC) and 20 TSC2 mutations (2 familial and 18 sporadic; 19 definite and 1 suspect TSC). We also reviewed all Japanese TSC mutations previously reported. Our study demonstrates significantly higher incidence (P=0.007) of TSC1 mutations among sporadic TSC patients in the Japanese population compared with US and European studies. No differences emerged in mutation distributions and types in precedent studies, excepting low frequency of the TSC2 nonsense mutation. Comparing clinical manifestations, developmental delay and/or mental retardation were milder in TSC1 patients than TSC2 patients for its frequency (P=0.032) and severity (P=0.015); however, no other symptoms were clearly different. PMID:23389244

Niida, Yo; Wakisaka, Akiko; Tsuji, Takanori; Yamada, Hiroshi; Kuroda, Mondo; Mitani, Yusuke; Okumura, Akiko; Yokoi, Ayano



Mis-reporting, previous health status and health status of family may seriously bias the association between food patterns and disease  

PubMed Central

Background Food pattern analyses are popular tools in the study of associations between diet and health. However, there is a need for further evaluation of this methodology. The aim of the present cross-sectional study was to evaluate the relationship between food pattern groups (FPG) and existing health, and to identify factors influencing this relationship. Methods The inhabitants of Västerbotten County in northern Sweden are invited to health check-ups when they turn 30, 40, 50, and 60 years of age. The present study includes data collected from almost 60,000 individuals between 1992 and 2005. Associations between FPG (established using K-means cluster analyses) and health were analyzed separately in men and women. Results The health status of the participants and their close family and reporting accuracy differed significantly between men and women and among FPG. Crude regression analyses, with the high fat FPG as reference, showed increased risks for several health outcomes for all other FPGs in both sexes. However, when limiting analysis to individuals without previous ill-health and with adequate energy intake reports, most of the risks instead showed a trend towards protective effects. Conclusions Food pattern classifications reflect both eating habits and other own and family health related factors, a finding important to remember and to adjust for before singling out the diet as a primary cause for present and future health problems. Appropriate exclusions are suggested to avoid biases and attenuated associations in nutrition epidemiology.



Allergic contact dermatitis mimicking angioedema due to paraphenylendiamine hypersensitivity: a case report.  


Active sensitization to paraphenylendiamine (PPD) and related compounds from temporary black henna tattoos has become an epidemic in the recent years. Hair dyes also include PPD like black henna tatoos which cause allergic contact dermatitis. Skin lesions of allergic contact dermatitis from PPD are mostly seen as an exudative erythema, an erythema multiforme-like eruption or a bullous contact dermatitis. We, herein, report a 27 year-old woman with an angioedema-like reaction occurring after the first exposure to hair dye who was unaware of being previously sensitized to PPD from black henna tattoo. PMID:22181557

Tukenmez Demirci, Gulsen; Kivanc Altunay, Ilknur; Atis, Guldehan; Kucukunal, Asli



Overwhelming postsplenectomy infection due to Mycoplasma pneumoniae in an asplenic cirrhotic patient: Case report  

PubMed Central

Background Mycoplasma pneumoniae infection is usually self-limited, but some fulminant cases are fatal, even when occurring in previously healthy individuals. It can also be the cause of overwhelming postsplenectomy infection (OPSI). Case presentation We report a case of OPSI in a 41-year-old woman with hypersplenism associated with hepatitis B cirrhosis. We detected a significant Mycoplasma pneumoniae agglutination titer, but no evidence of infection with Chlamydia pneumoniae, Legionnella spp., or any other bacterial or fungal pathogens. She eventually died despite aggressive therapy. Conclusions M. pneumoniae could be an underestimated cause of OPSI, and should be suspected in fulminant infectious cases in asplenic patients.



Acute carotid occlusion and stroke due to antiphospholipid antibody syndrome: case report and literature review.  


Neurologic events associated to antiphospholipoid syndrome (APLS) are not uncommon, but ischemic stroke due to acute carotid thrombosis, is a rare presentation of this syndrome. We report a case of a 48 years old female patient, without evidence of atherothrombosis or other vascular pathology, who presented an ischemic stroke due to acute thrombosis of the left internal carotid artery. The occlusion was diagnosed by Duplex scan and magnetic resonance angiography (Ds+MRA). The patient was anticoagulated and experienced total regression of her neurologic symptoms after a week. Ds+MRA were performed again and confirmed re-establishment of normal flow of internal carotid artery. A thorough clinical investigation confirmed the diagnosis of APLS (the association of a major thombotic event and high anticardiolipoid IgG antibody titers in three blood samples). The patient has been submitted to oral anticoagulation for three years and has not experienced new neurologic or thrombotic events. PMID:20671658

Marques, M A; Murad, F F; Ristow, A V; Silveira, P R M; Pinto, J E Ss; Gress, M H T; Massière, B; Cury, J M; Vescovi, A



Hypocalcemia and hypokalemia due to hyperventilation syndrome in spinal anesthesia -A case report-  

PubMed Central

Hyperventilation syndrome (HVS) often occurs under stressful conditions, and has been reported during or after anesthesia and operation. HVS, characterized by multiple somatic symptoms and electrolyte imbalances induced by inappropriate hyperventilation, should be managed as an emergency. We report a rare case of HVS during spinal anesthesia. The patient was a previously healthy 51-year-old female without psychogenic conditions. During spinal anesthesia for lower extremity surgery, the patient complained of nausea, headache, paresthesia in the upper extremities and perioral numbness. We found carpal spasm in both hands and flattening of T wave on electrocardiogram (ECG). Emergent arterial blood gas analysis (ABGA) revealed markedly decreased PaCO2, hypocalcemia and hypokalemia. We managed the patient with verbal sedation, electrolytes replacement therapy and closed mask inhalation. HVS subsided gradually. We conclude that monitoring for possible HVS during anesthesia is very important for patient safety.

Lee, Soo Kyung; Chung, Ji Hoon; In, Chi Bum



Marketers report disturbing increase in past-due money owed by customers  

SciTech Connect

In a little-talked about but unmistakable development, LP-gas marketers in many places nationwide have been reporting a greater number of past-due receivables and delinquent accounts than usual, mostly as a result of higher prices charged for propane during last winter's supply crisis. The monthly gallonage survey presented gives initial glimpses into the cash-flow problems that LP-gas marketers have been experiencing. A number of additional telephone calls confirmed the suspicion that late payments for fuel delivered during the winter are plaguing many suppliers.

Not Available



Mechanical bowel obstruction due to colonic hemangioma: report of a case.  


Colon hemangiomas are rare benign vascular lesions which are usually seen in teenagers. The frequent presentation is repetitive painless rectal bleeding. Colonic hemangiomas are occasionally found in the rectosigmoid area. A 62-year-old male patient was admitted to the hospital with the complaints of mechanical bowel obstruction. The radiological imaging techniques revealed a transverse colon tumor. Consequently, the patient was operated, and transverse colectomy and end-to-end anastomosis were performed. No postoperative complications occurred. The pathologic examination revealed cavernous hemangioma of the transverse colon. This report describes a very rare case of bowel obstruction due to colonic hemangioma. PMID:17205412

Demirba?, Tolga; Güler, Necdet; Cali?kan, Cemil; Gürcü, Bari?; Do?anav?argil, Ba?ak; Korkut, Mustafa



Case reports: new onset flushing due to unauthorized substitution of niacin for nicotinamide.  


Nicotinamide is the amide form of niacin and has anti-inflammatory properties that have led to its use in the treatment of several inflammatory dermatologic conditions, such as rosacea. Niacin has established its role in the prevention of coronary artery disease. Cutaneous flushing is a well-known and often dose-limiting side effect of niacin therapy, which does not occur with nicotinamide. We report a patient with rosacea who developed new onset flushing due to unauthorized substitution of niacin for nicotinamide. The anti-inflammatory mechanisms of nicotinamide and flushing mechanisms of niacin are discussed. PMID:18189062

Kademian, Monique; Bechtel, Mark; Zirwas, Matt



Knee Locking in Osteoarthritis due to Synovial Lipoma: A Case Report  

PubMed Central

Intra–articular synovial lipomas are very rare and only few cases have been reported till now. We are reporting a rare case of a unilateral intra–articular lipoma of osteoarthritic knee joint in a 62 years old male. Patient had two episodes of sudden locking of knee joint, which resolved spontaneously. A plain X-ray showed changes which were suggestive of osteoarthritis. Clinically, patient was diagnosed as a case of loose bodies in left knee joint. An arthrotomy was performed. After a Histopathological Examination (HPE) of loose bodies, a diagnosis of an intra–articular synovial lipoma was made. Due to wide differentials and varied clinical behaviour of loose bodies, lipoma should be included in differential diagnosis of osteroarthritic patients who complain of episodic locking of knees. Intraarticular lipomas, on arthroscopic guided excision, get cured permanently, with no recurrence. The differentiation of an intra-articular lipoma from a relatively more common entity, Lipoma arborescens, has also been discussed.

S. Amarjit, Kataria; Budhiraja, Shivali; Chandramouleeswari, K.; Anita, S.



Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?  

PubMed Central

Background Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. Case presentation A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. Conclusion The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports.

Evans, Marion W; Gilbert, Micheal L; Norton, Sandra



Update of the pompe disease mutation database with 60 novel GAA sequence variants and additional studies on the functional effect of 34 previously reported variants.  


Pompe disease is an autosomal recessive lysosomal glycogen storage disorder, characterized by progressive muscle weakness. Deficiency of acid ?-glucosidase (EC; can be caused by numerous pathogenic variants in the GAA gene. The Pompe Disease Mutation Database at aims to list all variants and their effect. This update reports on 94 variants. We examined 35 novel and 34 known mutations by site-directed mutagenesis and transient expression in COS-7 cells or HEK293T cells. Each of these mutations was given a severity rating using a previously published system, based on the level of acid ?-glucosidase activity in medium and transfected cells and on the quantity and quality of the different molecular mass species in the posttranslational modification and transport of acid ?-glucosidase. This approach enabled to classify 55 missense mutations as pathogenic and 13 as likely nonpathogenic. Based on their nature and the use of in silico analysis (Alamut® software), 12 of the additional 25 novel mutations were predicted to be pathogenic including 4 splicing mutations, 6 mutations leading to frameshift, and 2 point mutations causing stop codons. Seven of the additional mutations were considered nonpathogenic (4 silent and 3 occurring in intron regions), and 6 are still under investigation. PMID:22644586

Kroos, Marian; Hoogeveen-Westerveld, Marianne; Michelakakis, Helen; Pomponio, Robert; Van der Ploeg, Ans; Halley, Dicky; Reuser, Arnold



Septic arthritis due to Streptococcus bovis in a patient with liver cirrhosis due to hepatitis C virus: case report and literature review.  


Monoarthritis remains a diagnostic challenge in Rheumatology and Orthopedics. The author reports a case of septic arthritis due to Streptococcus bovis after several episodes of joint effusion treated with hyaluronic acid (Hylan G-F 20) and methylprednisolone acetate in a 69-year-old patient with liver cirrhosis due to hepatitis C virus. Neither adenoma of the colon nor endocarditis was present. The diagnostic possibilities for this case of monoarthritis, the pathologies related to the microorganism of interest to the rheumatologist, and the possible involvement of joint reaction to hyaluronic acid as a predisposing factor to joint effusion are discussed. PMID:21953003

Dallaverde Neto, Ernesto


Severe progressive scoliosis due to huge subcutaneous cavernous hemangioma: A case report  

PubMed Central

Cavernous hemangioma consists mainly of congenital vascular malformations present before birth and gradually increasing in size with skeletal growth. A small number of patients with cavernous hemangioma develop scoliosis, and surgical treatment for the scoliosis in such cases has not been reported to date. Here we report a 12-year-old male patient with severe progressive scoliosis due to a huge subcutaneous cavernous hemangioma, who underwent posterior correction and fusion surgery. Upon referral to our department, radiographs revealed a scoliosis of 85° at T6-L1 and a kyphosis of 58° at T4-T10. CT and MR images revealed a huge hemangioma extending from the subcutaneous region to the paraspinal muscles and the retroperitoneal space and invading the spinal canal. Posterior correction and fusion surgery using pedicle screws between T2 and L3 were performed. Massive hemorrhage from the hemangioma occurred during the surgery, with intraoperative blood loss reaching 2800 ml. The scoliosis was corrected to 59°, and the kyphosis to 45° after surgery. Seven hours after surgery, the patient suffered from hypovolemic shock and disseminated intravascular coagulation due to postoperative hemorrhage from the hemangioma. The patient developed sensory and conduction aphasia caused by cerebral hypoxia during the shock on the day of the surgery. At present, two years after the surgery, although the patient has completely recovered from the aphasia. This case illustrates that, in correction surgery for scoliosis due to huge subcutaneous cavernous hemangioma, intraoperative and postoperative intensive care for hemodynamics should be performed, since massive hemorrhage can occur during the postoperative period as well as the intraoperative period.



Brainstem encephalitis (rhombencephalitis) due to Listeria monocytogenes: case report and review.  


Listerial brainstem encephalitis is a rare disease. Only 62 cases have been reported previously; all were in adults, only 8% of whom were immunosuppressed. The disease has a characteristic biphasic course: a nonspecific prodrome of headache, nausea or vomiting, and fever lasting for several days is followed by progressive asymmetrical cranial-nerve palsies, cerebellar signs, hemiparesis or hypesthesia, and impairment of consciousness. Neck stiffness was initially present in only 55% of the cases described thus far. Studies of cerebrospinal fluid often revealed only mild abnormalities. Cultures of cerebrospinal fluid and blood were positive in 41% and 61% of cases, respectively. Respiratory failure occurred in 41% of cases. Initial computed tomography of the brain often gave normal results; magnetic resonance imaging better demonstrated brainstem abnormalities. Overall mortality was 51%. All untreated patients died. When treatment with ampicillin or penicillin was initiated early, the rate of survival was > 70%; however, neurological sequelae developed in 61% of survivors. PMID:8507761

Armstrong, R W; Fung, P C



Conjunctival squamous cell carcinoma due to ocular prostheses: a case report and review of literature.  


Conjunctival squamous cell carcinoma (SCC) is a rare finding in everyday clinical practice, but is the most common malignancy of the ocular surface. The incidence of this malignancy in the United States is 0.03 per 100,000 persons. It is one extreme of a spectrum of lesions encompassed in ocular surface squamous neoplasia which range from dysplasia to carcinoma in situ to invasive SCC. Exposure to ultraviolet radiation B (UVB), human papilloma virus (HPV), and human immunodeficiency virus (HIV) infection of eroded ocular surface are important risk factors predisposing to the development of this malignancy. Herein we report a case of SCC arising in chronic conjunctival irritation due to prolonged prosthetic use following enucleation for traumatic eye injury. PMID:20376710

Jain, Rohit K; Mehta, Rutika; Badve, Sunil



[Basilar artery occlusion due to embolism from the vertebral artery: three case reports].  


Without early recanalization, it is well known that acute basilar artery occlusion almost always results in death or severe disability. We report three cases of basilar artery occlusion due to vertebral artery thrombo-embolism. In all cases, the cause of the strokes was artery to artery embolism from the vertebral artery origin. In case 1 and 3, despite complete occlusion of the vertebral artery origin, the thrombus was drained into the basilar artery through collateral flow from the external carotid artery. Atherosclerotic lesion of the vertebral artery origin is one of the main embolic sources of basilar artery, in which case, angioplasty or stent placement of the vertebral artery origin should be considered in addition to thrombolysis of the basilar artery. PMID:20628195

Kikuchi, Osamu; Ushikoshi, Satoshi; Kashiwazaki, Daina; Takagawa, Yuuya; Yokoyama, Yuka; Ajiki, Minoru; Asaoka, Katsuyuki; Kazumata, Ken; Itamoto, Kouji



Leptomeningeal cyst in newborns due to vacuum extraction: report of two cases.  


Two new cases of leptomeningeal cysts subsequent to vacuum extraction are reported. Both children presented with a huge, nonpulsating, transilluminating subgaleal collection over the anterior fontanel that appeared soon after instrument delivery. Plain X-rays, computed tomography, and magnetic resonance imaging confirmed that the subgaleal collection was cerebrospinal fluid and showed the presence of a diastatic coronal suture in both cases. Treatment consisted of duraplasty with periosteal flaps and application of fibrin glue. In one case, an associated porencephalic cyst was treated with a cystoperitoneal shunt. Surgical treatment of leptomeningeal cyst due to vacuum extraction is simple and should not be postponed, despite the tendency for the extracranial cyst to regress, because of the potential risk of continuous growth of an underlying porencephalic cyst and risk of neurological damage. PMID:8869777

Djientcheu, V D; Rilliet, B; Delavelle, J; Argyropoulo, M; Gudinchet, F; de Tribolet, N



A patient presenting with acute abdomen due to metastatic small bowel melanoma: a case report  

PubMed Central

Introduction Malignant tumors of the small bowel are rare. Melanoma of the small intestine is in most cases metastatic from a primary skin lesion. Perforation of small bowel melanoma is an extremely rare entity. To the best of our knowledge this is the fifth case published to date. Case presentation We report a rare case of acute abdomen due to perforated metastatic small bowel melanoma in a 38-year-old Caucasian man. Conclusions In the majority of cases small bowel melanoma represents metastasis from cutaneous sites. Although rare, the possibility of abdominal metastatic melanoma presenting with the clinical picture of acute abdomen must be always considered by the operating surgeon in patients with a history of primary cutaneous malignant lesion.



Acute massive pulmonary thromboembolism due to acute intoxication by duloxetine: a case report.  


Duloxetine (Cymbalta) is a potent serotonin norepinephrine reuptake inhibitor used for the management of major depression and pain associated with diabetic peripheral neuropathy. Cymbalta delayed-release capsules contain Duloxetine HCl equivalent to 20, 30, 60 mg of Duloxetine. The ingestion of high quantities of Duloxetine may have serious outcomes such as venous thrombosis, causing cardiac respiratory arrest. The Authors outline a case report of an elderly woman, suffering from depression, found dead in her apartment. The cause of death was attributed to acute massive pulmonary thromboembolism due to acute intoxication of Duloxetine bought the day before. The thesis supported by the authors and confirmed by the data from other studies is that a massive intake of Duloxetine drug increases considerably the medication's side effects such as somnolence, dry mouth, fatigue, insomnia, dizziness, constipation, considerable increases in recumbent systolic and diastolic blood pressure, and a small decrease in heart rate. PMID:22351288

Mari, Francesco; Gualco, Barbara; Rensi, Regina; Bertol, Elisabetta



A case of acute hemolytic transfusion reaction due to anti-Dia antibody -A case report-  

PubMed Central

Many medical institutions in Korea have recently been performing an antibody screening test as one of the essential elements of a pre-transfusion test. The Dia antigen is well known as one of the antigens with low incidence among Caucasians; however, it has been discovered with a relatively higher incidence among Mongoloid populations. The frequency of the Dia antigen among the Korean population is estimated to be 6.4-14.5%. But in Korea, a screening panel of cells from abroad without Dia positive cells has been commonly used when a patient has an unexpected antibody screening test. Here we report a case of acute hemolytic transfusion reaction due to Anti-Dia antibody. To prevent other transfusion reaction by anti-Dia antibody, addition of Dia positive cells as unexpected antibody screening test is recommended.

Lee, Seung Hwan; No, Min Young



Bromovinyldeoxyurdine treatment of outer retinal necrosis due to varicella-zoster virus: a case-report.  


In December 1995, a 70-years old male was referred to us because of rapid visual loss in the right eye, one month after a central retinal artery occlusion in the left eye. This renal transplant patient, with limited renal function, was on immunosuppressive therapy. The diagnosis of bilateral progressive outer retinal necrosis (PORN) due to varicella-zoster virus (VZV) was confirmed by polymerase chain reaction (PCR) detection of VZV DNA in the aqueous fluid. As retinitis progressed despite of intravenous acyclovir administration, the antiviral therapy was switched to oral bromovinyldeoxyuridine (BVDU). This case-report demonstrates that oral BVDU can be a good alternative to acyclovir for the treatment of VZV retinal infections. PMID:9339038

Dullaert, H; Maudgal, P C; Leys, A; Dralands, L; Clercq, E



Dropped head syndrome due to myogenic atrophy - a case report of surgical treatment.  


We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment. Computed tomography revealed osseous contracture of cervical vertebral bodies in flexed position. Anterior combined posterior reconstruction surgery yielded a successful outcome in his activities of daily living, including his walking balance of spinal alignment. Pathologic study confirmed myogenic atrophy in the cervical extensor muscles. We suggest that consideration for surgical management should be given to dropped head syndrome especially due to INEM. PMID:21247445

Zenmyo, Michihisa; Abematsu, Masahiko; Yamamoto, Takuya; Ishidou, Yasuhiro; Komiya, Setsuro; Ijiri, Kosei



Gastrointestinal toxicity due to bitter bottle gourd (Lagenaria siceraria)--a report of 15 cases.  


Traditional medicine is widely practiced in tropical countries. Bottle gourd (Lagenaria siceraria) fruit juice is advocated as a part of complementary and alternative medicine. If the bottle gourd juice becomes bitter it is considered toxic. We report 15 patients, who developed toxicity due to drinking bitter bottle gourd juice. Patients presented with abdominal pain, vomiting, hematemesis, diarrhea and hypotension within 15 min to 6-h after ingestion of bottle gourd juice. Endoscopy showed esophagitis, gastric erosions, ulcers and duodenitis. Hypotension was treated with crystalloids and inotropic support. All patients recovered in 1-4 days. Endoscopically the lesions healed in 2 weeks. Bitter bottle gourd can cause gastrointestinal toxicity with hematemesis and hypotension. Supportive management is the treatment and all patients recover within 1 week. PMID:21986853

Puri, Rajesh; Sud, Randhir; Khaliq, Abdul; Kumar, Mandhir; Jain, Sanjay



Esophageal obstruction due to enteral feed bezoar: A case report and literature review  

PubMed Central

This paper describes a rare complication of enteral feeding, esophageal obstruction due to feeding formula bezoar, and reviews the published cases. An attempt to re-insert the nasogastric tube in a chronically ventilated 80-year-old female fed via a nasogastric tube with Jevity® failed. An esophagogastroduodenoscopy revealed an 18 cm-long concretion of the feeding formula, filling most of the esophageal lumen, which was removed endoscopically. Forty-two cases of feeding formula esophageal bezoars have been reported in the literature. The formation of feeding formula bezoars is triggered by acidic gastroesophageal reflux. The acidic pH in the esophagus causes clotting of the casein in the formula. Predisposing factors for bezoar formation are: mechanical ventilation, supine position, neurological diseases, diabetes mellitus, hypothyroidism, obesity and history of partial gastrectomy. Diagnosis and removal of the bezoar is done endoscopically. Feeding in a semi-recumbent position, administration of prokinetic agents and proton pump inhibitors may prevent this complication.

Marcus, Esther-Lee; Arnon, Ron; Sheynkman, Arkadiy; Caine, Yehezkel G; Lysy, Joseph



Ventricular fibrillation due to coronary spasm at the site of myocardial bridge -A case report-  

PubMed Central

Myocardial bridge is a congenital anomaly characterized by narrowing of some of the epicardial coronary arterial segments running in the myocardium during systole. Occasionally, the compression of a coronary artery by a myocardial bridge can be associated with the clinical manifestations of myocardial ischemia, and might even trigger a myocardial infarction or malignant ventricular arrhythmias. We report a case of ventricular fibrillation due to coronary spasm at the site of myocardial bridge. A 56-year-old man who had suffered from bronchial asthma was given remifentanil combined with sevoflurane in general anesthesia for endoscopic sinus surgery. During the surgery, ventricular fibrillation occurred following coronary spasm with bradycardia, hypotension, bronchospasm. we found myocardial bridge that coincided with an area of coronary spasm after coronary angiography.

Choi, Jung Gi; Lee, Cheol Seung; Choi, June Seog



Transient Pseudohypoaldosteronism due to Urinary Tract Infection in Infancy: A Report of 4 Cases  

PubMed Central

Hyponatremia with hyperkalemia in infancy is an uncommon but life-threatening occurrence. In the first weeks of life, this scenario is often associated with aldosterone deficiency due to salt-wasting congenital adrenal hyperplasia. However, alternative diagnoses involving inadequate mineralocorticoid secretion or action must be considered, particularly for infants one month of age or older. We report four infants who presented with profound hyponatremia accompanied by urinary tract infection, ultimately leading to the diagnosis of transient pseudohypoaldosteronism. Our cases provide support for the idea that the renal tubular resistance to aldosterone is due to urinary tract infection itself rather than to underlying urinary tract anomalies typically found in these infants. Awareness of this condition is important so that serum aldosterone, urine sodium, and urine cultures may be obtained immediately in any infant presenting with hyponatremia and hyperkalemia in whom a diagnosis of congenital adrenal hyperplasia was not found. Adequate replacement with intravenous saline and antibiotic therapy is sufficient to correct sodium levels over 24–48 hours.

Nandagopal, Radha; Vaidyanathan, Priya; Kaplowitz, Paul



Ritodrine for Intractable Uterine Pain Due to Extrapelvic Malignant Tumor Metastases: A Case Report.  


BACKGROUND:: Effective pain management is an essential component of cancer treatment as approximately 75% of all cancer patients experience excruciating nociceptive pain even at maximum safe doses of nonsteroidal anti-inflammatory drugs and/or opioids. We report a case where ritodrine hydrochloride effectively controlled refractory pain due to uterine metastases from thymic carcinoma. CASE PRESENTATION:: A 40-year-old woman presented at our hospital with chest discomfort, severe right femoral pain, and intermittent hypogastralgia. Computed tomography, magnetic resonance imaging, and positron emission tomography revealed a large mass in the anterior mediastinum, multiple nodules in the lungs, and multiple metastases on the uterus, lumbar vertebrae, and pelvic bones. Needle biopsies of the mediastinal and uterine cervical tumors revealed undifferentiated carcinoma of the thymus metastasizing to the uterus. Oxycodone and nonsteroidal anti-inflammatory drugs relieved the right femoral pain but not the hypogastralgia. We speculated that hypogastralgia did not result from somatalgia but from splanchnodynia. Ritodrine was administered in an effort to inhibit uterine contractions and to reduced the refractory pain and improved her quality of life. CONCLUSION:: Ritodrine relieved the pain caused by uterine contraction due to metastases and enhanced the quality of life. PMID:23567162

Sugiura, Yasoo; Nemoto, Etsuo; Kadohira, Ikuko; Kaseda, Shizuka



Morbidity and Mortality Weekly Report, Vol. 50, No. 26. June 06, 2001. Two Fatal Cases of Adenovirus-Related Illness in Previously Healthy Young Adults-Illinois, 2000.  

National Technical Information Service (NTIS)

Contents: Two Fatal Cases of Adenovirus-Related Illness in Previously Healthy Young Adults - Illinois, 2000; Health-Related Quality of Life - Los Angeles County, California, 1999; Outbreak of Listeriosis Associated With Homemade Mexican-Style Cheese - Nor...



[Traumatic changes of intrathoracic organs due to external mechanical cardiopulmonary resuscitation. Case reports].  


External mechanical resuscitation systems were developed for continuous and effective chest compression with the goal to increase the probability of spontaneous blood circulation renew. We describe results of four autopsy cases, where the external mechanical resuscitation by system Lucas (n=3) and AutoPulse (n=1) was performed prior to death. In all the cases were found traumatic changes which are commonly described in various studies such as skin abrasions on the chest, multiple rib fractures, fracture of the sternum and hematoma in the mediastinum or pericardium. In addition to these usual traumatic changes accompanying mechanical cardiopulmonary resuscitation we have observed injuries of intrathoracic organs, mainly the contusions of the heart and contusions and laceration of the lungs. In addition to these changes were in one case, associated with prolonged AutoPulse resuscitation, found ruptures of intima of the right common carotid artery. These injuries, with few exceptions, are not commonly described even over much wider number of examined persons. Injuries of the abdominal organs in connection with mechanical resuscitation, as described in a few case reports, were not present. However in one case there was found contusion of myocardium due to the external resuscitation by the Lucas system with clinical manifestation of sudden coronary incident even though the cause of death was massive thrombotic embolism to pulmonary arteries. All reported cases were similar in the relatively long-lasting mechanic cardiopulmonary resuscitation and prolonged time of dying of the patients. Keywords: cardiopulmonary resuscitation - Lucas - AutoPulse - intrathoracic injury. PMID:23964585

K?dela, Miroslav; Grossová, Iva; Strejc, P?emysl



Vertebral osteomyelitis and native valve endocarditis due to Staphylococcus simulans: a case report  

PubMed Central

Background Staphylococcus simulans is a common animal pathogen that occasionally can colonize human skin. Unlike other coagulase-negative staphylococci, S. simulans tends to cause more severe infections that resemble those caused by S. aureus. We present a case of vertebral osteomyelitis and endocarditis due to S. simulans. To the best of our knowledge, this is the first report of vertebral osteomyelitis associated with native valve endocarditis rather than orthopedic surgery. Case presentation A 46-year-old male butcher was admitted to the hospital with a 4-week history of high fever with profound sweating. He reported weakness in his legs and low back pain that compromised his walking ability. Blood cultures yielded Gram-positive cocci on Gram stain. These cocci were identified to the species level as S. simulans, a coagulase-negative staphylococcus. The patient was treated with antibiotics, which were discontinued after 6 months. Conclusion This case illustrates the importance of identifying coagulase-negative staphylococci to the species level. Accurate identification of S. simulans would further help investigations defining its pathogenic role in human infections.

Vallianou, Natalia; Evangelopoulos, Angelos; Makri, Polyxeni; Zacharias, Georgios; Stefanitsi, Panagiota; Karachalios, Athanasios; Avgerinos, Peter C




EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...


Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: Initial report of radiation therapy oncology group protocol 90-05  

Microsoft Academic Search

Purpose: To determine the maximum acutely tolerable dose of single fraction radiosurgery in patients with recurrent previously irradiated primary brain tumors or brain metastases.Methods and Materials: Between August 1990 and September 1993, 102 analyzable patients were entered on Radiation Therapy Oncology Group (RTOG) protocol 90-05, 38 of whom had recurrent primary brain tumors (median prior dose 60 Gy), and 64

Edward Shaw; Charles Scott; Luis Souhami; Robert Dinapoli; Jean-Paul Bahary; Robert Kline; Moody Wharam; Christopher Schultz; Phillip Davey; Jay Loeffler; John Del Rowe; Lawrence Marks; Barbara Fisher; Kyu Shin



German Risk Study - Main Report: A Study of the Risk Due to Accidents in Nuclear Power Plants.  

National Technical Information Service (NTIS)

A translation of the Deutsche Risikostudie Kernkraftwerke, this report assesses the risks due to accidents caused by the operation of nuclear power plants in the Federal Republic of Germany. The study, performed under the direction of the Federal Ministry...

A. W. Barsell I. B. Wall



Ileocolic intussusception due to giant ileal lipoma: Review of literature and report of a case  

PubMed Central

INTRODUCTION Intussusception in adults accounts for less than 5% of all intussusceptions. It occurs when a segment of intestine invaginates into itself. PRESENTATION OF A CASE We report a case of ileocolic intussusception in an adult caused by a giant ileal lipoma. DISCUSSION Intussusceptions can be classified as ileocolic, ileocecal, colo-colic and ileo-ileal. Most are due to neoplasms (60% malign and 24–40% benign). In the colon, the possibility of malignancy is higher than in small intestine. Lipomas are the most common benign mesenchymal intestinal tumors, accounting for less than 5% of all gastrointestinal tumors. They are more frequent in colon than small intestine. Small lipomas (less than 2 cm) are usually asymptomatic. Larger lesions may produce symptoms such as abdominal pain, obstruction or intussusception. Lipomas can be diagnosed with endoscopy, capsule endoscopy, barium enemas, CT and US. CONCLUSION Intussusceptions in adults is a rare condition, most of them are caused by a malign neoplasms followed by benign neoplasms. US and CT are useful for diagnosis. Surgery is mandatory.

Minaya Bravo, Ana Maria; Vera Mansilla, Cristina; Noguerales Fraguas, Fernando; Granell Vicent, Francisco Javier



[Traumatic luxation of the testis due to self-mutilation: a case report].  


A 16-year-old male patient was admitted to our hospital with traumatic luxation of right testis due to self-mutilation with a retractable knife on Apr. 20, 2004. He had been followed as temporal lobe epilepsy and suspicions of gender identify disorder by a pediatrician. He was fully oriented with a clear sensory and normal perception, but had no memory of what he had done. His parents were free of psychiatric disease, and he was the youngest in siblings of two older brothers. The laboratory examination showed no abnormal findings. Under general anesthesia, right testis was replaced in the scrotum and the scrotal wound was closed at the emergency operation. He had an attack of epilepsy and recovered by itself on the next day. He was discharged on the eighth postoperative day. After the operation, no recurrence has been seen until now. To our knowledge, this is the 37th case of male genital self-mutilation reported in the Japanese literature. PMID:16485555

Ishibiki, Yuji; Matsumura, Tsutomu



Scrotal calcinosis due to resorption of cyst walls: a case report  

PubMed Central

Introduction Scrotal calcinosis is a rare benign entity defined as the presence of multiple calcified nodules within the scrotal skin. There are controversies about the origin of this entity. In fact, it is still debatable whether scrotal calcinosis is an idiopathic growth or dystrophic calcification of dartoic muscles. It is also unclear whether scrotal calcinosis originates from inflammation of epidermal cysts affected by mild to moderate inflammation of mononuclear cells, from foreign body granuloma formation followed by resorption of cyst walls or from eccrine epithelial cysts. Case presentation We report a 41-year-old male Turkish patient presenting with a 10-year history of scrotal tumours increasing slowly in size and number. Histopathologically, there was no epithelial lining around the calcified nodules, but there was fibrosis adjacent to atrophic stratified squamous epithelium. Conclusion Results of histopathological examinations suggested that scrotal calcinosis might have been due to resorption of cyst walls. Surgery remains the key for this problem. In cases of non-massive scrotal calcinosis, like the case presented here, excision of the nodules from the affected part of the scrotal wall and repairing the defect with horizontal stitches offer good cosmetic results without relapse.

Parlakgumus, Alper; Canpolat, Emine T; Cal?skan, Kenan; Colakoglu, Tamer; Y?ld?r?m, Sedat; Ezer, Ali; Noyan, Turgut



Maternal and fetal recovery after severe respiratory failure due to influenza: a case report  

PubMed Central

Background During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present. Case presentation A 36 years old Caucasian pregnant woman with type 1 diabetes underwent mechanical ventilation in gestation week 27 for severe respiratory failure due to influenza and pneumonia. For three weeks during and following her most severe illness, fetal growth could not be detected and the umbilical flows and amniotic fluid volumes were affected too. The possibility of preterm delivery and extracorporeal membrane oxygenation (ECMO) treatment were considered, however the patient and her fetus recovered gradually on conservative treatment. Under close surveillance the pregnancy continued until term, with delivery of an infant with appropriate weight for gestational age. Conclusion Preterm delivery and decreased birth weight were reported for women with antepartum pneumonia. Mechanical ventilation and ECMO treatment for severe respiratory failure in pregnancy are life threatening conditions and have been associated with preterm delivery. It remains uncertain if delivery improves the respiratory status of a critically ill woman, and the fetal condition is likely to improve, if the maternal condition is stabilized. Severe respiratory insufficiency requiring mechanical ventilation in a diabetic pregnant woman with influenza was successfully treated conservatively. Despite clear signs of impaired fetal condition in the acute phase, watchful waiting resulted in delivery of a normal weight infant at term.



Drug-induced liver injury due to varenicline: a case report  

PubMed Central

Background Liver injury due to prescription and nonprescription medications is an expanding public health concern in the United States, with drug-induced liver injury (DILI) being the single most common reason for regulatory actions instituted by the Food and Drug Administration against certain medications and supplements. Case presentation A 69-year-old Latino man was referred to Hepatology Clinic for urgent evaluation of new onset jaundice, nausea and fatigue associated with a >40-fold increase in his transaminase levels and elevated INR and alkaline phosphatase. The patient had received a new prescription for varenicline to aid with smoking cessation approximately 3 weeks prior to his evaluation in Hepatology Clinic. Within 5?days of starting the varenicline, the patient developed new onset of nausea, vomiting, malaise and deep jaundice. The varenicline was discontinued on day 5 by the patient. Hepatologic evaluation revealed no evidence of acute viral hepatitis, autoimmune, metabolic or alcohol-related liver disorders. The patient’s past medical history was notable, however, for chronic hepatitis C. His liver enzymes and synthetic function completely normalized 9?weeks after discontinuation of the varenicline. Conclusion This report represents the second documented cases of drug-induced liver injury related to varenicline therapy, highlighting the need for clinician awareness regarding potential hepatotoxicity of varenicline, particularly among patients with pre-existing liver disease.



Postnasal drip due to inferior turbinate perforation after radiofrequency turbinate surgery: A case report  

PubMed Central

Management of inferior turbinate hypertrophy includes surgical options in case of failure with medical treatment and the main goal of turbinate surgery is to relieve the patient's symptoms of chronic nasal congestion while preserving mucosal surfaces with reduction of the submucosal and bony tissue. In this regard, radiofrequency volumetric tissue reduction has been a thermal technique associated with satisfactory results and fewer side effects. Historical detail on onset, timing, duration, and severity of symptoms and aggravating and relieving factors are important in the differential diagnosis of postnasal drip (PND). Here, we report development of intractable PND due to inferior turbinate perforation after radiofrequency turbinate surgery for the first time in the literature and the successful improvement via removal of pathological anatomic structure under nasal endoscopy–directed surgery in a 35-year-old female patient. The patient had a good functional outcome postoperatively with no further complications or signs of recurrence occurring, to date, within a postoperative follow-up period of 1 year.



Total fecal incontinence-a new method of gluteus maximus transposition: Preliminary results and report of previous experience with similar procedures  

Microsoft Academic Search

Since 1986, different procedures of gluteus maximus transposition have been performed, by one of the authors, in 10 patients with total anal incontinence not amenable to sphincter repair, due to congenital anomalies (four), sphincteric denervation (three) or after severe trauma (three). Variable degrees of long-lasting fecal control were obtained in all but one patient, with great improvement in six. Difficulties

J. M. Devesa; E. Vicente; J. M. Enríquez; J. Nufio; P. Bucheli; G. de Blas; M. G. Villanueva



Cri du Chat Syndrome and Congenital Heart Disease: A Review of Previously Reported Cases and Presentation of an Additional 21 Cases From the Pediatric Cardiac Care Consortium  

Microsoft Academic Search

OBJECTIVES.To analyze the cases submitted to the Pediatric Cardiac Care Consortium (PCCC) database from 1982 to 2002 to determine the frequency and distribution of congenital heart disease (CHD) found in this population, to review the literature for previously published accounts of CHD in this population, and to review current genotype-phenotype associations for cri du chat (CDC) syndrome with CHD. METHODS.We

Christine Hills; James H. Moller; Marsha Finkelstein; Jamie Lohr; Lisa Schimmenti



Successful treatment of an abdominal aortic aneurysm by endovascular graft placement through a previously placed prosthetic graft: Report of a case  

Microsoft Academic Search

A 77-year-old man with an infrarenal abdominal aortic aneurysm was referred with a complex medical history including pancreatitis,\\u000a chronic renal failure, atrial fibrillation, and a cerebral infarction. He also had a history of atherosclerosis obliterans,\\u000a treated with a vascular bypass using an 8-mm prosthetic graft 9 years previously. His complicated anatomy, including a small\\u000a access route and a large common

Daijiro Hori; Koichi Yuri; Kazunari Nemoto; Atsushi Yamaguchi; Hideo Adachi



Lemierre's syndrome due to Klebsiella pneumoniae in a 63-year-old man with diabetes: a case report  

PubMed Central

Introduction Lemierre's syndrome was originally documented to be caused by Fusobacterium necrophorum. It is a very rare condition with a prevalence of one to 14.4 instances per million. Its presentation is varied, not only in composition but also in the infecting organism. Treatment with anticoagulants has been controversial and applied only on a case-by-case basis. Case presentation A 63-year-old Saudi man who had had uncontrolled diabetes mellitus for 47 years presented to our facility with a five-day history of swelling on the right side of his neck and fever. The swelling progressively increased in size and was associated with pain, dysphagia, odynophagia, change of voice ('hot potato voice'), and reduced appetite. Abscess content culture and sensitivity testing revealed Klebsiella pneumoniae. However, blood culture results were repeatedly negative. The abscess was incised and drained without any complication. Our patient was treated with clindamycin and cefuroxime. Warfarin was also administered concurrently for six weeks, for an isolated internal jugular vein thrombosis (IJV), with complete resolution of the thrombus. Normoglycemia was achieved and our patient was discharged after complete wound healing and the return of his biochemical parameters to normal. Conclusions Only two cases of Lemierre's syndrome in patients with diabetes due to K. pneumoniae have been reported previously. A review of the literature suggested that an association exists between deep neck infections due to K. pneumoniae and diabetes mellitus. The reasons for this association are still not clear. This poses a question as to whether diabetes mellitus specifically predisposes these patients to infection with this organism. It is suggested that clinicians should consider infectious agents other than F. necrophorum in the causation of Lemierre's syndrome, especially in patients with diabetes.



Cervical arthroplasty for myelopathy adjacent to previous multisegmental fusion  

Microsoft Academic Search

In recent years, there has been increasing interest in the use of cervical arthroplasty for the treatment of degenerative cervical pathology. In its relative infancy, the applications for this technique are still being explored. In this report, we present the use of cervical arthroplasty in the treatment of progressive cervical myelopathy due to adjacent segment disease related to previous multisegmental

Ralph J. Mobbs; Nicholas Mehan; Peter Khong



Delayed homicides due to infant head injury initially reported as natural (cerebral palsy) deaths.  


A spectrum of neuropathology occurs in infants who sustain traumatic brain injury. Because of a prolonged survival interval, there is a risk that these deaths may not be recognized as a sequel of trauma. We reviewed the records in New York City of 5 delayed fatalities due to nonaccidental infant head injury that had survival intervals from 2.5 to 17 years. The head injuries occurred at 2 to 3 months of age, and death occurred at 2.5 to 17 years of age. Initially, they were reported as natural deaths by treating physicians, families, and/or police. All 5 infants had unexplained or poorly explained remote traumatic head injury that included subdural hematomas. At autopsy, the neuropathologic exam demonstrated remote subdural hemorrhages and lesions related to chronic hypoxic-ischemic injury including atrophy, arterial infarcts, border-zone infarcts, and cystic encephalomalacia. Each child survived the initial injury but later succumbed to the delayed effects of secondary hypoxic-ischemic encephalopathy. These 5 deaths highlight the need to investigate independently the medical history of any child (or adult) who dies with a clinical diagnosis of "cerebral palsy." The term cerebral palsy often is used as a catchall for any patient who has had neurologic impairment since infancy or childhood. If there is a direct link between the initial injury and the death, even if the injury occurred many years before death, then the injury is the proximate cause of death and dictates the manner of death. All 5 deaths were certified as homicides. PMID:18237236

Gill, James R; Morotti, Raffaella A; Tranchida, Vincent; Morhaime, Jacquelyn; Mena, Hernando


Application of the electromagnetic borehole flowmeter and evaluation of previous pumping tests at Paducah Gaseous Diffusion Plant. Final report, June 15, 1992--August 31, 1992  

SciTech Connect

Multi-well pumping tests have been concluded at wells MW79, MW108, and PW1 at the Paducah Gaseous Diffusion Plant (PGDP) to determine the hydraulic properties of the Regional Gravel Aquifer (RGA). Soil cores suggest that the RGA consists of a thin sandy facies (2 to 6 feet) at the top of a thicker (> 10 feet) gravelly facies. Previous analyses have not considered any permeability contrast between the two facies. To assess the accuracy of this assumption, TVA personnel conducted borehole flowmeter tests at wells MW108 and PW1. Well MW79 could not be tested. The high K sand unit is probably 10 times more permeable than comparable zone in the gravelly portion of the RGA. Previous analyses of the three multi-well aquifer tests do not use the same conceptual aquifer model. Data analysis for one pumping test assumed that leakance was significant. Data analysis for another pumping test assumed that a geologic boundary was significant. By collectively analyzing all three tests with the borehole flowmeter results, the inconsistency among the three pumping tests can be explained. Disparity exists because each pumping test had a different placement of observation wells relative to the high K zone delineating by flowmeter testing.

Young, S.C.; Julian, S.C.; Neton, M.J.



German risk study - main report: a study of the risk due to accidents in nuclear power plants  

Microsoft Academic Search

A translation of the Deutsche Risikostudie Kernkraftwerke, this report assesses the risks due to accidents caused by the operation of nuclear power plants in the Federal Republic of Germany. The study, performed under the direction of the Federal Ministry for Research and Technology, is organized into two phases: the current report presents an overview of the investigations and results of

A. W. Barsell; I. B. Wall



The Extent to Which Four-Year College Presidents Who Previously Served as Senior Student Affairs Officers Report Having the Characteristics of Effective Presidents  

ERIC Educational Resources Information Center

Results of a research study to determine the extent to which presidents of 4-year institutions with Senior Student Affairs Officer (SSAO) experience share the leadership characteristics of effective presidents as defined by earlier research are reported. Based on analysis of the data using t test and ANOVA statistical procedures, it is concluded…

Risacher, Joanne



Case report: Colonic bezoar due to Box Myrtle seeds: A very rare occurrence.  


Large bowel seed bezoars are rare and are mostly due to seeds of sunflower, prickly pear cactus, sesame and cucumber. We present a rare case of sigmoid colon seed bezoar due to Box Myrtle seeds because of an underlying benign stricture. PMID:21431028

Chauhan, Narvir Singh; Sood, Dinesh



Case report: Colonic bezoar due to Box Myrtle seeds: A very rare occurrence  

PubMed Central

Large bowel seed bezoars are rare and are mostly due to seeds of sunflower, prickly pear cactus, sesame and cucumber. We present a rare case of sigmoid colon seed bezoar due to Box Myrtle seeds because of an underlying benign stricture.

Chauhan, Narvir Singh; Sood, Dinesh



A point mutation in the agr locus rather than expression of the Panton-Valentine leukocidin caused previously reported phenotypes in Staphylococcus aureus pneumonia and gene regulation  

PubMed Central

The role of Panton-Valentine leukocidin (PVL) in Staphylococcus aureus pathogenesis is controversial. Here, we show that an unintended point mutation in the agr P2 promoter of S. aureus caused the phenotypes in gene regulation and murine pneumonia attributed to PVL by Labandeira-Rey et al. (Science 315:1130-3, 2007). In agreement with previous studies that failed to detect similar effects of PVL using community-associated methicillin-resistant S. aureus strains, we found no significant impact of PVL on gene expression or pathogenesis after we repaired the mutation. These findings further contribute to the idea that PVL does not have a major impact on S. aureus pathogenesis. Moreover, our results demonstrate that a single nucleotide polymorphism in an intergenic region can dramatically impact bacterial physiology and virulence. Finally, our work emphasizes the need to frequently evaluate the integrity of the S. aureus agr locus.

Villaruz, Amer E.; Wardenburg, Juliane Bubeck; Khan, Burhan A.; Whitney, Adeline R.; Sturdevant, Daniel E.; Gardner, Donald J.; DeLeo, Frank R.; Otto, Michael



[Unilateral auditory hallucinations due to left temporal lobe ischemia: a case report].  


Unilateral auditory hallucinations are a rare lateralization phenomenon experienced in one ear or from one direction. We recently encountered a 63-year-old right-handed man who developed transient unilateral auditory hallucinations associated with pure word deafness. The patient had a past history of myocardial infarction, lung cancer and aortic aneurysm, but no previous psychiatric or convulsive disorders. About six months before admission, he developed right hemiparesis and motor aphasia caused by a hemorrhagic left parietal infarct. These symptoms gradually improved over three weeks. Two days before admission, he suddenly lost the ability to understand spoken words. He concurrently experienced auditory hallucinations arising from the right anterior direction. On admission, he was very embarrassed to simple verbal commands. He was unable to comprehend spoken words and repeat speech, although he could fairly follow written commands. Confrontation naming, reading aloud, comprehension, spontaneous writing remained relatively unaffected, although he occasionally made paraphasic errors. He could distinguish environmental sounds such as a telephone ringing or running water. After gradual improvement of his auditory incomprehension, he began to describe auditory hallucinations of verbal, musical and elementary types. He was fully aware of the hallucinatory nature of his experience, and took some notes. Two days before admission, from the right anterior side of his head he heard a familiar radio announcer reporting news about the earthquake in Osaka Prefecture and the recommended places of refuge. After similar experiences over several days, he repetitively heard a familiar Japanese traditional song from the right side, which was followed by elementary auditory hallucinations such as a car engine and a siren. These symptoms spontaneously disappeared after nine days. Besides his auditory hallucinations, visual hallucinations and illusional emotion were temporarily present. The Wechsler adult intelligence scale revealed a verbal IQ of 91 and a performance IQ of 100. Pure tone audiometry revealed bilateral, mild peripheral sensorineural hearing loss. Brainstem auditory evoked potentials were unrevealing. The EEG showed slow activities in the left temporoparietal region. Magnetic resonance imaging of the brain failed to reveal any relevant abnormalities except for an old hemorrhagic parietal infarct. The SPECT with Tc99m-HMPAO, however, showed reduced blood flow in the left temporal lobe including the first temporal convolution as well as in the left parietal lobe. Based on the SPECT findings, unilateral auditory hallucinations in our patient are considered to have resulted from the left temporal lobe ischemia. Our case indicates that unilateral auditory hallucinations may have a clinicoanatomical correlation with contralateral temporal lobe lesions. PMID:8821499

Anegawa, T; Hara, K; Yamamoto, K; Matsuda, M



Adaptation of a previously validated vaccination report card for use in adult vaccine clinical trials to align with the 2007 FDA Toxicity Grading Scale Guidance.  


The Adult/Adolescent Vaccination Report Card (VRC) was developed and validated by Merck in 1998 for use in vaccine clinical trials to collect information from trial subjects on complaints for both local and systemic events after vaccination. This short report describes the revision to the original validated VRC in order to align with the guidelines outlined in the 2007 FDA Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials. Since the VRC elicits trial subjects' self-reports of any adverse experiences (AE) occurring post vaccination, it was important that subsequent modifications of the VRC retained the original user-friendly characteristics while gathering the appropriate information to align with the FDA Guidance. A convenience sample of 15 participants (71% females, 87% white and mean (SD) age 45 (13) years was recruited to obtain feedback in order to revise the Adult/Adolescent VRC. Based on the feedback received, the following were slightly revised: ruler for the measurements of local systemic reactions, severity ratings, and general instructions. The revised VRC is currently being used in Merck vaccine clinical trials. PMID:22906942

Norquist, Josephine M; Khawaja, Shazia S; Kurian, Cizely; Mast, T Christopher; Liaw, Kai-Li; Robertson, Michael N; Evans, Barbara; Gutsch, David; Saddier, Patricia



[Acute renal failure due to multiple stings by Africanized bees. Report on 43 cases].  


This study reports on acute renal failure (ARF) due to multiple stings by Africanized bees (AB) occurring in 43 cases collected between 1982 and 2007 (at the Nephrology Section, University of Antioquia School of Medicine and San Vicente de Paul University Hospital, Medellin, Colombia). No intervention on patient care was performed except for responding the Nephrology consult and prescribing dialysis. Data obtained from the medical records included demography; clinical presentation; laboratory results on admission; evolution of renal function to document improvement and normalization; intervals between stings and outcomes; number of dialysis sessions; length of follow-up and hospitalization; survival; and mortality. Not all patients had complete data and therefore, the number of observations is included where required. Mean age was 56 ± 26 yr (range 2-96); 37 (86%) were men; 38 (of 41 cases) came from rural areas (91%); 22 (of 39) were farmers (56.4%); 33 (of 41) lived in Medellin or in the department of Antioquia (80.5%). Number of stings per patient: ~ 900. Interval between stings and ARF < 48 hours: in 31 cases (72.1%; mean 2.6 ± 2.6 days; range 1-12); 37 (of 43) required dialysis (86%); mean number of sessions: 4.7 ± 3.3 (range 1-12). Survival occurred in 36 cases (83.7%) and mortality, in 7, all > 60 yr (16.3%). At last follow-up, renal function improvement was documented in 36 (83.7%) and normalization in 15 of them (41.7%). Interval until initiation of diuresis: 10.6 ± 6.8 days (range 1-25). Duration of hospitalization: 16.9 ± 8.7 days (range 1-39). Follow-up: 25.2 ± 18.3 days (range 1-75). Hematuria and oliguria occurred before 24 hours; there was an increase of CPK in 90%, of ALT in 96%, of AST in 89%, of DHL in 95%, and of BUN and creatinine in 100%. Based on our findings and on the review of the available information, we propose that this type of ARF occurs as a result of rhabdomyolysis with subsequent myoglobinuria, which lead to nephrotoxic acute tubular necrosis; a variable degree of direct nephrotoxicity, not quantifiable with current diagnostic methods, is also probably involved. A better knowledge of this entity by the medical community could improve care and prognosis of the patients who develop it. PMID:20613852

Mejía Vélez, G



49 CFR 579.28 - Due date of reports and other miscellaneous provisions.  

Code of Federal Regulations, 2010 CFR

...REPORTING OF INFORMATION AND COMMUNICATIONS ABOUT POTENTIAL DEFECTS Reporting of Early Warning Information... As used in this part, the plural includes the singular and the singular includes the plural to bring within the scope...



49 CFR 579.28 - Due date of reports and other miscellaneous provisions.  

Code of Federal Regulations, 2010 CFR

...REPORTING OF INFORMATION AND COMMUNICATIONS ABOUT POTENTIAL DEFECTS Reporting of Early Warning Information... As used in this part, the plural includes the singular and the singular includes the plural to bring within the scope...



Osteoradionecrosis of the cervical spine presenting with quadriplegia in a patient previously treated with radiotherapy for laryngeal cancer: a case report  

PubMed Central

Introduction Osteoradionecrosis of the mandible and temporal bones has been extensively reported in literature, but cases of avascular necrosis of the cervical spine following radiotherapy to the larynx appear to be extremely rare. A review of the English language literature has shown only one other case where radiotherapy treatment of a laryngeal carcinoma has resulted in osteoradionecrosis of the cervical spine. Case presentation We present the case of a 65 year old male patient who suffered from osteoradionecrosis of the cervical spine 20 years after radiotherapy treatment for a T1aN0M0 laryngeal carcinoma resulting in quadriplegia. Conclusions Radiotherapy carries a long-term risk of complications, including osteoradionecrosis which may present 20 years later with significant implications.



Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report.  


A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. Asphyxia was controlled with a complex apparatus which consisted of two elastic luggage rack straps, the first surrounding his waist, perineum, and buttocks, and the second the back of his body, and neck. According to the psychological autopsy based on a structured interview (SCID-I, SCID-II) with his father, the deceased was single, unemployed and with a part college education. He had grown up in a poor family with a reserved father and dominant mother, and was indicative of fulfilling DSM-IV diagnostic criteria for alcohol dependence, paraphilia involving hypoxyphilia with transvestic fetishism and anal masturbation and a borderline personality disorder. There was no evidence of previous psychiatric treatment. The Circumstances subscale of Beck's Suicidal Intent Scale (SIS-CS) pointed at the lack of final acts (thoughts or plans) in anticipation of death, and absence of a suicide note or overt communication of suicidal intent before death. Integration of the crime scene data with those of the forensic medicine and psychological autopsy enabled identification of the event as an accidental death, caused by neck strangulation, suffocation by a plastic bag, and vagal stimulation due to a foreign body in the rectum. PMID:19556957

Atanasijevi?, Tatjana; Jovanovi?, Aleksandar A; Nikoli?, Slobodan; Popovi?, Vesna; Jasovi?-Gasi?, Miroslava



Jaw bone necrosis without previous dental extractions associated with the use of bisphosphonates (pamidronate and zoledronate): a four-case report.  


Jaw bone necrosis is a clinical condition associated with defects in vascularization of the maxilla or the mandibular bone, usually present following head and neck radiotherapy and/or oral surgical interventions. Bisphosphonates are synthetic analogues of pyrophosphate used in the treatment of patients with hypercalcemia as a result of malignancy, bone metastasis and for the treatment of other disorders such as metabolic bone diseases, Paget's disease and osteoporosis. Over last 10 years, cases of jaw bone necrosis have been associated with the use of bisphosphonate therapy. In particular, Ruggiero et al. (J Oral Maxillofac Surg 2004; 62: 527-534) in 2004 described a large group of patients (63) with jaw bone necrosis probably related to the use of these drugs. It should be noted that all the patients in the group described either underwent head and neck radiotherapy or had a dental extraction while taking bisphosphonates. In the present study, we reported four cases of jawbone necrosis in patients taking pamidronate (Aredia) and zoledronate (Zometa) without having undergone any kind of radiotherapy or dental surgery. All the patients were females between the ages of 56 and 71 years; three were treated with bisphosphonates for bone metastasis and one for multiple myeloma. All the patients received surgical treatment with bone curettage, with partial and/or temporary improvement of the lesions. Although a treatment for bisphosphonate-induced bone lesions has not yet been established, we suggest careful evaluation of the patients' oral health before prescribing bisphosphonate treatment. PMID:16202082

Merigo, E; Manfredi, M; Meleti, M; Corradi, D; Vescovi, P



Epidural Blood Patch for the Treatment of Abducens Nerve Palsy due to Spontaneous Intracranial Hypotension -A Case Report-  

PubMed Central

Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.

Kim, Yeon A; Yoon, Duck Mi



A rare cause of deep peroneal nerve palsy due to compression of synovial cyst - Case report  

PubMed Central

INTRODUCTION Synovial cyst is a rare cause of compression neuropathy and its differential diagnosis can be misleading. PRESENTATION OF CASE This article presents clinical, radiological, and histological findings of deep peroneal nerve palsy due to compression of a synovial cyst in a 30-year-old patient admitted with sudden drop foot. DISCUSSION Focal nerve entrapment in lower extremity due to synovial cystis a rare entity. Differential diagnosis is important. Surgical excision is the main treatment method with high success rate. CONCLUSION Synovial cyst compression which can be treated easily with surgical excision should be considered in rapidly progressed drop foot.

Erdil, Mehmet; Ozkan, Korhan; Ozkan, Feyza Unlu; Bilsel, Kerem; Turkmen, Ismail; Senol, Serkan; Sarar, Serhan



Total hip arthroplasty in patients with high dislocation: a concise follow-up, at a minimum of fifteen years, of previous reports.  


We report the updated results at a minimum of fifteen years after eighty-four consecutive total hip arthroplasties performed in sixty-seven female patients with high dislocation of the hip. Sixty-four arthroplasties were performed in forty-nine patients, between 1976 and 1994, with Charnley low-friction acetabular and femoral components inserted with cement; nineteen arthroplasties were performed in seventeen patients, between 1990 and 1994, with the hybrid technique (acetabular component inserted without cement and femoral component inserted with cement); and one arthroplasty was done in 1991, with cementless acetabular and femoral components. All patients were followed prospectively on the basis of clinical assessment according to the Merle D'Aubigné and Postel scoring system, as modified by Charnley, and with radiographic analysis. At the time of the latest follow-up, twenty-six hips (41%) in the low-friction arthroplasty series, ten hips (53%) in the hybrid series, and the one hip with the cementless components had been revised for various reasons. The primary reason for revision in the low-friction arthroplasty group was aseptic loosening of the components (twenty-four hips), whereas the predominant reason for the revisions in the hybrid series and in the hip with cementless components was progressive polyethylene liner wear (six hips). After the minimal follow-up of fifteen years, twenty-five low-friction hip replacements and eight hybrid-type hip replacements had remained intact for an average of twenty-one years (range, seventeen to thirty-two years) and sixteen years (range, fifteen to nineteen years), respectively. These findings may be used in comparisons of results with newer techniques and designs. PMID:21915576

Hartofilakidis, George; Karachalios, Theofilos; Georgiades, George; Kourlaba, Georgia



49 CFR 579.28 - Due date of reports and other miscellaneous provisions.  

Code of Federal Regulations, 2011 CFR

...specificity. A claim or notice involving death, a claim or notice involving injury...manufacturer receives a claim or notice involving death or injury in which the vehicle or equipment...updated report to NHTSA reflecting that death. (g) When a report involving a...



Diabetic ketoacidosis precipitated by Staphylococcus aureus abscess and bacteremia due to acupuncture: case report and review of the literature.  


Acupuncture use is increasing in the United States. Despite multiple studies, the efficacy and safety of acupuncture are poorly defined. We report a previously healthy patient who developed a thigh abscess, bacteremia, and diabetic ketoacidosis after acupuncture treatment. We review the literature on infectious complications of acupuncture. PMID:16758409

Seeley, Eric J; Chambers, Henry F



Radicular dysfunction due to spinal deformities in Marfan syndrome at older age: Three case reports  

Microsoft Academic Search

Marfan syndrome is a inherited connective tissue disorder due to mutations in fibrillin-1. It presents with cardiovascular, ocular, skeletal, pulmonary and dural signs and symptoms. Some of the symptoms of later onset are those associated with scoliosis and dural ectasia. This is the enlargement of the neural canal especially in the lower lumbar and sacral region and occurs in over

N. C. Voermans; A. J. F. Hosman; N. van Alfen; R. H. M. A. Bartels; M. de Kleuver; J. W. op den Akker; B. G. M. van Engelen



Toxic epidermal necrolysis probably due to cosmetic cream: a case report.  


Toxic epidermal necrolysis (TEN) is a severe and life-threatening cutaneous reaction usually caused by systemic drug administration. Preparations applied to the skin and mucous membranes topically very rarely induce TEN. We present a case of TEN in a 35-year-old woman probably due to facial application of an over-the-counter (OTC) cosmetic cream. PMID:19350188

Kokcam, Ibrahim



Central nervous system infection due to Clostridium septicum : A case report and review of the literature  

Microsoft Academic Search

Summary A patient with end stage breast cancer was admitted to hospital due to fever, chills, multiply eroded discharging wounds, and sudden onset of left hemiparesis.Clostridium septicum bacteremia and brain abscess were diagnosed. The patient was treated successfully with intravenous penicillin and clindamycin and stereotactic aspiration of the abscess. Eleven cases ofC. septicum central nervous system infection are reviewed. They

Y.-T. Cheng; C.-T. Huang; H.-S. Leu; J.-S. Chen; M.-C. Kiu



Sudden death due to spontaneous acute dissection of the left subclavian artery with rupture during postpartum period: a case report.  


Subclavian artery dissection is usually associated with coexisting aortic disease. Isolated and spontaneous acute subclavian artery dissection is uncommon and rarely reported. In addition, no case of left subclavian artery dissection during pregnancy and early puerperium has been described. We report the autopsy case of a 24-year-old female who died suddenly 3 days after delivery due to a spontaneous left subclavian artery dissection with rupture. PMID:22740172

Barbesier, Marie; Duncanson, Emily R; Mackey-Bojack, Shannon M; Roe, Susan J; Thomas, Lindsey C



Sudden death due to massive hemoptysis secondary to pulmonary tuberculosis--a case report.  


Forensic pathologists deal not only with criminal, accidental and suicidal deaths, but also with a wide range of deaths from natural causes. Natural deaths at times can be sudden, unexpected and unattended by the relatives or friends or eye witnesses. In such cases, even though there is no criminal element in their causation, the case has to be investigated and medico-legal autopsy has to be conducted to know the exact cause of death, thus putting an end to the allegations raised. A 55-year-old male was found dead lying in his room in a pool of blood without any obvious injuries under suspicious circumstances with disturbed furniture in his room. The case was investigated due to suspicious circumstances of his death and absence of history of significant medical illness. The autopsy revealed the death was due to asphyxiation as a result of massive hemoptysis secondary to fibro-cavitatory tuberculosis. PMID:23910849

Hugar, Basappa S; Jayanth, S H; Chandra, Y P Girish; Shankar, B S Udaya



Paraplegia due to Missed Thoracic Meningioma after Laminotomy for Lumbar Spinal Stenosis: Report of Two Cases  

PubMed Central

To describe two cases of thoracic paraplegia due to a thoracic spinal cord tumor (meningioma) that was not detected during lumbar spinal decompressive surgery for lumbar canal stenosis and a complaint of claudication. The follow-up period ranged from 1 year and 6 months to 1 year and 8 months. The neurological deficit due to thoracic meningioma after surgery for lumbar canal stensois was decreased after mass excision. So, careful physical examination and magnetic resonance imaging can reveal another thoracic spine compressive lesion such as meningioma. Additional thoracic decompressive surgery can provide partial amelioration of each patient's neurological condition. Surgeons should know that a silent meningioma can aggrevate neurological symptoms after lower lumbar spine surgery and should inform their patient before surgery.

Lee, Sang-Wook; Shim, Jung-Hyun



Local vibration of transmission line towers due to flood flow. Technical report  

SciTech Connect

Local vibration of transmission line tower due to flood affects the lattices close to ground level, the lattices being slender. This is specially the case with broad based tangent towers for single conductor lines, since the stresses in the lattices are nominal and these have to be designed on the consideration of upper limit of slenderness ratio. Sustained flood flow can cause dynamic stresses resulting in yielding of the lattices ultimately leading to failure of the tower itself. Provision of intermediate supports for the lattices at suitable locations can bring down the amplitude of vibration and hence dynamic stresses. Interference with the vortex shedding by provision of wire winding or strakes, are also suitable steps to keep down the high dynamic stress due to flood flow.

Not Available



[Congenital adrenal hyperplasia due to 21 hydroxylase deficiency--case report].  


A girl with congenital adrenal hyperplasia due to 21 hydroxylase (CYP 21, p450c21) deficiency is the reviewed case. The clinical features (virilisation, clitoromegaly, rapid somatic growth, accelerated skeletal maturation) and laboratory findings (high levels of plasma 17hydroxy-progesterone, corticotrophin--ACTH, testosterone and dehydroepiandrostenedione--DHEA, low level of plasma cortisol, high level of urine 17-ketosteroids, synacthen and luteinising hormone releasing hormone--LHRH test) and the response to hydrocortisone therapy pointed at heterosexual gonadotrophin independent puberty due to irregular production of cortisol caused by 21 hydroxylase deficiency that leads to elevated ACTH and 17-hydroxy progesterone secretion and makes congenital adrenal hyperplasia as entity. The six-month therapy resulted in the clinical and laboratory findings improvement, such as the decreased annual growth of body height and the stagnation in the development of the secondary sexual features. PMID:18773697

Vlaski, Jovan; Katani?, Dragan; Kavecan, Ivana; Dautovi?, Slavica; Vorgucin, Ivana


A case of human enteric myiasis due to larvae of Hermetia illucens (Family: Stratiomyiadae): first report in Malaysia.  


A case of true enteric myiasis in a 7-year-old girl is reported. Two larvae were obtained from the vomitus of the patient. After processing and identification, the larvae were found to be those of Hermetia illucens (Soldier Fly). This is the first case of true enteric myiasis due to these larvae in Malaysia. PMID:8935136

Lee, H L; Chandrawathani, P; Wong, W Y; Tharam, S; Lim, W Y



Management of chronic lateral instability due to lateral collateral ligament deficiency after total knee arthroplasty: a case report  

Microsoft Academic Search

INTRODUCTION: Lateral instability following total knee arthroplasty (TKA) is a rare condition with limited report of treatment options. The objective of this case presentation is to demonstrate the outcomes of different surgical procedures performed in a single patient with lateral collateral ligament (LCL) deficiency. CASE PRESENTATION: We present a case of chronic lateral instability due to LCL deficiency after primary

Aasis Unnanuntana; James E Murphy; William J Petersilge



Non-healing ulcer due to Trichosporon loubieri in an immunocompetent host and review of published reports.  


We report here a case of non-healing ulcer due to Trichosporon loubieri in an apparently immunocompetent female. The identity of isolate was confirmed by DNA sequencing of D1/D2 region of 26S rDNA. The minimum inhibitory concentrations of the isolate were amphotericin B-0.5 ?g/ml; fluconazole-4 ?g/ml; posaconazole-0.25 ?g/ml; voriconazole-0.06 ?g/ml. The patient was managed by extensive debridement and oral fluconazole 150 mg daily for 6 weeks. She responded to therapy. To the best of our knowledge, till date, this is the fourth report of human infection due to T. loubieri and the first of its kind in an immunocompetent host. A review of published literature on infections due to T. loubieri is also included. PMID:23591623

Rastogi, Vijaylatha; Rudramurthy, Shivaprakash M; Maheshwari, Madhu; Nirwan, P S; Chakrabarti, Arunaloke; Batra, Shivra



Is Caregiver-Adolescent Disagreement Due to Differences in Thresholds for Reporting Manic Symptoms?  

PubMed Central

Abstract Introduction Cross-informant disagreement is common and results in different interpretations of a youth's behavior. Theoretical explanations for discrepancies typically rely on scale level analyses. This article explores whether caregivers and adolescents differ in when they notice and report symptoms of youth mania depending on the severity of overall manic disturbance. Method Participants were 459 adolescent-caregiver pairs recruited at either a community mental health center or an academic medical center. Adolescents were most likely to have a primary diagnosis of unipolar depression (37%) or attention-deficit/hyperactivity disorder/disruptive behavior disorder (36%). Nineteen percent of adolescents received a bipolar spectrum disorder diagnosis (4% bipolar I and 15% bipolar II, cyclothymia, or bipolar not otherwise specificed). Caregivers were primarily biological mothers (74%) or grandparents (8%). Adolescents and caregivers independently completed the Mood Disorder Questionnaire (MDQ) about the adolescent. Results Item response theory analyses of the entire sample indicated that in general, both caregivers and adolescents reserved endorsement of mania symptoms for the most severely ill half of participants. Comparisons of caregiver and adolescent report of symptoms on the MDQ indicated two significant differences. Caregivers were more likely to report irritability at significantly lower severity of mania than adolescents. Adolescents endorsed only increased energy or hyperactivity at lower severities than caregivers. Conclusions Adolescents and caregivers will have different concerns and might report different symptoms consistent with whom the symptom impacts first. Caregivers are more likely to report behaviors such as irritability, whereas adolescents are more likely to report subjective feelings such as feeling more energetic or more hyperactive.

Youngstrom, Eric A.; Freeman, Megan J.; Youngstrom, Jennifer Kogos; Findling, Robert L.



Severe accordion effect: Myocardial ischemia due to wire complication during percutaneous coronary intervention: A case report  

PubMed Central

A mechanical alteration during manoeuvring of stiff guidewires in tortuous coronary arteries frequently induces vessel wall shortening and coronary psedostenosis, referred as accordion phenomenon. Subtraction of the guidewires normally leads to the entire resolution of the lesions. A case of this transient angiographic finding, during percutaneous coronary intervention in a tortuous right coronary artery, which resulted in a flow limiting effect and myocardial ischemia, is described in the present report. Differential diagnosis from potential procedure complications and interventional methodology issues are discussed, while similar reports are reviewed.

Gavrielatos, Gerasimos; Pappas, Loukas K; Anthopoulos, Prodromos; Salachas, Anastasios; Ifantis, Georgios; Antonellis, Ioannis



Severe accordion effect: Myocardial ischemia due to wire complication during percutaneous coronary intervention: A case report.  


A mechanical alteration during manoeuvring of stiff guidewires in tortuous coronary arteries frequently induces vessel wall shortening and coronary psedostenosis, referred as accordion phenomenon. Subtraction of the guidewires normally leads to the entire resolution of the lesions. A case of this transient angiographic finding, during percutaneous coronary intervention in a tortuous right coronary artery, which resulted in a flow limiting effect and myocardial ischemia, is described in the present report. Differential diagnosis from potential procedure complications and interventional methodology issues are discussed, while similar reports are reviewed. PMID:18764947

Gavrielatos, Gerasimos; Pappas, Loukas K; Anthopoulos, Prodromos; Salachas, Anastasios; Ifantis, Georgios; Antonellis, Ioannis



Lemierre syndrome in a 22-month-old due to Streptococcus pyogenes: a case report.  


We report a case of Lemierre syndrome secondary to Streptococcus pyogenes in a 22-month-old girl. This case report and literature review took place at a pediatric intensive care unit at a freestanding tertiary children's hospital. Diagnosis occurred after the discovery of left internal jugular thrombus and multiple metastatic infection sites including the right knee, kidneys, lungs, and brain. Lemierre syndrome can occur in young children secondary to S. pyogenes, and a classic presentation may not occur. A high index of suspicion is crucial to the diagnosis. PMID:22068074

Frizzola, Meg A; Hertzog, James H



Postfixed brachial plexus radiculopathy due to thoracic disc herniation in a collegiate wrestler: a case report.  


Objective: To present the unique case of a collegiate wrestler with C7 neurologic symptoms due to T1-T2 disc herniation. Background: A 23-year-old male collegiate wrestler injured his neck in a wrestling tournament match and experienced pain, weakness, and numbness in his left upper extremity. He completed that match and 1 additional match that day with mild symptoms. Evaluation by a certified athletic trainer 6 days postinjury showed radiculopathy in the C7 distribution of his left upper extremity. He was evaluated further by the team physician, a primary care physician, and a neurosurgeon. Differential Diagnosis: Cervical spine injury, stinger/burner, peripheral nerve injury, spinal cord injury, thoracic outlet syndrome, brachial plexus radiculopathy. Treatment: The patient initially underwent nonoperative management with ice, heat, massage, electrical stimulation, shortwave diathermy, and nonsteroidal anti-inflammatory drugs without symptom resolution. Cervical spine radiographs were negative for bony pathologic conditions. Magnetic resonance imaging showed evidence of T1-T2 disc herniation. The patient underwent surgery to resolve the symptoms and enable him to participate for the remainder of the wrestling season. Uniqueness: Whereas brachial plexus radiculopathy commonly is seen in collision sports, a postfixed brachial plexus in which the T2 nerve root has substantial contribution to the innervation of the upper extremity is a rare anatomic variation with which many health care providers are unfamiliar. Conclusions: The injury sustained by the wrestler appeared to be C7 radiculopathy due to a brachial plexus traction injury. However, it ultimately was diagnosed as radiculopathy due to a T1-T2 thoracic intervertebral disc herniation causing impingement of a postfixed brachial plexus and required surgical intervention. Athletic trainers and physicians need to be aware of the anatomic variations of the brachial plexus when evaluating and caring for patients with suspected brachial plexus radiculopathies. PMID:23952042

Kuzma, Scott A; Doberstein, Scott T; Rushlow, David R



Fever of unknown origin due to dental infections: cases report and review.  


Persistent undiagnosed fever remains a common problem in clinical practice. In a variable number of cases, no definitive diagnosis is made. This lack of a clear etiology indicates that certain disorders are not being detected despite the recently developed technology usually applied in this situation. On occasion, dental disease is one potential cause of persistent fever. Oral symptoms usually are not present, thus allowing the oral cavity to be overlooked during physical examination. We describe three patients with persistent fever due to dental disease and discuss the pathogenesis of this disease. PMID:17301590

Karachaliou, Iris G; Karachalios, George N; Kanakis, Konstantinos V; Petrogiannopoulos, Constantinos L; Zacharof, Antonis K



Liver failure due to antithyroid drugs: report of a case and literature review.  


Hyperthyroidism is a common endocrine disorder affecting 2% of females and 0.5% of males worldwide and antithyroid drugs constitute the first line of treatment in the majority of cases. These agents may cause severe adverse effects and among them liver failure, although rare, is a potential lethal one. This case illustrates the sudden and abrupt deterioration of hepatic function due to antithyroid drug administration. This case along with a concise literature review is presented aiming to increase the awareness of endocrinologists of possible fatal complications from the everyday use of common agents such as antithyroid drugs. PMID:20960098

Livadas, Sarantis; Xyrafis, Xenofon; Economou, Frangiskos; Boutzios, Georgios; Christou, Maria; Zerva, Aristea; Karachalios, Athanasios; Palioura, Helen; Palimeri, Sotiria; Diamanti-Kandarakis, Evanthia



Alteration of liver function due to H1N1 infection: a case report  

PubMed Central

H1N1 virus is known to affect the respiratory tract. The majority of healthcare providers focus on the respiratory complications attributed to H1N1 infection, overlooking possible multi-organ involvement. We present a rare case of abnormal liver function in a child who was admitted for respiratory illness due to the H1N1 virus. There was a marked elevation in liver function tests concurrent with the respiratory disease. Our patient was treated with oseltamavir for the H1N1 infection, and the liver function levels decreased dramatically in 72 hours.

Alhammadi, Ahmed H; Hendaus, Mohamed A; Kayoum, Anas A



Brain Abscess Due to Listeria Monocytogenes: First Case Report in Thailand  

Microsoft Academic Search

Brain abscess with bacteremia caused by Listeria monocytogenes in a young woman with immune thrombocytopenic purpura was reported. The clinical features included fever, headache, and left-side weakness. Computed tomography and magnetic resonance imaging of the brain showed a large single abscess at the right frontoparietal area. L. monocytogenes was isolated from a blood culture. The patient promptly received a surgical

Somporn Srifeungfung


Report on the Partnership for Excellence in Teacher Education: An NSF Funded Project (NSF DUE-9343612).  

ERIC Educational Resources Information Center

Reports on the Partnership for Excellence in Teacher Education (PETE), an NSF-funded project to promote reform in mathematics and science teacher preparation that features the redesign of teacher preparation to reflect current research on learning and teaching. Concludes that new tools of technology have the potential for enhancing education but…

Blake, Sally; Tchoshanov, Mourat; Della-Piana, Connie Kubo; Pacheco, Arturo; Brady, Tom



Septic arthritis due to Mycobacterium szulgai in a patient with human immunodeficiency virus: case report.  


Mycobacterium szulgai is a rare human pathogen that mainly causes pulmonary diseases. We report the first case of M. szulgai causing septic arthritis in a patient with human immunodeficiency virus. A culture from the joint aspiration was needed to isolate and identify this organism. The patient was treated successfully with ciprofloxacin, clarithromycin, and ethambutol. PMID:15849060

Hakawi, Ahmed M; Alrajhi, Abdulrahman A



Leptomeningeal cyst in newborns due to vaccum extraction: report of two cases  

Microsoft Academic Search

Two new cases of leptomeningeal cysts subsequent to vacuum extraction are reported. Both children presented with a huge, nonpulsating, transilluminating subgaleal collection over the anterior fontanel that appeared soon after instrument delivery. Plain X-rays, computed tomography, and magnetic resonance imaging confirmed that the subgaleal collection was cerebrospinal fluid and showed the presence of a diastatic coronal suture in both cases.

Vincent de Paul Djientcheu; Bénédict Rilliet; Jacqueline Delavelle; Maria Argyropoulo; François Gudinchet; Nicolas Tribolet



Recurrent Spinal Cord Ischemia Due to Abdominal Aortic Aneurysm—A Case Report  

Microsoft Academic Search

Ischemic spinal cord lesions with abdominal aortic aneurysm are rare and are usually characterized by a single catastrophic event. The authors report a seventy-five-year-old woman who, over a period of three years, had three at tacks of acute neurologic deficit. The clinical features were those of bladder incontinence, a mixture of upper and lower motor neuron lower limb motor deficit,

Hiren B. Desai; A. H. Rajput; Ryan J. Uitti



Are gender differences in colorectal cancer screening rates due to differences in self-reporting?  

Microsoft Academic Search

ObjectiveStudies have found that women are less likely than men to undergo colorectal cancer (CRC) screening. While one source of these disparities may be gender differences in barriers and facilitators to screening, another may be differences in reporting bias.

Joan M. Griffin; Diana Burgess; Sally W. Vernon; Greta Friedemann-Sanchez; Adam Powell; Michelle van Ryn; Krysten Halek; Siamak Noorbaloochi; Joe Grill; Hanna Bloomfield; Melissa Partin



Dropped head syndrome due to myogenic atrophy --- a case report of surgical treatment  

Microsoft Academic Search

We report a case of a 69-year-old man with dropped head syndrome associated with isolated neck extensor myopathy (INEM). Over a period of 2 years, he exhibited progressive inability to lift his chin off his chest, resulting in the dropped head position that impaired his activities of daily living. He had a disturbed gait with severe imbalance of spinal alignment.

Michihisa Zenmyo; Masahiko Abematsu; Takuya Yamamoto; Yasuhiro Ishidou; Setsuro Komiya; Kosei Ijiri



[Pure motor monoparesis of a lower limb due to head injury: a case report].  


A 70-year-old woman sustained a head injury after a motor vehicle accident. Physical examination conducted on admission revealed pure motor monoparesis (PMM) and pathological reflexes in the right lower extremity. Her left lower extremity and upper extremities were intact. Computed tomography showed a spotty high-density lesion in the left precentral gyrus and a subgaleal hematoma in the left occipital region. Magnetic resonance imaging was performed on the next day. Fluid-attenuated inversion recovery (FLAIR) imaging demonstrated a high-intensity lesion in the left precentral gyrus, and T? imaging revealed a low-intensity lesion suggesting a small hemorrhage in the same area. The small hemorrhage and perifocal edema were identified on diffusion-weighted images in which low- and high-intensity lesions were observed in the anterior and posterior left precentral gyrus, respectively. Subsequent neurological examinations over 2 weeks showed improvement. We discuss the clinical presentation, diagnosis, and treatment of PMM due to head injury. We concluded that FLAIR and T? and diffusion-weighted imaging may be useful techniques for diagnosing PMM due to head injury. PMID:23209070

Ando, Kazuhiro; Maruya, Jun; Kanemaru, Yu; Nishimaki, Keiichi; Minakawa, Takashi



[Pulmonary edema due to venous air embolism during craniotomy: a case report].  


We present a 35-year-old healthy male patient who developed pulmonary edema (PE) probably due to venous air embolism during craniotomy in the semi-sitting position for arteriovenous malformation (AVM). Anesthesia was maintained with oxygen, nitrous oxide, propofol and fentanyl. During craniotomy, end-tidal carbon dioxide pressure decreased suddenly from 26 to 9 mmHg. Concurrently, a decrease in oxygen saturation from 99% to 91% occurred. There were no serious changes in blood pressure and heart rate. A "mill-wheel murmur" was confirmed. PE due to venous air embolism was suspected. The operation was discontinued and the patient was transferred to the intensive care unit. In the post-operative period, the patient developed PE and made a full recovery within a week. Four months later, the patient was scheduled again for surgical excision of AVM in the semi-sitting position in the same way as the first time. Anesthesia was maintained with oxygen, air, propofol and fentanyl. Transoesophageal echocardiography and pulmonary artery catheter were used. Saline was filled at the surgical site to prevent aspiration of air bubbles and surgical procedure was performed carefully without large vein injury and uneventfully. During neurosurgical intervention in the sitting position, special attention should be paid to entry of air bubbles into the venous system which may lead to PE. PMID:18975544

Ishida, Kumiko; Hishinuma, Miwako; Miyazawa, Mikiko; Tanaka, Toshiyuki; Iwasawa, Ken; Kitoh, Takeshi



Tuboovarian Abscess due to Colonic Diverticulitis in a Virgin Patient with Morbid Obesity: A Case Report.  


Since tuboovarian abscess is almost always a complication of pelvic inflammatory disease, it is rarely observed in virgins. A 30-year-old virgin patient presented with pelvic pain, fever, and vaginal spotting for the previous three weeks. Her abdominopelvic computed tomography scan revealed bilateral multiseptated cystic masses with prominent air-fluid levels suggesting tuboovarian abscesses. The sigmoid colon was lying between two tuboovarian masses, and its borders could not be distinguished from the ovaries. The patient was presumed to have bilateral tuboovarian abscesses which developed as a complication of the sigmoid diverticulitis. She was administered intravenous antibiotic therapy followed by percutaneous drainage under ultrasonographic guidance. She was discharged on the twenty second day with prominent clinical and radiological improvement. Diverticulitis may be a reason for development of tuboovarian abscess in a virgin patient. Early recognition of the condition with percutaneous drainage in addition to antibiotic therapy helps to have an uncomplicated recovery. PMID:22952477

Tuncer, Zafer Selçuk; Boyraz, Gokhan; Yücel, Senem Özge; Selçuk, Ilker; Yazicio?lu, Asl?han



Fatal myeloencephalopathy due to accidental intrathecal vincristin administration: a report of two cases.  


We report on two fatal cases of accidental intrathecal vincristine instillation in a 5-year old girl with recurrent acute lymphoblastic leucemia and a 57-year old man with lymphoblastic lymphoma. The girl died seven days, the man four weeks after intrathecal injection of vincristine. Clinically, the onset was characterized by the signs of opistothonus, sensory and motor dysfunction and ascending paralysis. Histological and immunohistochemical investigations (HE-LFB, CD-68, Neurofilament) revealed degeneration of myelin and axons as well as pseudocystic transformation in areas exposed to vincristine, accompanied by secondary changes with numerous prominent macrophages. The clinical course and histopathological results of the two cases are presented. A review of all reported cases in the literature is given. A better controlled regimen for administering vincristine and intrathecal chemotherapy is recommended. PMID:11587867

Dettmeyer, R; Driever, F; Becker, A; Wiestler, O D; Madea, B



Acute Kidney Injury due to Sodium Bromate Intoxication: A Report of Two Cases  

PubMed Central

Sodium bromate is a strong oxidant used as a neutralizing solution in hair permanents, as well as an auxiliary agent in printing and dyeing. Accidental or deliberate ingestion of bromate solution has rarely been reported in Korea. The clinical manifestations of bromate intoxication are vomiting, diarrhea, central nervous system symptoms, oliguric or non-oliguric acute kidney injury, hemolytic anemia, and deafness; most of these manifestations are reversible, with the exception of renal failure and deafness. Here, we report on two patients who demonstrated distinct clinical progressions. In the first case, a 16-year-old woman was successfully treated with hemodialysis and recovered renal function without hearing loss. However, in the second case, delayed hemodialysis resulted in persistent renal failure and hearing loss in a 77-year-old woman. This suggests that emergency therapeutic measures, including hemodialysis, should be taken as soon as possible, as the rapid removal of bromate may be essential to preventing severe intoxication and its sequelae.

Ryu, Dong Hwan; Jang, Kyung Ae; Kim, Seok Min; Park, Jong Won; Yoon, Kyung Woo



First Case Report of Catheter-Related Bacteremia Due to "Mycobacterium lacticola"  

PubMed Central

This is the first report of infection caused by “Mycobacterium lacticola,” a rapidly growing, scotochromogenic mycobacterium that was isolated from the blood of an immunosuppressed child. The organism was identified by sequence analysis of >1,400 bp of the 16S rRNA gene. The clinical relevance of this isolate, coupled with its unique 16S rRNA gene sequence, should prompt further investigation to establish this organism as a valid mycobacterial species.

Kiska, Deanna L.; Turenne, Christine Y.; Dubansky, A. Stephen; Domachowske, Joseph. B.



Shifts in reported gaze position due to changes in pupil size: ground truth and compensation  

Microsoft Academic Search

Camera-based eye trackers are the mainstay of today's eye movement research and countless practical applications of eye tracking. Recently, a significant impact of changes in pupil size on the accuracy of camera-based eye trackers during fixation has been reported [Wyatt 2010]. We compared the pupil-size effect between a scleral search coil based eye tracker (DNI) and an up-to-date infrared camera-based

Jan Drewes; Guillaume S. Masson; Anna Montagnini



A death due to concussive brain injury augmented by alcohol (case report)  

Microsoft Academic Search

We report here the case of a death following blunt trauma to the head in which the victim immediately became unconscious and\\u000a remained unconscious until death. There were no associated intracranial bleeding or visible macroscopic\\/microscopic injuries\\u000a to the brain. Additional injuries to other parts of the body included non-fatal contusions and abrasions. The victim was intoxicated,\\u000a with a blood alcohol

S. Kodikara



Endovascular treatment of massive retroperitoneal haemorrhage due to inferior adrenal artery injury. A case report.  


Massive retroperitoneal haemorrhage because of adrenal bleeding following blunt trauma is a rare entity. We describe a 23-year-old woman with massive retroperitoneal haemorrhage as a result of inferior adrenal artery (IAA) disruption following a car accident. Superselective transcatheter embolization of the IAA using polyvinyl alcohol particles was performed successfully to control haemorrhage. To our knowledge, this is the second report of massive retroperitoneal haemorrhage caused by IAA disruption successfully treated by transcatheter embolization. PMID:12100332

Dinc, H; Sim?ek, A; Ozyavuz, R; Ozgür, G K; Gümele, H R



Congenital nemaline myopathy due to ACTA1-gene mutation and carnitine insufficiency: a case report.  


A premature boy with a congenital form of nemaline myopathy due to mutation in the ACTA1-gene showed decreased carnitine levels in the eighth week of life. After sufficient oral carnitine substitution he improved gradually. In the first 15 months of life he made good progress; he reached full head control, learned to sit unsupported and was able to raise objects. At that time the carnitine levels were normal without substitution. Nemaline myopathy is clinically and genetically heterogenous. The pathogenesis of the muscle weakness is poorly understood. Disturbances of carnitine metabolism in this group of patients as one possibility are conceivable. Further investigations of carnitine metabolism in patients with nemaline myopathy may shed light on the pathogenesis of this entity. PMID:11748499

Buxmann, H; Schlösser, R; Schlote, W; Sewell, A; Nowak, K J; Laing, N G; Loewenich, V



Reduction of erosion in elbows due to flow modifications: Final report, Phase 1. [Elbows  

SciTech Connect

The objective of this project is to investigate the concept of flow-field modification as a method for reducing erosion in bends (elbows) used in pneumatic transport systems. Flow field modifications were primarily accomplished by injecting air at selected locations within the bends. Part I of this project shows the feasibility of the concept. Part II of this project will include further experiments and analysis, leading to a design methodology for incorporating this concept into piping systems. This report represents the final report for Part I of this project. This report contains a survey of the literature dealing with the erosion in bends (elbows) and the fundamental subjects of erosion and two-phase, gas-solids, flow. Based on this literature survey, a pneumatic transport test loop was constructed. Several bend designs were tested, using sand, under a variety of operating conditions. The results of this exploratory effort indicate that modifying the flow field in a bend with jets may: (1) decrease erosion; (2) change the erosion pattern with the same amount of erosion; or (3) significantly increase the erosion process. Data indicate that the erosion rate may be reduced by low-velocity jets for high phase-density flow. Apparently the interaction of jets with dilute phase-density flow tends to accelerate the erosion process. It is recommended that the project be continued in order to more fully understand the process and its capabilities to solve the difficult technical problem of erosion in bends (elbows).

Johnson, E.K.; Means, K.H.; Eyler, R.L.; Holtzworth, J.D.



Recurrent mycobacterial osteomyelitis. Report of a case due to Mycobacterium avium-intracellulare-scrofulaceum complex and BCG vaccination.  


A 28-year-old man suffering from recurrent mycobacterial osteomyelitis during several years is reported. Eight years old he had a Mycobacterium scrofulaceum infection in his right calcaneus. A serious infection with multiple foci of osteomyelitis occurred after BCG vaccination at the age of 14 years and 11 years later multifocal lesions of osteomyelitis due to Mycobacterium avium-intracellulare-scrofulaceum complex appeared. The special clinical problems due to the relative or complete resistence of these organisms to antituberculous drugs are emphasized. The mainstays of treatment are surgical revision and drainage with prolonged and intensive multiple drug therapy. PMID:7159201

Solheim, L F; Kjelsberg, F



Ileocolic intussusception due to intestinal metastatic melanoma. Case report and review of the literature.  


The small intestine is a frequent site of melanoma metastases and the most common cause of secondary intestinal tumors. Even though, its presentation with intestinal obstruction due to intussusception is very rare. We present a 47-year-old woman with a medical history of facial melanoma operated 17 years ago and recently diagnosed of cervical recurrence who complained of abdominal pain of one week duration accompanied with vomiting and abdominal distension. Computed tomography (CT) scan revealed marked distension of the small intestine with features suggesting intussusception of the distal ileum. At laparoscopic exploration a massive ileocolic intussusception was found with invagination of the last 60 cm of ileum inside the cecum and ascending colon. Surgical reduction revealed a tumor of approximately 2 cm in the distal end of the intussuscepted intestine acting as the lead point. Resection of non-viable ileum along with the tumor and end-to-end anastomosis was performed. Many other lesions of smaller size were found distantly in the proximal small bowel but were not treated. The patient had a full recovery and was discharged three days after surgery. Pathological examination showed metastatic melanoma and a positron emission tomography (PET) scan confirmed disseminated disease with brain metastasis. The patient died three months after surgery. Intestinal occlusion due to metastatic disease is a rare condition but should be taken into account particularly in patients with history of cancer. Surgical intervention with a mini-invasive laparoscopic approach is feasible. Intestinal resection and anastomosis is mandatory for either curative or palliative intentions providing a satisfactory treatment. PMID:22096701

Alvarez, Fernando A; Nicolás, Matías; Goransky, Jeremías; Vaccaro, Carlos A; Beskow, Axel; Cavadas, Demetrio



Ileocolic intussusception due to intestinal metastatic melanoma. Case report and review of the literature  

PubMed Central

The small intestine is a frequent site of melanoma metastases and the most common cause of secondary intestinal tumors. Even though, its presentation with intestinal obstruction due to intussusception is very rare. We present a 47-year-old woman with a medical history of facial melanoma operated 17 years ago and recently diagnosed of cervical recurrence who complained of abdominal pain of one week duration accompanied with vomiting and abdominal distension. Computed tomography (CT) scan revealed marked distension of the small intestine with features suggesting intussusception of the distal ileum. At laparoscopic exploration a massive ileocolic intussusception was found with invagination of the last 60 cm of ileum inside the cecum and ascending colon. Surgical reduction revealed a tumor of approximately 2 cm in the distal end of the intussuscepted intestine acting as the lead point. Resection of non-viable ileum along with the tumor and end-to-end anastomosis was performed. Many other lesions of smaller size were found distantly in the proximal small bowel but were not treated. The patient had a full recovery and was discharged three days after surgery. Pathological examination showed metastatic melanoma and a positron emission tomography (PET) scan confirmed disseminated disease with brain metastasis. The patient died three months after surgery. Intestinal occlusion due to metastatic disease is a rare condition but should be taken into account particularly in patients with history of cancer. Surgical intervention with a mini-invasive laparoscopic approach is feasible. Intestinal resection and anastomosis is mandatory for either curative or palliative intentions providing a satisfactory treatment.

Alvarez, Fernando A.; Nicolas, Matias; Goransky, Jeremias; Vaccaro, Carlos A.; Beskow, Axel; Cavadas, Demetrio



Acute liver failure due to Varicella zoster virus infection after lung transplantation: a case report.  


Most adults are Varicella zoster virus (VZV)-positive at the age of 20 years. Some, however, remain antibody-negative and may develop primary chicken pox during adulthood. We report a patient with Williams-Campbell syndrome who underwent double-lung transplantation while being VZV-negative. One year after the successful procedure, he was admitted with fulminant hepatic failure and some cutaneous vesicles in his face. Despite a rapid diagnosis of VZV infection and treatment with acyclovir, his situation deteriorated within 24 hours and while awaiting an urgent liver transplantation, he developed multiple organ failure and died. PMID:22664036

Verleden, G M; Vos, R; Van Raemdonck, D E; Laleman, W; Vanaudenaerde, B M



Colon Obstruction due to an Anticoagulant Induced Intramural Haematoma; A Rare Case Report  

PubMed Central

A spontaneous, intramural, intestinal haematoma is a rare complication of the anticoagulant therapy. We are reporting here, a rare case of a 63-years-old male, who presented with intestinal obstruction which was caused by an intramural and a submucosal colonic haematoma, which had resulted from warfarin administration. This patient rapidly improved after taking conservative treatment. A history of anticoagulant use with a prolonged INR value in patients who present with abdominal pain, should alert the physicians or surgeons to search for this entity. It is extremely important to recognize this syndrome at its early stages, to avoid an unnecessary operation, since the outcome is usually excellent after a conservative treatment.

Lobo, Lancelot; Koudki, Rakesh; Prasad HL, Kishan; Shetty, Balakrishna



Intracranial Hypertension due to Cerebral Venous Sinus Thrombosis following Head Trauma: A Report of Two Cases  

PubMed Central

Cerebral venous sinus thrombosis (CVST) may occur following head trauma and contribute to intracranial hypertension that mandates immediate action. Anticoagulant therapy is the first line of treatment in CVST but may not be applicable in patients with head trauma. Here, we report on the treatment of 2 patients with CVST. In 1 patient, there was an attempt to perform thrombectomy and thrombolysis, and eventually a decompressive craniectomy was performed. In this patient, there was an excellent outcome. In the other patient, an immediate decompressive craniectomy was performed that did not improve the outcome.

Lindvall, Peter; Koskinen, Lars-Owe D.



Acute myocardial infarction due to coronary vasospasm secondary to industrial nitroglycerin withdrawal. A case report.  


A case of acute transmural anterior myocardial infarction in a 45-year-old Black employee of an explosives factory during a period of withdrawal from industrial nitroglycerin is documented. Angiography revealed that the patient had normal coronary arteries. Coronary vasospasm could not be induced by the ergometrine (ergonovine) maleate provocation test. It is postulated that the infarction was directly attributable to coronary vasospasm provoked by the 'industrial nitroglycerin withdrawal syndrome', since there was no evidence of any other non-atheromatous aetiological factor. The authors believe this to be the first such case in a Black subject reported in the literature. PMID:6408745

Przybojewski, J Z; Heyns, M H



Suprapubic Fecal Fistula Due To Richter's Inguinal Hernia: A Case Report and Review of Literature  

PubMed Central

We encountered a 55-year-old man, who presented with an orifice in the suprapubic region, through which fecal material was discharged. On physical examination, the patient was unstable. After resuscitation, thorough evaluation, and laboratory and imaging investigations, he underwent an exploratory laparotomy. The ileum was entrapped at the deep inguinal ring, and there was some pus in the pelvic cavity. The purulent material was cleaned, and anastomosis was done after the resection of the defective ileal segment. In view of the rarity of this presentation and the paucity of published articles, this case is reported here.

Habib Faridi, Shahbaz; Siddiqui, Bushra; Amanullah Khan, Mohd; Anees, Afzal; Ali, Syed Asmat



[Male pseudo-hermaphroditism due to partial 5 alpha-reductase deficiency, a case report].  


Male pseudo hermaphroditism caused by steroid 5 alpha reductase deficiency is a rare autosomal recessive disorder. This enzyme catalyses the conversion of testosterone to dihydrotestosterone (DHT) in genital tissue. The potent androgen DHT is required for full masculinization of the external genitalia hence, masculinization defects of varying degree result from diminished DHT formation. We report a Tunisian patient who was raised as a girl, presented to us at the age of 15, because male phenotype had become predominant at puberty. Endocrinological investigations revealed an in crease in the ratio serum testosterone/DHT = 17. Treatment with dihydrotestosterone and surgical correction, after psychological evaluation permitted the change of gender identity to male. PMID:11515490

Hédia, S; Mohamed, S; Insaf, H A; Houda, G; Yamina, F; Myrvat, K; Maria, H; Ali, H



Severe jaundice due to coexistence of Dubin-Johnson syndrome and hereditary spherocytosis: a case report.  


Dubin-Johnson syndrome is a chronic, benign, intermittent jaundice, mostly of conjugated hyperbilirubinemia. The level of bilirubin is not expected to be more than 20 mg/dl in this syndrome. In this article, we report a patient who was evaluated for hyperbilirubinemia and liver function test abnormalities and diagnosed with Dubin-Johnson syndrome coexisting with hereditary spherocytosis. We suggest that other diseases should be investigated if patients with Dubin-Johnson syndrome present with severe hyperbilirubinemia. Dubin-Johnson syndrome accompanied by hemolytic diseases might also have high coproporphyrin levels (as in Rotor's syndrome) than expected in pure Dubin-Johnson syndrome. PMID:21948575

Korkmaz, U?ur; Duman, Ali Erkan; O?ütmen Koç, Deniz; Gürbüz, Ye?im; D?ndar, Gökhan; Ensaro?lu, Fatih; Sener, Selçuk Yusuf; Sentürk, Omer; Hülagü, Sadettin



Spontaneous acute subdural hematoma due to fondaparinux: Report of two cases  

PubMed Central

Background: Spontaneous acute subdural hematomas (SDHs) are rare. Risk factors for development of these hematomas include conditions such as hypertension, vascular abnormalities such as aneurysm or arteriovenous malformation, or consumption of anticoagulants. Case Description: Here, the authors report two patients who suffered from spontaneous acute SDH while taking fondaparinux for venous thromboembolism prophylaxis. One patient suffered from a remote episode of traumatic brain injury and underwent a decompressive craniectomy 3 weeks prior to presentation, whereas the other patient had been self-medicating with aspirin. Conclusion: To our knowledge, these two patients illustrate the first cases of spontaneous acute SDH formation most likely attributed to consumption of fondaparinux.

Fryburg, Karsten; Nguyen, Ha Son; Cohen-Gadol, Aaron A.



Acute kidney injury due to sodium bromate intoxication: a report of two cases.  


Sodium bromate is a strong oxidant used as a neutralizing solution in hair permanents, as well as an auxiliary agent in printing and dyeing. Accidental or deliberate ingestion of bromate solution has rarely been reported in Korea. The clinical manifestations of bromate intoxication are vomiting, diarrhea, central nervous system symptoms, oliguric or non-oliguric acute kidney injury, hemolytic anemia, and deafness; most of these manifestations are reversible, with the exception of renal failure and deafness. Here, we report on two patients who demonstrated distinct clinical progressions. In the first case, a 16-year-old woman was successfully treated with hemodialysis and recovered renal function without hearing loss. However, in the second case, delayed hemodialysis resulted in persistent renal failure and hearing loss in a 77-year-old woman. This suggests that emergency therapeutic measures, including hemodialysis, should be taken as soon as possible, as the rapid removal of bromate may be essential to preventing severe intoxication and its sequelae. PMID:22205849

Ryu, Dong Hwan; Jang, Kyung Ae; Kim, Seok Min; Park, Jong Won; Do, Jun Young; Yoon, Kyung Woo



Plasmapheresis leading to remission of refractory nephrotic syndrome due to fibrillary glomerulonephritis: a case report  

PubMed Central

Introduction Fibrillary glomerulonephritis (FibGN) is characterized by extracellular deposition of Congo red-negative microfibrils within the glomerular mesangium and leads to gross proteinuria or nephrotic syndrome. After diagnosis of FibGN, end-stage renal disease occurs within four years in 50% of patients. Case presentation A 36-year-old Caucasian woman with proteinuria and intermittent nephrotic syndrome due to FibGN intermittently received immunosuppressive therapies, including glucocorticoids, mycophenolate mofetil, and rituximab, for 10 years. However, disease remission was not achieved and progressive kidney injury developed. Ultimately, in stage IV of chronic kidney disease (Kidney Disease: Improving Global Outcomes), three cycles of plasmapheresis of five to seven sessions each were performed every three to four months, reducing steady-state proteinuria from 7 to less than 1 g/day. Here, plasmapheresis led to a remission of nephrotic syndrome associated with FibGN. Conclusions Plasmapheresis therapy is proposed as a further option for immunosuppressant-refractory FibGN.



Defecation pain and coccydynia due to an anteverted coccyx: a case report  

PubMed Central

Introduction Defecation pain is a common problem with many etiologies implicated. Elucidating a cause requires a thorough medical history, examination and appropriate investigations, which may include endoscopy, barium enema, examination under anesthesia and magnetic resonance imaging or computed tomography. Coccydynia is a term used to describe pain in the region of the coccyx, often due to abnormal mobility of the coccyx. Non-surgical management options remain the gold-standard for coccydynia with surgery being reserved for complicated cases. Case presentation This is a case of a 67-year-old Caucasian man who presented with a two-and-a-half-year history of worsening rectal pain. Conclusion To the best of our knowledge, we describe the first case in the literature of an abnormally mobile anteverted coccyx causing predominantly defecation pain and coccydynia, successfully treated by coccygectomy. When first-line investigations fail to elucidate a cause of defecation pain one must, in the presence of unusual symptoms, consider musculoskeletal pathologies emanating from the coccyx and an orthopedic consultation must then be sought for diagnostic purposes.



[Anaphylaxis Due to Ingestion of Ivy Syrup (Hedera hÈlix). Report of two Cases].  


Common ivy is an ornamental plant, that is ubiquitous in Mexico. Its allergens can cause contact dermatitis, asthma and allergic rhinitis. We describe two cases of anaphylaxis related to common ivy syrup ingestion. We performed skin prick test with Hedera helix syrup, and using a dialized and ultrafiltered of common ivy syrup commercial presentation (dry common ivy extract: 7mg/ml), as well as using Hedera helix pollen extract. We describe two cases of anaphylaxis related to ingestion of Hedera helix syrup. Skin prick test with the commercial presentation and with the pollen extract were positive in both patients. In this study we confirmed the causal relationship of anaphylaxis due to the ingestion of ivy syrup in two patients through skin prick tests with ivy syrup and ivy pollen extract. Common ivy can cause contact dermatitis, asthma and allergic rhinitis, but we do not know the allergens that could be related to systemic and respiratory reactions, then, more studies in this topic are requiered. PMID:24007931

Morfin-Maciel, Blanca María; Rosas-Alvarado, Alejandro; Velázquez-Sámano, Guillermo


Unattended fatal haemorrhage due to spontaneous peripheral varicose vein rupture--two case reports.  


Venous haemorrhage is a rare complication of varicose veins of the legs. Varicosis is found in 15-50% of the population. Haemorrhage from ruptured varicose veins of the legs can occur spontaneously or after a minor trauma. More frequent complications of varicosis include peripheral oedema of the ankles, skin pigmentation and skin ulcers. In case of venous haemorrhage simple possibilities of first aid can be applied, therefore fatal haemorrhage is a rarity. Two cases of fatal varicose vein rupture are presented. A 58-year-old man and a 76-year-old woman, both living alone, were found dead in the bathrooms of their apartments. Significant traces of blood were found in all rooms. Both corpses showed typical signs of death from exsanguination. No traumatic lesion was found. Cause of the haemorrhage was a small lesion of the skin of the lower legs of the victims with continuation to an underlying superficial varicose vein. Misinterpretation of life-threatening varicose haemorrhage, unconsciousnous, alcohol or drug influence, old age and dementia can promote the death. In case of fatal haemorrhage the death scene can simulate crime due to massive traces of blood and may focus primarily on a non-natural death. However, police investigations and autopsy will disclose the rare cause of spontaneous natural death. PMID:20655677

Doberentz, E; Hagemeier, L; Veit, C; Madea, B



Drug-induced liver injury due to "natural products" used for weight loss: A case report  

PubMed Central

Taking herbal-extracts to lose weight is an underestimated health hazard. Often, these products contain active agents that can cause acute liver damage. In this case report, a 22-year-old female patient, who presented with a feature of cholestatic syndrome, was so sure that the “natural products” were not dangerous that she did not inform her physicians that she had taken them, making their task that much more challenging. Clinical presentation mimicked acute cholecystitis and the patient underwent a cholecystectomy. Surgery was without any consequences and complications, although it did not completely cure the illness. She later admitted to having taken herbal remedies and this led to the correct diagnosis of phytotherapy-related hepatotoxicity and a successful therapeutic approach. The true incidence of phytotherapy-related hepatotoxicity and its pathogenic mechanisms are largely unknown. It is important to increase the awareness of both clinicians and patients about the potential dangers of herbal remedies.

Tarantino, Giovanni; Pezzullo, Martina Gilda; Dario di Minno, Matteo Nicola; Milone, Francesco; Pezzullo, Luigi Sossio; Milone, Marco; Capone, Domenico



Unusual cardiac outcomes of bacteremia due to Staphylococcus aureus infection: a case report  

PubMed Central

Introduction Patients on hemodialysis, particularly those with temporary non-tunneled dialysis access, constitute a high-risk population for bloodstream infections associated with significant morbidity and mortality rates. This population also has a high prevalence of cardiovascular diseases with poor prognosis. Case presentation We report the case of a 62-year-old Caucasian man with end-stage renal disease undergoing hemodialysis, who presented with an eventually lethal case of staphylococcal septicemia with an unusual involvement of the heart, including bacterial coronary arteritis, myocardial abscesses and papillary muscle infarction and rupture, along with complications involving other organs. Conclusions It is important to try to minimize invasive procedures in patients who are hemodialysis dependent. The strict control of heart function is indicated considering the large spectrum of unusual cardiac complications.



Bronchobiliary fistula due to hydatid disease of the liver: a case report.  


As a complication of hydatid cyst disease of the liver, bronchobiliary fistula is a rare condition and manifests as bilioptysis. We report the case of a 34 year-old man with echinococcosis of the liver who developed a bronchobiliary fistula which manifested as chronic cough and bile stained sputum. A chest X-ray showed an unilateral infiltrate in the costodiaphragmatic angle. Bronchoscopy revealed bile filling the right basal bronchi. Magnetic resonance cystography revealed that the hepatic bile ducts communicated with the right basal pleural space. Percutaneous transhepatic drainage was applied. When the patient was reevaluated, the hydatid cyst had eroded into the pleural space, and a pleural effusion had developed. The condition of the patient deteriorated. Hence, surgical therapy was performed. After surgery, the condition of the patient improved. He was discharged from the hospital in good condition. PMID:12136544

Uzun, K; Ozbay, B; Etlik, O; Kotan, C; Gencer, M; Sakarya, M Emin



Asymptomatic elevation of liver enzymes due to levetiracetam: a case report.  


Levetiracetam is a commonly used broad-spectrum anticonvulsant efficacious in both partial and generalized seizures. It has an extremely favorable side effect profile with few drug-drug interactions, low potential for hematological and hepatic toxicity, and thus has rapidly become the preferred drug in patients with traumatic brain injuries who need seizure prophylaxis. We report, here, a patient who was started on levetiracetam for seizure prophylaxis after developing large bifrontal-parietal traumatic subdural hematomas (SDH) following a fall from a horse necessitating bifrontal craniotomies for evacuation. The patient developed an asymptomatic elevation of the liver enzymes. The liver enzymes trended back to normal after levetiracetam was stopped, and topiramate was initiated in its place. PMID:23420283

Sethi, Nitin K; Sethi, Prahlad K; Torgovnick, Josh; Arsura, Edward; Cukierwar, Frances



Drug overdose due to malfunction of a patient-controlled analgesia machine -A case report-.  


Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future. PMID:23560197

Yi, Yuri; Kang, Seongsik; Hwang, Byeongmun



A mother with green breastmilk due to multivitamin and mineral intake: a case report.  


It is a globally accepted fact that breastfeeding reduces infant mortality and morbidity, optimizes infant growth, is superior to other forms of nutrition for infants, and has economic advantages for the family and the country. This case study reports a new mother who stopped breastfeeding her baby because her breastmilk was green. When her second child was born, her milk came in green, and a consultation was requested from pediatrics and infectious diseases. A physical examination and laboratory tests revealed that the abnormal color of her breastmilk was related to multivitamin intake. The patient was advised to continue breastfeeding despite the odd color. Although clinical specialists know that the color of breastmilk can change with the ingestion of certain medications and foods, mothers are usually unaware and may unnecessarily terminate breastfeeding. PMID:22148928

Yazgan, Hamza; Demirdöven, Mehmet; Yazgan, Zerrin; Toraman, Ahmet Ruhi; Gürel, Ahmet



Colon Obstruction due to an Anticoagulant Induced Intramural Haematoma; A Rare Case Report.  


A spontaneous, intramural, intestinal haematoma is a rare complication of the anticoagulant therapy. We are reporting here, a rare case of a 63-years-old male, who presented with intestinal obstruction which was caused by an intramural and a submucosal colonic haematoma, which had resulted from warfarin administration. This patient rapidly improved after taking conservative treatment. A history of anticoagulant use with a prolonged INR value in patients who present with abdominal pain, should alert the physicians or surgeons to search for this entity. It is extremely important to recognize this syndrome at its early stages, to avoid an unnecessary operation, since the outcome is usually excellent after a conservative treatment. PMID:23730664

Lobo, Lancelot; Koudki, Rakesh; Prasad Hl, Kishan; Shetty, Balakrishna



Hepatotoxicity due to tocilizumab and anakinra in rheumatoid arthritis: two case reports  

PubMed Central

Elevation of liver enzymes in patients with rheumatoid arthritis treated with the biological agents, tocilizumab and anakinra, is now well documented. However, histological characterization of these effects and outcomes has not been defined. Here we report toxic liver effects in two women with rheumatoid arthritis, refractory to all nonbiological therapies, following treatment with anakinra and tocilizumab. Liver biopsy in both cases showed focal necrosis of hepatocytes as a hallmark of drug toxicity, along with steatosis and early fibrosis. In addition, the patient treated with anakinra demonstrated inflammatory changes. Tocilizumab was continued with no further deterioration in liver function. Withdrawal of anakinra led to rapid normalization of liver function. The biological agents, tocilizumab and anakinra, may result in significant histological hepatic changes, including necrosis, but despite this, the outcome appears to be good.

Mahamid, Mahmud; Paz, Kalman; Reuven, Mader; Safadi, Rifaat



Iron deficiency anemia due to lymphocytic gastritis with Helicobacter pylori infection in childhood: case report.  


Lymphocytic gastritis (LG) is a chronic inflammatory process of poorly understood pathogenesis. We report the case of a 12-year-old premenstrual girl with refractory iron deficiency anemia in which the oral iron absorption challenge suggested iron malabsorption. Laboratory studies ruled out celiac disease and autoimmune gastritis, and carbon-13 urea breath test for Helicobacter pylori was also negative. Upper endoscopy with gastric body and antral mucosa biopsies revealed a LG with focal intestinal metaplasia and H. pylori infection. H. pylori eradication was undertaken with success and 3 months later her hematologic parameters normalized. Histologic reevaluation showed disappearance of LG. This case shows that investigation of malabsorption disease in the presence of refractory iron deficiency anemia can lead to the diagnosis of important gastric diseases, even in the absence of gastrointestinal symptoms. This nonceliac child was diagnosed with a severe histopathologic pattern of LG, with potential risk of malignant transformation, which was completely reverted with adequate H. pylori eradication treatment. PMID:23528908

Santalha, Marta F F; Costa, Emília; Miguel, Natalina; Vizcaíno, Ramón; Barbot, José; Pereira, Fernando



Rapidly progressive paraplegia due to an extradural lumbar meningocele mimicking a cyst. Case report.  


Unlike arachnoid meningoceles, arachnoid cysts frequently cause local pressure effects probably because there is no free communication between the cyst and the subarachnoid space. Following the first detailed description of cystic lesions of spinal nerve roots by Tarlov in 1938, a simplified classification of spinal meningeal cysts was developed in 1988, containing three major categories. The authors report on a lumbar intraspinal extradural meningocele that caused incomplete paraplegia in an otherwise healthy 31-year-old man in whom magnetic resonance imaging revealed stigmata of Scheuermann disease. Intraoperatively, the lesion was classified as a transitional-type lesion, in accordance with Type IA of the Nabors classification, because a communication with the subarachnoid space was observed. After complete removal of the meningocele, the patient's recovery was prompt and complete. PMID:17633492

Fiss, Ingo; Danne, Marco; Hartmann, Christian; Brock, Mario; Stendel, Ruediger



Meningitis due to Bacillus cereus: A case report and review of the literature  

PubMed Central

Bacillus cereus is infrequently associated with invasive central nervous system (CNS) disease. Infection is associated with conditions that lead to reduced host immunity and provide direct access to the CNS, such as spinal anesthesia and ventricular tubes and shunts. A case of ventriculitis secondary to B cereus in a patient receiving intrathecal chemotherapy is reported, along with a review of the current literature. B cereus can colonize medical devices, thus posing a risk for invasive disease. Despite aggressive treatment with broad-spectrum anti-infectives, the mortality of CNS invasive B cereus is high. Clinicians should not dismiss Gram-positive rods resembling Bacillus species from normally sterile sites as contaminants in critically ill patients. Appropriate antibiotic therapy should be promptly initiated to limit morbidity and mortality.

Stevens, Michael P; Elam, Kara; Bearman, Gonzalo



Schistosomal myeloradiculopathy due to Schistosoma mansoni: Report on 17 cases from an endemic area  

PubMed Central

Background: After malaria, schistosomiasis is the second most prevalent tropical disease. The prevalence of oviposition in CNS of infected persons varies from 0.3 to 30%. The conus medullaris is a primary site of schistosomiasis, either granulomatous or acute necrotizing myelitis. Objective: To report the clinical, radiological, and laboratory results of spinal cord schistosomiasis (SCS) and to design proper therapeutic regimens. Materials and Methods: Seventeen patients (13 males and four females) with SCS were enrolled between 1994 and 2009 at Mansoura University Hospitals. Their median age at diagnosis was 19 years (13-30 years). Independent neurological, radiological, and laboratory assessments were performed for both groups, excluding pathological confirmation that was done earlier in eight patients (Group 1). In the group 2 (nine patients), indirect hemagglutination (IHA) test for bilharziasis in blood and cerebrospinal fluid (CSF) was performed. Higher positive titer in CSF than serum indicated SCS plus induction of antibilharzial and corticosteroid protocols for 12 months with a three-year follow-up. Results: Rate of neurological symptoms of granulomatous intramedullary cord lesion was assessed independently in 16 cases and acute paraparesis in one case. All patients in group 2 had positive IHA against Schistosoma mansoni with median CSF and serum ranges 1/640 and 1/320, respectively. Seven patients (41.18%) had complete recovery, eight patients (47.06%) showed partial recovery, and no response was reported in two patients (11.76%) (P = 0.005). There was no recorded mortality in the current registry. Conclusions: Rapid diagnosis of SCS with early medical therapies for 12 months is a crucial tool to complete recovery.

Badr, Hatem I.; Shaker, Ashraf A.; Mansour, Mohamed A.; Kasem, Mohamed A; Zaher, Ahmad A.; Salama, Hassan H.; Safwat, Mohamed I.



Remote cerebellar hemorrhage due to ventriculoperitoneal shunt in an infant: a case report  

PubMed Central

Introduction Cerebellar hemorrhage remote from the operative site is an unpredictable and rare complication in neurosurgery, with reported rates of morbidity and mortality in the literature of 8.4% and 7.8%, respectively. The range of procedures associated with remote cerebellar hemorrhage is diverse and includes both supratentorial and spinal procedures that entail significant cerebral spinal fluid loss or resection of supratentorial content. We present here the first documented case of remote cerebellar hemorrhage after controlled supratentorial cerebral spinal fluid drainage by ventriculoperitoneal shunt, and discuss the proposed pathophysiology and treatment. Case presentation We present the case of a four-month-old Saudi Arabian male baby who presented with progressive symptoms and signs of congenital hydrocephalus. An uneventful ventriculoperitoneal shunting was performed with our patient recovering smoothly in the immediate postoperative period. On the next day, he had frequent episodes of vomiting and became lethargic. An urgent computed tomography scan of his brain revealed mild ventricular decompression and unexpected cerebellar hemorrhage. The infant was put under close observation, with marked spontaneous improvement over 48?hours and complete resolution of the hemorrhage on a follow-up computed tomography brain scan two weeks later. On regular outpatient visits at one, three and twelve months, he had no neurological deficit. Conclusion Remote cerebellar hemorrhage is a complication that remains enigmatic in terms of both the underlying mechanism and clinical behavior. Our case revealed that the risk factors identified in the literature are not sufficient in predicting patients at risk of developing remote cerebellar hemorrhage. Our report also adds to the growing body of evidence challenging the currently accepted hypothesis explaining the pathomechanism of remote cerebellar hemorrhage. It thereby remains an unpredictable hazard that requires further study and increased awareness, as many cases in the literature are incidental findings.



Multiple Intestinal Erosions as a Result of Hemorrhage due to Parasites: Case Reports and Review of the Literature  

PubMed Central

Obscure gastrointestinal bleeding appears to be uncommon in patients with parasites. In spite of that some reports had described this relationship in patients evaluated during capsule endoscopy procedures; the characteristic of the bleeding lesions remains unclear. This paper describes two patients with a massive obscure gastrointestinal bleeding due to ascariasis, using the new capsule endoscopy technology “MiroCam”, describing the characteristic of the lesions found in our patients (observed in a better image quality), and reviewing the literature.

Pitanga Lukashok, Hannah; Robles-Jara, Carlos; Robles-Medranda, Carlos



Evaluation of the electromagnetic effects due to direct lighting to nuclear explosive areas at Pantex. Final report  

SciTech Connect

This report summarizes the effort to quantify the electromagnetic environments in the nuclear explosive areas at Pantex due to direct lightning. The fundamental measure of the threat to nuclear safety is assumed to be the maximum voltage between any two points in an assembly area, which is then available for producing arcing or for driving current into critical subsystems of a nuclear weapon. This maximum voltage has been computed with simple analytical models and with three-dimensional finite-difference computer codes.

Merewether, K.O.; Chen, K.C.



Permanent Neonatal Diabetes Mellitus Due to a C96Y Heterozygous Mutation in the Insulin Gene. A Case Report  

Microsoft Academic Search

Context Neonatal diabetes is a rare disorder with an incidence of 1 in 215,000-500,000 live births with 50% of them having permanent neonatal diabetes mellitus. Case report We present a case of permanent neonatal diabetes mellitus due to a C96Y (c.287G>A; p.Cys96Tyr) heterozygous mutation in the insulin (INS) gene. Both the patient and his father (who had childhood- onset insulin-requiring

Anish Ahamed; Ambika Gopalakrishnan Unnikrishnan; Sanket Sharad Pendsey; Sheela Nampoothiri; Nisha Bhavani; Valliyaparambil Pavithran Praveen; Harish Kumar; Rohinivilasam Vasukutty Jayakumar; Vasantha Nair; Sian Ellard; Emma L Edghill


Idiopathic autoimmune hemolytic anemia due to lecithin overdose: a case report  

PubMed Central

Introduction Idiopathic Autoimmune Hemolytic Anemia is a potentially fatal condition which requires prompt and potent treatment. Diagnosis of idiopathic autoimmune hemolytic anemia requires both serologic evidence of autoantibody presence and hemolysis. Although most of the times it is considered idiopathic, several underlying causes have been identified, like autoimmune and connective tissue diseases, viral infections, drugs or hyper function of the immune system. To our knowledge, this is the first case in the international literature describing lecithin-induced autoimmune hemolytic anemia. Case Presentation This case report is to highlight a rare but dangerous adverse reaction to overdose of lecithin. A 38 year old white female from Greece, presented to our emergency room with progressive fatigue over a period of ten days and icteric discoloration of her skin and conjunctiva. The patient had been taking lecithin supplements (1200 mg, 3 capsules a day) over a period of ten days for weight loss. She reports that the last 3 days, prior to the examination, she took 5 capsules/day, so that the supplement would take effect more rapidly. Her past medical, social and family history showed no disturbance. Relatives of the patient were requested to submit any blood-tests taken over a period of 20 days prior to the onset of symptoms caused by Lecithin. All tests proved that all functions were within normal scale. Her physical examination revealed pallor and jaundice without palpable hepatosplenomegaly. Blood biochemistry tests showed total bilirubin 7.5 mg/dl, with indirect bilirubin 6.4 mg/dl and complete blood count showed hemoglobin 7.6 g/dl with blood levels 21.4%. Conclusion In every case of idiopathic autoimmune hemolytic anemia the administration of pharmaceutical substances should always be examined, except for the standard reasons that cause it. In this case the cause of hemolysis was attributed to the excessive intake of lecithin capsules for the loss of body weight. It is important that clinicians and immunologists are aware of this adverse effect.



Rhinocerebral mucormycosis due to Rhizopus oryzae in a diabetic patient: a case report.  


Mucormycosis is an opportunistic fulminant fungal infection, which affects nose and paranasal sinuses by direct invasion or through the blood vessels mainly in diabetic and immunocompromised patients. In the present study, a rhino-orbito-cerebral mucormycosis in a 24-year-old female with diabetes mellitus as underlying disease was reported. Computed tomography (CT scan) demonstrated an increase in the soft tissue densities in the left nasal cavity, maxillary and ethmoid sinuses and destruction of the antral wall with soft tissue densities in the pterygopalatine fossa and retromaxillary fissure. In histopathology, wide ribbon-shape non-septate hyphae were seen in tissue sections stained with hematoxylin-eosin (H&E). The etiologic fungus isolated from tissue biopsy on mycological media was identified by the amplification and sequencing of the 5.8S RNA gene and of the adjacent internal transcriber spacer domains, ITS1/ITS4, as Rhizopous oryzae. Recognition of the unique patterns of this high mortality rhinocerebral fungal infection in patients with diabetes is a key to early diagnosis and successful treatment. PMID:23721995

Erami, M; Shams-Ghahfarokhi, M; Jahanshiri, Z; Sharif, A; Razzaghi-Abyaneh, M



[Total A-V block due to tuberous sclerosis. A case report].  


Tuberous sclerosis is a neurologic disease affecting various organs with a triade: sebaceum adenoma, mental retardation and seizures. This report presents a case of a patient with tuberous sclerosis and third degree A-V block with complete invasive and non-invasive evaluation. The patient had sincope and complete A-V block with QRS complexes showing right bundle branch block morphology. The echocardiogram showed dilated cardiomyopathy with diffuse left ventricular dysfunction and had normal coronary arteriography. The eletrophysiologic evaluation showed complete infra-hisian A-V block and QRS with left bundle branch block pattern with normal sinus nodal and A-V nodal function. It was not possible to induce ventricular tachtyarrhythmias up to two extrastimuli. Histologic study showed normal myocardium under light and electronic microscopy. After permanent VVI pacemaker implant, the patient in follow-up for 16 years. This case seems to be the first in the international medical literature of tuberous sclerosis with complete heart block. PMID:2629681

Valente, N; Guidugli Neto, J; De Paola, A A; Pimenta, J



Severe gynecomastia due to anti androgens intake: A case report and literature review.  


Gynecomastia is the most bothersome side effect in men taking antiandrogens. It is exceptionally severe and distressing physically and mentally as in the reported case. A man, aged 63, with a history of a well-treated macroprolactinoma, was referred in 2004 for gynecomastia that appeared after treatment by microsurgery, radiotherapy and flutamide for a lesion suspected to be prostate cancer. Clinical examination was normal except for huge enlargement of the breasts. Mammography and breasts MRI did not show any tumor. There was not any metastasis of the supposed prostate cancer and prostatic acid phosphates were within normal ranges. Hormonal exploration showed subclinical hypogonadism [testosterone: 7.4 ng/ml (n: 3-9), FSH: 14.9 mu/ml (n: 0.7-11) and LH: 9.7 mu/ml (n: 0.8-7.6)]. Testes ultrasounds were normal. Radiological and hormonal adrenal explorations were normal [Cortisol: 76 ng/ml (n: 50-250), DHEA-S: 59 ?g/ml (n: 50-560), E2:40.2 pg/ml (n < 50)]. Body scan was normal too. The discussed etiologies were post radiation subclinical hypogonadism, and treatment with anti androgens. After flutamide withdraw, there was not any sign of prostate cancer recurrence, and gynecomastia decreased significantly, but did not disappear probably because of fibrosis. PMID:23961495

Farida, Chentli; Faiza, Belhimer



Abdominal angina due to recurrence of cancer of the papilla of Vater: a case report  

PubMed Central

Introduction Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater. Case presentation An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death. Conclusion Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.



Phytocontact Dermatitis due to Mustard Seed Mimicking Burn Injury: Report of a Case  

PubMed Central

Mustard seeds have been used in traditional folk medicine as a stimulant, diuretic, and purgative and to treat a variety of ailments including peritonitis and neuralgia. Mustards are still used today in mustard plasters to treat rheumatism, arthritis, chest congestion, aching back, and sore muscles. To make a mustard plaster, mix equal parts of flour and powdered mustard and spread it as a paste on a doubled piece of soft cloth. Apply mustard plaster to the affected area for a maximum of 15 minutes. Prolonged application can result in burns to the skin and nerve damage. Skin lesions occur within hours after exposure, and there is no significant therapy procedure. This case report is about a patient with second-degree burn, occurred when a mixture including mustard seed was exposed to her skin in the pain therapy of the osteoarthritis in her left knee. There are no studies analyzing treatment of skin burns induced by mustard seed in the literature. While in this type of burns our experience is limited, we think that conservative approach should be first choice of treatment.

Yabanoglu, Hakan; Akbulut, Sami; Karakayali, Feza



Death due to ingestion of nicotine-containing solution: case report and review of the literature.  


Nicotine, a lipid-soluble alkaloid obtained from the dried leaves of Nicotiana, is most frequently encountered in tobacco products for smoking, chewing or sniffing as well as in a limited number of pesticides. Though nicotine is one of the most toxic drugs of abuse, it has rarely led to fatalities. Sudden death can be caused by cardiovascular arrest, respiratory muscle paralysis and/or central respiratory failure. A 42-year-old man was found dead by his wife. He was lying on the floor, next to a box containing many empty bottles of beer and vodka. Some labeled chemical bottles found at the scene contained various substances, including nicotine and brucine. Gross examination of the organs at autopsy revealed no specific findings. The toxicological examination failed to disclose any lethal toxic agents other than a high concentration of nicotine and its primary metabolite cotinine in femoral venous blood (2.2 microg/mL). Blood alcohol was determined to be 2.1 g/L in femoral venous blood. Only a paucity of fatal cases of nicotine poisoning has been reported in the literature so far. PMID:19954906

Solarino, Biagio; Rosenbaum, Frank; Riesselmann, Benno; Buschmann, Claas T; Tsokos, Michael



Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer: case report and review of the literature.  


CONTEXT Coagulase-negative staphylococci are common colonizers of the human skin and have become increasingly recognized as agents of clinically significant nosocomial infections. CASE REPORT The case of a 79-year-old male patient with multi-infarct dementia who presented systemic inflammatory response syndrome is reported. This was attributed to bacteremia due to Staphylococcus cohnii ssp. urealyticus, which was grown on blood cultures originating from an infected pressure ulcer. The few cases of Staphylococcus cohnii infection reported in the literature consist of bacteremia relating to catheters, surgical prostheses, acute cholecystitis, brain abscess, endocarditis, pneumonia, urinary tract infection and septic arthritis, generally presenting a multiresistant profile, with nearly 90% resistance to methicillin. CONCLUSIONS The reported case is, to our knowledge, the first case of true bacteremia due to Staphylococcus cohnii subsp. urealyticus caused by an infected pressure ulcer. It shows that this species may be underdiagnosed and should be considered in the differential diagnosis for community-acquired skin infections. PMID:23538597

Soldera, Jonathan; Nedel, Wagner Luis; Cardoso, Paulo Ricardo Cerveira; d'Azevedo, Pedro Alves



ACTH-independent hyperadrenocorticism due to food-dependent hypercortisolemia in a dog: a case report.  


In addition to adrenocortical tumours, aberrant expression of functional hormone receptors in the adrenal cortex may cause adrenocorticotrophic hormone (ACTH)-independent hyperadrenocorticism. Here we report on a 6 year old Vizsla dog in which ACTH-independent hyperadrenocorticism was associated with meal-induced hypercortisolemia. Diagnosis was based on history, physical findings, biochemical changes, and elevation of the urinary corticoid/creatinine ratio (UCCR) on two consecutive days (11 and 8.3 x 10(-6), reference range <8.3 x 10(-6)). Basal plasma ACTH concentration was found by repeated measurements to be suppressed (<1 ng/L, reference range 5-85 ng/L) and administration of corticotrophin releasing hormone (CRH) resulted in a minor increase (to 6 ng/L), consistent with ACTH-independent hyperadrenocorticism. Ultrasonography and computed tomography revealed two uniformly enlarged adrenal glands. Magnetic resonance imaging of the pituitary area showed a non-enlarged, normally enhancing pituitary gland. Based on these results, expression of functional aberrant adrenocortical receptors was suspected and the possibility of food-dependent hyperadrenocorticism was explored. The UCCR on two separate occasions rose from 11 and 8 x 10(-6) before a meal to 25 and 23 x 10(-6) at 3 h after ingestion of a meal, respectively. There was a corresponding increase in plasma cortisol concentration (from 90 to 150 nmol/L), while plasma ACTH concentration remained low or undetectable. Consistent with the diagnostic criteria for food-dependent hyperadrenocorticism in humans, administration of octreotide completely prevented meal-induced hypercortisolemia. The dog was treated successfully with the cortisol-synthesis-inhibitor trilostane (2h before meal), and at 26 months after the final diagnosis the dog is still in good condition. The combination of (1) low plasma ACTH concentration in the absence of an adrenocortical tumour, (2) an increase of >100% in UCCR after ingestion of a meal, (3) prevention of the meal-induced increase in plasma cortisol concentration by octreotide, and (4) reversal of signs of hypercortisolism by administration of trilostane a few hours before the meal led to the diagnosis of food-dependent hyperadrenocorticism in this dog. PMID:17572120

Galac, S; Kars, V J; Voorhout, G; Mol, J A; Kooistra, H S



Saturn's Ring Particles: Lossier than Previously Thought  

NASA Astrophysics Data System (ADS)

We apply a sophisticated ray-tracing code to dynamically realistic computer simulations of a patch in Saturn's rings to model the elastic and photometric properties of the ring particles. In particular, we continue our efforts to reproduce the characteristics (i.e., the orbital phase, the shape, and amplitude) of the azimuthal brightness variation in Saturn's A ring that has long been known (eg., Dones and Porco 1989) to be caused by self-gravity wakes in the rings. In earlier dynamical simulations, we assumed a particle velocity-dependent coefficient of restitution, epsilon, appropriate for smooth ice spheres (Supulver et al., 1995), and failed to match the asymmetry amplitude by factors of several. We previously noted as the likely cause of this discrepancy the abundance of small particles between the wakes in the simulations and the consequent low wake/inter-wake contrast in optical depth. We report new results in which we match the overall ring brightness and the asymmetry amplitude and shape, as observed in low-solar-phase Cassini and Voyager images, by assuming a velocity-dependent restitution law that yields an epsilon 2.5 times lower at the relative velocities of the inter-wake particles than that expected for smooth ice spheres. We simultaneously find a particle albedo and phase function consistent with those deduced from photometric analyses of Cassini images taken on approach to Saturn (Porco et al., 2005). These results suggest that the ring particle collisions in Saturn's A ring are considerably more lossy than previously expected, a result very likely due to particle surface roughness (Borderies et al., 1984). Dones, L. and Porco, C. 1989. B.A.A.S. 21, 929; Supulver, et al. 1995. Icarus 113, 188; Porco, C.C., et al. 2005. Science 307, 1226; Borderies, N. et al. 1984. Planetary Rings, ed. R. Greenberg, A. Brahic, p. 713.

Porco, Carolyn C.; Weiss, J. W.; Richardson, D. C.; Dones, L.



Coronary artery stent mimicking intracardiac thrombus on cardiac magnetic resonance imaging due to signal loss: case report.  


Since the introduction of percutaneous coronary intervention for coronary artery disease, thousands of patients have been treated with the implantation of coronary stents. Moreover, several of the patients with coronary stent undergo cardiac magnetic resonance (CMR) imaging every year. This case report is of a 77-year-old man who was previously treated with the implantation of a coronary stent in the left circumflex artery. He underwent CMR imaging, which revealed a process 14×21 mm in the left atrium. Cardiac contrast computed tomography did not demonstrate any cardiac pathology. While the signal loss on MRI associated with implanted metallic devices is known, we report a case where an implanted coronary stent in the left circumflex artery led to an intracardiac signal loss mimicking intracardiac thrombus/tumor. PMID:22495236

Qayyum, Abbas Ali; Vejlstrup, Niels Grove; Ahtarovski, Kiril Aleksov; Kofoed, Klaus Fuglsang; Kastrup, Jens



Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature  

PubMed Central

Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0?mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children is summarized. Review of the literature showed that the prevalence of this condition could be underestimated in the neonatal period and in Prader-Willi syndrome. Isolated ACTH deficiency occurs in older children as well as in neonates.

Torchinsky, Michael Y.; Wineman, Robert; Moll, George W.



Abdominal compartment syndrome due to a giant multilobulated ovarian serous cystadenoma. Case report and review of the literature.  


The Authors report a case of abdominal compartment syndrome due to a giant ovarian serous cystadenoma. Despite of the relief of intra-abdominal hypertension (IAP: 16 mmHg), mild symptomatology (clinostatic dyspnea) lead to defer the emergency surgical treatment; after CT scan of abdomen and pelvis was performed a resection en bloc of the cystic mass, oophorectomy and cholecystectomy. However it seems advisable to perform an emergency laparotomy in patients with abdominal compartment syndrome (ACS) grade II when presenting as an acute abdomen. PMID:22615039

Merlicco, Domenico; Roggia, Gerardo; Lombardi, Massimo; Lattanzio, Lucia; Marzaioli, Rinaldo; Nacchiero, Michele


A previously unreported etiology of trigger toe.  


Trigger toe is a rare entity, with only a few cases reported in the literature. It is usually seen in ballet dancers as a result of compression of the flexor hallucis longus tendon in the tarsal tunnel beneath the medial malleolus. We report a case of trigger toe due to a constricting lesion on the extensor hallucis longus tendon. PMID:16868331

Ozkan, Korhan; Goksan, Bora; Ozkan, Feyza Unlu; Bilsel, Kerem; Bilgic, Bilge; Ciftci, Feyyaz


Beckwith-Wiedemann syndrome with placental chorangioma due to H19-differentially methylated region hypermethylation: a case report.  


Beckwith-Wiedemann syndrome (BWS) is a common overgrowth syndrome that involves abdominal wall defects, macroglossia, and gigantism. It is sometimes complicated by placental tumor and polyhydramnios. We report a case of BWS, prenatally diagnosed with ultrasonography. A large and well-circumscribed tumor also existed on the fetal surface of the placenta, which was histologically diagnosed as chorangioma after delivery. Polyhydramnios was obvious and the fetal heart enlarged progressively during pregnancy. Because the biophysical profiling score dropped to 4 points at 33 weeks of gestation, we carried out cesarean section. By epigenetic analysis, H19-differentially methylated region hypermethylation was observed in the placental tumor, normal placental tissue, and cord blood mononuclear cells. This is the first report of BWS with placental tumor due to H19-differentially methylated region hypermethylation. PMID:21955307

Aoki, Aiko; Shiozaki, Arihiro; Sameshima, Azusa; Higashimoto, Ken; Soejima, Hidenobu; Saito, Shigeru



A comparison of the copper sensitivity of two economically important saltwater mussel species and a review of previously reported copper toxicity data for mussels: important implications for determining future ambient copper saltwater criteria in the USA.  


Saltwater bivalves of the genus Mytilus are among the most copper sensitive taxa listed in both the current and recently proposed U.S. EPA ambient saltwater copper criteria documents. The copper saltwater quality criteria are somewhat unique in that the criteria were set specifically to protect Mytilus. However, there is considerable uncertainty in the reported taxonomy of Mytilus species in the criteria database and it has recently been demonstrated the copper toxicity to M. galloprovincialis is dependent on the organic matter content of the test water. A review of the toxicity and biogeography literature was conducted to rationalize the existing criteria database. Elimination of some data is suggested due to the uncertainty of test organism genotype. Moreover, due to the lack of reported dissolved organic matter content of the test waters in tests included in the criteria database, it is impossible to determine if the difference in species mean acute values reported in the criteria documents for Mytilus was due to differences in water chemistry or differences in species sensitivity. Experiments were designed and conducted with M. galloprovincialis and M. edulis (genetically confirmed) to determine if copper toxicity is a function of organic matter content for these two species and if there is a significant difference in species copper sensitivity. Results showed that copper toxicity is a function of organic matter concentration for both species and copper sensitivity of each species was statistically similar. Results support the normalization of the saltwater copper criteria database with respect to dissolved organic matter when developing ambient saltwater copper criteria. The USEPA toxicity database would benefit from future testing of M. trossulus and M. californianus. PMID:19065681

Arnold, W Ray; Cotsifas, Jeffrey S; Smith, D Scott; Le Page, Steven; Gruenthal, Kristen M



No Previous Public Services Required  

ERIC Educational Resources Information Center

|In 2007, the Supreme Court heard a case that involved the question of whether a school district could be required to reimburse parents who unilaterally placed their child in private school when the child had not previously received special education and related services in a public institution ("Board of Education v. Tom F."). The Court's 4-4…

Taylor, Kelley R.



Femoral component revision with use of impaction bone-grafting and a cemented polished stem: a concise follow-up, at fifteen to twenty years, of a previous report.  


We previously reported our results for thirty-three consecutive femoral component revisions with impaction bone-grafting, performed with the X-change femoral revision system and a cemented polished Exeter stem, at a minimum of eight years of follow-up. The present updated study shows the results after fifteen to twenty years. One stem was revised again for mechanical reasons during a rerevision of an acetabular cup. The probability of survival at seventeen years was 96% (95% confidence interval [CI], 72% to 99%) with a femoral rerevision for any reason as the end point and 100% (95% one-sided CI, 69% to 100%) with rerevision for aseptic loosening as the end point. The average subsidence was 3 mm and stable relative to our previous report. Although three early femoral fractures occurred after this surgery, in this update no additional fractures were seen. In conclusion, the probability of survival of femoral component revisions with impaction bone-grafting and a cemented polished stem was excellent at a mean of seventeen years. PMID:23224393

te Stroet, Martijn A J; Gardeniers, Jean W M; Verdonschot, Nico; Rijnen, Wim H C; Slooff, Tom J J H; Schreurs, B Willem



Ascitic fluid due to type II herpes simplex virus infection: report of a case with immunocytochemical confirmation.  


Herpes simplex virus (HSV) infection is usually observed in the oral cavity and external genitals, and HSV peritonitis is extremely rare. Herein, we report a case of type II HSV peritonitis successfully diagnosed by ascitic cytology. A 66-year-old Japanese man, who had been treated with steroid inhalation for 5 years due to chronic obstructive pulmonary disease, was suspected to have acute cholecystitis. Laparoscopic cholecystectomy and intraoperative cytological examination of ascitic fluid were performed. Cytological study of ascitic fluid revealed that abundant granular cell debris, degenerative cells and apoptotic bodies were present, as well as some single or multinucleated cells with ground glass nuclei. However, vivid mesothelial cells were rarely seen. Immunocytochemical staining for type II HSV was positive in single or multinucleated cells with ground glass nuclei. Therefore, a diagnosis of type II HSV peritonitis was made. This is the first reported case of type II HSV peritonitis successfully diagnosed by ascitic cytology. This report highlights that the presence of abundant cell debris, degenerative cells and apoptotic bodies, and the absence of vivid mesothelial cells are the key cytological findings to suspect HSV peritonitis, and the diagnosis can be confirmed by careful surveillance for characteristic nuclear findings of single or multinucleated cells. The frequency of opportunistic infection is increased because of the increased numbers of iatrogenic immunocompromised patients as seen in this case, therefore, cytological examination is a useful method for early detection of the causative agent of peritonitis including HSV. PMID:22282082

Yoshida, Keiko; Miyahira, Yoshimitsu; Ishida, Mitsuaki; Iwai, Muneo; Kagotani, Akiko; Arita, Namie; Iwamoto, Nozomi; Takikita, Mikiko; Kojima, Fumiyoshi; Okabe, Hidetoshi



Recalls of foods and cosmetics due to microbial contamination reported to the U.S. Food and Drug Administration.  


In the U.S., food product recalls serve as an important intervention in stemming the consumption of food products contaminated with infectious disease agents. We summarize the number and nature of foods and cosmetics recalled as a result of microbial contamination reported to the U.S. Food and Drug Administration (FDA) for the period 1 October 1993 through 30 September 1998. During this period, microbial contamination of food and cosmetic products was the leading cause for recalls, accounting for a total of 1,370 recalls (36% of all products recalled). Listeria monocytogenes accounted for the greatest number of food products recalled because of microbial contamination, whereas Pseudomonas aeruginosa was the most common microbe associated with recalls of cosmetic products. Dairy products, followed by seafood and pastry items, were the types of products most often associated with recalls due to microbial contamination. The FDA was the entity most often responsible for detecting microbial contamination of foods and cosmetics (33% of all such recalls), followed by state regulatory agencies (24%), and manufacturers/retailers (21%). Nineteen percent of recalls were associated with at least one reported case of illness. Salmonella was the pathogen most often implicated in reports of illness associated with these recalled products. PMID:10945589

Wong, S; Street, D; Delgado, S I; Klontz, K C



When algorithms falter: a case report of a very small melanoma excised due to the dermatoscopic "ugly duckling" sign.  


We present a case report of a 3.5 mm diameter superficial spreading melanoma on the upper back of a 27-year-old woman, signed out as Clark level 2, Breslow thickness 0.2 mm with regression to 0.45 mm. The patient, with Fitzpatrick type 1 skin and minimal actinic damage, had presented for a routine skin check with no previous history of skin cancers. At the age of 17 she had received chemotherapy and radiotherapy for Ewing's sarcoma of the right hip with pulmonary metastases. The skin lesion was assessed as dermatoscopically symmetrical and was not predicted as a melanoma by any algorithmic method. The provisional diagnosis of melanoma was made on the basis that this lesion was completely different in dermatoscopic pattern to her other nevi, a dermatoscopic "ugly duckling" lesion. We draw attention to the recently established link between defects in the STAG2 gene and Ewing's sarcoma, glioblastoma and melanoma. PMID:23785647

Inskip, Mike; Magee, Jill; Weedon, David; Rosendahl, Cliff



Massive hemoptysis and complete unilateral lung collapse in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome: a case report  

PubMed Central

Background We report an extremely rare case of massive hemoptysis and complete left-sided lung collapse in pregnancy due to pulmonary tuberculosis in a health care worker with good maternal and fetal outcome. Case presentation A 33-year-old human immuno deficiency virus seronegative African health care worker in her fourth pregnancy with two previous second trimester miscarriages and an apparently healthy daughter from her third pregnancy presented coughing up copious amounts of blood at 18 weeks and two days of gestation. She had a cervical suture in situ for presumed cervical weakness. Computed tomography of her chest showed complete collapse of the left lung; subsequent bronchoscopy was apparently normal. Her serum ?-human chorionic gonadotropin, tests for autoimmune disease and echocardiography were all normal. Her lung re-inflated spontaneously. Sputum for acid alcohol fast bacilli was positive; our patient was commenced on anti-tuberculosis medication and pyridoxine. At 41 weeks and three days of pregnancy our patient went into spontaneous labor and delivered a live born female baby weighing 2.6 kg with APGAR scores of nine and 10 at one and five minutes respectively. She and her baby are apparently doing well about 10 months after delivery. Conclusion It is possible to have massive hemoptysis and complete unilateral lung collapse with spontaneous resolution in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome.



Molecular characterization of twelve patients affected by homocystinuria due to cystathionine beta-synthase deficiency: Report of two novel mutations  

SciTech Connect

Cystathionine beta-synthase (CBS) deficiency, an autosomal recessive disorder of sulfur amino acid metabolism (MIM 236200), causes homocystinuria and a clinical presentation involving eye, skeleton, central nervous and vascular systems. Less that 20 mutations of CBS gene have been characterized so far, G919A and T833C being the most commonly reported (36 and 9 out of 62 identified alleles, respectively). We have investigated 12 patients (10 Italians, 1 Jewish-French, 1 Italian-Spanish) and one allele of each patient has been characterized at least. T833C has been found in 7 independent alleles (6 in heterozygosity and 1 in homozygosity); G9191A, the most common mutation in Irish and North-European patients, has never been detected in the present survey. C341T (previously reported in 1 Irish-German patient only) has been found in 3 patients in heterozygosity. Besides the two new mutations previously described, i.e. G374A and C770T, we have identified two additional new missense mutations: C869T, a transition in exon 8, causing a P290L amino acid substitution, and C262T, a transition in exon 2, causing a P88S amino acid change. In 4 additional Italian patients, none of the known mutations have been detected; in one of them, a 50 bp deletion has been found in intron 11. The deletion involves the entire sequence of the second element of a tandem repeat. Conclusions: T833C is the most common panethnic mutation; C341T is relatively widespread, while G919A appears to be restricted to North-European patients. Exons 3 and 8 of the CBS gene are the hot-spots of mutational events leading to CBS deficiency.

Sebastio, G.; Sperandeo, M.P.; Panico, M. [Federico II Univ. of Naples (Italy)] [and others



Arthroscopic decompression of an entrapped suprascapular nerve due to an ossified superior transverse scapular ligament: a case report  

PubMed Central

Introduction Suprascapular neuropathy is an uncommon cause of shoulder pain and weakness and therefore is frequently misdiagnosed. As a consequence, misdiagnosis can include inappropriate conservative treatment or unsuccessful surgical procedure. Case presentation A rare case is reported of a 54-year-old woman who suffered from suprascapular nerve entrapment syndrome. The patient was subjected to arthroscopy of the left shoulder, where a compression of the suprascapular nerve due to an ossified superior transverse scapular ligament was diagnosed. The arthroscopic release of the suprascapular nerve brought relief from pain, weakness and atrophy of the supraspinatus and infraspinatus muscles. Conclusion Arthroscopic decompression of the entrapped suprascapular nerve is technically challenging, but less invasive and potentially a more effective way to treat suprascapular neuropathy, as it may provide a more rapid recovery, especially in the rare case that the nerve is depressed by an ossified superior transverse scapular ligament.

Sergides, Neoptolemos N; Boukoros, Euangelos; Papagiannopoulos, George



First U.S. report of shellfish harvesting closures due to confirmed okadaic acid in Texas Gulf coast oysters.  


Between March 7 and April 12, 2008, several bay systems on the east (Gulf of Mexico) coast of Texas, USA were closed to the harvesting of oysters (Crassostrea virginica) due to the presence of the DSP (Diarrheic Shellfish Poisoning) toxin okadaic acid in excess of the 20 microg/100 g tissue FDA regulatory guidance level. This was the first shellfish harvesting closure due to the confirmed presence of DSP toxins in US history. Light microscopic cell counts were performed on water samples collected from numerous sampling sites along the Texas Gulf coast where shellfish harvesting occurs. Ultra performance liquid chromatography, electrospray ionization, selected reaction monitoring, mass spectrometry (UPLC/ESI/SRM/MS) was used to detect DSP toxins in oysters. The closures were associated with an extensive bloom of the dinoflagellate Dinophysis cf. ovum. Only okadaic acid (OA) and OA acyl esters were found in shellfish tissues (max. OA eq. levels 47 microg/100 g tissue). OA was also confirmed in a bloom water sample. No illnesses were reported associated with this event. DSP toxins now add to a growing list of phycotoxins, which include those responsible for PSP (paralytic shellfish poisoning), NSP (neurotoxic shellfish poisoning), and ASP (amnesic shellfish poisoning) which must now be monitored for in US coastal waters where shellfish are harvested. PMID:20060850

Deeds, Jonathan R; Wiles, Kirk; Heideman, Gary B; White, Kevin D; Abraham, Ann



Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report.  


Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were "irritability, regressive behavior, apathy, crying and truancy" which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg's sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5?mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg's sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3?months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6?months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal symptoms lacking a clear etiology may be rare manifestation of vitamin B12 and/or folate deficiency in children and adolescents and be potentially amenable to treatment. PMID:22726236

Tufan, Ali Evren; Bilici, Rabia; Usta, Genco; Erdo?an, Ayten



Thyroid carcinoma and primary amenorrhea due to Mayer-Rokitansky-K?ster-Hauser syndrome: a case report  

PubMed Central

Introduction This case report describes an association between an exceptionally rare congenital anomaly and differentiated thyroid carcinoma. Mayer-Rokitansky-Küster-Hauser syndrome is characterized by vaginal aplasia associated with other Müllerian duct abnormalities. Its penetrance varies, as does the involvement of other organs. The association with thyroid carcinoma appears to be exceptionally rare, and warrants further attention. Case presentation We present the case of a 19-year-old Caucasian woman with amenorrhea and thyroid disease, with an unusually late diagnosis of gynecological abnormality. Management of her amenorrhea included investigation for congenital anomalies, including Mayer-Rokitansky-Küster-Hauser syndrome. Endocrine evaluation included a detailed analysis of sex hormone levels and thyroid function. The results of a physical examination and neck ultrasonography revealed abnormalities of the thyroid gland, which led to a diagnosis of thyroid cancer. To the best of our knowledge, thyroid cancer has not previously been reported in association with Mayer-Rokitansky-Küster-Hauser syndrome. However, genetic links between Mayer-Rokitansky-Küster-Hauser syndrome and thyroid cancer have not been investigated. The association may therefore be coincidental. Conclusions All women with primary amenorrhea should undergo complete investigation of the genital tract and the endocrine axis. Careful examination of the thyroid gland is recommended.



Use of previous office hysteroscopy in IVF  

Microsoft Academic Search

Introduction: Infertility related to the uterine cavity is the etiologic factor most commonly found in the 10% to 15% of the cases. Hysterosalpingography (HSG) is the routine evaluation technique of the uterine cavity to determinate congenital or acquired alterations; normally when we suspect uterine pathology by HSG we proceed to do a hysteroscopy. Previous reports in the existing literature have

A. Morales; L. Sordia; E. Rosales; O. Vidal; M. Merino; M. Garc??a; D. Sald??var; J. Vázquez; L. Ben??tez; E. de la Fuente; G. Pons; G. Sáenz; G. Félix; H. Sierra; A. Soria; E. Treviño; M. Luna



Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report  

SciTech Connect

This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken.

Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W. [Science and Engineering Associates, Inc., Albuquerque, NM (United States)



Fatal Mycobacterium colombiense/cytomegalovirus coinfection associated with acquired immunodeficiency due to autoantibodies against interferon gamma: a case report  

PubMed Central

Background Reports of acquired immunodeficiency due to autoantibodies against interferon gamma in the adult population are increasing. The interleukin-12-dependent interferon-gamma axis is a major regulatory pathway of cell-mediated immunity and is critical for protection against a few intracellular organisms, including non-tuberculous mycobacteria and Salmonella spp. We report the first case of a fatal disseminated Mycobacterium colombiense/cytomegalovirus coinfection in an adult woman associated with the acquisition of autoantibodies against interferon-gamma. Case presentation A 49-year-old woman, born to nonconsanguineous parents in Laos, but who had lived in Canada for the past 30 years, presented with a 1-month history of weight loss, fatigue, cough, and intermittent low-grade fever. A thoracic computed tomography scan revealed an 8 × 7 cm irregular mass impacting the right superior lobar bronchus along with multiple mediastinal and hilar adenopathies. On the fourth day of admission, the patient developed fever with purulent expectorations. Treatment for a post-obstructive bacterial pneumonia was initiated while other investigations were being pursued. Almost every culture performed during the patient’s hospitalization was positive for M. colombiense. Given the late presentation of symptoms - at the age of 49 years - and the absence of significant family or personal medical history, we suspected an acquired immunodeficiency due to the presence of anti-interferon-gamma autoantibodies. This was confirmed by their detection at high levels in the plasma and a STAT1 phosphorylation assay on human monocytes. The final diagnosis was immunodeficiency secondary to the production of autoantibodies against interferon-gamma, which resulted in a post-obstructive pneumonia and disseminated infection of M. colombiense. The clinical course was complicated by the presence of a multiresistant Pseudomonas aeruginosa post-endobronchial ultrasound mediastinitis, cytomegalovirus pneumonitis with dissemination, and finally, susceptible P. aeruginosa ventilator-associated pneumonia with septic shock and multiple organ failure, leading to death despite appropriate antibacterial and anti-mycobacterial treatment. Conclusions Although rare, acquired immunodeficiency syndromes should be considered in the differential diagnosis of patients with severe, persistent, or recurrent infections. Specifically, severe non-tuberculous mycobacteria or Salmonella infections in adults without any other known risk factors may warrant examination of autoantibodies against interferon-gamma because of their increasing recognition in the literature.



Dropped-head syndrome due to steroid responsive focal myositis: a case report and review of the literature.  


Isolated severe weakness of the paraspinal musculature, either at the cervical level leading to a "dropped head syndrome" or at the thoracic level leading to a "bent-spine syndrome", is a rare disorder. Etiologically it may be present in a variety of neurological diseases including Parkinson's disease, multiple system atrophy, neuromuscular or motor neuron diseases, as well as non-inflammatory, inflammatory, dystrophic or metabolic myopathies. We present a previously healthy 74-year-old man with a 2-month history of progressive difficulty in lifting his chin off his chest. Magnetic resonance imaging and skeletal muscle biopsy revealed an isolated myositis of the neck extensor and trapezius muscles, which responded well to steroid therapy. This case and other rare reports obtained from a systematic review of the literature indicate that in a subgroup of patients "dropped head syndrome" or "bent spine syndrome" is caused by a myositis, which emphasizes the necessity to obtain a MRI examination, as well as a muscle biopsy to diagnose this potentially treatable disease. PMID:17964603

Kastrup, Andreas; Gdynia, Hans-Jürgen; Nägele, Thomas; Riecker, Axel



Secondary recurrent miscarriage is associated with previous male birth.  


Secondary recurrent miscarriage (RM) is defined as three or more consecutive pregnancy losses after delivery of a viable infant. Previous reports suggest that a firstborn male child is associated with less favourable subsequent reproductive potential, possibly due to maternal immunisation against male-specific minor histocompatibility antigens. In a retrospective cohort study of 85 cases of secondary RM we aimed to determine if secondary RM was associated with (i) gender of previous child, maternal age, or duration of miscarriage history, and (ii) increased risk of pregnancy complications. Fifty-three women (62.0%; 53/85) gave birth to a male child prior to RM compared to 32 (38.0%; 32/85) who gave birth to a female child (p=0.002). The majority (91.7%; 78/85) had uncomplicated, term deliveries and normal birth weight neonates, with one quarter of the women previously delivered by Caesarean section. All had routine RM investigations and 19.0% (16/85) had an abnormal result. Fifty-seven women conceived again and 33.3% (19/57) miscarried, but there was no significant difference in failure rates between those with a previous male or female child (13/32 vs. 6/25, p=0.2). When patients with abnormal results were excluded, or when women with only one previous child were considered, there was still no difference in these rates. A previous male birth may be associated with an increased risk of secondary RM but numbers preclude concluding whether this increases recurrence risk. The suggested association with previous male birth provides a basis for further investigations at a molecular level. PMID:21129780

Ooi, Poh Veh; Russell, Noirin; O'Donoghue, Keelin



Invasive infections due to Candida norvegensis and Candida inconspicua: report of 12 cases and review of the literature.  


Abstract Candida inconspicua and Candida norvegensis are two closely related species rarely involved in invasive infections. The purpose of this study was to depict the epidemiologic and clinical characteristics of candidemia due to these emerging fluconazole less susceptible species. A retrospective analysis of the epidemiology of C. inconspicua and C. norvegensis during the period 2006-2010 was initiated in six French University hospitals. From this, demographics, clinical, diagnostic and therapeutic data of C. inconspicua or C. norvegensis candidemia were recorded and compared to the observations reported in the literature. C. inconspicua was more frequently isolated compared to C. norvegensis (ratio 2.6) but from the same preferential body sites: mainly digestive (56.4% and 48.37%, respectively, for C. inconspicua and C. norvegensis) and respiratory (26% and 28.2%, respectively). Thirteen cases of candidemia were recorded and five additional cases were found in the literature. Hematogical malignancy was the main underlying disease (n = 12). Associated factors were the presence of a vascular catheter (n = 18), broad-spectrum antibiotics (n = 15), and neutropenia (n = 14). In 13 cases (72%), prior colonization was noted before the candidemia diagnosis. Combining the results for the two species, Minimal Inhibitory Concentrations (MIC50) of amphotericin B, fluconazole, voriconazole and caspofungin were 0.125, 48, 0.25, and 0.19 mg/l, respectively. These two species must be added to the growing list of emerging Candida species poorly susceptible to fluconazole. PMID:23855412

Guitard, Juliette; Angoulvant, Adéla; Letscher-Bru, Valérie; L'ollivier, Coralie; Cornet, Muriel; Dalle, Frédéric; Grenouillet, Frédéric; Lacroix, Claire; Vekhoff, Anne; Maury, Eric; Caillot, Denis; Charles, Pierre Emmanuel; Pili-Floury, Sébastien; Herbrecht, Raoul; Raffoux, Emmanuel; Brethon, Benoit; Hennequin, Christophe



Obstructive uropathy due to prolapsed lower ureters and bladder in patients with severe procidentia: A report of two cases  

PubMed Central

INTRODUCTION Pelvic organ prolape is not uncommon in multi-parous or elderly women. It is one of the rare but important causes of obstructive uropathy. Herein, we report two cases of severe procidentia that were referred with obstructive uropathy due to prolapsed bladder and ureters. PRESENTATION OF CASE The first case was a 78-year-old woman, with severe pelvic organ prolape and secondary bilateral hydroureteronephrosis and post-renal failure. She was treated successfully by bilateral nephrostomy insertion and then pessary insertion. The second case was a 75-year-old woman who referred with the same presentation, but treated surgically with burch colposuspention and synchronous bilateral ureteral stent insertion. DISCUSSION Pelvic organ prolapse is not uncommon in old women. In addition to physical problems of procidentia, it may cause acute renal failure (ARF), chronic renal failure (CRF), and finally end stage renal disease (ESRD) if undiagnosed. CONCLUSION In every aged female case with obstructive uropathy and/or bilateral hydroureteronephrosis with unknown causes, gynecologic examination should be performed for early detection of possible pelvic organ prolapse. Appropriate management is necessary to prevent renal failure from uterine prolapse (UP).

Moslemi, Mohammad Kazem; Abedinzadeh, Mehdi; Nazari, Alireza



Pulmonary thrombosis associated with antidiuretic hormone replacement therapy due to secondary diabetes insipidus after traumatic brain injury: A case report  

PubMed Central

INTRODUCTION Diabetes insipidus is a well-recognized complication of traumatic brain injury. The majority of patients with post-traumatic diabetes insipidus will require antidiuretic hormone (ADH) replacement therapy and tend to show dehydration. On the other hand, some negative effects of ADH on blood coagulation, such as increased platelet cohesion and the promotion of von Willebrand factor release, have also been reported. However, the incidence of thrombosis during antidiuretic hormone replacement therapy is disputed. PRESENTATION OF CASE A case of pulmonary thrombosis associated with ADH replacement therapy due to secondary diabetes insipidus after traumatic brain injury is presented here. DISCUSSION In our case, there were three factors that may have contributed to the observed thrombosis (dehydration, bed rest for a long period and ADH replacement therapy). CONCLUSION We believe that controlling urinary output and monitoring urinary and serum osmotic pressure are necessary for the management for diabetes insipidus patients after traumatic brain injury. In particular, we must carefully monitor the management of such patients during antidiuretic hormone replacement therapy.

Naito, Kiyohito; Watari, Taiji; Yasunari, Eisuke; Yamano, Miki; Mogami, Atsuhiko; Obayashi, Osamu; Kaneko, Kazuo



Identifying questions in the American Association of Swine Veterinarian's PRRS risk assessment survey that are important for retrospectively classifying swine herds according to whether they reported clinical PRRS outbreaks in the previous 3 years.  


The American Association of Swine Veterinarian's (AASV) Production Animal Disease Risk Assessment Program (PADRAP) is a web-based program that offers a set of risk assessment surveys being used by veterinarians who are members of the AASV. Members use PADRAP to help producers systematically assess risk factors that may be associated with clinical outcomes. As assessments are performed the completed surveys are added to the dataset maintained at the Iowa State University College of Veterinary Medicine. One of the surveys included in PADRAP is the porcine reproductive and respiratory syndrome (PRRS) Risk Assessment for the Breeding Herd. The aim of the study was to categorize questions in version 2 of the PRRS Risk Assessment for the Breeding Herd survey as important or unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. The results elucidate the relative importance of risk factors and areas of risk factors for clinical outcomes and removing unimportant questions may reduce the time required to complete the survey without affecting the quality of information obtained. Surveys from 896 sow herd sites in the United States and Canada completed between March 2005 and March 2009 were included in the analysis. The survey contained a large number of questions with a complex correlation structure among the questions. Responses for several questions were dependent upon responses to others. To address these issues, an approach was developed using a series of statistical methods including random forest, principle component analysis, logistic regression and receiver operating characteristic (ROC) analysis to classify the herds using the questions in the survey as explanatory variables. Questions were ranked by importance and systematically excluded from least important to most important. The questions excluded, without significantly affecting the performance of the model for classifying herds were identified as unimportant. Thirty-eight of the 127 questions analyzed were identified as unimportant for classifying herds according to whether they reported clinical PRRS outbreaks in the previous 3 years. Sections of the survey where a large number of questions were identified as unimportant included (1) entry of semen into the breeding herd and (2) transportation of live animals. Sections with a high percentage of questions identified as unimportant included (1) characteristics of the site, (2) disposal of dead animals and waste management and (3) employee and visitors. PMID:22475927

Holtkamp, Derald J; Lin, Hui; Wang, Chong; O'Connor, Annette M



Surgical management of previously coiled intracranial aneurysms.  


With the increased use of endovascular therapy in the treatment of ruptured intracranial aneurysms the number of incompletely coiled aneurysms presenting for further management either due to lack of universal durability of this method or due to recurrent rupture is increasing. Since 1998, seven patients with previously coiled aneurysms underwent surgical obliteration of refractory or recurrent lesions. All patients were recorded in a prospective registry. Indications for surgery, the surgical techniques used and patient outcome were analysed. Surgery of recurrent or residual aneurysms resulted in a good outcome in four and a moderate outcome in one patient. Despite early clipping after recurrent haemorrhage after coil occlusion one of the two patients died, the other one had a moderate outcome. Our experience indicates that good results are obtainable, although technical challenges are frequently encountered. PMID:12820757

Deinsberger, W; Mewes, H; Traupe, H; Boeker, D K



Laparoscopic cholecystectomy due to acute calculous cholecystitis in 16 weeks' in vitro fertilization and embryo transfer pregnancy: report of the first case.  


The most common cases of acute abdomen during pregnancy are acute appendicitis followed by acute cholecystitis. The case presented is a 33-year-old patient in 16 weeks' in vitro fertilization and embryo transfer pregnancy who developed acute cholecystitis. Previously there were two unsuccessful cycles, one complicated with ovarian hyperstimulation syndrome. Due to clinical deterioration during intravenous antibiotic therapy laparoscopic cholecystectomy was performed and acute cholecystitis found. The postoperative course was uneventful. During the first 24 h tocolysis with intravenous fenoterol in addition to peroral atenolol 2 ? 50 mg was administered. Postoperative course was uneventful with further normal pregnancy. Elective cesarean section was made in term pregnancy (39 weeks) with singleton with Apgar 10/10. Current guidelines do not recommend prophylactic tocolysis in pregnant population with acute abdomen but there is no mention of the IVF-ET subpopulation of patients. Also, there are no guidelines for thromboprophylaxis in such patients with increased risk of thromboembolic accidents. To our knowledge this is the first case report of a laparoscopic cholecystectomy during IVF-ET gestation. PMID:23298928

Augustin, G; Vrcic, H; Zupancic, B


Patellar instability with increased knee flexion due to lateral femoral condyle distal dysplasia: a report of two cases.  


We present two case reports with clinical and radiological assessment of the anatomical features at the distal lateral end of trochlea and femur in patients with patellar instability in higher knee flexion and how these findings could possibly be involved in the genesis of this rare type of patellar instability. Both patients underwent several (nine and seven) surgical procedures, but the patellar instability could not be successfully eliminated. Our hypothesis was that a short and flattened lateral distal condyle/trochlea may cause lateral patellar instability in higher flexion. We found considerable anatomical variations at the distal lateral femoral condyle and trochlea in both patients. Individually tailored surgical procedures were selected for each patient according to the documented variations and the previous operations. Our surgical interventions consisted of different components, such as osteotomy of the distal lateral femoral condyle/trochlea with lengthening and elevation, balancing of the medial and lateral patellar soft tissue structures, MPFL reconstruction, transposition of the medialised tibial tubercle and the patellar tendon back to lateral to the normal initial anatomical position. With these procedures, lateral patellar instability with increased flexion could be completely eliminated in both patients at the 1- and 2-year follow-up. Our experience of assessment and treatment of these patients let us conclude that variations of the distal lateral femoral condyle/trochlea morphology may be responsible for patellar instability with increased flexion. This is another type of patellar instability caused by distal condyle/trochlea dysplasia compared to the well known and often described types of patellar instability close to extension caused by proximal trochlea dysplasia. PMID:21440445

Biedert, Roland M



Minimally invasive presacral approach for revision of an Axial Lumbar Interbody Fusion rod due to fall-related lumbosacral instability: a case report  

PubMed Central

Introduction The purpose of this study was to describe procedural details of a minimally invasive presacral approach for revision of an L5-S1 Axial Lumbar Interbody Fusion rod. Case presentation A 70-year-old Caucasian man presented to our facility with marked thoracolumbar scoliosis, osteoarthritic changes characterized by high-grade osteophytes, and significant intervertebral disc collapse and calcification. Our patient required crutches during ambulation and reported intractable axial and radicular pain. Multi-level reconstruction of L1-4 was accomplished with extreme lateral interbody fusion, although focal lumbosacral symptoms persisted due to disc space collapse at L5-S1. Lumbosacral interbody distraction and stabilization was achieved four weeks later with the Axial Lumbar Interbody Fusion System (TranS1 Inc., Wilmington, NC, USA) and rod implantation via an axial presacral approach. Despite symptom resolution following this procedure, our patient suffered a fall six weeks postoperatively with direct sacral impaction resulting in symptom recurrence and loss of L5-S1 distraction. Following seven months of unsuccessful conservative care, a revision of the Axial Lumbar Interbody Fusion rod was performed that utilized the same presacral approach and used a larger diameter implant. Minimal adhesions were encountered upon presacral re-entry. A precise operative trajectory to the base of the previously implanted rod was achieved using fluoroscopic guidance. Surgical removal of the implant was successful with minimal bone resection required. A larger diameter Axial Lumbar Interbody Fusion rod was then implanted and joint distraction was re-established. The radicular symptoms resolved following revision surgery and our patient was ambulating without assistance on post-operative day one. No adverse events were reported. Conclusions The Axial Lumbar Interbody Fusion distraction rod may be revised and replaced with a larger diameter rod using the same presacral approach.



Heroin Addicts Reporting Previous Heroin Overdoses Also Report Suicide Attempts  

ERIC Educational Resources Information Center

|Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmo, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt…

Bradvik, Louise; Frank, Arne; Hulenvik, Per; Medvedeo, Alvaro; Berglund, Mats



Unusual Presentation of Lemierre's Syndrome Due to Fusobacterium nucleatum  

Microsoft Academic Search

We report a case of Lemierre's syndrome due to Fusobacterium nucleatum in a previously healthy 19-year-old male. This is the first case report of Lemierre's syndrome due to thrombophlebitis of the external jugular vein. The patient had a rapid clinical response to anticoagulation and antibiotics, as supported by anecdotal evidence.

Michael D. Williams; Caroline A. Kerber; Helen F. Tergin



Classification of organisms previously reported as the SP and Stewart-Letscher groups, with descriptions of Necropsobacter gen. nov. and of Necropsobacter rosorum sp. nov. for organisms of the SP group.  


To allow classification of bacteria previously reported as the SP group and the Stewart-Letscher group, 35 isolates from rodents (21), rabbits (eight), a dog and humans (five) were phenotypically and genotypically characterized. Comparison of partial rpoB sequences showed that 34 of the isolates were closely related, demonstrating at least 97.4 % similarity. 16S rRNA gene sequence comparison of 20 selected isolates confirmed the monophyly of the SP group and revealed 98.5 %-100 % similarity between isolates. A blast search using the 16S rRNA gene sequences showed that the highest similarity outside the SP group was 95.5 % to an unclassified rat isolate. The single strain, P625, representing the Stewart-Letscher group showed the highest 16S rRNA gene similarity (94.9-95.5 %) to members of the SP group. recN gene sequence analysis of 11 representative strains resulted in similarities of 97-100?% among the SP group strains, which showed 80 % sequence similarity to the Stewart-Letscher group strain. Sequence similarity values based on the recN gene, indicative for whole genome similarity, showed the SP group being clearly separated from established genera, whereas the Stewart-Letscher group strain was associated with the SP group. A new genus, Necropsobacter gen. nov., with only one species, Necropsobacter rosorum sp. nov., is proposed to include all members of the SP group. The new genus can be separated from existing genera of the family Pasteurellaceae by at least three phenotypic characters. The most characteristic properties of the new genus are that haemolysis is not observed on bovine blood agar, positive reactions are observed in the porphyrin test, acid is produced from (+)-L-arabinose, (+)-D-xylose, dulcitol, (+)-D-galactose, (+)-D-mannose, maltose and melibiose, and negative reactions are observed for symbiotic growth, urease, ornithine decarboxylase and indole. Previous publications have documented that both ubiquinones and demethylmenaquinone were produced by the proposed type strain of the new genus, Michel A/76(T), and that the major polyamine of representative strains (type strain not included) of the genus is 1,3-diaminopropane, spermidine is present in moderate amounts and putrescine and spermine are detectable only in minor amounts. The major fatty acids of strain Michel A/76(T) are C(14 : 0), C(16 : 0), C(16:1)?7c and summed feature C(14 : 0) 3-OH/iso-C(16 : 1) I. This fatty acid profile is typical for members of the family Pasteurellaceae. The G+C content of DNA of strain Michel A/76(T) was estimated to be 52.5 mol% in a previous investigation. The type strain is P709(T) (?= Michel A/76(T) ?= CCUG 28028(T) ?= CIP 110147(T) ?= CCM 7802(T)). PMID:20817838

Christensen, H; Korczak, B M; Bojesen, A M; Kuhnert, P; Frederiksen, W; Bisgaard, M



[Successful control of hyper-cortisolemia due to ACTH-producing thyroid carcinoid by laparoscopic bilateral adrenalectomy : a case report].  


A 22-year-old man was referred to our hospital because of facial edema and increasing body weight. Under the diagnosis of Cushing syndrome due to an adrenocorticotropic (ACTH)-producing thyroid tumor, thyroidectomy with regional lymph node dissection was performed. Histopathological diagnosis was thyroid carcinoid. In spite of the operation, serum ACTH and cortisol concentrations increased again due to mediastinal lymph node metastasis. His hyper-cortisolemia was resistant to drug therapy. Then, laparoscopic bilateral adrenalectomy was performed. After the operation, hyper-cortisolemia and clinical symptoms markedly improved. An additional chemotherapy is implemented because of new metastasis in the mediastinum lymph nodes. PMID:23945320

Kojima, Yuta; Kamimura, Noritaka; Yamamoto, Hayato; Murasawa, Hiromi; Okamoto, Akiko; Imai, Atsushi; Hatakeyama, Shingo; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Ohyama, Chikara



Transporter Associated with Antigen Processing Deficiency Syndrome: Case Report of an Adolescent with Chronic Perforated Granulomatous Skin Lesions Due to TAP2 Mutation.  


A previously unreported case of transporter associated with antigen processing (TAP) deficiency syndrome (with no parental consanguinity) due to a homozygous TAP2 mutation is presented. Characteristic nonhealing, chronic, ulcerative granulomatous leg lesions combined with recurrent otitis media and sinopulmonary infections led to this boy being diagnosed at 15 years old. The role of the dermatologist was crucial in making the correct diagnosis and thereby positively influencing the quality of life and life expectancy of this boy. PMID:23662797

Konstantinou, Paschalis; Kanariou, Maria; Giliani, Silvia C; Pantelidaki, Aikaterini; Kokolakis, Athanasios; Tosca, Androniki



Tenosynovitis due to Mycobacterium avium intracellulare and Mycobacterium chelonei : Report of two cases with review of the literature  

Microsoft Academic Search

Atypical mycobacteria can induce soft tissue infections such as tenosynovitis. We observed one case of finger flexor tendon tenosynovitis infected withMycobacterium avium intracellulare and one case of knee and ankle arthritis with lateral peroneal tendon tenosynovitis due toM. chelonei. In the first patient, a tenosynovectomy only was performed leading to resolution of the infection. The second patient was immunocompromised as

E. Toussirot; A. Chevrolet; D. Wendling



Specialty Compounding, LLC Issues Nationwide Voluntary Recall of All Lots of Unexpired Sterile Products Due to Reports of Adverse Events  

NASA Website

Specialty Compounding, LLC, a subsidiary of Peoples Pharmacy Inc., is voluntarily recalling all lots of sterile medications within expiry. The recall was initiated after reports of bacterial infection affecting 15 patients at two Texas hospitals, ...


First Case Report of Bloodstream Infection Due to a Candida Species Closely Related to the Novel Species Candida pseudorugosa  

PubMed Central

Candida pseudorugosa is a novel species closely related to Candida rugosa for which only one case has been reported. We report the first case of a bloodstream infection in humans caused by a Candida sp. closely related to C. pseudorugosa. We contribute evidence to show this organism as a potential human pathogen that may be misidentified by conventional methods, also pointing out its lower sensitivity to azoles and other antifungal agents.

Cordoba, Susana; Isla, Guillermina; Fernandez, Norma; Garcia, Susana; Mazza, Mariana; Murisengo, Omar Alejandro; Vivot, Walter; Szusz, Wanda; Davel, Graciela; Tiraboschi, Iris Nora; Bosco-Borgeat, Maria Eugenia



Recurrent Pericardial Effusion Due to Gunshot Wound of the Heart in a Hemodynamically Stable ChildA Case Report  

Microsoft Academic Search

A 12-year-old girl presented with recurrent pericardial effusion due to firearm pellet injury to the left ventricle. The pellet was localized by two-dimensional echocardiog raphy within the left ventricular apical wall. Since the patient was asymptomatic, left ventriculotomy was avoided to extract the pellet and only pericardial tube drainage was carried out. A slightly elevated blood lead level of the

Semra Atalay; Adnan Uysalel; Haldun Özberrak; Gülendam Koçak; H. Ercan Tutar



Acute-on-chronic liver failure due to thiamazole in a patient with hyperthyroidism and trilogy of Fallot: case report  

Microsoft Academic Search

BACKGROUND: Thiamazole is a widely used antithyroid agent that has been approved for the treatment of hyperthyroidism. Although thiamazole-induced hepatotoxicity is a main side effect, it may progress to liver failure in a very few cases. CASE PRESENTATION: We described a 24-year-old patient with hyperthyroidism and trilogy of Fallot, who developed liver failure due to thiamazole. Liver biopsy showed intrahepatic

Chuan Shen; Cai-Yan Zhao; Fang Liu; Ya-Dong Wang; Jun Yu



Encephalomyelitis due to Cryptococcus neoformans var gattii presenting as spinal tumour: case report and review of the literature  

PubMed Central

A 24 year old immunocompetent German resident is described who developed multifocal encephalomyelitis due to infection with Cryptococcus neoformans var gatti, commonly considered a disease of tropical regions. In the light of current knowlege on the epidemiology of C neoformans var gatti and the travel history of the patient it is assumed that the infection was aquired outside Europe. As exclusive intramedullary involvement is an outstandingly rare manifestation in spinal cryptococcosis, the particular diagnostic procedure and the therapeutic stratagies are discussed??

Grosse, P; Tintelnot, K; Sollner, O; Schmitz, B



Economic Assessment of the Impact on Coal Production Due to Enforcement of the Surface Mining Control and Reclamation Act of 1977. Cost Report.  

National Technical Information Service (NTIS)

The report summarizes the efforts made in the cost analysis portion of the 'Economic Assessment of the Impact on Coal Production Due to Enforcement of the Surface Mining Control and Reclamation Act (SMCRA) of 1977. The objective of the cost analysis porti...



Femoral fracture following knee ligament reconstruction surgery due to an unpredictable complication of bioabsorbable screw fixation: a case report and review of literature  

Microsoft Academic Search

We report an unusual case of femoral fracture from minimal trauma, due to the rapid disappearance of a bioabsorbable interference\\u000a screw used for reconstruction of the posterolateral corner of the knee. The literature on bone tunnel fractures following\\u000a knee ligament reconstruction surgery is also reviewed.

Sujith Konan; Fares Sami Haddad



Self-Reported Reduced Productivity Due to Musculoskeletal Symptoms: Associations with Workplace and Individual Factors Among White-Collar Computer Users  

Microsoft Academic Search

The aim was to assess whether self-reported reduced productivity occurred in computer users due to musculoskeletal symptoms and the association to workplace, symptom, and individual factors. The study group consisted of 1283 computer users from different occupations, of whom 498 were men and 785 were women. Reduced productivity was self-assessed by two questions addressing if and how much productivity was

Mats Hagberg; Ewa Wigaeus Tornqvist; Allan Toomingas



77 FR 70176 - Previous Participation Certification  

Federal Register 2010, 2011, 2012, 2013

...No. FR-5603-N-86] Previous Participation Certification AGENCY: Office of evaluate participants' previous participation in government programs and ensure that...information: Title of Proposed: Previous Participation Certification. OMB Approval...



(Reduce uncertainty in projection of future sea-level change due to ice wastage): Progress report, August 1988--April 1989  

SciTech Connect

Since the conclusion of our 1988 field work activities, we have been occupied with organizing field data and redesigning our numerical model. Publications are in preparation describing last summer's field experiments and the basis for our new numerical model; one manuscript presenting current model results has been submitted to Water Resources Research. We are also planning an experimental program to accompany our field work. The accomplished goals of these activities are outlined below. A brief report on field studies at Agassiz Ice Cap, Ellesmere Island, Canada, in May, 1988, and on the Greenland Ice Sheet in August, 1988, was submitted to DOE in September, 1988, and is enclosed as Attachment A. Observational data from Agassiz Ice Cap were organized into an in-house data report last year. Additional information has been reduced from field notes and is being incorporated into the data report. The new information includes extra density profiles and macrophotographs of snow grains. A public data report is in preparation and will be available this summer through World Data Center A. A condensed data report may also be submitted for publication this summer.

Meier, M.



Femoral vein thrombophlebitis and septic pulmonary embolism due to a mixed anaerobic infection including Solobacterium moorei: a case report  

PubMed Central

Background Primary foci of necrobacillosis infection outside the head and neck are uncommon but have been reported in the urogenital or gastrointestinal tracts. Reports of infection with Solobacterium moorei are rare. Case presentation A 37-year-old male intravenous drug user was admitted with pain in his right groin, fever, rigors and vomiting following a recent injection into the right femoral vein. Admission blood cultures grew Fusobacterium nucleatum, Solobacterium moorei and Bacteroides ureolyticus. The patient was successfully treated with intravenous penicillin and metronidazole. Conclusion This case report describes an unusual case of femoral thrombophlebitis with septic pulmonary embolism associated with anaerobic organisms in a groin abscess. Solobacterium moorei, though rarely described, may also have clinically significant pathogenic potential.

Martin, Claire A; Wijesurendra, Rohan S; Borland, Colin DR; Karas, Johannis A



Effects of kinesio taping in a physical therapist with acute low back pain due to patient handling: A case report  

Microsoft Academic Search

Objectives  The paper describes the case of a physical therapist with acute Low Back Pain (LBP) due to patient handling and the efficacy\\u000a of Kinesio Taping (KT) around the trunk in the treatment of this occupational LBP. Materials and\\u000a \\u000a \\u000a \\u000a \\u000a Methods  KT was applied around the trunk for 3 days, for an average of 10 h\\/day. Kinesio tape was applied with 130–140% stretch

Gak Hwang-Bo; Jung-Hoon Lee



Gastrointestinal tolerability with ibandronate after previous weekly bisphosphonate treatment  

PubMed Central

Data from two open-label trials (PRIOR and CURRENT) of women with postmenopausal osteoporosis or osteopenia were evaluated to assess whether monthly oral and quarterly intravenous (IV) ibandronate dosing improved self-reported gastrointestinal (GI) tolerability for patients who had previously experienced GI irritation with bisphosphonate (BP) use. In PRIOR, women who had discontinued daily or weekly BP treatment due to GI intolerance received monthly oral or quarterly IV ibandronate for 12 months. The CURRENT subanalysis included women receiving weekly BP treatment who switched to monthly oral ibandronate for six months. GI symptom severity and frequency were assessed using the Osteoporosis Patient Satisfaction Questionnaire™. In PRIOR, mean GI tolerability scores increased significantly at month 1 from screening for both treatment groups (oral: 79.3 versus 54.1; IV: 84.4 versus 51.0; p < 0.001 for both). Most patients reported improvement in GI symptom severity and frequency from baseline at all post-screening assessments (>90% at Month 10). In the CURRENT subanalysis >60% of patients reported improvements in heartburn or acid reflux and >70% indicated improvement in other stomach upset at month 6. Postmenopausal women with GI irritability with daily or weekly BPs experienced improvement in symptoms with extended dosing monthly or quarterly ibandronate compared with baseline.

Derman, Richard; Kohles, Joseph D; Babbitt, Ann



Irreducible Palmar Metacarpophalangeal Joint Dislocation Due to Junctura Tendinum Interposition: A Case Report and Review of the Literature  

Microsoft Academic Search

Three different anatomic structures have been reported to prevent reduction of a palmar dislocation of metacarpophalangeal joint: dorsal capsule, palmar plate, and a ruptured collateral ligament. In our case, extensor digitorum communis of the fifth finger and extensor digiti minimi subluxated on the ulnar side of the fifth metacarpal neck. Extensor digitorum communis of the fourth finger remained in its

Mukund R. Patel; Lynn Bassini



Case Report: Severe Hemolytic Disease of the Newborn Due to anti-Dib Treated with Phototherapy and Intravenous Immunoglobulin  

Microsoft Academic Search

The Di b antigen usually occurs with high incidence, except in certain Asian and South American Indian populations. In general, hemolysis caused by anti-Dib is not severe and its clinical course is benign. We report a Korean neonate with severe hemolytic disease of the newborn caused by anti-Dib. The phenotype and genotype of the Diego blood group system of the

Eun-Jee Oh; Dong Wook Jekarl; Hyun-Sik Jang; Hae-Il Park; Yeon-Joon Park; Hyun Ah Choi; Chung-Sik Chun; Yonggoo Kim; Hyung Hoi Kim


Fatality Assessment and Control Evaluation (FACE) Investigative Report: Volunteer Fire Fighter Dies Due to Inadvertent Fireworks Discharge in North Dakota.  

National Technical Information Service (NTIS)

On July 5, 2002, a 44-year-old male volunteer fire fighter (the victim) was killed while loading shells into mortars at a public fireworks display. Approximately 40 minutes into the show, the victim suddenly yelled and ran from the mortar, reportedly cove...



Chylous ascites and chylothorax due to constrictive pericarditis in a patient infected with HIV: a case report  

PubMed Central

Introduction Chylothorax and chylous ascites are uncommon and usually associated with trauma or neoplasms. To the best of our knowledge, constrictive pericarditis leading to chylothorax and chylous ascites in a person infected with HIV has never previously been described. Case presentation A 39-year-old Thai man was referred to our institute with progressive dyspnea, edema and abdominal distension. His medical history included HIV infection and pulmonary tuberculosis that was complicated by tuberculous pericarditis and cardiac tamponade. Upon further investigation, we found constrictive pericarditis, chylothorax and chylous ascites. A pericardiectomy was performed which resulted in gradual resolution of the ascites and chylous effusion. Conclusions Although constrictive pericarditis is an exceptionally rare cause of chylothorax and chylous ascites, it should nonetheless be considered in the differential diagnosis as a potentially reversible cause.



[Giant cell tumor of the ribs that required emergency surgery due to massive hemothorax; report of a case].  


A 63-year-old man with a left rib tumor, which had been diagnosed as a giant cell tumor 2 years previously, had been followed up at another hospital after embolization of a feeding artery of the tumor. He was admitted to the emergency room of our hospital with complaints of breathing difficulties. A chest computed tomography (CT) revealed a left chest wall tumor, about 11 cm in size, originating from the 8th rib and a massive left hemothorax. Emergency operation was performed to releave hemorrhagic shock. Bleeding from the tumor was confirmed at thoracotomy. Tumor was removed with combined resection of the adjacent chest wall and diaphragm. His postoperative course was uneventful and he was discharged on the 8th postoperative day. PMID:22750839

Hamada, Akira; Kanauchi, Naoki; Endoh, Makoto; Suzuki, Jun



Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate  

PubMed Central

Background The simian parasite Plasmodium knowlesi is recognized as a common cause of severe and fatal human malaria in Sabah, Malaysia, but is morphologically indistinguishable from and still commonly reported as Plasmodium malariae, despite the paucity of this species in Sabah. Since December 2008 Sabah Department of Health has recommended intravenous artesunate and referral to a general hospital for all severe malaria cases of any species. This paper reviews all malaria deaths in Sabah subsequent to the introduction of these measures. Reporting of malaria deaths in Malaysia is mandatory. Methods Details of reported malaria deaths during 2010-2011 were reviewed to determine the proportion of each Plasmodium species. Demographics, clinical presentations and management of severe malaria caused by each species were compared. Results Fourteen malaria deaths were reported, comprising seven Plasmodium falciparum, six P. knowlesi and one Plasmodium vivax (all PCR-confirmed). Of the six P. knowlesi deaths, five were attributable to knowlesi malaria and one was attributable to P. knowlesi-associated enterobacter sepsis. Patients with directly attributable P. knowlesi deaths (N?=?5) were older than those with P. falciparum (median age 51 [IQR 50-65] vs 22 [IQR 9-55] years, p?=?0.06). Complications in fatal P. knowlesi included respiratory distress (N?=?5, 100%), hypotension (N?=?4, 80%), and renal failure (N?=?4, 80%). All patients with P. knowlesi were reported as P. malariae by microscopy. Only two of five patients with severe knowlesi malaria on presentation received immediate parenteral anti-malarial treatment. The patient with P. vivax-associated severe illness did not receive parenteral treatment. In contrast six of seven patients with severe falciparum malaria received immediate parenteral treatment. Conclusion Plasmodium knowlesi was responsible, either directly or through gram-negative bacteraemia, for almost half of malaria deaths in Sabah. Patients with severe non-falciparum malaria were less likely to receive immediate parenteral therapy. This highlights the need in Sabah for microscopically diagnosed P. malariae to be reported as P. knowlesi to improve recognition and management of this potentially fatal species. Clinicians need to be better informed of the potential for severe and fatal malaria from non-falciparum species, and the need to treat all severe malaria with immediate intravenous artesunate.



Peritonitis Due to Blastobotrys proliferans in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis?  

PubMed Central

Blastobotrys proliferans is an ascomycetous yeast never previously reported as a human pathogen. Here we report a case of peritonitis due to Blastobotrys proliferans in a 46-year-old man undergoing peritoneal dialysis.

Quirin, N.; Desnos-Ollivier, M.; Cantin, J. F.; Valery, J. C.; Doussy, Y.; Goursaud, R.; Dromer, F.; Tivollier, J. M.



Paroxysmal non-kinesigenic dyskinesia due to a PNKD recurrent mutation: report of two Southern European families.  


Paroxysmal non-kinesigenic dyskinesia (PNKD) is an autosomal dominant disorder characterized by attacks of dystonic or choreathetotic movements precipitated by stress, fatigue, coffee, alcohol or menstruation. In this report we present two families with PNKD of Southern European origin carrying a PNKD recurrent mutation. Incomplete penetrance and intrafamilial variability was detected in both families. Treatment with valproic acid and levetiracetam provided favorable response. PMID:21962874

Pons, Roser; Cuenca-León, Ester; Miravet, Elena; Pons, Montse; Xaidara, Athina; Youroukos, Sotiris; Macaya, Alfons



Acute poisoning due to alkalis used during industrial cleaning of soft drinks' glass containers: a case report.  


Corrosive alkalis are used in the soft drink and beer industries for the cleaning of the non-disposable glass containers using several different methods. It is well understood that complete cleaning of these vessels by multiple and well-organized rinsing is an absolute necessity. In cases of disturbance of this process, some residuals of alkaline agents may be retained in the glass containers, causing severe health risks to consumers. This case of acute poisoning due to caustic alkalis concerns a young woman who consumed carbonated lemonade from a non-disposable glass container. Clinical signs and symptoms and the treatment of the affected woman are described. Toxicological analysis of the soft drink consumed led to the detection, identification and quantitative determination of the presence of the alkalis. PMID:9311091

Stefanidou, M; Georgiou, M; Koupparis, M; Koutselinis, A



Fungemia and cutaneous zygomycosis due to Mucor circinelloides in an intensive care unit patient: case report and review of literature.  


Mucor spp. are rarely pathogenic in healthy adults, but can cause fatal infections in patients with immuosuppression and diabetes mellitus. Documented mucor fungemia is a very rare condition in the literature. We described a fungemia and cutaneous mucormycosis case due to Mucor circinelloides in an 83-year-old woman with diabetes mellitus who developed acute left frontoparietal infarctus while hospitalized in a neurological intensive care unit. The diagnosis was made based on the growth of fungi in the blood, skin biopsy cultures, and a histopathologic examination of the skin biopsy. The isolates were identified as M. circinelloides by molecular methods. This case is important in that it shows a case of cutaneous mucormycosis which developed after fungemia and provides a contribution to the literature regarding Mucor fungemia. PMID:19305057

Dizbay, Murat; Adisen, Esra; Kustimur, Semra; Sari, Nuran; Cengiz, Bulent; Yalcin, Burce; Kalkanci, Ayse; Gonul, Ipek Isik; Sugita, Takashi



Preliminary report on crustal deformation surveys and tsunami measurements due to the July 17, 2006 Java Earthquake and Tsunami, Indonesia  

NASA Astrophysics Data System (ADS)

A large earthquake along a plate boundary occurred in the south of Java Island on July 17, 2006, whose magnitude was 7.7 (USGS) and caused significant tsunami. We made GPS observations and tsunami heights measurements during the period from July 24 to August 1, 2006. The earthquake seems to be due to an interplate low angle reverse faulting (e.g. Yagi, 2006). Yet, there would be a possibility of high angle faulting within the subducting lithosphere (e.g., Yamanaka, 2006). Crustal deformation distribution due to the earthquake, aided by tsunami heights measurements, might clarify which would be the case. We occupied 29 sites by GPS in the area of southern Java Island encompassing the area from 107.8E to 109.50E. These sites were occupied once before the earthquake so that co-seismic displacements might be seen. If we assume that the slip on the fault surface is as that estimated assuming magnitude to be 7.7, co- seismic displacements would be as small as a few centimeters or less. However, the tsunami heights measurements at 11 sites that were conducted along with the GPS observation were 6-7m along the southern coast of Java Islands and indicates that the observed heights are systematically higher than that estimated from numerical simulations (e.g., Koshimura, 2006). This might suggest that fault offsets have been larger nearly double - than that estimated using seismic analysis. If this is the case, the co-seismic crustal movements might be larger than above estimation. This might lead us to an idea that the rupture was very slow and did not radiate enough seismic energy to underestimate the earthquake magnitude. If this is the case, the earthquake might have been a "tsunami earthquake" that is similar to the one that occurred on June 2, 1994 in the east of the present earthquake.

Kato, T.; Ito, T.; Abidin, H. Z.; Agustan, A.



Critical Pulmonary Infection Due to Nontuberculous Mycobacterium in Pediatric Leukemia: Report of a Difficult Diagnosis and Review of Pediatric Series.  


Nontuberculous mycobacterial infections are rare but severe complications of chemotherapy in children. In children with prolonged lymphopoenia after mieloablative regimens, symptoms can be nonspecific and fever and pulmonary impairment are the most common clinical features. Diagnosis is challenging for physicians and microbiologists and often requires invasive techniques. We report a girl affected by acute lymphoblastic leukemia, who developed a disseminated infection sustained by Mycobacterium avium complex. Identification of the microorganism was obtained by open lung biopsy and evidence of mycobacterium genome. We also reviewed 15 literature cases of disseminated infections of nontuberculous mycobacterium in children with leukemia. PMID:23528901

Arlotta, Annalisa; Giuseppina, Cefalo M; Palma, Maurizi; Antonio, Ruggiero; Icilio, Dodi; Riccardo, Riccardi



Babesiosis due to the canine Babesia microti -like small piroplasm in dogs - first report from Portugal and possible vertical transmission  

Microsoft Academic Search

Background  Canine babesiosis (or piroplasmosis) is endemic in northern Portugal, but molecularly confirmed cases of infection with small\\u000a piroplasms have not been reported in the country. Three German shepherd dogs - a bitch and its 2-month old pup and an unrelated\\u000a male - clinically suspected of piroplasmosis were assessed for babesial infection.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Parasitemia with small piroplasms was detected by microscopy in

Paula Brilhante Simões; Luís Cardoso; Manuela Araújo; Yael Yisaschar-Mekuzas; Gad Baneth



Congenital adrenal hypoplasia and male pseudohermaphroditism due to DAX1 mutation, SF1 mutation or neither: a patient report.  


A 15 year-old African American phenotypic female with congenital adrenal hypoplasia and intra-abdominal testes is described; she received cortisone acetate, 9alpha-Florinef, Premarin and Provera for maintenance therapy. Evaluation for DAX1, SF1 mutations using Southern blotting, PCR, PCR amplification, coding sequences, and splice site analyses have not detected any genetic abnormalities. While only 30% of the reported DAX1 mutation defects have been identified by a variety of genetic laboratory techniques, it remains probable that this unusual patient has either a DAX1 or SF1 mutation defect. A Wnt-4 defect was not evaluated. PMID:15379426

AvRuskin, Theodore W; Krishnan, Narayana; Juan, Christina S



Recurrent burner syndrome due to presumed cervical spine osteoblastoma in a collision sport athlete - a case report  

PubMed Central

We present a case of a 35-year-old active rugby player presenting with a history of recurrent burner syndrome thought secondary to an osteoblastoma involving the posterior arch of the atlas. Radiographically, the lesion had features typical for a large osteoid osteoma or osteoblastoma, including osseous expansion, peripheral sclerosis and bony hypertrophy, internal lucency, and even suggestion of a central nidus. The patient subsequently underwent an en bloc resection of the posterior atlas via a standard posterior approach. The surgery revealed very good clinical results. In this report, we will discuss in detail, the presentation, treatment, and return to play recommendations involving this patient.

Elias, Ilan; Pahl, Michael A; Zoga, Adam C; Goins, Maurice L; Vaccaro, Alexander R



Tetany due to hypoparathyroidism as the initial manifestation of autoimmune polyendocrine syndrome type-2: A case report.  


Hypoparathyroidism is most commonly isolated and idiopathic. Hypoparathyroidism in autoimmune polyendocrine syndrome type-2 (APS-2) is extremely rare with few isolated reports and usually presents late. We present perhaps for the first time, hypoparathyroidism being the initial manifestation of APS-2 which was diagnosed in a 32 year lady with tingling of the extremities along with hypocalcemic tetany for 15 years. She also had generalized acral and mucosal hyperpigmentation of 2 years duration. Investigations were significant for low calcium (7.1mg/dl), elevated phosphorus (4.8mg/dl), vitamin-D insufficiency (27.4ng/ml), low intact parathyroid hormone (2.3pg/ml), low basal (4.7mcg/dl) and stimulated serum cortisol (9.2mcg/dl at half hour, 11.4mcg/dl at 1 hour post synacthen), elevated triiodothyronine (2.1ng/ml) and free tetraiodothyronine (2.4ng/dl) along with suppressed TSH (<0.005 U/L). Imaging relevaled mild cerebellar calcification, normal adrenals with diffuse uptake of Tc(99)- pertechnate. A diagnosis of hypoparathyroidism with Addison's and Graves' disease as a part of APS-2 was made. This report intends to highlight the clinical heterogeneity and varied presentation of APS-2. Routine screening of other hormonal function (especially adrenal function, thyroid function and blood glucose) in a patient with diagnosed hypoparathyroidism is advisable to decrease the chances of missing APS-2. PMID:23565477

Dutta, Deep; Maisnam, Indira; Ghosh, Sujoy; Dasgupta, Ranen; Mukhopadhyay, Satinath; Chowdhury, Subhankar



[A cardiac embolic stroke due to malposition of the pacemaker lead in the left ventricle. A case report].  


Misplacement of a permanent pacemaker lead has been described in several locations but rarely in the left ventricle. Less commonly, as described in our report, malposition may occur when the lead perforates the interatrial septum and extends across the left atrium and through the mitral valve into the left ventricle. The actual incidence of this pacemaker complication is unknown. Consequences may include perforation and systemic or cerebral thromboembolic events. We report the case of a patient with unintentionally misplaced left heart pacemaker lead admitted for neurological symptoms consistent with embolic stroke. The patient was on aspirin when symptoms occurred. The lead misplacement was not recognized at the time of implantation. Pacing threshold was normal. A 12-lead electrocardiogram showed right bundle branch block configuration paced complexes. By two-dimensional and transesophageal echocardiography, the pacemaker lead was carefully evaluated. The pacemaker lead crossed the interatrial septum, the left atrium, the mitral valve to be implanted in the left ventricular endocardium. To avoid the risk of future embolization, it was felt that the lead should be removed and right ventricular pacing established, once anticoagulation treatment was initiated. Successful percutaneous lead replacement was accomplished without sequelae. Measures to avoid lead misplacement are suggested. PMID:10832129

Agnelli, D; Ferrari, A; Saltafossi, D; Falcone, C



Selective mutism due to a dog bite trauma in a 4-year-old girl: a case report  

PubMed Central

Introduction A child experiencing an event of threatening or catastrophic nature may experience considerable post-traumatic psychological distress. Dog bites present an important public health problem and are a frequent cause of physical trauma in children. Physicians who manage paediatric trauma may not be vigilant of the high risk of psychological stress in children exposed to a physical injury. Case presentation A 4-year-old white girl of Greek origin, with a dog-bite related trauma was admitted to the University Hospital of Crete, Greece, for surgical repair and intravenous antibiotic therapy due to extensive lesions. Exposure to the traumatic event triggered the onset of an unusual psychological response, selective mutism and acute post-traumatic stress disorder. Conclusion There is limited literature discussing the psychological effect of dog bites in children. Parents and physicians involved in pediatric physical trauma need to be more familiar with post-traumatic behavioral reactions. Awareness of the potential development of such reactions may result in early detection and effective management of children at risk.



Scrotal Swelling and Testicular Atrophy due to Schistosomiasis in a 9-Year-Old Boy: A Case Report  

PubMed Central

Schistosomiasis is a communicable disease which commonly involves urinary bladder causing hematuria, or large bowel causing bloody stool. The common species encountered in this lake region surrounding Lake Victoria in Tanzania are Schistosoma haematobium and Schistosoma mansoni. Complications can lead to portal hypertension due portal fibrosis in liver, and fibrosis in lung can lead to pulmonary hypertension; this commonly seen with S. mansoni. Major complications of S. maeametobium are chronic cystitis with squamous metaplasia with subsequent development of squamous cell carcinoma. Involvement of spinal cord causing paraplegia has been observed in S. haematobium. Other unusual pathology of schistosomiasis has been described, such as involvement of the appendix, ovary, prostate, and cervix. Here, we present a case of schistosomiasis in a 9-year-old boy who presented with left scrotal pain for one year which was accompanied by scrotal swelling; surgical exploration was done, and the finding was hydrocele and atrophic testes with nodules on the surface. Histological examination reveals atrophic testis and heavy active granulomatous inflammation with schistosoma eggs consistent with Schistosoma haematobium in the tunica vaginalis.

Rambau, Peter F.; Chandika, Alphonce; Chalya, Philipo L.; Jackson, Kahima



Ureteral obstruction and urinary fistula due to fibrin glue after partial nephrectomy: A case report and review of the literature  

PubMed Central

In the present study, we report the case of a 69-year-old female who developed urinary leakage following partial nephrectomy (PN) to remove left renal masses. The results of CT and MR urography revealed left proximal ureteral obstruction and urinary fistula. Reoperation was performed on the 16th postoperative day to explore the left kidney and ureter in order to relieve the obstruction. The left proximal ureter was found to be enfolded by fibrin glue and showed marked stiffness and adhesion during the reoperation. The lesion of the ureter was resected and the ureter was anastomosed with the routine double-J stent. Pathological examination of surgical specimens revealed fat fibrous scar tissue hyperplasia with inflammatory cell infiltration. The patient recovered completely without exudate. Our experience suggests that care should be taken to avoid touching the ureter with fibrin glue during PN surgery.




Pontine venous congestion due to dural arteriovenous fistula of the cavernous sinus: Case report and review of the literature  

PubMed Central

Background: We report herein a case of cavernous sinus (CS)-dural arteriovenous fistula (DAVF) with brainstem venous congestion that was successfully treated by transarterial embolization, followed by radiotherapy. Case Description: An 80-year-old woman presented with right eye chemosis and left hemiparesis. T2-weighted magnetic resonance imaging showed hyperintensity of the pons. Diagnostic cerebral angiography demonstrated CS-DAVF draining into the right superior orbital vein and petrosal vein, and fed by bilateral internal and external carotid arteries. Transarterial embolization was performed and followed by radiotherapy, resulting in resolution of the pontine lesion and neurological and ophthalmological symptoms within 5 months. Conclusions: We also review the literature regarding therapy for CS-DAVF with brainstem venous congestion. Once CS-DAVF with venous congestion of the brainstem has been definitively diagnosed, immediate therapy is warranted. Treatment with transarterial embolization followed by radiation may be an important option for elderly patients when transvenous or transarterial embolization is not an option.

Miyagishima, Takaaki; Hara, Tetsuo; Inoue, Masato; Terano, Naruhiko; Ohno, Hiroyasu; Okamoto, Kouichiro; Hasuo, Kanehiro



Avascular necrosis of the femoral head due to the bilateral injection of heroin into the femoral vein: A case report  

PubMed Central

In this study, we report a case of avascular necrosis of the femoral head (ANFH) caused by the bilateral intravenous injection of heroin into the femoral vein. The patient had not used steroids, did not smoke and did not drink excessively. The patient did not present with any systemic diseases that may cause ANFH. ANFH often causes changes to the bone mass of the femoral head, particularly, the weight-bearing bone region. Imaging examination revealed that in addition to the bilateral hip joints, widespread changes to the bone mass existed in the peripheral area, where phlebitis and disseminated thrombosis had been caused by the injection of heroin. These results suggest that this ANFH case was related to the injection of heroin. This case is different from other cases of ANFH which have been caused by steroids and other factors, including smoking, alcohol intake and cytotoxic agents.




Metallosis due to impingement between the socket and the femoral head in a total hip prosthesis. A case report.  


Metallosis is usually defined as aseptic fibrosis, local necrosis, or loosening of a device secondary to metallic corrosion and release of wear debris. It is an occasional but characteristic clinical finding in patients who have a metal-on-metal design of total hip replacement, or when metal surfaces contact after a failure or erosion of the polyethylene component. We report the case of a patient who had severe metallosis caused by wear of the femoral head with the titanium socket, after the complete erosion and destruction of the polyethylene cup, with failure of the accetabular component. Breakage of the acetabular cup constitutes one of the possible long-term complications occurring as a result of a total hip replacement. This extremely rare complication can occur at any time postoperatively and may not be associated with symptoms or other problems for a long time. PMID:12643077

Gambera, Dario; Carta, Serafino; Crainz, Edoardo; Fortina, Mattia; Maniscalco, Pietro; Ferrata, Paolo



A Case Report of Iatrogenic Pulmonary Artery Injury due to Chest-Tube Insertion Repaired under Cardiopulmonary Bypass  

PubMed Central

The authors presented a case of a 50-year-old patient with multiple trauma who suffered from the inadvertent cannulation of the main pulmonary artery at the second attempt of left chest drainage. Pulmonary artery injury has been suspected because early chest tube production was 2300?mL of blood. CT scan showed injury of the trunk of the pulmonary artery, left hemothorax, and suspect damage of the right branch of the pulmonary artery. That chest tube touched the posterior wall of ascending aorta. Surgical approach was median sternotomy. Exploration showed a perforation of the trunk of pulmonary artery without lesion of the right pulmonary branch and the posterior wall of the ascending aorta. The lesion was repaired under normothermic partial cardiopulmonary bypass. Postoperative period was free of events. Review of the literatures for this rare case report has been done.

Gabriel, Ciss Amadou; Adama, Dieng Papa; Salmane, Ba Papa; Magaye, Gaye; Souleymane, Diatta; Mohamed, Leye; Lamine, Fall; Birame, Sene Etienne; Assane, N'diaye; Oumar, Diarra; Oumar, Kane; Mouhamadou, N'diaye



Venous Stasis Ulcers Due to Primary, Isolated Deep Venous Insufficiency in a Patient with Systemic Lupus Erythematosus: Report of a Case  

Microsoft Academic Search

.  \\u000a Primary, isolated deep venous incompetence is rare, difficult to diagnose, and can lead to the development of venous stasis\\u000a ulcers. We herein report a case demonstrating chronic venous stasis ulcers due to primary, isolated deep venous incompetence,\\u000a which was misdiagnosed as vasculitis ulcers associated with systemic lupus erythematosus (SLE). Although primary, isolated\\u000a deep venous incompetence is rare, it is

Toshiya Nishibe; Fabio Kudo; Jorge Flores; Takahiro Imai; Keiko Miyazaki; Keishu Yasuda



Venous stasis ulcers due to primary, isolated deep venous insufficiency in a patient with systemic lupus erythematosus: report of a case.  


Primary, isolated deep venous incompetence is rare, difficult to diagnose, and can lead to the development of venous stasis ulcers. We herein report a case demonstrating chronic venous stasis ulcers due to primary, isolated deep venous incompetence, which was misdiagnosed as vasculitis ulcers associated with systemic lupus erythematosus (SLE). Although primary, isolated deep venous incompetence is rare, it is important to bear this possibility in mind when a patient presents with leg ulcers. PMID:12376799

Nishibe, Toshiya; Kudo, Fabio; Flores, Jorge; Imai, Takahiro; Miyazaki, Keiko; Yasuda, Keishu



Recurrent Meningitis and Subarachnoid Hemorrhage Due to Salmonella in an HIV+ Patient: Case Report and Mini-Review of the Literature.  


Meningitis due to non-typhi salmonella is infrequent in HIV-positive adults.We report a case of a patient with >300 CD4+ cells/mm3 who presented with five episodes of recurrent meningitis, focal subarachnoid hemorrhage and cerebral vasculitis ultimately attributed to Salmonella choleraesuis infection. Even within the cART era invasive salmonellosis can occur in unusual ways in HIV-infected patients. PMID:21772932

Belloso, Waldo H; Romano, Marina; Greco, Graciela S; Davey, Richard T; Perelsztein, Ariel G; Sánchez, Marisa L; Ajzenszlos, Martín R; Otegui, Inés M



Endocarditis of native aortic and mitral valves due to Corynebacterium accolens: report of a case and application of phenotypic and genotypic techniques for identification.  


Endocarditis of native aortic and mitral valves due to an organism identified as Corynebacterium accolens developed in a 73-year-old patient without predisposing factors. The organism was identified as C. accolens by biochemical identification, amplified rRNA gene restriction analysis, and DNA-DNA hybridization. This is the first case of C. accolens endocarditis reported, adding to the increasing number of Corynebacterium-related cases of endocarditis. PMID:8727922

Claeys, G; Vanhouteghem, H; Riegel, P; Wauters, G; Hamerlynck, R; Dierick, J; de Witte, J; Verschraegen, G; Vaneechoutte, M



Endocarditis of native aortic and mitral valves due to Corynebacterium accolens: report of a case and application of phenotypic and genotypic techniques for identification.  

PubMed Central

Endocarditis of native aortic and mitral valves due to an organism identified as Corynebacterium accolens developed in a 73-year-old patient without predisposing factors. The organism was identified as C. accolens by biochemical identification, amplified rRNA gene restriction analysis, and DNA-DNA hybridization. This is the first case of C. accolens endocarditis reported, adding to the increasing number of Corynebacterium-related cases of endocarditis.

Claeys, G; Vanhouteghem, H; Riegel, P; Wauters, G; Hamerlynck, R; Dierick, J; de Witte, J; Verschraegen, G; Vaneechoutte, M



Sudden unexpected early neonatal death due to undiagnosed Hirschsprung disease enterocolitis: a report of two cases and literature review.  


Hirschsprung enterocolitis (HEC) is an uncommon, albeit well known, complication of Hirschsprung disease (HD). It is multifactorial and can appear in different age groups, but is particularly important in the neonatal period where it is characteristically seen in full-term neonates. Two cases of HEC are reported that were diagnosed at post-mortem examination, which presented as early sudden neonatal death, with a review the literature on fatal Hirschsprung enterocolitis. Case 1 was a 4-day old male neonate who was found unwell, struggling to breath, and with green vomitus. He was taken to hospital and pronounced dead a short time later. According to the parents meconium was passed on the first day. Post-mortem examination demonstrated necrotizing enterocolitis with isolated bowel perforation. Histology disclosed unsuspected HD. Case 2 was a 2-day old male neonate who was found wheezing with green vomitus. He arrived floppy, cyanosed, and in shock at the hospital and died a few hours later. Meconium was not passed, according to the parents. Post-mortem examination revealed necrotizing enterocolitis. There was also recto-sigmoidal aganglionosis and acetylcholinesterase staining confirmed HD. HEC is a multifactorial and sometimes recurrent complication of HD which characteristically develops in full-term neonates. Presentation with early sudden neonatal death is rare but should be considered in the diagnostic work-up of sudden deaths in this age group. PMID:23842858

Peres, Luiz Cesar; Cohen, Marta Cecilia



Spray formation: three-dimensional liquid break-up due to surface tension. Final report, April 1986-March 1988  

SciTech Connect

The growth instabilities on the interface between a liquid jet and its gaseous environment is an important mechanism in spray atomization, and it is the subject of the work reported herein. Numerical simulations based on the Navier-Stokes equations were used to model liquid/gas interface flows. An algorithm was developed for solving the unsteady Navier-Stokes equations for incompressible fluid with a discontinuity in density and with surface tensions and its accuracy was demonstrated. In flows representative of round pressure-atomized jets and pressure-swirl atomizers, nonuniform mean velocity distributions resulting from viscous boundary-layers were found to have a significant effect on instability growth. In a round jet, the inclusion of a boundary-layer-like velocity profile significantly reduced the growth rate of small-wavelength instabilities. The velocity profile had a much greater effect than surface tension on the initial atomization process for the flow parameters considered. A good estimate of initial fuel droplet size was obtained by considering boundary-layer effects but disregarding surface tension. In a flow representative of the fuel issuing from a pressure-swirl nozzle, nonuniformity of the velocity profile was found to increase the growth rate of a disturbance mode which is directly responsible for spray breakup.

Childs, R.E.



[Cardiorespiratory arrest due to acute pulmonary thromboembolism during chemotherapy for female urothelial carcinoma of urethra: a case report].  


We report a case of deep vein thrombosis and acute pulmonary thromboembolism that occurred during chemotherapy for urethral carcinoma. A 68-year-old woman suffered from dysuria for a period of 2 years. When the symptoms worsened, a urethral catheter was placed and she was referred to our hospital for further examinations. Imaging analysis revealed a urethral tumor with multiple metastases. Pathological diagnosis on a specimen obtained from transurethral resection of the urethral mucosa was urothelial carcinoma and combined chemotherapy with gemcitabine and cisplatin was administered. On day 6 of the second course, the patient collapsed and was found to be in cardiorespiratory arrest. Cardiopulmonary resuscitation was successful and she received percutaneous cardiopulmonary support. Computed tomography at that time revealed a pulmonary embolism and deep vein thrombosis in the right popliteal vein. After her condition improved, an inferior vena cava filter was inserted to avoid further thromboembolism. The patient decided to continue the chemotherapy despite this episode. After the fourth course of combined chemotherapy, the urethral tumor and metastatic tumors were downsized, and she could urinate as she did before. PMID:23719136

Nakazawa, Shigeaki; Uemura, Motohide; Matsuzaki, Kyosuke; Yoshida, Takahiro; Takao, Tetsuya; Tsujimura, Akira; Nonomura, Norio



Hepatotoxicity due to troglitazone: report of two cases and review of adverse events reported to the United States Food and Drug Administration  

Microsoft Academic Search

Two patients (a 48-year-old woman and a 62-year-old man) developed clinical and laboratory signs of hepatotoxicity due to troglitazone (Rezulin), a thiazolidinedione used in treatment of diabetes mellitus. There was no clear clinical evidence of drug allergy, although the woman experienced colitis before the onset of recognized hepatotoxicity. Liver biopsies showed bridging necrosis and fibrosis in the woman and hepatitis

James Kohlroser; Jijy Mathai; James Reichheld; Barbara F. Banner; Herbert L. Bonkovsky



A previously diagnosed mitochondrial neurogastrointestinal encephalomyopathy patient presenting with perforated ileal diverticulitis.  


Mitochondrial neurogastrointestinal encephalomyopathy is an autosomal recessive multisystem disorder characterized clinically by severe gastrointestinal dysmotility; cachexia; ptosis, opthalmoparesis or both; peripheral neuropathy; leukoencephalopathy and mitochondrial abnormalities in muscle. Gastrointestinal dysmotility causes intestinal pseudo-obstruction and small intestinal diverticula. In this case report, we present a previously diagnosed 32-year-old female mitochondrial neurogastrointestinal encephalomyopathy syndrome patient who was hospitalized and operated due to ileal diverticulitis perforation and died due to postoperative respiratory complications, and we discuss the characteristic manifestations of the disease. PMID:16547854

Aksoy, Fikret; Demirel, Gökhan; Bilgiç, Tayfun; Güngör, Ibrahim Gürhan; Ozçelik, Alp



Economic assessment of the impact on coal production due to enforcement of the Surface Mining Control and Reclamation Act of 1977. Benefits report. Volume 1. Final report  

Microsoft Academic Search

The study assesses the major economic benefits and costs that are associated with the enforcement of the Surface Mining Control and Reclamation ACt (SMCRA). The report addresses the benefits of surface coal mining and land reclamation that follow from the Act. As originally conceived, the study was to evaluate, preferably in monetary terms, the specific benefits and socio-economic impacts of

T. N. Kyle; R. M. McOmber; J. M. Roberts



Fatal Mycotic Aneurysms Due to Scedosporium and Pseudallescheria Infection?  

PubMed Central

Angioinvasive complications of Scedosporium infections are rare. We report two cases of mycotic aneurysm, following apparent localized infection, due to Scedosporium apiospermum and Pseudallescheria boydii. The thoracoabdominal aorta was affected in one patient, and cerebral vessels were affected in the other. Despite voriconazole therapy and surgical resection, the patients died. Previously reported cases are reviewed.

Ong, Adrian; Blyth, Christopher C.; Bency, Rosamma; Vicaretti, Mauro; Harun, Azian; Meyer, Wieland; Shingde, Meena; Gilroy, Nicky; Chapman, Jeremy; Chen, Sharon C.-A.



Central Line Sepsis in a Child Due to a Previously Unidentified Mycobacterium  

PubMed Central

A rapidly growing mycobacterium similar to strains in the present Mycobacterium fortuitum complex (M. fortuitum, M. peregrinum, and M. fortuitum third biovariant complex [sorbitol positive and sorbitol negative]) was isolated from a surgically placed central venous catheter tip and three cultures of blood from a 2-year-old child diagnosed with metastatic hepatoblastoma. The organism’s unique phenotypic profile and ribotype patterns differed from those of the type and reference strains of the M. fortuitum complex and indicate that this organism may represent a new pathogenic taxon.

Hogg, Geoffrey G.; Schinsky, Mark F.; McNeil, Michael M.; Lasker, Brent A.; Silcox, Vella A.; Brown, June M.



Lupus anticoagulant and ANCA associated thrombotic vasculopathy due to cocaine contaminated with levamisole: a case report and review of the literature.  


A 2010 US report recently detected the presence of levamisole in greater than 77 % of seized cocaine samples. A syndrome of retiform purpura, often involving ears and flanks, with vasculopathy or vasculitis on biopsy, associated with anti-nuclear cytoplasmic antibodies as well as antiphospholipid antibodies, previously associated with therapeutic use of levamisole has now re-emerged, and is associated with cocaine adulterated with levamisole. Patients with this unusual constellation of signs and laboratory findings should be questioned about exposure to cocaine. PMID:22437653

Gulati, Shuchi; Donato, Anthony A



[Bi-weekly nab-paclitaxel and trastuzumab therapy effective against recurrent breast cancer with multiple lung metastases in elderly patient who had previously undergone two chemotherapeutic regimens for treatment of metastatic disease-a case Report].  


We herein report a 75-year-old patient with recurrent hormone-nonresponsive, HER2-positive breast cancer who presented with multiple lung metastases. She had undergone a mastectomy followed by adjuvant chemotherapy with FEC, CMF, and UFT. Forty-six months after the surgery, multiple lung, liver, and bone metastases were observed. Docetaxel and trastuzumab were administered as first-line chemotherapy for 13 months. A partial response and stable disease were observed, but progressive disease in the lung and brain was subsequently revealed. The patient then underwent g-knife treatment for brain metastasis. Lapatinib and capecitabine treatment was administered as second-line chemotherapy for 9 months. Stable disease was observed, but progressive disease in the lung metastases with clinical symptoms including cough, exertional dyspnea, and general malaise was revealed. As third-line chemotherapy, the patient was administered low-dose, bi-weekly nab-paclitaxel(150mg/m2)and trastuzumab therapy. Four weeks after beginning the nab-paclitaxel and trastuzumab treatment, the cough disappeared; 2 months after beginning the therapy, a partialresponse in the lung metastases was seen. The patient is well and the treatment has been continued for 50 weeks. No progression has been seen. Bi-weekly nab-paclitaxel treatment appears to have few side effects and might be an effective treatment option for patients with recurrent breast cancer. PMID:23152023

Sakurai, Teruhisa; Jinta, Eri; Suzuma, Takaomi; Yoshimura, Gorou; Umemura, Teiji; Sakurai, Takeo



Pregnancy coexisting with uterus didelphys with a blind hemivagina complicated by pyocolpos due to Pediococcus infection: a case report and review of the published reports.  


A woman in early pregnancy was referred due to severe pelvic pain. Vaginal examination showed a severely protruding left vaginal wall with severe tenderness. A transvaginal ultrasound showed a double uterus and a mixed echogenic mass next to the cervix of the left uterus. After creating an opening in the left vaginal wall and inserting a Foley catheter through the opening into the vaginal wall for drainage with antibiotic therapy, the patient's condition rapidly improved. A culture of the pus drained from the vaginal wall showed Pediococcus species. The patient delivered a healthy infant by cesarean section at term gestation without recurrence of pyocolpos. Ten months after delivery, resection of the vaginal septum was performed and the left cervix was exposed. Ultrasound revealed normal kidneys. PMID:23718909

Park, Tae Chul; Lee, Hee Joong



[Left atrial myxoma with a coronary artery steal syndrome due to the coronary artery to left atrial fistula; report of a case].  


A 73-year-old woman with dyspnea was diagnosed with a left atrial myxoma by echocardiography. Right and left circumflex coronary angiography showed neovascularity in the tumor and the blood flow jet extending from the tumor to the left atrial cavity, which led to the steal phenomenon in the left anterior descending artery. Surgical excision of the left atrial tumor and the maze procedure were performed with a cardiopulmonary circuit. To our knowledge, this is the 1st study to report the development of the coronary artery steal syndrome due to a cardiac myxoma. Exercise testing would involve risks such as embolism and left ventricular inflow disturbance; furthermore, the presence of concomitant chest symptoms with cardiac myxoma is not rare. Therefore, preoperative coronary angiography would be used for differential diagnosis and for detecting the coronary artery disease, which is reported to be common in patient with cardiac myxomas. PMID:23575189

Sogabe, Osanori; Inokawa, Hidetoshi; Tanaka, Shin; Yamamoto, Hiroyuki; Hashimoto, Kouhei



IND Applications for Clinical Investigations: Previous Human ...  

Center for Drug Evaluation (CDER)

... If an investigational drug has been investigated or marketed previously, either in the United States or other countries, detailed information about ... More results from


GMPs - Section Three: Previous Surveys of Manufacturing ...  

Center for Food Safety and Applied Nutrition (CFSAN)

... GMPs - Section Three: Previous Surveys of Manufacturing Practices in the Food Industry. ... 3.6 Automation Practices in the Food Industry. ... More results from


Pasteurized Milk Ordinance 2005: Previous Editions  

Center for Food Safety and Applied Nutrition (CFSAN)

... 971 from Public Health Reports of November 7, 1924. 1926. Ordinance only. Reprint No. 1099 from Public Health Reports of July 30, 1926. 1927. ... More results from


Survey context and question wording affects self reported annoyance due to road traffic noise: a comparison between two cross-sectional studies  

PubMed Central

Background Surveys are a common way to measure annoyance due to road traffic noise, but the method has some draw-backs. Survey context, question wording and answer alternatives could affect participation and answers and could have implications when comparing studies and/or performing pooled analyses. The aim of this study was to investigate the difference in annoyance reporting due to road traffic noise in two types of surveys of which one was introduced broadly and the other with the clearly stated aim of investigating noise and health. Methods Data was collected from two surveys carried out in the municipality of Malmö, southern Sweden in 2007 and 2008 (n = 2612 and n = 3810). The first survey stated an aim of investigating residential environmental exposure, especially noise and health. The second survey was a broad public health survey stating a broader aim. The two surveys had comparable questions regarding noise annoyance, although one used a 5-point scale and the other a 4-point scale. We used geographic information systems (GIS) to assess the average road and railway noise (LAeq,24h) at the participants' residential address. Logistic regression was used to calculate odds ratios for annoyance in relation to noise exposure. Results Annoyance at least once a week due to road traffic noise was significantly more prevalent in the survey investigating environment and health compared to the public health survey at levels > 45 dB(A), but not at lower exposure levels. However no differences in annoyance were found when comparing the extreme alternatives "never" and "every day". In the study investigating environment and health, "Noise sensitive" persons were more likely to readily respond to the survey and were more annoyed by road traffic noise compared to the other participants in that survey. Conclusions The differences in annoyance reporting between the two surveys were mainly due to different scales, suggesting that extreme alternatives are to prefer before dichotomization when comparing results between the two. Although some findings suggested that noise-sensitive individuals were more likely to respond to the survey investigating noise and health, we could not find convincing evidence that contextual differences affected either answers or participation.



Effects of heading exposure and previous concussions on neuropsychological performance among Norwegian elite footballers  

PubMed Central

Background: Cross-sectional studies have indicated that neurocognitive performance may be impaired among football players. Heading the ball has been suggested as the cause, but recent reviews state that the reported deficits are more likely to be the result of head injuries. Objective: To examine the association between previous concussions and heading exposure with performance on computer based neuropsychological tests among professional Norwegian football players. Methods: Players in the Norwegian professional football league (Tippeligaen) performed two consecutive baseline neuropsychological tests (Cogsport) before the 2004 season (90.3% participation, n = 271) and completed a questionnaire assessing previous concussions, match heading exposure (self-reported number of heading actions per match), player career, etc. Heading actions for 18 players observed in two to four matches were counted and correlated with their self-reported values. Results: Neither match nor lifetime heading exposure was associated with neuropsychological test performance. Nineteen players scored below the 95% confidence interval for one or more subtasks, but they did not differ from the rest regarding the number of previous concussions or lifetime or match heading exposure. The number of previous concussions was positively associated with lifetime heading exposure (exponent (B) = 1.97(1.03–3.75), p = 0.039), but there was no relation between previous concussions and test performance. Self-reported number of headings correlated well with the observed values (Spearman's ? = 0.77, p<0.001). Conclusion: Computerised neuropsychological testing revealed no evidence of neuropsychological impairment due to heading exposure or previous concussions in a cohort of Norwegian professional football players.

Straume-Naesheim, T; Andersen, T; Dvorak, J; Bahr, R



No cumulative effects for one or two previous concussions  

PubMed Central

Background Sports medicine clinicians and the general public are interested in the possible cumulative effects of concussion. Objective To examine whether athletes with a history of one or two previous concussions differed in their preseason neuropsychological test performances or symptom reporting. Method Participants were 867 male high school and university amateur athletes who completed preseason testing with ImPACT version 2.0. They were sorted into three groups on the basis of number of previous concussions. There were 664 athletes with no previous concussions, 149 with one previous concussion, and 54 with two previous concussions. Multivariate analysis of variance was conducted using the verbal memory, visual memory, reaction time, processing speed, and postconcussion symptom composite scores as dependent variables and group membership as the independent variable. Results There was no significant multivariate effect, nor were there any significant main effects for individual scores. There was no measurable effect of one or two previous concussions on athletes' preseason neuropsychological test performance or symptom reporting. Conclusion If there is a cumulative effect of one or two previous concussions, it is very small and undetectable using this methodology.

Iverson, G L; Brooks, B L; Lovell, M R; Collins, M W



Previous Open Rotor Research in the US.  

National Technical Information Service (NTIS)

Previous Open Rotor noise experience in the United States, current Open Rotor noise research in the United States and current NASA prediction methods activities were presented at a European Union (EU) X-Noise seminar. The invited attendees from EU industr...

D. VanZante



Characterization of a rare case of Ullrich congenital muscular dystrophy due to truncating mutations within the COL6A1 gene C-Terminal domain: a case report  

PubMed Central

Background Mutations within the C-terminal region of the COL6A1 gene are only detected in Ullrich/Bethlem patients on extremely rare occasions. Case presentation Herein we report two Brazilian brothers with a classic Ullrich phenotype and compound heterozygous for two truncating mutations in COL6A1 gene, expected to result in the loss of the ?1(VI) chain C2 subdomain. Despite the reduction in COL6A1 RNA level due to nonsense RNA decay, three truncated alpha1 (VI) chains were produced as protein variants encoded by different out-of-frame transcripts. Collagen VI matrix was severely decreased and intracellular protein retention evident. Conclusion The altered deposition of the fibronectin network highlighted abnormal interactions of the mutated collagen VI, lacking the ?1(VI) C2 domain, within the extracellular matrix, focusing further studies on the possible role played by collagen VI in fibronectin deposition and organization.



Babesiosis due to the canine Babesia microti-like small piroplasm in dogs - first report from Portugal and possible vertical transmission  

PubMed Central

Background Canine babesiosis (or piroplasmosis) is endemic in northern Portugal, but molecularly confirmed cases of infection with small piroplasms have not been reported in the country. Three German shepherd dogs - a bitch and its 2-month old pup and an unrelated male - clinically suspected of piroplasmosis were assessed for babesial infection. Results Parasitemia with small piroplasms was detected by microscopy in two dogs. All three dogs were positive by PCR and the Babesia microti-like small piroplasm (syn. Theileria annae) was identified by DNA sequencing. These are the first confirmed cases of babesiosis caused by the B. microti-like piroplasm both in dogs from Portugal and in dogs suspected of clinical piroplasmosis outside of Spain. Conclusions Although the bitch and the male had visited neighboring Galicia (northwestern Spain), where the disease is endemic, incursion of this piroplasm into northern Portugal is evident and infection of the non-traveled pup was due to either vertical transmission or autochthonous tick infection.



Spontaneous tibiotalar arthrodesis as a complication of acute tibial osteomyelitis due to Panton-Valentine leukocidin-producing Staphylococcus aureus: a case report  

PubMed Central

Introduction Strains of Panton-Valentine leukocidin-producing Staphylococcus aureus producing a new pattern of disease have emerged worldwide. Infection with these bacteria typically presents as a life-threatening infection of soft tissues and bones, and may cause potentially devastating consequences. Case presentation We report a case of osteoarticular infection caused by Panton-Valentine leukocidin-producing Staphylococcus aureus. A 12-year-old Caucasian girl presented with acute osteomyelitis of the tibia associated with toxic shock syndrome, which was complicated by an unexpected spontaneous ankle arthrodesis. Conclusions Osteoarticular infections due to Panton-Valentine leukocidin-producing Staphylococcus aureus appear to be severe, and are characterized by their tendency to evolve towards serious complications. This case highlights the need for early and aggressive surgical procedures in conjunction with appropriate antimicrobial therapy and regular long-term follow-up.



Neurological deterioration due to missed thoracic spinal stenosis after decompressive lumbar surgery: A report of six cases of tandem thoracic and lumbar spinal stenosis.  


There have been a few reports of patients with a combination of lumbar and thoracic spinal stenosis. We describe six patients who suffered unexpected acute neurological deterioration at a mean of 7.8 days (6 to 10) after lumbar decompressive surgery. Five had progressive weakness and one had recurrent pain in the lower limbs. There was incomplete recovery following subsequent thoracic decompressive surgery. The neurological presentation can be confusing. Patients with compressive myelopathy due to lower thoracic lesions, especially epiconus lesions (T10 to T12/L1 disc level), present with similar symptoms to those with lumbar radiculopathy or cauda equina lesions. Despite the rarity of this condition we advise that patients who undergo lumbar decompressive surgery for stenosis should have sagittal whole spine MRI studies pre-operatively to exclude proximal neurological compression. Cite this article: Bone Joint J 2013;95-B:1388-91. PMID:24078537

Fushimi, K; Miyamoto, K; Hioki, A; Hosoe, H; Takeuchi, A; Shimizu, K



Basal ganglia stroke due to mild head trauma in pediatric age - clinical and therapeutic management: a case report and 10 year literature review  

PubMed Central

Ischemia of the basal ganglia as an immediate consequence of minor head injury in children is rare (< 2% of all ischemic stroke in childhood) and is due to vasospasm of the lenticulostriate arteries. The clinical history of these lesions is particularly favourable because they are usually small, and also because the facial-brachial-crural hemiparesis typical of this pathology usually regresses after a period ranging from several weeks to several months, despite the persistence of an ischemic area on MRI. This is due to the well known neuronal plasticity of the CNS, in particular, of the primary motor cortex. The most effective therapeutic approach appears to be the conservative one, although the best treatment regimen is still not well defined. Young patients should be closely monitored and treated conservatively with osmotic diuretics to reduce perilesional edema. At the same time, however, it is very important to exclude, by means of instrumental and laboratory studies, conditions that could favour the onset of ischemia, including emboligen heart disease, thrombophilia and acute traumatic arterial dissections. Generally speaking, the prognosis in these cases is good. The authors describe their experience treating a 10-month old baby girl, with a left lenticular nucleus ischemia and report a literature review.



Recurrent cardiac amyloidosis following previous heart transplantation  

Microsoft Academic Search

Recurrent cardiac amyloidosis has been reported in the literature. We present two cases, one at 41 months after heart transplant and autologous stem cell transplant, and the other, at 83 months following heart transplantation. The former is the first case ever reported of a patient with amyloid light chain amyloidosis with systemic recurrence following these two treatment modalities, and the

Adriana Luk; Eric Ahn; Andrew Lee; Heather J. Ross; Jagdish Butany



Expanded Prader-Willi syndrome due to chromosome 15q11.2-14 deletion: report and a review of literature.  


We report on a male infant with de novo unbalanced t(5;15) translocation resulting in a 17.23?Mb deletion within 15q11.2-q14 and a 25.12?kb deletion in 5pter. The 15q11.2-q14 deletion encompassed the 15q11.2-q13 Prader-Willi syndrome (PWS) critical region and the recently described 15q13.3 microdeletion syndrome region while the 5pter deletion contained no RefSeq genes. From our literature review, patients with similar deletions in chromosome 15q exhibit expanded phenotype of severe developmental delay, protracted feeding problem, absent speech, central visual impairment, congenital malformations and epilepsy in addition to those typical of PWS. The patient reported herein had previously unreported anomalies of mega cisterna magna, horseshoe kidney and the rare neonatal interstitial lung disease known as pulmonary interstitial glycogenosis. Precise breakpoint delineation by microarray is useful in patients with atypical PWS deletions to guide investigation and prognostication. PMID:23633107

Liu, Anthony P Y; Tang, Wing Fai; Lau, Elizabeth T; Chan, Kelvin Y K; Kan, Anita S Y; Wong, Kar Yin; Tso, Winnie W Y; Jalal, Khair; Lee, So Lun; Chau, Christy S K; Chung, Brian H Y



Acute tubular necrosis due to cutaneous contact with cresol.  


The authors report a case of a 43-year-old woman who presented with second degree chemical burns to 9% of the total body surface area due to cutaneous contact with cresol. This was associated with acute oliguric kidney injury requiring haemodialysis. In contrast to previous reports of cresol ingestion, the patient did not have evidence of hepatic dysfunction, possibly due to a low cresol concentration in the portal vein and liver. Renal histopathology showed regional accentuated tubular necrosis and disruption of the tubular basement membrane. Renal toxicity was thought to be due to direct tubular toxicity and impaired renal blood flow. PMID:22707573

Okamoto, Koji; Noiri, Eisei; Oka, Machiko; Moriya, Hidekazu; Ohtake, Takayasu; Kobayashi, Shuzo



Acute tubular necrosis due to cutaneous contact with cresol  

PubMed Central

The authors report a case of a 43-year-old woman who presented with second degree chemical burns to 9% of the total body surface area due to cutaneous contact with cresol. This was associated with acute oliguric kidney injury requiring haemodialysis. In contrast to previous reports of cresol ingestion, the patient did not have evidence of hepatic dysfunction, possibly due to a low cresol concentration in the portal vein and liver. Renal histopathology showed regional accentuated tubular necrosis and disruption of the tubular basement membrane. Renal toxicity was thought to be due to direct tubular toxicity and impaired renal blood flow.

Okamoto, Koji; Noiri, Eisei; Oka, Machiko; Moriya, Hidekazu; Ohtake, Takayasu; Kobayashi, Shuzo



Placenta previa and previous cesarean section  

Microsoft Academic Search

Objective: To assess the relationship between previous cesarean section and subsequent development of placenta previa and placenta previa with accreta. Method: The records of all patients delivered with the diagnosis of placenta previa during the 10-year period from 1984 to 1993 were reviewed. Results: From a total of 50 485 deliveries, 421 (0.83%) had placenta previa, 43 (10.2%) of whom

W. W. K. To; W. C. Leung



Sudden death in custody due to pituitary apoplexy during long restriction in a sitting position: A case report and review of the literature.  


Pituitary apoplexy is an uncommon clinical emergency arising from hemorrhage into or infarction of a pituitary adenoma. The most common presentation is sudden headache, visual field defects and signs of hypopituitarism. It usually occurs in the age group from 20 to 50 years and affects more male than female. Sudden death due to pituitary apoplexy without common symptoms is rarely reported. Here, we described a scarcely-reported case of sudden death in custody caused by pituitary apoplexy resulting from stress-induced hemorrhage of gonadotroph adenoma, a kind of pituitary adenoma, without common clinical symptoms. In this case, a 49-year-old man was restrained in a sitting position for 4 days and died unexpectedly. At autopsy, external examination showed free of trauma. Destruction of bony structure and a circumscribed pituitary tumor were observed in sella turcica. Immunohistochemically, the tumor cells were particular positive for follicle-stimulating hormone (FSH) and luteinizing hormone (LH), thus clarifying the presence of a pituitary gonadotroph adenoma. We provide the case description and a short review of pituitary apoplexy and pituitary adenoma as a rare cause of sudden death. PMID:24112326

Sun, Tingyi; Liu, Liang; Sunnassee, Ananda; Zhuo, Luo; Zhu, Shaohua



A previously undescribed coronavirus associated with respiratory disease in humans  

Microsoft Academic Search

The etiology of acute respiratory tract illnesses is sometimes unclear due to limitations of diagnostic tests or the existence of as-yet-unidentified pathogens. Here we describe the identification and characterization of a not previously recognized coronavirus obtained from an 8-mo-old boy suffering from pneumonia. This coronavirus replicated efficiently in tertiary monkey kidney cells and Vero cells, in contrast to human coronaviruses

Ron A. M. Fouchier; Nico G. Hartwig; Theo M. Bestebroer; Berend Niemeyer; Jan C. de Jong; James H. Simon; Albert D. M. E. Osterhaus



Previous injuries and behavior problems predict children's injuries.  


Investigated factors related to unintentional injuries in 50 children from summer day camps for economically underprivileged youth. Data were collected on parent reports of children's previous medically treated injuries, Eyberg Child Behavior Inventory (ECBI) scores, and the day camp's incident reports of injuries. One year later, parents completed a second questionnaire about medically and home-treated injuries. Multiple linear regression indicated that previous medically treated injury, ECBI opposition score, and injury at camp accounted for 50% of the variance of medically treated injuries in the year after camp. Previous medically treated injury accounted for 21% of the variance in frequent home-treated injuries during the year after camp. Children who have behavior problems may behave in ways that predispose them to common injuries. Conceptualizing injury as a behavioral process suggests behavior change strategies to reduce injury risk and ways to target children for injury prevention efforts. PMID:8151497

Jaquess, D L; Finney, J W



Clinical characteristics of depressed outpatients previously overdiagnosed with bipolar disorder  

Microsoft Academic Search

The diagnosis of bipolar disorder in depressed patients requires the ascertainment of prior episodes of mania and hypomania. Several research reports and commentaries have suggested that bipolar disorder is underrecognized and that many patients with nonbipolar major depressive disorder have, in fact, bipolar disorder. In a previous article from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS)

Mark Zimmerman; Camilo J. Ruggero; Iwona Chelminski; Diane Young



[Trial of labor after previous cesarean section].  


Elective repeat cesarean section continues to remain the standard to care at GYK and OBST. Department in Sarajevo. This paper is a study of 216 patients with previous cesarean section who requested and were allowed a trial of labor. One hundred fifty-six (72%) achieved successful vaginal delivery with no maternal or fetal mortality or significant morbidity. Review of the USA literature indicates similar results in other independent studies. Continued accumulation of cases showing the efficacy of post-cesarean section trial of labor should encourage a reassessment of the continuing practice of elective repeat cesarean section. PMID:15202322

Dizdarevi?, Jadranka; Abadzi?, Nidzara; Begi?, Kerim; Nikulin, Boris; Mulali?, Lejla; Dekovi?, Sanjin; Gavrankapeta-novi?, Faris; Beganovi?, Naila; Stojkanovi?, Goran



Intra-abdominal hypertension due to heparin - induced retroperitoneal hematoma in patients with ventricle assist devices: report of four cases and review of the literature  

PubMed Central

Introduction Elevated intra-abdominal pressure (IAP) has been identified as a cascade of pathophysiologic changes leading in end-organ failure due to decreasing compliance of the abdomen and the development of abdomen compartment syndrome (ACS). Spontaneous retroperitoneal hematoma (SRH) is a rare clinical entity seen almost exclusively in association with anticoagulation states, coagulopathies and hemodialysis; that may cause ACS among patients in the intensive care unit (ICU) and if treated inappropriately represents a high mortality rate. Case Presentation We report four patients (a 36-year-old Caucasian female, a 59-year-old White-Asian male, a 64-year-old Caucasian female and a 61-year-old Caucasian female) that developed an intra-abdominal hypertension due to heparin-induced retroperitoneal hematomas after implantation of ventricular assist devices because of heart failure. Three of the patients presented with dyspnea at rest, fatigue, pleura effusions in chest XR and increased heart rate although b-blocker therapy. A 36-year old female (the forth patient) presented with sudden, severe shortness of breath at rest, 10 days after an "acute bronchitis". At the time of the event in all cases international normalized ratio (INR) was <3.5 and partial thromboplastin time <65 sec. The patients were treated surgically, the large hematomas were evacuated and the systemic manifestations of the syndrome were reversed. Conclusion Identifying patients in the ICU at risk for developing ACS with constant surveillance can lead to prevention. ACS is the natural progression of pressure-induced end-organ changes and develops if IAP is not recognized and treated in a timely manner. Failure to recognize and appropriately treat ACS is fatal while timely intervention - if indicated - is associated with improvements in organ function and patient survival. Means for surgical decision making are based on clinical indicators of adverse physiology, rather than on a single measured parameter.



Current Psychopathology in Previously Assaulted Older Adults  

ERIC Educational Resources Information Center

Older adult women age 55+ years (N = 549) were interviewed as part of a population-based epidemiological research study of lifetime experiences with physical and sexual assault and current mental health problems. Although overall rates of psychopathology were low, producing very small cells for comparison, women who reported experiencing physical…

Acierno, Ron; Lawyer, Steven R.; Rheingold, Alyssa; Kilpatrick, Dean G.; Resnick, Heidi S.; Saunders, Benjamin E.



Observations on water system and pipeline performance in the Limon area of Costa Rica due to the April 22, 1991 earthquake. Technical report  

SciTech Connect

The document focuses on earthquake damage to water and oil pipelines, water supply, and water treatment following the 22 April 1991 Costa Rica Earthquake. The moment magnitude 7.5 earthquake occurred approximately 40 km south-southwest of Limon, and resulted in a coseismic uplift of up to 1.5 meters along Costa Rica's east coast. The report also provides an overview of the engineering aspects of the event and recovery activities. Turbidity in the watershed which provides Limon's primary water supply increased to as high as 2.4 percent solids, making it extremely difficult to treat. In addition, the water treatment plant was damaged by the earthquake. Cast iron, ductile iron and reinforced concrete cylinder pipe water transmission lines were damaged by both wave propagation and permanent ground deformation. Water distribution piping, also including PVC and galvanized iron, was similarly impacted. Documentation and evaluation of that damage is described, and compared with empirical estimates from previous earthquakes. Twin 150 mm (6 in), 100 km long, oil transmission lines suffered only a single failure from wrinkling. A description of the pipelines and the failure is provided.

O'Rourke, M.J.; Ballantyne, D.



Lemierre's syndrome due to community-acquired meticillin-resistant Staphylococcus aureus infection and presenting with orbital cellulitis: a case report  

PubMed Central

Introduction Lemierre's syndrome is septic thrombophlebitis of the internal jugular vein leading to metastatic septic complications following an oropharyngeal infection. It is usually caused by the anaerobe, Fusobacterium necrophorum. Of late, meticillin-resistant Staphylococcus aureus is increasingly being recognised as a cause of community-acquired skin and soft tissue infections. We report a rare case of Lemierre's syndrome caused by community-acquired meticillin-resistant Staphylococcus aureus infection. Case presentation A previously healthy 16-year-old girl presented with fever of 13 days duration, painful swelling around the right eye and diplopia followed by the appearance of pulmonary infiltrates. Imaging studies confirmed the clinical suspicion of bilateral jugular venous thrombosis with septic pulmonary embolism. Meticillin-resistant Staphylococcus aureus was isolated on blood cultures. The hospital course was complicated by massive haemoptysis and pulmonary aspiration necessitating mechanical ventilation. The patient subsequently made a complete recovery. Conclusion Lemierre's syndrome, although rare, is a potentially lethal but treatable complication of head and neck sepsis. Early clinical recognition of Lemierre's syndrome and appropriate antibiotic treatment can be life-saving. One should consider the possibility of community-acquired meticillin-resistant Staphylococcus aureus infection in patients with suspected Lemierre's syndrome.

Kadhiravan, Tamilarasu; Piramanayagam, Paramasivan; Banga, Amit; Gupta, Rajiva; Sharma, Surendra K



Acalculous candidal cholecystitis: a previously unrecognized complication after cardiac transplantation.  


Acalculous cholecystitis is a life-threatening complication in critically ill surgical patients. Whereas Candida albicans and Torulopsis glabrata have been reported as the primary pathogens in 14 previous cases of acalculous cholecystitis, we report the first case of Candida parapsilosis as a biliary pathogen in a patient after cardiac transplantation. Although cardiac transplant recipients often have many of the risk factors for acalculous candidal cholecystitis, including major surgery, immunosuppression, antibiotic therapy, parenteral nutrition, and prolonged intensive care unit stay, this entity has not been previously reported in the cardiac transplant population. Although rare, acalculous candidal cholecystitis is associated with very high morbidity and a mortality rate of 40%. Early diagnosis necessitates an aggressive approach to the critically ill patient with abdominal complaints. Prompt drainage or cholecystectomy, if possible, represent the mainstays of therapy and offer the greatest chance for survival. PMID:7639242

Mandak, J S; Pollack, B; Fishman, N O; Furth, E E; Kochman, M L; Acker, M A; Lichtenstein, G R



[Syndrome of inappropriate secretion of anti-diuretic hormone associated with limbic encephalitis due to herpes simplex virus infection--a case report].  


We report a case of syndrome of inappropriate secretion of anti-diuretic hormone (SIADH) associated with limbic encephalitis. A 79-year-old woman was admitted with a complaint of fever, disturbance of consciousness and generalized seizure. Her conscious level was E1V2M4 by Glasgow coma scale. Physical examination showed generalized seizure, neck stiffness, hyperreflexia and flaccid paralysis in her all extremities, and pathological reflexes. Blood analysis revealed hyponatremia, decrease of plasma osmolarity, spared secretion of urine sodium and increase of ADH, leading to the diagnosis of SIADH. Cerebrosponal fluid examination showed mild pleocytosis, elevated protein, and normal glucose level. Although herpes simplex virus (HSV) DNA was not detected by the polymerase chain reaction method, titers of anti-HSV IgG antibody elevated chronologically. Brain MRI revealed abnormal T2 and FLAIR high intensities in the cingulate gyrus and hippocampus bilaterally. An EEG revealed periodic synchronous discharges predominantly in the frontal areas. Based on the clinical course, laboratory data, MRI and EEG findings, we diagnosed as SIADH associated with acute limbic encephalitis caused by HSV infection. After the fluid restriction and sodium supply, plasma sodium was normalized. Administration of acyclovir and steroid was not so effective, however her condition improved gradually. Several cases of SIADH associated with limbic encephalitis have been reported; however, the pathophysiology is to be clarified. We thought that in the presented case, SIADH was caused by disturbance of the hormonal control at the hypothalamus on the pituitary gland due to the spreading of inflammation from limbic system to these areas. PMID:18409538

Kuriki, Ayako; Ishihara, Kenji; Satoh, Hironori; Sugie, Masayuki; Kato, Hirotaka; Kawamura, Mitsuru



Congruency sequence effects are driven by previous-trial congruency, not previous-trial response conflict.  


Congruency effects in distracter interference tasks are often smaller after incongruent trials than after congruent trials. However, the sources of such congruency sequence effects (CSEs) are controversial. The conflict monitoring model of cognitive control links CSEs to the detection and resolution of response conflict. In contrast, competing theories attribute CSEs to attentional or affective processes that vary with previous-trial congruency (incongruent vs. congruent). The present study sought to distinguish between conflict monitoring and congruency-based accounts of CSEs. To this end, we determined whether CSEs are driven by previous-trial reaction time (RT)-a putative measure of response conflict-or by previous-trial congruency. In two experiments using a face-word Stroop task (n = 49), we found that current-trial congruency effects did not vary with previous-trial RT independent of previous-trial congruency. In contrast, current-trial congruency effects were influenced by previous-trial congruency independent of previous-trial RT. These findings appear more consistent with theories that attribute CSEs to non-conflict processes whose recruitment varies with previous-trial congruency than with theories that link CSEs to previous-trial response conflict. PMID:24027550

Weissman, Daniel H; Carp, Joshua



Due Process and Higher Education: A Systemic Approach to Fair Decision Making. ASHE-ERIC Higher Education Report, Volume 27, Number 2.  

ERIC Educational Resources Information Center

|Due process has become an important principle in higher education as a result of many new legal issues, including dismissals of students from campus, firings of staff members, faculty tenure and promotion, sexual harassment, discrimination, and substance abuse. This volume defines due process; explains when due process procedures are required;…

Stevens, Ed


Successful Treatment of Cardiomyopathy due to Very Long-Chain Acyl-CoA Dehydrogenase Deficiency: First Case Report from Oman with Literature Review.  


Very long-chain acyl-CoA dehydrogenase deficiency (MIM 201475) is a severe defect of mitochondrial energy production from oxidation of very long-chain fatty acids. This inherited metabolic disorder often presents in early neonatal period with episodes of symptomatic hypoglycemia usually responding well to intravenous glucose infusion. These babies are often discharged without establishment of diagnosis but return by 2-5 months of age with severe and progressive cardiac failure due to hypertrophic cardiomyopathy with or without hepatic failure and steatosis. An early diagnosis and treatment with high concentration medium chain triglycerides based feeding formula can be life saving in such patients. Here, we report the first diagnosed and treated case of Very long-chain acyl-CoA dehydrogenase deficiency in Oman. This infant developed heart failure with left ventricular dilation, hypertrophy and pericardial effusion at the age of 7 weeks. Prompt diagnosis and subsequent intervention with medium chain triglycerides-based formula resulted in a reversal of severe clinical symptoms with significant improvement of cardiac status. This treatment also ensured normal growth and neurodevelopment. It is stressed that the disease must be recognized by the pediatricians and cardiologists since the disease can be identified by Tandem Mass Spectrometry; therefore, it should be considered to be included in expanded newborn screening program, allowing early diagnosis and intervention in order to ensure better outcome and prevent complications. PMID:24044064

Sharef, Sharef Waadallah; Al-Senaidi, Khalfan; Joshi, Surendra Nath



Forest NEP is significantly driven by previous year's weather  

NASA Astrophysics Data System (ADS)

Understanding the response of forest net ecosystem productivity (NEP) to environmental drivers under climate change is highly relevant for predictions of annual forest carbon (C) flux budgets. Modeling annual forest NEP with soil-vegetation-atmosphere transfer models (SVATs), however, remains challenging due to unknown responses of forests to weather of the previous year. In this study, we addressed the influence of previous year's weather on the inter-annual variability of NEP for a subalpine spruce forest in Switzerland. Analysis of long-term (1997-2011) eddy covariance measurements showed that the Norway spruce forest Davos Seehornwald was a consistent sink for atmospheric CO2, sequestering 210 ± 88 g C m-2 per year on average. Previous year's weather strongly affected inter-annual variability of NEP, increasing the explained variance in linear models to 53% compared to 20% without previous year's weather. Thus, our results highlight the need to consider previous year's weather in modeling annual C budgets of forests. Furthermore, soil temperature in the current year's spring played a major role controlling annual NEP, mainly by influencing gross primary productivity early in the year, with spring NEP accounting for 56% of annual NEP. Consequently, we expect an increase in net CO2 uptake with future climate warming, as long as no other resources become limiting.

Zielis, S.; Etzold, S.; Zweifel, R.; Eugster, W.; Haeni, M.; Buchmann, N.



Radiotherapeutic alternatives for previously irradiated recurrent gliomas  

PubMed Central

Re-irradiation for recurrent gliomas has been discussed controversially in the past. This was mainly due to only marginal palliation while being associated with a high risk for side effects using conventional radiotherapy. With modern high-precision radiotherapy re-irradiation has become a more wide-spread, effective and well-tolerated treatment option. Besides external beam radiotherapy, a number of invasive and/or intraoperative radiation techniques have been evaluated in patients with recurrent gliomas. The present article is a review on the available methods in radiation oncology and summarizes results with respect to outcome and side effects in comparison to clinical results after neurosurgical resection or different chemotherapeutic approaches.

Combs, Stephanie E; Debus, Jurgen; Schulz-Ertner, Daniela



Acute formation of a pseudoaneurysm adjacent to a previously clipped anterior communicating artery aneurysm  

PubMed Central

Background: Cerebral pseudoaneurysms, especially of the anterior communicating artery (ACoA), are rare. Case Description: Herein, the authors report a 66-year-old patient who underwent successful clip ligation of a small ruptured ACoA aneurysm. Eighteen days after surgery, he suffered from another episode of subarachnoid hemorrhage due to the rupture of a newly formed pseudoaneurysm adjacent to the previously clipped aneurysm. This pseudoaneurysm was treated through clip ligation as well. Conclusion: A pseudoaneurysm may rarely form adjacent to a previously clipped cerebral aneurysm and should be included in the differential diagnosis of recurrent subarachnoid hemorrhage. Potential mechanisms of formation and management strategies for this challenging problem will be discussed.

Shoja, Mohammadali M.; Tubbs, R. Shane; Cohen-Gadol, Aaron A.



Accessing previous mental sleep experience in REM and NREM sleep.  


This study investigated the processes by which contents previously stored in memory are retrieved and inserted into mental sleep experience (MSE). MSE reports were collected from six subjects awakened three times on each of eight nights in two alternate sequences of awakenings (NREM-REM-NREM; REM-REM-REM). The occurrences of interrelations between contents of report pairs were scored using Clark's (1970) feature matching model. These were greater for same night pairs than for different night pairs, and did not differ with respect to sequence of awakenings or order of report pairs (first-second, second-third, first-third). Contents of previous MSEs, therefore, seem to be accessible in both sleep types for insertion into current MSE. The interrelated units were more frequently lexical than propositional, with more paradigmatic than syntagmatic relationships in report pairs from both sequences of awakenings. Thus, the re-elaboration of contents of previous MSEs seems to occur mainly at the level of single contents in both types of sleep, with similar modalities of processing. PMID:2590707

Fagioli, I; Cipolli, C; Tuozzi, G



A previously undescribed pathway for pyrimidine catabolism  

PubMed Central

The b1012 operon of Escherichia coli K-12, which is composed of seven unidentified ORFs, is one of the most highly expressed operons under control of nitrogen regulatory protein C. Examination of strains with lesions in this operon on Biolog Phenotype MicroArray (PM3) plates and subsequent growth tests indicated that they failed to use uridine or uracil as the sole nitrogen source and that the parental strain could use them at room temperature but not at 37°C. A strain carrying an ntrB(Con) mutation, which elevates transcription of genes under nitrogen regulatory protein C control, could also grow on thymidine as the sole nitrogen source, whereas strains with lesions in the b1012 operon could not. Growth-yield experiments indicated that both nitrogens of uridine and thymidine were available. Studies with [14C]uridine indicated that a three-carbon waste product from the pyrimidine ring was excreted. After trimethylsilylation and gas chromatography, the waste product was identified by mass spectrometry as 3-hydroxypropionic acid. In agreement with this finding, 2-methyl-3-hydroxypropionic acid was released from thymidine. Both the number of available nitrogens and the waste products distinguished the pathway encoded by the b1012 operon from pyrimidine catabolic pathways described previously. We propose that the genes of this operon be named rutA–G for pyrimidine utilization. The product of the divergently transcribed gene, b1013, is a tetracycline repressor family regulator that controls transcription of the b1012 operon negatively.

Loh, Kevin D.; Gyaneshwar, Prasad; Markenscoff Papadimitriou, Eirene; Fong, Rebecca; Kim, Kwang-Seo; Parales, Rebecca; Zhou, Zhongrui; Inwood, William; Kustu, Sydney



Sebacinales everywhere: previously overlooked ubiquitous fungal endophytes.  


Inconspicuous basidiomycetes from the order Sebacinales are known to be involved in a puzzling variety of mutualistic plant-fungal symbioses (mycorrhizae), which presumably involve transport of mineral nutrients. Recently a few members of this fungal order not fitting this definition and commonly referred to as 'endophytes' have raised considerable interest by their ability to enhance plant growth and to increase resistance of their host plants against abiotic stress factors and fungal pathogens. Using DNA-based detection and electron microscopy, we show that Sebacinales are not only extremely versatile in their mycorrhizal associations, but are also almost universally present as symptomless endophytes. They occurred in field specimens of bryophytes, pteridophytes and all families of herbaceous angiosperms we investigated, including liverworts, wheat, maize, and the non-mycorrhizal model plant Arabidopsis thaliana. They were present in all habitats we studied on four continents. We even detected these fungi in herbarium specimens originating from pioneering field trips to North Africa in the 1830s/40s. No geographical or host patterns were detected. Our data suggest that the multitude of mycorrhizal interactions in Sebacinales may have arisen from an ancestral endophytic habit by specialization. Considering their proven beneficial influence on plant growth and their ubiquity, endophytic Sebacinales may be a previously unrecognized universal hidden force in plant ecosystems. PMID:21347229

Weiss, Michael; Sýkorová, Zuzana; Garnica, Sigisfredo; Riess, Kai; Martos, Florent; Krause, Cornelia; Oberwinkler, Franz; Bauer, Robert; Redecker, Dirk



Sebacinales Everywhere: Previously Overlooked Ubiquitous Fungal Endophytes  

PubMed Central

Inconspicuous basidiomycetes from the order Sebacinales are known to be involved in a puzzling variety of mutualistic plant-fungal symbioses (mycorrhizae), which presumably involve transport of mineral nutrients. Recently a few members of this fungal order not fitting this definition and commonly referred to as ‘endophytes’ have raised considerable interest by their ability to enhance plant growth and to increase resistance of their host plants against abiotic stress factors and fungal pathogens. Using DNA-based detection and electron microscopy, we show that Sebacinales are not only extremely versatile in their mycorrhizal associations, but are also almost universally present as symptomless endophytes. They occurred in field specimens of bryophytes, pteridophytes and all families of herbaceous angiosperms we investigated, including liverworts, wheat, maize, and the non-mycorrhizal model plant Arabidopsis thaliana. They were present in all habitats we studied on four continents. We even detected these fungi in herbarium specimens originating from pioneering field trips to North Africa in the 1830s/40s. No geographical or host patterns were detected. Our data suggest that the multitude of mycorrhizal interactions in Sebacinales may have arisen from an ancestral endophytic habit by specialization. Considering their proven beneficial influence on plant growth and their ubiquity, endophytic Sebacinales may be a previously unrecognized universal hidden force in plant ecosystems.

Weiss, Michael; Sykorova, Zuzana; Garnica, Sigisfredo; Riess, Kai; Martos, Florent; Krause, Cornelia; Oberwinkler, Franz; Bauer, Robert; Redecker, Dirk



The central Onodi cell: A previously unreported anatomic variation  

PubMed Central

Preoperative recognition of the Onodi cell is necessary to avoid injury to closely associated structures, including the internal carotid artery and the optic nerve. This article describes the central Onodi cell, a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge. To our knowledge, this anatomic variation has not been previously reported in the literature. Radiographic and endoscopic imaging of this unique variation is provided.

Cherla, Deepa V.; Tomovic, Senja; Liu, James K.



The central Onodi cell: A previously unreported anatomic variation.  


Preoperative recognition of the Onodi cell is necessary to avoid injury to closely associated structures, including the internal carotid artery and the optic nerve. This article describes the central Onodi cell, a variation in which a posterior ethmoid cell lies superior to the sphenoid sinus in a midline position with at least one optic canal bulge. To our knowledge, this anatomic variation has not been previously reported in the literature. Radiographic and endoscopic imaging of this unique variation is provided. PMID:23772328

Cherla, Deepa V; Tomovic, Senja; Liu, James K; Eloy, Jean Anderson



Previous injuries and persisting symptoms in female soccer players.  


One hundred and fifty players in a female senior soccer division, starting up a new season, were examined for past injuries and persisting symptoms. An incidence of 0.18 injury/player/year was found, which is not significantly different from previously reported injury rates for male soccer. Sprains to the lower extremity and shin-splints were the most common previous injuries. Forty-three percent of the players had some kind of persistent symptom as a result of a past injury. Symptoms from previous ankle and knee sprains and from overuse injuries were the most common. Players who had sustained an ankle joint injury were more prone to have persistent symptoms (p less than 0.05) if they had persistent mechanical instability. Compared to previous retrospective studies on men's soccer, the women showed a higher rate of previous patellar dislocations. These injuries often caused persistent symptoms. The women showed fewer serious knee injuries. This might depend on a real difference in incidence or is just a reflection of female players ceasing to play soccer after a severe knee injury. PMID:2286489

Brynhildsen, J; Ekstrand, J; Jeppsson, A; Tropp, H



5 CFR 732.301 - Due process.  

Code of Federal Regulations, 2010 CFR

... 2009-01-01 2009-01-01 false Due process. 732.301 Section 732.301 Administrative...CONTINUED) NATIONAL SECURITY POSITIONS Due Process and Reporting § 732.301 Due process. When an agency makes an...



5 CFR 732.301 - Due process.  

Code of Federal Regulations, 2010 CFR

... 2010-01-01 2010-01-01 false Due process. 732.301 Section 732.301 Administrative...CONTINUED) NATIONAL SECURITY POSITIONS Due Process and Reporting § 732.301 Due process. When an agency makes an...



Due process in gifted education  

Microsoft Academic Search

Twenty?eight states and the District of Columbia currently provide due process for gifted students. When parents or administrators cannot settle a dispute at the local school board level, some states by law and\\/or regulation offer aggrieved parties the right to mediation or due process. Seven states reported holding 26 due process hearings during the years 1992–1995. This article examines these

Frances A. Karnes; Debra A. Troxclair; Ronald G. Marquardt



Patient-reported visual function outcomes improve after ranibizumab treatment in patients with vision impairment due to diabetic macular edema: randomized clinical trial.  


IMPORTANCE Few data are available on relative changes in vision-related function after treatment for diabetic macular edema (DME). OBJECTIVE To determine the impact of intravitreal ranibizumab, 0.5 mg, compared with laser on patient-reported visual function. DESIGN Phase 3, randomized, double-masked, 12-month study (RESTORE). SETTING Outpatient retina practices in Australia, Canada, and Europe. PARTICIPANTS Patients 18 years or older with type 1 or 2 diabetes mellitus and visual impairment due to DME. INTERVENTIONS Patients were randomized to ranibizumab plus sham laser (n?=?116), ranibizumab plus laser (n?=?118), or sham injections plus laser (n?=?111). Ranibizumab and sham injections were given for 3 consecutive months then as needed; laser or sham laser treatment was given at baseline then as needed. MAIN OUTCOMES AND MEASURES National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) scores at 0, 3, and 12 months for patients receiving 1 or more study treatments with 1 or more postbaseline NEI VFQ-25 assessments and last observation carried forward for missing data. RESULTS Mean baseline NEI VFQ-25 composite scores were 72.8, 73.5, and 74.1 in the ranibizumab, laser, and ranibizumab plus laser groups, respectively. At 12 months, the mean composite scores (95% CIs) improved by 5.0 (ranibizumab vs laser, 2.6 to 7.4; P?=?.01 vs laser) and 5.4 (ranibizumab plus laser vs laser alone, 3.3 to 7.4; P?=?.004 vs laser) from baseline in the ranibizumab and ranibizumab plus laser groups, respectively, compared with 0.6 (-1.8 to 3.0) for the laser group. Near activities scores improved by 9.0 (ranibizumab vs laser, 5.0 to 13.0; P?=?.01) and 9.1 (ranibizumab plus laser vs laser, 5.6 to 12.6; P?=?.006) compared with 1.1 (-3.0 to 5.2) for the laser group, whereas distance activities scores improved by 5.3 (ranibizumab vs laser, 1.8 to 8.9; P?=?.04) and 5.6 (ranibizumab plus laser vs laser, 2.3 to 9.0; P?=?.03) compared with 0.4 (-3.1 to 3.8) for the laser group. Patients with better baseline visual acuity or lower central retinal thickness had greater improvements with ranibizumab treatment compared with laser in composite and some subscale scores compared with patients with worse visual acuity or higher central retinal thickness. CONCLUSIONS AND RELEVANCE These data provide vision-related, patient-reported outcome evidence that mirrors visual acuity outcomes and supports benefits from ranibizumab or ranibizumab plus laser treatment for patients with DME and characteristics similar to those enrolled in this randomized clinical trial. TRIAL REGISTRATION Identifier: NCT00687804. PMID:23974915

Mitchell, Paul; Bressler, Neil; Tolley, Keith; Gallagher, Meghan; Petrillo, Jennifer; Ferreira, Alberto; Wood, Robert; Bandello, Francesco



[Anaphylaxis due to chicken meat].  


Acute anaphylaxis due to chicken meat is very rare; only a few cases have been reported in the literature. We report the case of a 13-year-old girl, with a past history of allergic urticaria due to eggs, who presented immediately after ingestion of lightly grilled chicken meat with facial edema, dysphonia, acute dyspnoea and a feeling of suffocation. A few months later, the patient developed asthma in the vicinity of poultry and after contact with chicken feathers. PMID:22240229

Cheikh Rouhou, S; Bachouch, I; Racil, H; Chaouch, N; Zarrouk, M; Salmi, L; Chabbou, A



Pregnancy hemoperitoneum and placenta percreta in a patient with previous pelvic irradiation and ovarian failure  

SciTech Connect

Placenta percreta in a patient with previous pelvic irradiation has never been described. Reported is a case of placenta percreta with hemoperitoneum associated with a second-trimester incomplete abortion in a patient with previous pelvic irradiation and ovarian failure.

Pridjian, G.; Rich, N.E.; Montag, A.G. (Univ. of Chicago, IL (USA))



Bilateral orbital infarction and retinal detachment in a previously undiagnosed sickle cell hemoglobinopathy African child  

PubMed Central

Bone infarction involving the orbit in sickle cell disease is not common. Bilateral orbital infarction in a previously undiagnosed sickle cell hemoglobinopathy has not been previously reported. In this report, we present a case of an 11-year-old previously undiagnosed sickle cell disease Nigerian girl with severe acute bilateral orbital infarction and retinal detachment to highlight that hemoglobinopathy induced orbital infarction should be considered in African children with acute onset proptosis with or without previous history of sickle cell hemoglobinopathy.

Helen, Onakpoya Oluwatoyin; Ajite, K. O.; Oyelami, O. A.; Asaleye, C. M.; Adeoye, A. O.



An examination of the due process in South Africa which led to the adoption of the draft International Financial Reporting Standard for Small and Medium-sized Entities  

Microsoft Academic Search

Differential reporting was introduced in South Africa with the enactment of the Corporate Laws Amendment Act 24 2006. Since it was urgent that the standard-setters provide limited interest companies with interim guidance as to the preparation and presentation of financial statements, South Africa adopted the International Accounting Standards Board’s International Financial Reporting Standard for Small and Mediumsized Entities in its

L. J. Stainbank



Statin-induced myopathy in a patient with previous poliomyelitis.  


This report describes a patient with a history of poliomyelitis who developed new, progressive symptoms of muscle fatigue and weakness, suggestive of postpoliomyelitis syndrome. However, comprehensive investigations led to the diagnosis of statin-induced myopathy as the cause of the patient's symptoms. This case highlights the possibility of statin-induced myopathy in patients with a history of poliomyelitis and the differential diagnosis between postpoliomyelitis syndrome and statin-induced myopathy in these patients. The possibility of statin-induced myopathy should be considered when patients with previous poliomyelitis who take statin medication develop symptoms suggestive of postpoliomyelitis syndrome. PMID:23370588

Martikainen, Mika H; Gardberg, Maria; Kohonen, Ia; Lähdesmäki, Janne



Successful Recovery After Disseminated Infection Due to Mycobacterium Abscessus in a Lung Transplant Patient: Subcutaneous Nodule as First Manifestation—A Case Report  

Microsoft Academic Search

Mycobacterium abscessus infection following lung transplantation (LT) has been described in a few cases. It is characterized by a variable initial location and subsequent course in this special risk group of patients, particularly those with cystic fibrosis (CF). Herein we have presented the case of a patient subjected to LT due to CF, who 1 year after transplantation developed a

P. Morales; J. A. Ros; M. Blanes; D. Pérez-Enguix; V. Saiz; M. Santos



FASCITIS NECROSANTE DEBIDO A STREPTOCOCO BETA HEMOLITICO GRUPO A: REPORTE DE UN CASO Necrotizing fasciitis due to group A streptococcal beta haemoli  

Microsoft Academic Search

SUMMARY A case of necrotizante Fascitis due to haemolytic Streptococo appears beta group A or S. pyoge- nes in a greater person, feminine sex without well-known underlying disease, with an injury with front door in hand by penetrating minimal traumatism. Consult initially by a acute abdomen and fever, that evolves with local and systemic signs in fast form to the

Luis Ignacio Arjol; Carlos Esteban; Ayala Ortiz; Fausto Rafael Ayala Ortiz


Intra-abdominal hypertension due to heparin - induced retroperitoneal hematoma in patients with ventricle assist devices: report of four cases and review of the literature  

Microsoft Academic Search

INTRODUCTION: Elevated intra-abdominal pressure (IAP) has been identified as a cascade of pathophysiologic changes leading in end-organ failure due to decreasing compliance of the abdomen and the development of abdomen compartment syndrome (ACS). Spontaneous retroperitoneal hematoma (SRH) is a rare clinical entity seen almost exclusively in association with anticoagulation states, coagulopathies and hemodialysis; that may cause ACS among patients in

Stavros I Daliakopoulos; Manja Schaedel; Michael N Klimatsidas; Sotirios Spiliopoulos; Reiner Koerfer; Gero Tenderich



Widely Used Pesticides with Previously Unknown Endocrine Activity Revealed as in Vitro Antiandrogens  

PubMed Central

Background Evidence suggests that there is widespread decline in male reproductive health and that antiandrogenic pollutants may play a significant role. There is also a clear disparity between pesticide exposure and data on endocrine disruption, with most of the published literature focused on pesticides that are no longer registered for use in developed countries. Objective We used estimated human exposure data to select pesticides to test for antiandrogenic activity, focusing on highest use pesticides. Methods We used European databases to select 134 candidate pesticides based on highest exposure, followed by a filtering step according to known or predicted receptor-mediated antiandrogenic potency, based on a previously published quantitative structure–activity relationship (QSAR) model. In total, 37 pesticides were tested for in vitro androgen receptor (AR) antagonism. Of these, 14 were previously reported to be AR antagonists (“active”), 4 were predicted AR antagonists using the QSAR, 6 were predicted to not be AR antagonists (“inactive”), and 13 had unknown activity, which were “out of domain” and therefore could not be classified with the QSAR (“unknown”). Results All 14 pesticides with previous evidence of AR antagonism were confirmed as antiandrogenic in our assay, and 9 previously untested pesticides were identified as antiandrogenic (dimethomorph, fenhexamid, quinoxyfen, cyprodinil, ?-cyhalothrin, pyrimethanil, fludioxonil, azinphos-methyl, pirimiphos-methyl). In addition, we classified 7 compounds as androgenic. Conclusions Due to estimated antiandrogenic potency, current use, estimated exposure, and lack of previous data, we strongly recommend that dimethomorph, fludioxonil, fenhexamid, imazalil, ortho-phenylphenol, and pirimiphos-methyl be tested for antiandrogenic effects in vivo. The lack of human biomonitoring data for environmentally relevant pesticides presents a barrier to current risk assessment of pesticides on humans.

Orton, Frances; Rosivatz, Erika; Scholze, Martin; Kortenkamp, Andreas



Congestive myelopathy (Foix-Alajouanine Syndrome) due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature  

PubMed Central

Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients’ symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

Krishnan, Prasad; Banerjee, Tapas Kumar; Saha, Manash



Atrial fibrillation after taser exposure in a previously healthy adolescent.  


We are reporting a previously healthy adolescent who developed atrial fibrillation after being tased. He has a structurally normal heart on echocardiogram, normal electrolyte level and thyroid function test results, and a urine toxicology screen positive for marijuana. The patient ultimately required external defibrillation to convert his cardiac rhythm to normal sinus rhythm and has had no recurrent arrhythmias since hospital discharge (approximately 1 year). This is the first reported case of atrial fibrillation developing after a Taser shot, occurring in an adolescent without other risk factors. This case illustrates the arrhythmogenic potential of a Taser in otherwise healthy young individuals, and further study of occurrence of Taser-induced arrhythmias is warranted. PMID:20016356

Multerer, Sara; Berkenbosch, John W; Das, Bibhuti; Johnsrude, Christopher



Late Periprosthetic Joint Infection due to Staphylococcus lugdunensis Identified by Matrix-Assisted Laser Desorption/Ionisation Time of Flight Mass Spectrometry: A Case Report and Review of the Literature  

PubMed Central

Staphylococcus lugdunensis, member to the group of coagulase-negative staphylococci, is previously thought to be rarely isolated. Recently other staphylococci have been described, which were supposedly related to S. lugdunensis, such as Staphylococcus pseudolugdunensis and Staphylococcus pettenkoferi. To decrease the rate misidentifications, an accurate identification method, such as matrix-assisted laser desorption ionization time of flight mass spectrometry or molecular methods, should be used. S. lugdunensis is usually associated with severe infections similar to those caused by S. aureus. Moreover, it has been described that skin infections due to S. lugdunensis are severely underreported and could be also underreported in periprosthetic joint infections. Ours is the first case of a late periprosthetic infection of the hip due to S. lugdunensis, identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. A periprosthetic infection due to S. lugdunensis should be treated according to protocols of S. aureus periprosthetic infections, and therefore an accurate species identification is desirable.

Szabados, Florian; Anders, Agnes; Kaase, Martin; Marlinghaus, Lennart; Gatermann, Soren G.; Teske, Wolfram; Lichtinger, Thomas



Deepwater Gulf of Mexico more profitable than previously thought  

SciTech Connect

Economic evaluations and recent experience show that the deepwater Gulf of Mexico (GOM) is much more profitable than previously thought. Four factors contributing to the changed viewpoint are: First, deepwater reservoirs have proved to have excellent productive capacity, distribution, and continuity when compared to correlative-age shelf deltaic sands. Second, improved technologies and lower perceived risks have lowered the cost of floating production systems (FPSs). Third, projects now get on-line quicker. Fourth, a collection of other important factors are: Reduced geologic risk and associated high success rates for deepwater GOM wells due primarily to improved seismic imaging and processing tools (3D, AVO, etc.); absence of any political risk in the deepwater GOM (common overseas, and very significant in some international areas); and positive impact of deepwater federal royalty relief. This article uses hypothetical reserve distributions and price forecasts to illustrate indicative economics of deepwater prospects. Economics of Shell Oil Co.`s three deepwater projects are also discussed.

Craig, M.J.K.; Hyde, S.T. [Spirit Energy 76, Lafayette, LA (United States)



[Infective fungal endocarditis in patients with no previous cardiac disease].  


Infective endocarditis is a serious and uncommon condition affecting the endocardium. Less than 10% of these cases are of fungal origin. A growing number of individuals are at high risk, due to insertion of central venous catheters, total parenteral nutrition and prolonged exposure to broad-spectrum antibiotics, even without previous heart diseases. We retrospectively analysed the records of six children with Candida endocarditis, reviewing the comorbidities, clinical outcome, and treatment. The antifungal agents used were amphotericin B, 5-?uorocytosine and fluconazole. Patients underwent surgical excision of vegetation, five tricuspid valve repairs and one mitral valve replacement. There were no hospital deaths, and one child needed a new valvuloplasty one year later. The mean follow up was five years, and all have good valvular function without recurrent endocarditis. A combination of synergistic long-term antifungal treatment and early surgical intervention is recommended. PMID:22841655

Marcano Sanz, L; Naranjo Ugalde, A; González Guillén, A; Bermúdez Gutiérrez, G; Frías Griskho, F



A Sarcoma at the Site of Previous Extravasation of Adriamycin  

PubMed Central

We report the case of a 66-year-old man presenting with a high-grade pleomorphic sarcoma at the left elbow 16 years after the extravasation of adriamycin given for a malignant ifbrous histiocytoma of the tibia.We suggest that this sarcoma originated in a multistep way over many years, out of the chronic inflammatory tissue that developed due to a non-specific cellular damage at the nuclear level, interfering with normal cell replication necessary for normal healing tissue healing. As a result, the non-healed chronic inflammatory tissue transformed over several years into a preneoplastic mesenchymal tumour and later into a high-grade pleomorphic sarcoma.

Ceulemans, Joris; Sciot, Raf; Debiec-Rychter, Maria; van Oosterom, Allan T.



Analysis of reservoir heterogeneities due to shallowing-upward cycles in carbonate rocks of the Pennsylvanian Wahoo Limestone of Northeastern Alaska. Annual report, September 1989--September 1990.  

National Technical Information Service (NTIS)

This report presents the preliminary results of research accomplished by a team of specialists in carbonate petrology, biostratigraphy, and diagenesis during the 1989--1990 fiscal year. It includes a summary of some of the petrographic data which has been...

K. F. Watts



Primary intrahepatic malignant mesothelioma with multiple lymphadenopathies due to non-tuberculous mycobacteria: A case report and review of the literature  

PubMed Central

Primary intrahepatic malignant mesothelioma (PIHMM) is an extremely rare tumor with clinicopathological characteristics that remain to be elucidated. The current study presents the case of a 68-year-old female with PIHMM and multiple lymphadenopathies due to non-tuberculous mycobacteria. The patient presented with an intrahepatic tumor, 70 mm in diameter, in the right lobe of the liver. An ultrasound-guided fine-needle aspiration biopsy of the liver tumor revealed findings that were consistent with an intrahepatic malignant mesothelioma. The systemic lymph node swellings were due to epithelioid granulomas that were caused by non-tuberculous mycobacteria. However, a hepatic rupture occurred due to the rapid growth of the liver tumor and consequently, a surgical resection was not performed. A review of the literature revealed that the clinicopathological characteristics of PIHMM are similar to those of non-occupational mesothelioma. However, PIHMM is usually a solitary tumor and is rarely associated with cavity effusion in contrast with conventional mesothelioma. Therefore, surgical resection with curative intent is often recommended for patients with PIHMM.




Splenic infarction as a rare complication of infectious mononucleosis due to Epstein-Barr virus infection in a patient with no significant comorbidity: Case report and review of the literature.  


Abstract We report the case of a 17-y-old boy diagnosed with infectious mononucleosis due to Epstein-Barr virus infection who complained of left upper quadrant pain. A magnetic resonance imaging scan showed a splenic infarct in the enlarged spleen. Other causes of splenic infarction were excluded. Thus, infectious mononucleosis may cause splenic infarction in patients without other comorbidities. PMID:23957538

Gavriilaki, Eleni; Sabanis, Nikolaos; Paschou, Eleni; Grigoriadis, Savas; Mainou, Maria; Gaitanaki, Alexandra; Skargani-Koraka, Maria



Ground subsidence due to mining operations. October 1976-November 1989 (Citations from the COMPENDEX data base). Report for October 1976-November 1989  

SciTech Connect

This bibliography contains citations concerning ground subsidence associated with mining operations. Mine subsidence is discussed with reference to mathematical modeling, forecasting extent of cavitation, and rock mechanics and mechanisms of stress relaxation. Damage to above- and below-ground structures as well as agricultural areas, and mining techniques designed to prevent or reduce subsidence are included. Monitoring of subsidence and detection of cavitation for surface, underground, and ocean-floor mining areas are discussed and examples are analyzed. Subsidence due to aquifer water removal is referenced in a related published bibliography. (Contains 213 citations fully indexed and including a title list.)

Not Available



Ulnar-sided wrist pain due to isolated disk tear of triangular fibrocartilage complex within the distal radioulnar joint: two case reports.  


Wrist arthroscopy has been successfully used with many modifications and improvements. However, distal radioulnar joint (DRUJ) arthroscopy is still uncommon. We experienced 2 cases of ulnar-sided wrist pain due to isolated triangular fibrocartilage complex (TFCC) disk tear within the DRUJ. DRUJ arthroscopy in these cases showed horizontal tear and fibrillation of TFCC disk without TFCC tear at the radiocarpal joint. Foveal attachment was intact in both cases. These were treated with debridement, which relieved pain after surgery and achieved good functional recovery. Although DRUJ arthroscopy is technically difficult, it is mandatory for making a diagnosis and treating ulnar-sided wrist pain. PMID:21548155

Abe, Yukio; Tominaga, Yasuhiro



Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.  

ERIC Educational Resources Information Center

|Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. Total employment of registered nurses (RNs) per capita and the national unemployment rate for RNs have declined, and providers from around the country report growing difficulty recruiting and…

Heinrich, Janet


Low back pain due to spinal chronic subdural hematoma mimicking intradural tumor in the lumbar area: a case report and literature review  

Microsoft Academic Search

Although magnetic resonance imaging has dramatically enhanced the ability to diagnose spinal mass lesions, some lesions remain difficult to diagnose. We report a spinal chronic subdural hematoma that comprised the cauda equina ventrally in the lumbar area in a 51-year-old man who was under anticoagulant therapy. Low back pain was the only symptom of the patient after sports activity. Surgical

Serdar Kahraman; Sait ?irin; Hakan Kayali; Ilker Solmaz; Altay Bedük



CIRRPC Science Panel report No. 6: Use of probability of causation by the veterans administration in the adjudication of claims of injury due to exposure to ionizing radiation  

SciTech Connect

The report was prepared in response to a request from the Administrator of Veterans Affairs, Veterans Administration (VA) Coordination (CIRRPC) to provide guidelines to the VA with respect to the questions ``...for what levels of radiation exposure, if any, the radioepidemiological tables can be used credibly in the rule-making we are conducting pursuant to Public Law 98-542`` and ``...whether CIRRPC`s views in this regard vary with the type of cancer involved and whether use of the NIH tables for certain cancers may be more justifiable than for other cancers.`` The report prepared by the Science Subpanel on Radioepidemiological Tables and approved by the CIRRPC Science Panel answers these questions by listing those cancers both considered to be radiogenic in the NIH Report and to be applicable to veterans and by providing, for these cancers, radiation doses that allow the VA to exclude from further consideration those claims having ``no reasonable possibility`` (a VA stated criteria) of merit. The report provides important scientific information which can be used as part of the evidence for evaluating, along with other evidence, claims not eliminated by the screening procedure.




Metastatic sarcomatoid carcinoma to liver and bone marrow in renal transplant recipient: due to exacerbation of quiescent renal cancer? A case report.  


Sarcomatoid carcinoma is a rare tumor with rapid growth and a poor prognosis. A 60-year-old man underwent kidney transplantation. Three months after transplantation, multiple tumors were found in the liver and bone, and the patient died several days later. Pathological examination of liver and bone marrow biopsies revealed metastatic sarcomatoid carcinoma. Pretransplantation, the patient's workup was positive only for mild thrombocytopenia and a complicated cyst with peripheral rim calcification (Bosniak IIF) in the right kidney. Retrospectively, we found the abdominal computed tomography film, which had been examined at another hospital 6 years previously. The calcified complicated cyst was a 3-cm enhancing solid mass in the right kidney, suggesting renal cell cancer. It is possible that the cancer developed from the calcified complicated cyst. In this case, immunosuppressants may have altered malignant cell proliferation, invasion, and the form of metastasis. PMID:22310638

Choi, H N; Kim, Y S; Chang, J H; Jung, J Y; Chung, W K; Park, Y H; Lee, H H



Fatal frontal sinusitis due to Neisseria sicca and Eubacterium lentum.  


Infectious sinusitis may on occasion be associated with meningitis, subdural empyema, epidural empyema, brain abscess, or osteomyelitis. We report a 29-year-old male patient with frontal sinusitis who developed all of these intracranial complications due to two previously unreported causative organisms, Neisseria sicca and Eubacterium lentum. The fulminant and fatal course resulting from locally invasive disease underscores the importance of early diagnosis and proper treatment of these complications. Possible exacerbating factors in this patient were sickle cell disease and immune compromise due to intravenous drug abuse. PMID:2873255

Moon, T; Lin, R Y; Jahn, A F



22 CFR 40.91 - Certain aliens previously removed.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Certain aliens previously removed. 40.91 Section 40...IMMIGRATION AND NATIONALITY ACT, AS AMENDED Aliens Previously Removed § 40.91 Certain aliens previously removed. (a) 5-year...




Microsoft Academic Search

Zemke BS, Batty RW, Sorenson AM, Ullom GM. The Lasting Neurological Effects of Resistance Training: Comparing Strength Gains in Previously Trained and Non-previously trained College-Aged Males. Journal of Undergraduate Kinesiology Research 2007;3(1):79-85. Purpose: Strength gains made during resistance training are made due to neurological and morphological adaptations. During a period of detraining, some of these adaptations are lost, which need



Combined coronary surgery and aortic valve replacement after previous right pneumonectomy.  


Cardiac surgery in patients with previous pneumonectomy is infrequently reported. We report a case of combined coronary artery bypass grafting and aortic valve replacement in a patient with left ventricular ejection fraction less then 35% and a previous right pneumonectomy. All steps in operative management of this rare condition are discussed. PMID:17685124

Sleilaty, Ghassan; Yazigi, Alexandre; El Asmar, Bechara; Hajj-Chahine, Jamil; Nakad, Joseph; Madi-Jebara, Samia; Aoun-Bacha, Zeina; Badaoui, Georges


In Utero Treatment of Severe Fetal Anaemia due to Parvovirus B19 in One Fetus in a Twin Pregnancy – A Case Report and Literature Review  

Microsoft Academic Search

Background: Parvovirus B19 (PVB19) is a well-established cause of nonimmune hydrops fetalis and fetal anaemia in pregnancy. However, discordant viral infection of only 1 fetus in a twin pregnancy is a rare occurrence. Case Report: A 40-year-old female with dichorionic, diamniotic twin pregnancy presented at 22 weeks with fetal hydrops and severe anaemia in 1 twin. Maternal PVB19 infection was

M. T. Bekhit; P. A. Greenwood; R. Warren; E. Aarons; E. Jauniaux



Onychomycosis due to saprophytic fungi  

Microsoft Academic Search

Twenty five cases of onychomycosis due to filamentous saprophytic agents were diagnosed within the period 1981–1982 in two mycology laboratories in Medellín, Colombia. These cases represented 4.5% and 9.5% respectively of the total fungal nail lesions (FNL) seen at those institutions. No explanation was found for the high frequencies, which sharply contrast with the previous local experience with the disease

H. Vélez; F. Díaz



Reconsolidation may incorporate state-dependency into previously consolidated memories.  


Some memories enter into a labile state after retrieval, requiring reconsolidation in order to persist. One functional role of memory reconsolidation is the updating of existing memories. There are reports suggesting that reconsolidation can be modulated by a particular endogenous process taking place concomitantly to its natural course, such as water or sleep deprivation. Here, we investigated whether an endogenous process activated during a natural/physiological experience, or a pharmacological intervention, can also contribute to memory content updating. Using the contextual fear conditioning paradigm in rats, we found that the endogenous content of an aversive memory can be updated during its reconsolidation incorporating consequences of natural events such as water deprivation, transforming a previously stored memory into a state-dependent one. This updating seems to be mediated by the activation of angiotensin AT1 receptors in the dorsal hippocampus and local infusion of human angiotensin II (ANGII) was shown to mimic the water deprivation effects on memory reconsolidation. Systemic morphine injection was also able to turn a previously acquired experience into a state-dependent memory, reproducing the very same effects obtained by water deprivation or local angiotensin II infusion, and suggesting that other state-dependent-inducing protocols would also be able to contribute to memory updating. These findings trigger new insights about the influence of ordinary daily life events upon memory in its continuing reconstruction, adding the realm of reconsolidation to the classical view of endogenous modulation of consolidation. PMID:23782508

Sierra, Rodrigo O; Cassini, Lindsey F; Santana, Fabiana; Crestani, Ana P; Duran, Johanna M; Haubrich, Josué; de Oliveira Alvares, Lucas; Quillfeldt, Jorge A



Case report of pediatric gastroenteritis due to CTX-M-15 extended-spectrum beta-lactamase-producing Salmonella enterica serotype enteritidis.  


A clinical isolate of Salmonella enterica serotype Enteritidis in Korea was found to produce the extended-spectrum beta-lactamase CTX-M-15. The isolate was recovered in 2008 from the stool of a 3-yr-old boy with gastroenteritis. This isolate was found to be resistant to multiple drugs, including ampicillin, piperacillin, cefotaxime, ceftazidime, cefepime, and aztreonam. The resistance to cefotaxime was transferred by conjugation to recipient Escherichia coli J53. The patient was eventually successfully treated with trimethoprim-sulfamethoxazole. This is the first report of the bla (CTX-M-15) gene in S. enterica serotype Enteritidis in Korea. PMID:19893356

Lee, Kon Hee; Song, Wonkeun; Jeong, Seok Hoon; Choi, Ka Young; Yoon, Hae Sun; Park, Min Jeong



Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report  

PubMed Central

The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery. Although it is a rare syndrome, early diagnosis and treatment prevents permanent neurological deficits and improve patient's quality of life.



Procedural Due Process.  

ERIC Educational Resources Information Center

A central issue in litigation arising from adverse employment decisions affecting school personnel is the adequacy of due process procedures. Due process is required only if a teacher is able to establish a protected property or liberty interest. The first section of this chapter accordingly discusses the circumstances under which due process is…

Cambron-McCabe, Nelda H.


Wildlife Loss Estimates and Summary of Previous Mitigation Related to Hydroelectric Projects in Montana, Volume Three, Hungry Horse Project.  

SciTech Connect

This assessment addresses the impacts to the wildlife populations and wildlife habitats due to the Hungry Horse Dam project on the South Fork of the Flathead River and previous mitigation of theses losses. In order to develop and focus mitigation efforts, it was first necessary to estimate wildlife and wildlife hatitat losses attributable to the construction and operation of the project. The purpose of this report was to document the best available information concerning the degree of impacts to target wildlife species. Indirect benefits to wildlife species not listed will be identified during the development of alternative mitigation measures. Wildlife species incurring positive impacts attributable to the project were identified.

Casey, Daniel



Analysis of reservoir heterogeneities due to shallowing-upward cycles in carbonate rocks of the Pennsylvanian Wahoo Limestone of Northeastern Alaska. Annual report, September 1989--September 1990  

SciTech Connect

This report presents the preliminary results of research accomplished by a team of specialists in carbonate petrology, biostratigraphy, and diagenesis during the 1989--1990 fiscal year. It includes a summary of some of the petrographic data which has been entered into a computerized database; a discussion of biostratigraphic data, particularly conodont biofacies analyses; an overview of diagenetic studies; and a section of the regional geological framework studies. The database is allowing us to test which parameters, such as ooids, can be used to recognize and understand the carbonate petrology of the shallowing-upward cycles. The cycles have been interpreted in terms of depositional environments and sea-level fluctuations and used to develop detailed facies models.

Watts, K.F.